HB 7132

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Author: Public Health Committee

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House of Representatives

January Session, 2019

Substitute House Bill No. 7132

House of Representatives, April 9, 2019

The Committee on Public Health reported through REP. STEINBERG of the 136th Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.

AN ACT CONCERNING LICENSURE OF PROFESSIONAL COUNSELOR ASSOCIATES AND MARITAL AND FAMILY THERAPIST ASSOCIATES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

1Section 1. Section 20-195aa of the general statutes is repealed and

2the following is substituted in lieu thereof (Effective October 1, 2019):

3As used in this section and sections 20-195bb to 20-195ee, inclusive,

4as amended by this act, and section 5 of this act:

5(1) "Licensed professional counselor" or "professional counselor"

6means a person who has been licensed as a professional counselor

7pursuant to this chapter;

8 (2) "Licensed professional counselor associate" or "professional

9counselor associate" means a person who has been licensed as a

10professional counselor associate pursuant to this chapter;

11[(2)] (3) "Commissioner" means the Commissioner of Public Health;

12[(3)] (4) "Department" means the Department of Public Health;

13 [(4)] (5) "Professional counseling" means the application, by persons 14 trained in counseling, of established principles of psycho-social 15 development and behavioral science to the evaluation, assessment, 16 analysis, diagnosis and treatment of emotional, behavioral or

17interpersonal dysfunction or difficulties that interfere with mental

18health and human development. "Professional counseling" includes,

22individuals or groups;

23[(5)] (6) "Under professional supervision" means the practice of

24 professional counseling under the supervision of a licensed

25professional counselor, a physician licensed pursuant to chapter 370,

26who is certified in psychiatry by the American Board of Psychiatry and

27Neurology, an advanced practice registered nurse licensed pursuant to

28chapter 378, who is certified as a psychiatric and mental health clinical

29 nurse specialist or nurse practitioner by the American Nurses

30Credentialing Center, a psychologist licensed pursuant to chapter 383,

31a marital and family therapist licensed pursuant to chapter 383a or a

32licensed clinical social worker licensed pursuant to chapter 383b;

33 [(6)] (7) "Direct professional supervision" means face-to-face

34consultation between one supervisor, who is a professional described

35in subdivision [(5)] (6) of this section, and one person receiving

36supervision that consists of not less than a monthly review with a

37written evaluation and assessment by the supervisor of such person's

38practice of professional counseling; and

39[(7)] (8) "Related mental health field" means social work, marriage

40and family therapy or psychology.

41Sec. 2. Section 20-195bb of the general statutes is repealed and the

42following is substituted in lieu thereof (Effective October 1, 2019):

43(a) Except as provided in subsection (c) of this section, no person

44may practice professional counseling unless licensed pursuant to

45section 20-195cc, as amended by this act.

46(b) No person may use the title "licensed professional counselor",

47"licensed professional counselor associate" or "professional counselor"

48or make use of any title, words, letters or abbreviations that may

49reasonably be confused with licensure as a professional counselor or

50professional counselor associate unless licensed pursuant to section 20-

51195cc, as amended by this act.

52(c) No license as a professional counselor shall be required of the

53following: (1) A person who furnishes uncompensated assistance in an

54emergency; (2) a clergyman, priest, minister, rabbi or practitioner of

55any religious denomination accredited by the religious body to which

56the person belongs and settled in the work of the ministry, provided

57the activities that would otherwise require a license as a professional

58counselor are within the scope of ministerial duties; (3) a sexual assault

59counselor, as defined in section 52-146k; (4) a person participating in

60uncompensated group or individual counseling; (5) a person with a

61master's degree in a health-related or human services-related field

62employed by a hospital, as defined in subsection (b) of section 19a-490,

63performing services in accordance with section 20-195aa, as amended

64by this act, under the supervision of a [person licensed by the state in

65one of the professions identified in clauses (i) to (vii), inclusive, of

66subparagraph (C) of subdivision (1) of subsection (a) of section 20-

67195dd] physician licensed pursuant to chapter 370, who is certified in

68psychiatry by the American Board of Psychiatry and Neurology, an

69advanced practice registered nurse licensed pursuant to chapter 378,

70who is certified as a psychiatric and mental health clinical nurse

71specialist or nurse practitioner by the American Nurses Credentialing

72Center, a psychologist licensed pursuant to chapter 383, a marital and

73family therapist licensed pursuant to chapter 383a or a licensed clinical

74social worker licensed pursuant to chapter 383b; (6) a person licensed

75or certified by any agency of this state and performing services within

76the scope of practice for which licensed or certified; (7) a student,

77intern or trainee pursuing a course of study in counseling in a

78regionally accredited institution of higher education, provided the

79activities that would otherwise require a license as a professional

80counselor are performed under supervision and constitute a part of a

81supervised course of study; (8) a person employed by an institution of

82higher education to provide academic counseling in conjunction with

83 the institution's programs and services; or (9) a vocational

84rehabilitation counselor, job counselor, credit counselor, consumer

85counselor or any other counselor or psychoanalyst who does not

86purport to be a counselor whose primary service is the application of

87established principles of psycho-social development and behavioral

88science to the evaluation, assessment, analysis and treatment of

89emotional, behavioral or interpersonal dysfunction or difficulties that

90interfere with mental health and human development. [; or (10) a

91person who earned a degree in accordance with the requirements of

92subdivision (2) of subsection (a) of section 20-195dd, provided (A) the

93activities performed and services provided by such person constitute

97exemption to the licensure requirement shall cease if the person did

98not successfully complete the licensing examination, as required under

99subdivision (4) of subsection (a) of said section.]

100Sec. 3. Section 20-195cc of the general statutes is repealed and the

101following is substituted in lieu thereof (Effective October 1, 2019):

102(a) The Commissioner of Public Health shall grant a license (1) as a

103professional counselor to any applicant who furnishes evidence

104satisfactory to the commissioner that such applicant has met the

105requirements of section 20-195dd, as amended by this act, and (2) as a

106professional counselor associate to any applicant who furnishes

107evidence satisfactory to the commissioner that such applicant has met

108the requirements of section 20-195dd, as amended by this act. The

109commissioner shall develop and provide application forms. The

110application fee for a professional counselor shall be three hundred

111fifteen dollars. The application fee for a professional counselor

112associate shall be two hundred twenty dollars.

113(b) Licenses issued to professional counselors and professional

114counselor associates under this section may be renewed annually

115pursuant to section 19a-88, as amended by this act. The fee for such

116renewal shall be one hundred ninety-five dollars. Each licensed

117professional counselor and professional counselor associate applying

120programs. The commissioner shall adopt regulations, in accordance

121with chapter 54, to (1) define basic requirements for continuing

122education programs that shall include (A) not less than one contact

123hour of training or education each registration period on the topic of

124cultural competency, (B) on and after January 1, 2016, not less than two

125contact hours of training or education during the first renewal period

126in which continuing education is required and not less than once every

127six years thereafter on the topic of mental health conditions common to

128veterans and family members of veterans, including (i) determining

129whether a patient is a veteran or family member of a veteran, (ii)

130screening for conditions such as post-traumatic stress disorder, risk of

131suicide, depression and grief, and (iii) suicide prevention training, and

132(C) on and after January 1, 2018, not less than three contact hours of

133training or education each registration period on the topic of

134professional ethics, (2) delineate qualifying programs, (3) establish a

135system of control and reporting, and (4) provide for a waiver of the

136continuing education requirement for good cause.

