LEGISLATIVE & REGULATORY UPDATE

Written on April 24, 2018
Catherine Atkins, JD
Deputy Executive Director

The California legislative session for 2018 is well underway, being half-way through the second year of a two-year legislative cycle. Hundreds of bills have been introduced, which CAMFT has reviewed to determine the impact on CAMFT members and the profession; some bills are still under review as we learn more about their intent and effect. This article provides a brief overview on CAMFT’s legislative priorities/ outcomes for 2018. For more information on what bills CAMFT is sponsoring or taking a position, we encourage members to review CAMFT’s Legislative Action Center.

STATE ADVOCACY


CAMFT Legislation for 2018
AB 2088 (Santiago)—Minor’s Records: This bill would permit all patients, not just adult patients, to addend (not amend/change) their records upon finding a mistake or error. Under current law, minors age 12 or older can consent for their own treatment, with a few exceptions. Minors also have the right to inspect their treatment records. This bill would give minors the ability to add an addendum up to 250 words in length to their records when they believe the record is incomplete or inaccurate. This right to addend a treatment record is important given that these records may be subject to disclosure and have the potential to impact the patients’ lives and their ability to pursue various endeavors. This bill has passed through the Assembly with no “no” votes and is now in the Senate.

Other 2018 State Legislation
AB 93 (Medina)—Supervision Requirements: This bill, sponsored by the Board of Behavioral Sciences (BBS), revises and recasts some LMFT supervised experience requirements. To address changing and evolving supervised experience and supervisor relationships, the BBS formed a special committee in 2014 to examine supervision requirements. Through that Committee, and relying on fruitful stakeholder participation, came SB 620 (2015) and AB 93.

CAMFT participated in all stakeholder meetings and has taken a position of support on this legislation.

Some of the more notable changes in AB 93 include:

  • Supervisors to monitor for and address clinical dynamics, including countertransference, intrapsychic-, interpersonal-, or trauma-related issues that may affect the supervisory or the practitioner-patient relationship;
  • Supervisors to directly observe or review recordings of supervisee’s counseling, as deemed appropriate;
  • Supervisors to review supervisee’s progress notes, process notes and other patient treatment records, as deemed appropriate;
  • The BBS will obtain the right to audit the records of supervisors to verify completion of supervisor qualifications; and,
  • One hour of face to face supervision will now include “triadic supervision” which means one hour of face-to-face between one supervisor and two supervisees.
  • Starting in 2020, all hours gained post-degree/pre-registration must be gained at a live-scanned facility.**

**In mid-2017, the Senate Business and Professions Committee (Committee) raised concerns within AB 93 as to the 90-day rule (which allows providers to count hours between graduation and registration if the provider has applied for a registration number within 90 days of the degree posting). The Committee’s concerns were that the 90-day rule allows unregistered individuals to provide mental health services without a fingerprint clearance. Accordingly, the bill was held unless the 90 day rule was removed or an alternative could be put forward. In response CAMFT and the BBS agreed to an alternative to losing the 90-day rule altogether: allowing post-graduates/pre-registrants the ability to gain hours if they did so at a live-scanned facility.

CAMFT participated in all stakeholder meetings and has taken a position of support on this legislation.

AB 1779 (Nazarian)—SOCE with a Minor: Existing law prohibits mental health providers from performing sexual orientation change efforts (SOCE) with a patient under 18 years of age. Existing law provides that any sexual orientation change efforts attempted on a patient under 18 years of age by a mental health provider shall be considered unprofessional conduct and shall subject the provider to discipline by the provider’s licensing entity. This bill would additionally prohibit a mental health provider from engaging in SOCE with a patient, regardless of age, under a conservatorship or a guardianship.In line with prior positions on the issue of SOCE with minor patients, CAMFT has taken a position of support on this legislation.

AB 1968 (Low)—5150s and Gun Possession: This bill prohibits an individual from owning a firearm if the person is taken into custody, assessed, and admitted to a designated facility because he or she is a danger to himself/herself or others because of a mental health disorder, more than once within a one-year period. The prohibition is also subject to the right to challenge the prohibition at periodic court hearings. The California Psychiatric Association has taken a position of oppose, whereas the California Psychological Association has taken a position of support. The CAMFT Legislative Committee is currently reviewing this legislation in order to provide a recommendation to the Board of Directors.

AB 2022 (Chu)—Mental Health within K-12 School System: The purpose of this bill is to increase mental health services geared towards children and youth. The goal is to place paid mental health professionals onto the campus, both providing timely services for children as well as breaking down stigma surrounding mental health generally. Although CAMFT is thankful for and supportive of the merits and purpose of this bill, the language as currently written has the possibility of displacing currently working (and future) pre-licensed MFTs. CAMFT is currently working with the author’s office to ensure there are no unintended consequences of this piece of legislation.

AB 2138 (Low)—DCA Licensees: Existing law provides that a health care provider shall not be denied a license under the BBS solely on the basis that the person has been convicted of a felony if he or she has obtained a certificate of rehabilitation, the conviction has been dismissed, or that the person has been convicted of a misdemeanor if he or she met certain requirements of rehabilitation developed by the board. This bill would instead prohibit a person from being denied a license solely on the basis that he or she has been convicted of a nonviolent crime and would make conforming changes. The BBS has expressed concerns about this bill, specifically consumer protection. The CAMFT Legislative Committee is currently reviewing this legislation.

AB 2324 (Rubio)—Elder Abuse and Shaming: This bill amends into the Elder Abuse and Dependent Adult Civil Protection Act, “public shaming” as a reportable act under abuse of an elder. This bill would also make it a misdemeanor to publicly shame an elder or dependent adult. Although the intent behind the bill is understandable, the language as written is vague and unclear as to what “shaming” means and how providers would apply it within their practice and abuse reporting. CAMFT is currently working with the author to ensure a clear definition within the mandated reporting law moves forward.