137Sec. 4. Section 20-195dd of the general statutes is repealed and the

138following is substituted in lieu thereof (Effective October 1, 2019):

139[(a) (1) Except as otherwise provided in subsections (b) and (c) of

140this section, an applicant for a license as a professional counselor shall,

141 prior to January 1, 2019, submit evidence satisfactory to the

142commissioner of having: (A) Completed sixty graduate semester hours

143in or related to the discipline of counseling at a regionally accredited

144institution of higher education, that included coursework in each of the

145following areas: (i) Human growth and development, (ii) social and

146cultural foundations, (iii) counseling theories and techniques or

147helping relationships, (iv) group dynamics, (v) processing and

148counseling, (vi) career and lifestyle development, (vii) appraisals or

149tests and measurements for individuals and groups, (viii) research and

150evaluation, and (ix) professional orientation to counseling; (B) earned,

151from a regionally accredited institution of higher education a master's

152or doctoral degree in social work, marriage and family therapy,

153counseling, psychology or a related mental health field; (C) acquired

154three thousand hours of postgraduate-degree-supervised experience in

155the practice of professional counseling, performed over a period of not

156less than one year, that included a minimum of one hundred hours of

157direct supervision by (i) a physician licensed pursuant to chapter 370

158who has obtained certification in psychiatry from the American Board

159of Psychiatry and Neurology, (ii) a psychologist licensed pursuant to

160chapter 383, (iii) an advanced practice registered nurse licensed

161pursuant to chapter 378 and certified as a clinical specialist in adult

162psychiatric and mental health nursing with the American Nurses

163Credentialing Center, (iv) a marital and family therapist licensed

164pursuant to chapter 383a, (v) a clinical social worker licensed pursuant

165to chapter 383b, (vi) a professional counselor licensed, or prior to

166October 1, 1998, eligible for licensure, pursuant to section 20-195cc, or

167(vii) a physician certified in psychiatry by the American Board of

168Psychiatry and Neurology, psychologist, advanced practice registered

169nurse certified as a clinical specialist in adult psychiatric and mental

170health nursing with the American Nurses Credentialing Center,

171marital and family therapist, clinical social worker or professional

172counselor licensed or certified as such or as a person entitled to

173perform similar services, under a different designation, in another state

174or jurisdiction whose requirements for practicing in such capacity are

175substantially similar to or higher than those of this state; and (D)

176passed an examination prescribed by the commissioner. Any such

177applicant who, on or before July 1, 2017, is a matriculating student in

178good standing in a graduate degree program at a regionally accredited

179institution of higher education in one of the fields required under

180subparagraph (B) of this subdivision on or before July 1, 2017, but who

181cannot reasonably complete the requirements set forth in this

182 subdivision prior to January 1, 2019, as determined by the

183commissioner, may apply for a license under this subdivision on and

184after January 1, 2019.]

185[(2)] (a) Except as otherwise provided in subsections [(b)] (c) and

186[(c)] (d) of this section, an applicant for a license as a professional

187counselor shall [, on and after January 1, 2019,] submit evidence

188satisfactory to the commissioner of having: [(A) (i)] (1) (A) Earned a

189graduate degree in clinical mental health counseling as part of a

190program of higher learning accredited by the Council for Accreditation

191of Counseling and Related Educational Programs, or a successor

192organization, or [(ii) (I)] (B) (i) completed at least sixty graduate

193semester hours in counseling or a related mental health field at a

194regionally accredited institution of higher education that included

195coursework in each of the following areas: Human growth and

196development; social and cultural foundations; counseling theories;

197counseling techniques; group counseling; career counseling; appraisals

198or tests and measurements to individuals and groups; research and

199evaluation; professional orientation to mental health counseling;

200 addiction and substance abuse counseling; trauma and crisis

201counseling; and diagnosis and treatment of mental and emotional

202disorders, [(II)] (ii) earned from a regionally accredited institution of

203higher education a graduate degree in counseling or a related mental

204health field, [(III)] (iii) completed a one-hundred-hour practicum in

205counseling taught by a faculty member licensed or certified as a

206professional counselor or its equivalent in another state, and [(IV)] (iv)

207completed a six-hundred-hour clinical mental health counseling

208internship taught by a faculty member licensed or certified as a

209professional counselor or its equivalent in another state; [(B)] (2)

210acquired three thousand hours of postgraduate experience under

211professional supervision, including a minimum of one hundred hours

212of direct professional supervision, in the practice of professional

213counseling, performed over a period of not less than two years; and

214[(C)] (3) passed an examination prescribed by the commissioner.

215(b) An applicant for a license as a professional counselor associate

216 shall submit to the Commissioner of Public Health evidence

217satisfactory to the commissioner of having (1) earned a graduate

218degree in clinical mental health counseling as part of a program of

219higher learning accredited by the Council for Accreditation of

220Counseling and Related Educational Programs, or a successor

221organization, or (2) (A) completed at least sixty graduate semester

222hours in counseling or a related mental health field at a regionally

223accredited institution of higher education that included coursework in

224each of the following areas: Human growth and development; social

225and cultural foundations; counseling theories; counseling techniques;

226 group counseling; career counseling; appraisals or tests and

227measurements to individuals and groups; research and evaluation;

228professional orientation to mental health counseling; addiction and

229substance abuse counseling; trauma and crisis counseling; and

230diagnosis and treatment of mental and emotional disorders, (B)

231completed a one-hundred-hour practicum in counseling taught by a

232faculty member licensed or certified as a professional counselor or its

233equivalent in another state, (C) completed a six-hundred-hour clinical

234mental health counseling internship taught by a faculty member

235licensed or certified as a professional counselor or its equivalent in

236another state, and (D) earned from a regionally accredited institution

237of higher education a graduate degree in counseling or a related

238mental health field.

239[(b)] (c) An applicant for licensure by endorsement shall present

240evidence satisfactory to the commissioner that the applicant is licensed

241or certified as a professional counselor or professional counselor

242associate, or as a person entitled to perform similar services under a

243 different designation, in another state or jurisdiction whose

244requirements for practicing in such capacity are substantially similar to

245or higher than those of this state and that there are no disciplinary

246actions or unresolved complaints pending.

247[(c)] (d) An applicant who is licensed or certified as a professional

248counselor or its equivalent in another state, territory or commonwealth

249of the United States may substitute three years of licensed or certified

250work experience in the practice of professional counseling in lieu of the

251requirements of [subparagraph (C) of subdivision (1) of subsection (a)

252of this section, or subparagraph (B) of] subdivision (2) of subsection (a)

253of this section, [as applicable,] provided the commissioner finds that

254such experience is equal to or greater than the requirements of this

255state.

256Sec. 5. (NEW) (Effective October 1, 2019) (a) An individual licensed as

257a professional counselor pursuant to section 20-195dd of the general

258statutes, as amended by this act, may practice professional counseling.

259The practice of professional counseling includes, but is not limited to,

260engaging in the independent practice of professional counseling.

261(b) An individual licensed as a professional counselor associate

262pursuant to subsection (d) of section 20-195dd of the general statutes,

263as amended by this act, may practice professional counseling under

264professional supervision. Except as provided in subsection (c) of

265section 20-195bb of the general statutes, as amended by this act, a

266licensed professional counselor associate may not engage in the

267independent practice of professional counseling.

268Sec. 6. Section 20-195ff of the general statutes is repealed and the

269following is substituted in lieu thereof (Effective October 1, 2019):

270The Commissioner of Public Health may adopt regulations, in

271accordance with the provisions of chapter 54, to further the purposes

272of subdivision (18) of subsection (c) of section 19a-14, as amended by

273this act, subsection (e) of section 19a-88, as amended by this act,

274subdivision (15) of section 19a-175, subsection (b) of section 20-9,

275sections 20-195aa to [20-195ff] 20-195ee, inclusive, as amended by this

276act, and [sections 20-206jj to 20-206oo, inclusive] section 5 of this act.

277Sec. 7. Section 20-195a of the general statutes is repealed and the

278following is substituted in lieu thereof (Effective October 1, 2019):

279For purposes of this chapter:

280(1) "Commissioner" means the Commissioner of Public Health;

281(2) "Department" means the Department of Public Health;

282(3) "Marital and family therapy" means the evaluation, assessment,

283diagnosis, counseling, management and treatment of emotional

284disorders, whether cognitive, affective or behavioral, within the

285context of marriage and family systems, through the professional

286application of individual psychotherapeutic and family-systems

287theories and techniques in the delivery of services to individuals,

288couples and families; [.]

289(4) "Licensed marital and family therapy associate" means a person

290who has been licensed by the department as a marital and family

291therapy associate pursuant to this chapter and whose license permits

292the person to engage in the practice of marital and family therapy

293under the clinical supervision of a licensed marital and family

294therapist; and

295(5) "Licensed marital and family therapist" means a person who has

296been licensed by the department as a marital and family therapist

297pursuant to this chapter.

298Sec. 8. Section 20-195b of the general statutes is repealed and the

299following is substituted in lieu thereof (Effective October 1, 2019):

300(a) Except as provided in section 20-195f, no person shall practice

301marital and family therapy unless licensed in accordance with section

30220-195c, as amended by this act.

303(b) No person shall use the title "licensed marital and family

304therapist" or "licensed marital and family therapist associate" unless

305[he is] licensed in accordance with the provisions of section 20-195c, as

306amended by this act.

307Sec. 9. Section 20-195c of the general statutes is repealed and the

308following is substituted in lieu thereof (Effective October 1, 2019):

309(a) Each applicant for licensure as a marital and family therapist

310shall present to the department satisfactory evidence that such

311applicant has: (1) Completed a graduate degree program specializing

312in marital and family therapy [from] offered by a regionally accredited

313college or university or an accredited postgraduate clinical training

314program accredited by the Commission on Accreditation for Marriage

315and Family Therapy Education offered by a regionally accredited

316institution of higher education; (2) completed a supervised practicum

317or internship with emphasis in marital and family therapy supervised

318by the program granting the requisite degree or by an accredited

319 postgraduate clinical training program [,] accredited by the

320Commission on Accreditation for Marriage and Family Therapy

321Education and offered by a regionally accredited institution of higher

322education, in which the student received a minimum of five hundred

323direct clinical hours that included one hundred hours of clinical

324supervision; (3) completed twelve months of relevant postgraduate

325experience, including (A) a minimum of one thousand hours of direct

326client contact offering marital and family therapy services subsequent

327to being awarded a master's degree or doctorate or subsequent to the

328training year specified in subdivision (2) of this subsection, and (B) one

329hundred hours of postgraduate clinical supervision provided by a

330licensed marital and family therapist; and (4) passed an examination

331prescribed by the department. The fee shall be three hundred fifteen

332dollars for each initial application.

333(b) Each applicant for licensure as a marital and family therapist

334associate shall present to the department (1) satisfactory evidence that

335such applicant has completed a graduate degree program specializing

336in marital and family therapy offered by a regionally accredited

337institution of higher education or an accredited postgraduate clinical

338training program accredited by the Commission on Accreditation for

339Marriage and Family Therapy Education and offered by a regionally

340accredited institution of higher education, and (2) verification from a

341supervising licensed marital and family therapist that the applicant is

342working toward completing the postgraduate experience required for

343licensure as a marital and family therapist under subdivision (3) of

344subsection (a) of this section. The fee shall be one hundred twenty-five

345dollars for each initial application.

346[(b)] (c) The department may grant licensure without examination,

347subject to payment of fees with respect to the initial application, to any

348applicant who is currently licensed or certified as a marital or marriage

349and family therapist or a marital and family therapist associate in

350another state, territory or commonwealth of the United States,

351provided such state, territory or commonwealth maintains licensure or

352certification standards which, in the opinion of the department, are

353equivalent to or higher than the standards of this state. No license shall

354 be issued under this section to any applicant against whom

355professional disciplinary action is pending or who is the subject of an

356unresolved complaint.

357[(c) Licenses] (d) (1) A license issued to a marital and family

358therapist issued under this section may be renewed annually in

359accordance with the provisions of section 19a-88, as amended by this

360act. The fee for such renewal shall be three hundred twenty dollars.

361Each licensed marital and family therapist applying for license renewal

362shall furnish evidence satisfactory to the commissioner of having

363participated in continuing education programs. The commissioner

364shall adopt regulations, in accordance with chapter 54, to [(1)] (A)

365define basic requirements for continuing education programs, which

366shall include not less than one contact hour of training or education

367each registration period on the topic of cultural competency and, on

368and after January 1, 2016, not less than two contact hours of training or

369education during the first renewal period in which continuing

370education is required and not less than once every six years thereafter

371on the topic of mental health conditions common to veterans and

372family members of veterans, including [(A)] (i) determining whether a

373patient is a veteran or family member of a veteran, [(B)] (ii) screening

374for conditions such as post-traumatic stress disorder, risk of suicide,

375depression and grief, and [(C)] (iii) suicide prevention training, [(2)] (B)

376delineate qualifying programs, [(3)] (C) establish a system of control

377and reporting, and [(4)] (D) provide for waiver of the continuing

378education requirement for good cause.

379(2) A license issued to a marital and family therapist associate shall

380expire on or before twenty-four months after the date on which such

381license was issued and may be renewed once for an additional twenty-

382four months in accordance with the provisions of section 19a-88, as

383amended by this act. The fee for such renewal shall be two hundred

384twenty dollars. Each licensed marital and family therapist associate

385applying for license renewal shall furnish evidence satisfactory to the

386commissioner of working toward completing the postgraduate

387experience required for licensure as a marital and family therapist

388under subdivision (3) of subsection (a) of this section and the potential

389for successful completion of such experience prior to the expiration of

390the twenty-four month renewal period.

391[(d)] (e) Notwithstanding the provisions of this section, an applicant

392who is currently licensed or certified as a marital or marriage and

393family therapist in another state, territory or commonwealth of the

394United States that does not maintain standards for licensure or

395certification that are equivalent to or higher than the standards in this

396state may substitute three years of licensed or certified work

397experience in the practice of marital and family therapy, as defined in

398section 20-195a, as amended by this act, in lieu of the requirements of

399subdivisions (2) and (3) of subsection (a) of this section.

400Sec. 10. Subdivision (1) of subsection (e) of section 19a-88 of the

401general statutes is repealed and the following is substituted in lieu

402thereof (Effective October 1, 2019):

403(e) (1) Each person holding a license or certificate issued under

404section 19a-514, 20-65k, 20-74s, 20-185k, 20-185l, 20-195cc, as amended

405by this act, or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to

406381a, inclusive, 383 to 383c, inclusive, 384, 384a, 384b, 384d, 385, 393a,

407395, 399 or 400a and section 20-206n or 20-206o shall, annually, or, in

408the case of a person holding a license as a marital and family therapist

409associate under section 20-195c, as amended by this act, on or before

410twenty-four months after the date of initial licensure, during the

411month of such person's birth, apply for renewal of such license or

412certificate to the Department of Public Health, giving such person's

413name in full, such person's residence and business address and such

414other information as the department requests.

415Sec. 11. Subsection (a) of section 20-206oo of the general statutes is

416repealed and the following is substituted in lieu thereof (Effective

417October 1, 2019):

418(a) The Commissioner of Public Health may adopt regulations in

419accordance with the provisions of chapter 54 to carry out the

420provisions of subdivision (24) of subsection (c) of section 19a-14,

421subsection (e) of section 19a-88, as amended by this act, subsection (b)

422of section 20-9, subsection [(c)] (d) of section 20-195c, as amended by

423this act, [sections 20-195aa to 20-195ff, inclusive,] and sections 20-206jj

424to [20-206oo] 20-206nn, inclusive.