AB 2498 (Eggman)—School Health Care and Social Worker Pilot Program: Similar to AB 2022, this bill provides grant funding in certain K-12 school districts, as a pilot program, to fund mental health services. However, the pilot program is only aimed at social workers with a credential under the Department of Education or Licensed Clinical Social Workers. While CAMFT generally supports any additional funding of mental health services to children in California, there is concern that the program is only aimed at credentialed staff or LCSWs. This could lead to disenfranchisement of other mental health professionals, as well as limit the access to qualified mental health professionals. The CAMFT Legislative Committee is currently reviewing this legislation.

AB 2608 (Stone)—BBS Licensees and Grants: This bill increases the licensing fee (by $10) for those regulated by the BBS to fund grants to repay educational loans for licensees who had grown up through the foster care system. While the intent of the bill has merit, there are concerns that it is unfair to provide preferential treatment to one group over another in accessing the grant funds. The CAMFT Legislative Committee is currently reviewing this legislation.

AB 2943 (Low)—SOCE and Unlawful Practices: This bill would include, as an unlawful practice prohibited under the Consumer Legal Remedies Act, advertising, offering to engage in, or engaging in sexual orientation change efforts with any individual. CAMFT has received feedback from the membership both in support as well as opposed to this piece of legislation. CAMFT has worked with the author to amend language into the bill clarifying that this prohibition does not include sexual orientation-neutral interventions to promote healthy sexual and romantic relationships. The CAMFT Legislative Committee is currently reviewing this legislation in order to provide a recommendation to the Board of Directors.

AB 3087 (Kalra)—Health Care in California: This bill establishes the Health Care Cost, Quality, and Equity Commission (Commission), in an attempt to control in-state health care costs and set the amounts accepted as payment by health plans, hospitals, physicians, physician groups, and other healthcare providers. This bill has been opposed by numerous health care provider groups, hospitals, and health care plan groups. Some of the concerns raised have been the loss of health care provider positions, lack of attention to Medi-Cal services, likely lowering of provider rates, administrative complexities, and loss of revenue in the billions to hospitals. The CAMFT Legislative Committee is currently reviewing this legislation.

SB 399 (Portafino)—Applied Behavioral Analysis: This bill makes changes to the mandate on health plans and health insurers to cover behavioral health treatment for pervasive developmental disorder or autism, such as prohibiting a health plan or insurer from denying or reducing coverage for medically necessary services. This bill also broadens the eligibility criteria to become a qualified autism service professional and paraprofessional. Although CAMFT is generally in support of increased access to care, the bill as currently written limits the opportunities pre-licensees have when working with the ABA population. CAMFT is currently working with the author to ensure that no unintended consequences result through this legislation.

SB 968 (Pan)—Mental Health Counselors and Colleges: This bill requires the California State University (CSU), Board of Trustees, Board of Governors (BOG) of the California Community College (CCC) and requests the Regents of University of California (UC) to have one fulltime equivalent mental health counselor per 1,000 students enrolled at each of their respective campuses. CAMFT is supportive of the intent and merits of hiring additional mental health professionals at the college level, however similar to AB 2022, CAMFT needs to ensure that this bill moves forward in a manner that does not put pre-licensees jobs on the college campuses in jeopardy. CAMFT is currently working with the author to ensure that there are no unintended consequences through this legislation.

SB 974 (Lara)—Health for All: This bill extends eligibility for fullscope Medi-Cal benefits, including mental health care, to individuals of all ages who are otherwise eligible for those benefits but for their immigration status. CAMFT supports increasing access to mental health care services, and accordingly has taken a position of support.

FEDERAL ADVOCACY


Medicare: CAMFT’s priority on the federal landscape is to pass legislation that will allow LMFTs to reimburse as Medicare providers. CAMFT has obtained bi-partisan co-authors in both the House and Senate (Sen. Barrasso (R-WY), Sen. Stabenow (D-WY), Rep. Thompson (D-CA), and Rep. Katko (R-NY)). HR 3032 has been introduced in the House, and S 1879 in the Senate. HR 3032 has 55 cosponsors, including 13 from California. S 1879 has 10 co-sponsors, and neither Senators Feinstein nor Harris have signed on to date.

Following CAMFT’s (and the Grassroots Advocacy Team’s) lobbying trip to Washington DC in April 2018, Rep. Buchanan (R-FL) and Rep. Murphy (D-FL), introduced HR 5531, The Opioid Emergency Response Act. The bill targets the growing drug abuse epidemic through greater research and prevention efforts, expanded access to treatment for those in recovery, and better screening to catch illegal drugs before they enter the country. Rep. Buchanan has included CAMFT’s Medicare bill, HR 3032, in its entirety as part of his bill. CAMFT is hopeful that as HR 5531 moves forward, HR 3032 remains attached.

Veterans Affairs: CAMFT continues to monitor the Department of Veteran Affairs (VA) as they discuss implementation of the Military Construction, Veterans Affairs, and Related Agencies Appropriation Bill. This bill, signed into law in 2016 removed the requirement that LMFTs must be graduates of COAMFTE-accredited programs in order to work at the VA. A committee consisting of five LMFTs employed through the VA, and a psychologist, have begun drafting the new employment standards for LMFT hiring. Because the VA committed to a Fall 2017 completion date, which has now come and gone, CAMFT has been meeting with both the Senate and House to put pressure on the VA to prioritize the completion of the standards; the VA has yet to release the standards.

Catherine L. Atkins, JD, is a staff attorney and the Deputy Executive Director at CAMFT. Cathy is available to answer members’ questions regarding legal, ethical, and licensure issues.