425Sec. 12. Subdivisions (6) to (19), inclusive, of subsection (c) of section

42619a-14 of the general statutes are repealed and the following is

427substituted in lieu thereof (Effective October 1, 2019):

428(6) Marital and family therapist and marriage and family therapist

429associate;

430(7) Nurse-midwife;

431(8) Licensed clinical social worker;

432(9) Respiratory care practitioner;

433(10) Asbestos contractor, asbestos consultant and asbestos training

434provider;

435(11) Massage therapist;

436(12) Registered nurse's aide;

437(13) Radiographer;

438(14) Dental hygienist;

439(15) Dietitian-Nutritionist;

440(16) Asbestos abatement worker;

441(17) Asbestos abatement site supervisor;

442(18) Licensed or certified alcohol and drug counselor;

443(19) Professional counselor and professional counselor associate;

This act shall take effect as follows and shall amend the following sections:

Statement of Legislative Commissioners:

In Section 4(a), "Subsections (b) and (c)" were changed to Subsections "(c) and (d)" for accuracy, Subparas. (A)(i) to (C), inclusive, were redesignated as Subdivs. (1)(A) to (3), inclusive, for consistency with standard drafting conventions and in Section 4(d), "or a professional counselor associate or its equivalent" was deleted and the closing bracket was moved from after "of this section, or" to after "subparagraph (B) of" for accuracy.

PH Joint Favorable Subst.

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:

Municipal Impact: None

Explanation

The bill, which requires the licensure of professional counselor associates (PCAs) and licensed martial and family therapist associates (LMFTAs) by the Department of Public Health (DPH), is anticipated to result in a net General Fund revenue gain of approximately $14,001 in FY 20 and $35,341 in FY 21.

The anticipated FY 20 cost to the State of $26,834 includes total estimated DPH expenses of $19,531. DPH costs reflect the salary for a half-time Office Assistant $17,731 (partial year, as the bill is effective 10/1/19), and a one-time equipment cost of $1,800 for a computer, software, and scanner for this employee. The full-year salary for the Office Assistant in FY 21 is approximately $23,641. The State Comptroller fringe benefit cost for this position is $7,303 in FY 20 $9,738 in FY 21.

1The fringe benefit costs for most state employees are budgeted centrally in accounts administered by the Comptroller. The estimated active employee fringe benefit cost associated with most personnel changes is 41.19% of payroll in FY 20 and FY 21.

General Fund revenue of approximately $40,835 is anticipated in FY

20 from the following:

∙The initial licensure of approximately 143 PCAs with a fee of $220 per application = $31,460

∙The initial licensure of approximately 75 LMFTAs with a fee of $125 per application = $9,375

In FY 21, General Fund revenue of approximately $68,720 is anticipated from:

∙The initial licensure of approximately 143 PCAs = $31,460

∙The renewal licensure of approximately 143 PCAs with a fee of $195 per application = $27,885

∙The initial licensure of approximately 72 LMFTAs = $9,375

In 2018, there were 2,865 licensed professional counselors and 1,489 licensed martial and family therapist in Connecticut. Using the percent of Master's Level Social Worker temporary licenses issued for the licensed Master's Level Social Worker population, it is assumed that approximately 5% of professional counselors and licensed martial and family therapists will seek associate licensure annually. LMFTA licensure is biannual under the bill. Therefore, revenue from its $220 renewal fee is not anticipated until the out years.

The Out Years

The annualized ongoing fiscal impact identified above will continue into the future subject to the number of initial and renewal licenses for professional counselor associates and licensed martial and family therapist associates issued by DPH, and cost inflation.

OLR Bill Analysis sHB 7132

AN ACT CONCERNING LICENSURE OF PROFESSIONAL COUNSELOR ASSOCIATES AND MARITAL AND FAMILY THERAPIST ASSOCIATES.

SUMMARY

This bill creates a new associate licensure category for licensed professional counselors (LPCs) and marital and family therapists (MFTs) that allows them to practice under professional supervision while pursuing full licensure. To qualify for an associate license, the applicant must meet certain educational and clinical training requirements.

The bill also prohibits anyone who is unlicensed from using the title

(1)"licensed professional counselor associate" or "professional counselor" or any title, words, letters, or abbreviations that may reasonably be confused with licensure or (2) "licensed marital and family therapist associate." Existing law similarly prohibits unlicensed people from using a title that indicates that they are fully licensed LPCs and MFTs.

For LPCs, the associate license must be renewed annually. The initial license fee is $220 and the renewal fee is $195. For MFTs, the associate license is valid for two years and may be renewed once. The initial license fee is $125 and the renewal fee is $220.

Current law allows students who graduate with advanced degrees in professional counseling and marital and family therapy to practice without a license in order to complete the supervised work experience required for full licensure, but only (1) if supervised by someone licensed in their respective profession and (2) for up to two years after completing the supervised work experience, if they failed the

respective licensing examination. (The bill eliminates this provision for professional counseling students, but not for MFT students.)

The bill also makes technical and conforming changes.

EFFECTIVE DATE: October 1, 2019

1- 6 — LPC ASSOCIATE LICENSE Initial Licensure Requirements

To obtain an LPC associate license, an applicant must submit to the Department of Public Health (DPH) commissioner satisfactory evidence of having earned a graduate degree in clinical mental health counseling as part of a higher education program accredited by the Council for Accreditation of Counseling and Related Educational Programs, or its successor. Alternatively, the bill allows an applicant to complete:

1.at least 60 graduate semester hours in counseling or a related mental health field at a regionally accredited higher education institution that included coursework in (a) human growth and development; (b) social and cultural foundations; (c) counseling theories and techniques; (d) group, career, addiction and substance abuse, and trauma and crisis counseling; (e) appraisals or tests and measurements to individuals and groups; (f) research and evaluation; (g) professional orientation to mental health counseling; and (h) diagnosing and treating mental and emotional disorders;

2.a 100-hour counseling practicum and a 600-hour clinical mental health counseling internship each taught by a faculty member licensed or certified as a professional counselor or its equivalent in another state; and

3.a graduate degree in counseling or a related mental health field from a regionally accredited higher education institution.

Licensure by Endorsement

As with LPC licenses under existing law, the bill allows DPH to grant an LPC associate license by endorsement to LPC associates licensed or certified in another state or jurisdiction with requirements substantially similar to or higher than Connecticut's. Applicants must have no pending disciplinary actions or complaints.

License Scope

The bill generally prohibits an LPC associate from practicing professional counseling unless he or she is under the supervision of a:

1.LPC;

2.licensed psychiatrist certified by the American Board of Psychiatry and Neurology;

3.licensed advanced practice registered nurse (APRN) certified as a psychiatric and mental health clinical nurse specialist or nurse practitioner by the American Nurses Credentialing Center; or

4.licensed psychologist, MFT, or clinical social worker.

License Renewal

To renew a license, the bill requires LPC associates to submit satisfactory evidence to DPH that they completed continuing education requirements the commissioner sets in regulations. Such continuing education must include at least:

1.one contact hour (i.e., 50 minutes) of education or training in cultural competency;

2.two contact hours of training or education in mental health conditions common to veterans and their family members, during the first renewal period and every six years thereafter; and

3.three contact hours of training or education in professional ethics.

7- 12 — MFT ASSOCIATE LICENSE Initial Licensure Requirements

To obtain an MFT associate license, an applicant must provide DPH satisfactory evidence of having:

1.completed a (a) graduate degree program specializing in marital and family therapy offered by a regionally accredited higher education institution or (b) postgraduate clinical training program accredited by the Commission on Accreditation for Marriage and Family Therapy Education and offered by a regionally accredited higher education institution and

2.verification from a supervising licensed MFT that the applicant is working toward completing the postgraduate experience requirements for an MFT license.

Licensure Without Examination

As with MFT licenses under existing law, the bill allows DPH to grant an MFT associate license without examination to MFT associates licensed or certified in another U.S. state, territory, or commonwealth. An applicant can obtain a license in this way if the other jurisdiction's licensing standards are at least as strict as Connecticut's. Applicants must also have no pending disciplinary actions or complaints.

License Renewals

The MFT associate license is valid for two years and is renewable once during the applicant's birth month. The applicant must submit evidence that he or she is working to complete the postgraduate experience requirements for an MFT license and can successfully do so during the two-year renewal period.

COMMITTEE ACTION

Public Health Committee

HB 7132

Version: File+No.+557+R000557+FC
Author: Public Health Committee

Created by BCL easyConverter SDK 5 (HTML Version)

House of Representatives

January Session, 2019

Substitute House Bill No. 7132

House of Representatives, April 9, 2019

The Committee on Public Health reported through REP. STEINBERG of the 136th Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.

AN ACT CONCERNING LICENSURE OF PROFESSIONAL COUNSELOR ASSOCIATES AND MARITAL AND FAMILY THERAPIST ASSOCIATES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

1Section 1. Section 20-195aa of the general statutes is repealed and

2the following is substituted in lieu thereof (Effective October 1, 2019):

3As used in this section and sections 20-195bb to 20-195ee, inclusive,

4as amended by this act, and section 5 of this act:

5(1) "Licensed professional counselor" or "professional counselor"

6means a person who has been licensed as a professional counselor

7pursuant to this chapter;

8 (2) "Licensed professional counselor associate" or "professional

9counselor associate" means a person who has been licensed as a

10professional counselor associate pursuant to this chapter;

11[(2)] (3) "Commissioner" means the Commissioner of Public Health;

12[(3)] (4) "Department" means the Department of Public Health;

13 [(4)] (5) "Professional counseling" means the application, by persons 14 trained in counseling, of established principles of psycho-social 15 development and behavioral science to the evaluation, assessment, 16 analysis, diagnosis and treatment of emotional, behavioral or

17interpersonal dysfunction or difficulties that interfere with mental

18health and human development. "Professional counseling" includes,

22individuals or groups;

23[(5)] (6) "Under professional supervision" means the practice of

24 professional counseling under the supervision of a licensed

25professional counselor, a physician licensed pursuant to chapter 370,

26who is certified in psychiatry by the American Board of Psychiatry and

27Neurology, an advanced practice registered nurse licensed pursuant to

28chapter 378, who is certified as a psychiatric and mental health clinical

29 nurse specialist or nurse practitioner by the American Nurses

30Credentialing Center, a psychologist licensed pursuant to chapter 383,

31a marital and family therapist licensed pursuant to chapter 383a or a

32licensed clinical social worker licensed pursuant to chapter 383b;

33 [(6)] (7) "Direct professional supervision" means face-to-face

34consultation between one supervisor, who is a professional described

35in subdivision [(5)] (6) of this section, and one person receiving

36supervision that consists of not less than a monthly review with a

37written evaluation and assessment by the supervisor of such person's

38practice of professional counseling; and

39[(7)] (8) "Related mental health field" means social work, marriage

40and family therapy or psychology.

41Sec. 2. Section 20-195bb of the general statutes is repealed and the

42following is substituted in lieu thereof (Effective October 1, 2019):

43(a) Except as provided in subsection (c) of this section, no person

44may practice professional counseling unless licensed pursuant to

45section 20-195cc, as amended by this act.

46(b) No person may use the title "licensed professional counselor",

47"licensed professional counselor associate" or "professional counselor"

48or make use of any title, words, letters or abbreviations that may

49reasonably be confused with licensure as a professional counselor or

50professional counselor associate unless licensed pursuant to section 20-

51195cc, as amended by this act.

52(c) No license as a professional counselor shall be required of the

53following: (1) A person who furnishes uncompensated assistance in an

54emergency; (2) a clergyman, priest, minister, rabbi or practitioner of

55any religious denomination accredited by the religious body to which

56the person belongs and settled in the work of the ministry, provided

57the activities that would otherwise require a license as a professional

58counselor are within the scope of ministerial duties; (3) a sexual assault

59counselor, as defined in section 52-146k; (4) a person participating in

60uncompensated group or individual counseling; (5) a person with a

61master's degree in a health-related or human services-related field

62employed by a hospital, as defined in subsection (b) of section 19a-490,

63performing services in accordance with section 20-195aa, as amended

64by this act, under the supervision of a [person licensed by the state in

65one of the professions identified in clauses (i) to (vii), inclusive, of

66subparagraph (C) of subdivision (1) of subsection (a) of section 20-

67195dd] physician licensed pursuant to chapter 370, who is certified in

68psychiatry by the American Board of Psychiatry and Neurology, an

69advanced practice registered nurse licensed pursuant to chapter 378,

70who is certified as a psychiatric and mental health clinical nurse

71specialist or nurse practitioner by the American Nurses Credentialing

72Center, a psychologist licensed pursuant to chapter 383, a marital and

73family therapist licensed pursuant to chapter 383a or a licensed clinical

74social worker licensed pursuant to chapter 383b; (6) a person licensed

75or certified by any agency of this state and performing services within

76the scope of practice for which licensed or certified; (7) a student,

77intern or trainee pursuing a course of study in counseling in a

78regionally accredited institution of higher education, provided the

79activities that would otherwise require a license as a professional

80counselor are performed under supervision and constitute a part of a

81supervised course of study; (8) a person employed by an institution of

82higher education to provide academic counseling in conjunction with

83 the institution's programs and services; or (9) a vocational

84rehabilitation counselor, job counselor, credit counselor, consumer

85counselor or any other counselor or psychoanalyst who does not

86purport to be a counselor whose primary service is the application of

87established principles of psycho-social development and behavioral

88science to the evaluation, assessment, analysis and treatment of

89emotional, behavioral or interpersonal dysfunction or difficulties that

90interfere with mental health and human development. [; or (10) a

91person who earned a degree in accordance with the requirements of

92subdivision (2) of subsection (a) of section 20-195dd, provided (A) the

93activities performed and services provided by such person constitute

97exemption to the licensure requirement shall cease if the person did

98not successfully complete the licensing examination, as required under

99subdivision (4) of subsection (a) of said section.]

100Sec. 3. Section 20-195cc of the general statutes is repealed and the

101following is substituted in lieu thereof (Effective October 1, 2019):

102(a) The Commissioner of Public Health shall grant a license (1) as a

103professional counselor to any applicant who furnishes evidence

104satisfactory to the commissioner that such applicant has met the

105requirements of section 20-195dd, as amended by this act, and (2) as a

106professional counselor associate to any applicant who furnishes

107evidence satisfactory to the commissioner that such applicant has met

108the requirements of section 20-195dd, as amended by this act. The

109commissioner shall develop and provide application forms. The

110application fee for a professional counselor shall be three hundred

111fifteen dollars. The application fee for a professional counselor

112associate shall be two hundred twenty dollars.

113(b) Licenses issued to professional counselors and professional

114counselor associates under this section may be renewed annually

115pursuant to section 19a-88, as amended by this act. The fee for such

116renewal shall be one hundred ninety-five dollars. Each licensed

117professional counselor and professional counselor associate applying

120programs. The commissioner shall adopt regulations, in accordance

121with chapter 54, to (1) define basic requirements for continuing

122education programs that shall include (A) not less than one contact

123hour of training or education each registration period on the topic of

124cultural competency, (B) on and after January 1, 2016, not less than two

125contact hours of training or education during the first renewal period

126in which continuing education is required and not less than once every

127six years thereafter on the topic of mental health conditions common to

128veterans and family members of veterans, including (i) determining

129whether a patient is a veteran or family member of a veteran, (ii)

130screening for conditions such as post-traumatic stress disorder, risk of

131suicide, depression and grief, and (iii) suicide prevention training, and

132(C) on and after January 1, 2018, not less than three contact hours of

133training or education each registration period on the topic of

134professional ethics, (2) delineate qualifying programs, (3) establish a

135system of control and reporting, and (4) provide for a waiver of the

136continuing education requirement for good cause.

137Sec. 4. Section 20-195dd of the general statutes is repealed and the

138following is substituted in lieu thereof (Effective October 1, 2019):

139[(a) (1) Except as otherwise provided in subsections (b) and (c) of

140this section, an applicant for a license as a professional counselor shall,

141 prior to January 1, 2019, submit evidence satisfactory to the

142commissioner of having: (A) Completed sixty graduate semester hours

143in or related to the discipline of counseling at a regionally accredited

144institution of higher education, that included coursework in each of the

145following areas: (i) Human growth and development, (ii) social and

146cultural foundations, (iii) counseling theories and techniques or

147helping relationships, (iv) group dynamics, (v) processing and

148counseling, (vi) career and lifestyle development, (vii) appraisals or

149tests and measurements for individuals and groups, (viii) research and

150evaluation, and (ix) professional orientation to counseling; (B) earned,

151from a regionally accredited institution of higher education a master's

152or doctoral degree in social work, marriage and family therapy,

153counseling, psychology or a related mental health field; (C) acquired

154three thousand hours of postgraduate-degree-supervised experience in

155the practice of professional counseling, performed over a period of not

156less than one year, that included a minimum of one hundred hours of

157direct supervision by (i) a physician licensed pursuant to chapter 370

158who has obtained certification in psychiatry from the American Board

159of Psychiatry and Neurology, (ii) a psychologist licensed pursuant to

160chapter 383, (iii) an advanced practice registered nurse licensed

161pursuant to chapter 378 and certified as a clinical specialist in adult

162psychiatric and mental health nursing with the American Nurses

163Credentialing Center, (iv) a marital and family therapist licensed

164pursuant to chapter 383a, (v) a clinical social worker licensed pursuant

165to chapter 383b, (vi) a professional counselor licensed, or prior to

166October 1, 1998, eligible for licensure, pursuant to section 20-195cc, or

167(vii) a physician certified in psychiatry by the American Board of

168Psychiatry and Neurology, psychologist, advanced practice registered

169nurse certified as a clinical specialist in adult psychiatric and mental

170health nursing with the American Nurses Credentialing Center,

171marital and family therapist, clinical social worker or professional

172counselor licensed or certified as such or as a person entitled to

173perform similar services, under a different designation, in another state

174or jurisdiction whose requirements for practicing in such capacity are

175substantially similar to or higher than those of this state; and (D)

176passed an examination prescribed by the commissioner. Any such

177applicant who, on or before July 1, 2017, is a matriculating student in

178good standing in a graduate degree program at a regionally accredited

179institution of higher education in one of the fields required under

180subparagraph (B) of this subdivision on or before July 1, 2017, but who

181cannot reasonably complete the requirements set forth in this

182 subdivision prior to January 1, 2019, as determined by the

183commissioner, may apply for a license under this subdivision on and

184after January 1, 2019.]

185[(2)] (a) Except as otherwise provided in subsections [(b)] (c) and

186[(c)] (d) of this section, an applicant for a license as a professional

187counselor shall [, on and after January 1, 2019,] submit evidence

188satisfactory to the commissioner of having: [(A) (i)] (1) (A) Earned a

189graduate degree in clinical mental health counseling as part of a

190program of higher learning accredited by the Council for Accreditation

191of Counseling and Related Educational Programs, or a successor

192organization, or [(ii) (I)] (B) (i) completed at least sixty graduate

193semester hours in counseling or a related mental health field at a

194regionally accredited institution of higher education that included

195coursework in each of the following areas: Human growth and

196development; social and cultural foundations; counseling theories;

197counseling techniques; group counseling; career counseling; appraisals

198or tests and measurements to individuals and groups; research and

199evaluation; professional orientation to mental health counseling;

200 addiction and substance abuse counseling; trauma and crisis

201counseling; and diagnosis and treatment of mental and emotional

202disorders, [(II)] (ii) earned from a regionally accredited institution of

203higher education a graduate degree in counseling or a related mental

204health field, [(III)] (iii) completed a one-hundred-hour practicum in

205counseling taught by a faculty member licensed or certified as a

206professional counselor or its equivalent in another state, and [(IV)] (iv)

207completed a six-hundred-hour clinical mental health counseling

208internship taught by a faculty member licensed or certified as a

209professional counselor or its equivalent in another state; [(B)] (2)

210acquired three thousand hours of postgraduate experience under

211professional supervision, including a minimum of one hundred hours

212of direct professional supervision, in the practice of professional

213counseling, performed over a period of not less than two years; and

214[(C)] (3) passed an examination prescribed by the commissioner.

215(b) An applicant for a license as a professional counselor associate

216 shall submit to the Commissioner of Public Health evidence

217satisfactory to the commissioner of having (1) earned a graduate

218degree in clinical mental health counseling as part of a program of

219higher learning accredited by the Council for Accreditation of

220Counseling and Related Educational Programs, or a successor

221organization, or (2) (A) completed at least sixty graduate semester

222hours in counseling or a related mental health field at a regionally

223accredited institution of higher education that included coursework in

224each of the following areas: Human growth and development; social

225and cultural foundations; counseling theories; counseling techniques;

226 group counseling; career counseling; appraisals or tests and

227measurements to individuals and groups; research and evaluation;

228professional orientation to mental health counseling; addiction and

229substance abuse counseling; trauma and crisis counseling; and

230diagnosis and treatment of mental and emotional disorders, (B)

231completed a one-hundred-hour practicum in counseling taught by a

232faculty member licensed or certified as a professional counselor or its

233equivalent in another state, (C) completed a six-hundred-hour clinical

234mental health counseling internship taught by a faculty member

235licensed or certified as a professional counselor or its equivalent in

236another state, and (D) earned from a regionally accredited institution

237of higher education a graduate degree in counseling or a related

238mental health field.

239[(b)] (c) An applicant for licensure by endorsement shall present

240evidence satisfactory to the commissioner that the applicant is licensed

241or certified as a professional counselor or professional counselor

242associate, or as a person entitled to perform similar services under a

243 different designation, in another state or jurisdiction whose

244requirements for practicing in such capacity are substantially similar to

245or higher than those of this state and that there are no disciplinary

246actions or unresolved complaints pending.

247[(c)] (d) An applicant who is licensed or certified as a professional

248counselor or its equivalent in another state, territory or commonwealth

249of the United States may substitute three years of licensed or certified

250work experience in the practice of professional counseling in lieu of the

251requirements of [subparagraph (C) of subdivision (1) of subsection (a)

252of this section, or subparagraph (B) of] subdivision (2) of subsection (a)

253of this section, [as applicable,] provided the commissioner finds that

254such experience is equal to or greater than the requirements of this

255state.

256Sec. 5. (NEW) (Effective October 1, 2019) (a) An individual licensed as

257a professional counselor pursuant to section 20-195dd of the general

258statutes, as amended by this act, may practice professional counseling.

259The practice of professional counseling includes, but is not limited to,

260engaging in the independent practice of professional counseling.

261(b) An individual licensed as a professional counselor associate

262pursuant to subsection (d) of section 20-195dd of the general statutes,

263as amended by this act, may practice professional counseling under

264professional supervision. Except as provided in subsection (c) of

265section 20-195bb of the general statutes, as amended by this act, a

266licensed professional counselor associate may not engage in the

267independent practice of professional counseling.

268Sec. 6. Section 20-195ff of the general statutes is repealed and the

269following is substituted in lieu thereof (Effective October 1, 2019):

270The Commissioner of Public Health may adopt regulations, in

271accordance with the provisions of chapter 54, to further the purposes

272of subdivision (18) of subsection (c) of section 19a-14, as amended by

273this act, subsection (e) of section 19a-88, as amended by this act,

274subdivision (15) of section 19a-175, subsection (b) of section 20-9,

275sections 20-195aa to [20-195ff] 20-195ee, inclusive, as amended by this

276act, and [sections 20-206jj to 20-206oo, inclusive] section 5 of this act.

277Sec. 7. Section 20-195a of the general statutes is repealed and the

278following is substituted in lieu thereof (Effective October 1, 2019):

279For purposes of this chapter:

280(1) "Commissioner" means the Commissioner of Public Health;

281(2) "Department" means the Department of Public Health;

282(3) "Marital and family therapy" means the evaluation, assessment,

283diagnosis, counseling, management and treatment of emotional

284disorders, whether cognitive, affective or behavioral, within the

285context of marriage and family systems, through the professional

286application of individual psychotherapeutic and family-systems

287theories and techniques in the delivery of services to individuals,

288couples and families; [.]

289(4) "Licensed marital and family therapy associate" means a person

290who has been licensed by the department as a marital and family

291therapy associate pursuant to this chapter and whose license permits

292the person to engage in the practice of marital and family therapy

293under the clinical supervision of a licensed marital and family

294therapist; and

295(5) "Licensed marital and family therapist" means a person who has

296been licensed by the department as a marital and family therapist

297pursuant to this chapter.

298Sec. 8. Section 20-195b of the general statutes is repealed and the

299following is substituted in lieu thereof (Effective October 1, 2019):

300(a) Except as provided in section 20-195f, no person shall practice

301marital and family therapy unless licensed in accordance with section

30220-195c, as amended by this act.

303(b) No person shall use the title "licensed marital and family

304therapist" or "licensed marital and family therapist associate" unless

305[he is] licensed in accordance with the provisions of section 20-195c, as

306amended by this act.

307Sec. 9. Section 20-195c of the general statutes is repealed and the

308following is substituted in lieu thereof (Effective October 1, 2019):

309(a) Each applicant for licensure as a marital and family therapist

310shall present to the department satisfactory evidence that such

311applicant has: (1) Completed a graduate degree program specializing

312in marital and family therapy [from] offered by a regionally accredited

313college or university or an accredited postgraduate clinical training

314program accredited by the Commission on Accreditation for Marriage

315and Family Therapy Education offered by a regionally accredited

316institution of higher education; (2) completed a supervised practicum

317or internship with emphasis in marital and family therapy supervised

318by the program granting the requisite degree or by an accredited

319 postgraduate clinical training program [,] accredited by the

320Commission on Accreditation for Marriage and Family Therapy

321Education and offered by a regionally accredited institution of higher

322education, in which the student received a minimum of five hundred

323direct clinical hours that included one hundred hours of clinical

324supervision; (3) completed twelve months of relevant postgraduate

325experience, including (A) a minimum of one thousand hours of direct

326client contact offering marital and family therapy services subsequent

327to being awarded a master's degree or doctorate or subsequent to the

328training year specified in subdivision (2) of this subsection, and (B) one

329hundred hours of postgraduate clinical supervision provided by a

330licensed marital and family therapist; and (4) passed an examination

331prescribed by the department. The fee shall be three hundred fifteen

332dollars for each initial application.

333(b) Each applicant for licensure as a marital and family therapist

334associate shall present to the department (1) satisfactory evidence that

335such applicant has completed a graduate degree program specializing

336in marital and family therapy offered by a regionally accredited

337institution of higher education or an accredited postgraduate clinical

338training program accredited by the Commission on Accreditation for

339Marriage and Family Therapy Education and offered by a regionally

340accredited institution of higher education, and (2) verification from a

341supervising licensed marital and family therapist that the applicant is

342working toward completing the postgraduate experience required for

343licensure as a marital and family therapist under subdivision (3) of

344subsection (a) of this section. The fee shall be one hundred twenty-five

345dollars for each initial application.

346[(b)] (c) The department may grant licensure without examination,

347subject to payment of fees with respect to the initial application, to any

348applicant who is currently licensed or certified as a marital or marriage

349and family therapist or a marital and family therapist associate in

350another state, territory or commonwealth of the United States,

351provided such state, territory or commonwealth maintains licensure or

352certification standards which, in the opinion of the department, are

353equivalent to or higher than the standards of this state. No license shall

354 be issued under this section to any applicant against whom

355professional disciplinary action is pending or who is the subject of an

356unresolved complaint.

357[(c) Licenses] (d) (1) A license issued to a marital and family

358therapist issued under this section may be renewed annually in

359accordance with the provisions of section 19a-88, as amended by this

360act. The fee for such renewal shall be three hundred twenty dollars.

361Each licensed marital and family therapist applying for license renewal

362shall furnish evidence satisfactory to the commissioner of having

363participated in continuing education programs. The commissioner

364shall adopt regulations, in accordance with chapter 54, to [(1)] (A)

365define basic requirements for continuing education programs, which

366shall include not less than one contact hour of training or education

367each registration period on the topic of cultural competency and, on

368and after January 1, 2016, not less than two contact hours of training or

369education during the first renewal period in which continuing

370education is required and not less than once every six years thereafter

371on the topic of mental health conditions common to veterans and

372family members of veterans, including [(A)] (i) determining whether a

373patient is a veteran or family member of a veteran, [(B)] (ii) screening

374for conditions such as post-traumatic stress disorder, risk of suicide,

375depression and grief, and [(C)] (iii) suicide prevention training, [(2)] (B)

376delineate qualifying programs, [(3)] (C) establish a system of control

377and reporting, and [(4)] (D) provide for waiver of the continuing

378education requirement for good cause.

379(2) A license issued to a marital and family therapist associate shall

380expire on or before twenty-four months after the date on which such

381license was issued and may be renewed once for an additional twenty-

382four months in accordance with the provisions of section 19a-88, as

383amended by this act. The fee for such renewal shall be two hundred

384twenty dollars. Each licensed marital and family therapist associate

385applying for license renewal shall furnish evidence satisfactory to the

386commissioner of working toward completing the postgraduate

387experience required for licensure as a marital and family therapist

388under subdivision (3) of subsection (a) of this section and the potential

389for successful completion of such experience prior to the expiration of

390the twenty-four month renewal period.

391[(d)] (e) Notwithstanding the provisions of this section, an applicant

392who is currently licensed or certified as a marital or marriage and

393family therapist in another state, territory or commonwealth of the

394United States that does not maintain standards for licensure or

395certification that are equivalent to or higher than the standards in this

396state may substitute three years of licensed or certified work

397experience in the practice of marital and family therapy, as defined in

398section 20-195a, as amended by this act, in lieu of the requirements of

399subdivisions (2) and (3) of subsection (a) of this section.

400Sec. 10. Subdivision (1) of subsection (e) of section 19a-88 of the

401general statutes is repealed and the following is substituted in lieu

402thereof (Effective October 1, 2019):

403(e) (1) Each person holding a license or certificate issued under

404section 19a-514, 20-65k, 20-74s, 20-185k, 20-185l, 20-195cc, as amended

405by this act, or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to

406381a, inclusive, 383 to 383c, inclusive, 384, 384a, 384b, 384d, 385, 393a,

407395, 399 or 400a and section 20-206n or 20-206o shall, annually, or, in

408the case of a person holding a license as a marital and family therapist

409associate under section 20-195c, as amended by this act, on or before

410twenty-four months after the date of initial licensure, during the

411month of such person's birth, apply for renewal of such license or

412certificate to the Department of Public Health, giving such person's

413name in full, such person's residence and business address and such

414other information as the department requests.

415Sec. 11. Subsection (a) of section 20-206oo of the general statutes is

416repealed and the following is substituted in lieu thereof (Effective

417October 1, 2019):

418(a) The Commissioner of Public Health may adopt regulations in

419accordance with the provisions of chapter 54 to carry out the

420provisions of subdivision (24) of subsection (c) of section 19a-14,

421subsection (e) of section 19a-88, as amended by this act, subsection (b)

422of section 20-9, subsection [(c)] (d) of section 20-195c, as amended by

423this act, [sections 20-195aa to 20-195ff, inclusive,] and sections 20-206jj

424to [20-206oo] 20-206nn, inclusive.

425Sec. 12. Subdivisions (6) to (19), inclusive, of subsection (c) of section

42619a-14 of the general statutes are repealed and the following is

427substituted in lieu thereof (Effective October 1, 2019):

428(6) Marital and family therapist and marriage and family therapist

429associate;

430(7) Nurse-midwife;

431(8) Licensed clinical social worker;

432(9) Respiratory care practitioner;

433(10) Asbestos contractor, asbestos consultant and asbestos training

434provider;

435(11) Massage therapist;

436(12) Registered nurse's aide;

437(13) Radiographer;

438(14) Dental hygienist;

439(15) Dietitian-Nutritionist;

440(16) Asbestos abatement worker;

441(17) Asbestos abatement site supervisor;

442(18) Licensed or certified alcohol and drug counselor;

443(19) Professional counselor and professional counselor associate;

This act shall take effect as follows and shall amend the following sections:

Statement of Legislative Commissioners:

In Section 4(a), "Subsections (b) and (c)" were changed to Subsections "(c) and (d)" for accuracy, Subparas. (A)(i) to (C), inclusive, were redesignated as Subdivs. (1)(A) to (3), inclusive, for consistency with standard drafting conventions and in Section 4(d), "or a professional counselor associate or its equivalent" was deleted and the closing bracket was moved from after "of this section, or" to after "subparagraph (B) of" for accuracy.

PH Joint Favorable Subst.

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:

Municipal Impact: None

Explanation

The bill, which requires the licensure of professional counselor associates (PCAs) and licensed martial and family therapist associates (LMFTAs) by the Department of Public Health (DPH), is anticipated to result in a net General Fund revenue gain of approximately $14,001 in FY 20 and $35,341 in FY 21.

The anticipated FY 20 cost to the State of $26,834 includes total estimated DPH expenses of $19,531. DPH costs reflect the salary for a half-time Office Assistant $17,731 (partial year, as the bill is effective 10/1/19), and a one-time equipment cost of $1,800 for a computer, software, and scanner for this employee. The full-year salary for the Office Assistant in FY 21 is approximately $23,641. The State Comptroller fringe benefit cost for this position is $7,303 in FY 20 $9,738 in FY 21.

1The fringe benefit costs for most state employees are budgeted centrally in accounts administered by the Comptroller. The estimated active employee fringe benefit cost associated with most personnel changes is 41.19% of payroll in FY 20 and FY 21.

General Fund revenue of approximately $40,835 is anticipated in FY

20 from the following:

∙The initial licensure of approximately 143 PCAs with a fee of $220 per application = $31,460

∙The initial licensure of approximately 75 LMFTAs with a fee of $125 per application = $9,375

In FY 21, General Fund revenue of approximately $68,720 is anticipated from:

∙The initial licensure of approximately 143 PCAs = $31,460

∙The renewal licensure of approximately 143 PCAs with a fee of $195 per application = $27,885

∙The initial licensure of approximately 72 LMFTAs = $9,375

In 2018, there were 2,865 licensed professional counselors and 1,489 licensed martial and family therapist in Connecticut. Using the percent of Master's Level Social Worker temporary licenses issued for the licensed Master's Level Social Worker population, it is assumed that approximately 5% of professional counselors and licensed martial and family therapists will seek associate licensure annually. LMFTA licensure is biannual under the bill. Therefore, revenue from its $220 renewal fee is not anticipated until the out years.

The Out Years

The annualized ongoing fiscal impact identified above will continue into the future subject to the number of initial and renewal licenses for professional counselor associates and licensed martial and family therapist associates issued by DPH, and cost inflation.

OLR Bill Analysis sHB 7132

AN ACT CONCERNING LICENSURE OF PROFESSIONAL COUNSELOR ASSOCIATES AND MARITAL AND FAMILY THERAPIST ASSOCIATES.

SUMMARY

This bill creates a new associate licensure category for licensed professional counselors (LPCs) and marital and family therapists (MFTs) that allows them to practice under professional supervision while pursuing full licensure. To qualify for an associate license, the applicant must meet certain educational and clinical training requirements.

The bill also prohibits anyone who is unlicensed from using the title

(1)"licensed professional counselor associate" or "professional counselor" or any title, words, letters, or abbreviations that may reasonably be confused with licensure or (2) "licensed marital and family therapist associate." Existing law similarly prohibits unlicensed people from using a title that indicates that they are fully licensed LPCs and MFTs.

For LPCs, the associate license must be renewed annually. The initial license fee is $220 and the renewal fee is $195. For MFTs, the associate license is valid for two years and may be renewed once. The initial license fee is $125 and the renewal fee is $220.

Current law allows students who graduate with advanced degrees in professional counseling and marital and family therapy to practice without a license in order to complete the supervised work experience required for full licensure, but only (1) if supervised by someone licensed in their respective profession and (2) for up to two years after completing the supervised work experience, if they failed the

respective licensing examination. (The bill eliminates this provision for professional counseling students, but not for MFT students.)

The bill also makes technical and conforming changes.

EFFECTIVE DATE: October 1, 2019

1- 6 — LPC ASSOCIATE LICENSE Initial Licensure Requirements

To obtain an LPC associate license, an applicant must submit to the Department of Public Health (DPH) commissioner satisfactory evidence of having earned a graduate degree in clinical mental health counseling as part of a higher education program accredited by the Council for Accreditation of Counseling and Related Educational Programs, or its successor. Alternatively, the bill allows an applicant to complete:

1.at least 60 graduate semester hours in counseling or a related mental health field at a regionally accredited higher education institution that included coursework in (a) human growth and development; (b) social and cultural foundations; (c) counseling theories and techniques; (d) group, career, addiction and substance abuse, and trauma and crisis counseling; (e) appraisals or tests and measurements to individuals and groups; (f) research and evaluation; (g) professional orientation to mental health counseling; and (h) diagnosing and treating mental and emotional disorders;

2.a 100-hour counseling practicum and a 600-hour clinical mental health counseling internship each taught by a faculty member licensed or certified as a professional counselor or its equivalent in another state; and

3.a graduate degree in counseling or a related mental health field from a regionally accredited higher education institution.

Licensure by Endorsement

As with LPC licenses under existing law, the bill allows DPH to grant an LPC associate license by endorsement to LPC associates licensed or certified in another state or jurisdiction with requirements substantially similar to or higher than Connecticut's. Applicants must have no pending disciplinary actions or complaints.

License Scope

The bill generally prohibits an LPC associate from practicing professional counseling unless he or she is under the supervision of a:

1.LPC;

2.licensed psychiatrist certified by the American Board of Psychiatry and Neurology;

3.licensed advanced practice registered nurse (APRN) certified as a psychiatric and mental health clinical nurse specialist or nurse practitioner by the American Nurses Credentialing Center; or

4.licensed psychologist, MFT, or clinical social worker.

License Renewal

To renew a license, the bill requires LPC associates to submit satisfactory evidence to DPH that they completed continuing education requirements the commissioner sets in regulations. Such continuing education must include at least:

1.one contact hour (i.e., 50 minutes) of education or training in cultural competency;

2.two contact hours of training or education in mental health conditions common to veterans and their family members, during the first renewal period and every six years thereafter; and

3.three contact hours of training or education in professional ethics.

7- 12 — MFT ASSOCIATE LICENSE Initial Licensure Requirements

To obtain an MFT associate license, an applicant must provide DPH satisfactory evidence of having:

1.completed a (a) graduate degree program specializing in marital and family therapy offered by a regionally accredited higher education institution or (b) postgraduate clinical training program accredited by the Commission on Accreditation for Marriage and Family Therapy Education and offered by a regionally accredited higher education institution and

2.verification from a supervising licensed MFT that the applicant is working toward completing the postgraduate experience requirements for an MFT license.

Licensure Without Examination

As with MFT licenses under existing law, the bill allows DPH to grant an MFT associate license without examination to MFT associates licensed or certified in another U.S. state, territory, or commonwealth. An applicant can obtain a license in this way if the other jurisdiction's licensing standards are at least as strict as Connecticut's. Applicants must also have no pending disciplinary actions or complaints.

License Renewals

The MFT associate license is valid for two years and is renewable once during the applicant's birth month. The applicant must submit evidence that he or she is working to complete the postgraduate experience requirements for an MFT license and can successfully do so during the two-year renewal period.

COMMITTEE ACTION

Public Health Committee