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Written on December 8, 2018
Catherine Atkins, JD Deputy Executive Director
The California legislative session for 2017/2018 is ending. Hundreds of bills were introduced and many were signed or vetoed by the Governor. CAMFT reviewed these bills to determine the impact on CAMFT members and the profession. 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.
CAMFT Legislation for 2018
AB 2088 (Santiago)—Minor’s Records: This bill permits 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 affect the patients’ lives and their ability to pursue various endeavors. This bill was signed by the Governor, and goes into effect January 1, 2019.
Other 2018 State Legislation
AB 93 (Medina)—Supervision Requirements: This bill, sponsored by the Board of Behavioral Sciences (BBS), revises 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 supported this legislation. Some of the more notable changes in AB 93 include:
**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. The agreed upon compromise to avoid losing the 90-day rule altogether was allowing postgraduates/ pre-registrants the ability to gain hours only if they did so at a live-scanned facility. As noted above, this particular section of AB 93 goes into effect in 2020.
This bill was signed by the Governor. CAMFT has produced a summary of these changes in The Therapist and has a six hour education session via online learning.
AB 1436 (Levine)—Suicide Risk Training: This bill requires an applicant for licensure with the Board of Behavioral Sciences (BBS) to show that the applicant has completed a minimum of six hours of coursework or specified supervised experience in suicide risk assessment and intervention. This training can be completed as part of the applicant’s graduate degree program, obtained as part of supervised experience, or by taking a CE course by an approved provider. CAMFT was opposed to this legislation, as therapists are in the best position to determine which areas of continuing education they are in need of. This bill was signed by the Governor, and goes into effect January 1, 2021. The BBS will be providing additional guidance on how this new requirement is to be completed.
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 took a position of support on this legislation. This bill did not make it out of Committee.
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. CAMFT took a position of support of this legislation. This bill has been signed by the Governor and goes into effect on January 1, 2019.
AB 2022 (Chu)—Mental Health within K-12 School System: After multiple amendments and iterations of this bill, the final version requires each school of a school district or county office of education and charter schools to notify students and parents or guardians of pupils, at least twice per school year, how to initiate access to available student mental health services on campus or in the community. CAMFT was in support off this bill. Ab 2022 was signed by the Governor and goes into effect January 1, 2019.
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. CAMFT took a neutral position on this legislation. AB 2138 was signed by the Governor, and goes into effect January 1, 2019.
AB 2143 (Caballero)—Financial Grants: This bill authorizes licensed mental health service providers who may apply for educational loan repayment grants under the Licensed Mental Health Service Provider Education Program to apply for additional grants under the program if they subsequently attain licensure and currently practice as 1) a nurse practitioner registered as “psychiatric mental health nurses” with the Board of Registered Nursing or 2) a physician assistant who works in a psychiatric mental health setting. CAMFT was in support of this legislation, which was ultimately vetoed by the Governor.
AB 2608 (Stone)—BBS Licensees and Grants: This bill creates a new account within the Mental Health Practitioner Education Fund, where future appropriations by the Legislature could be deposited to a fund grant program to repay educational loans for applicants who were formerly in California’s foster youth care system and commit to provide direct patient care in a publicly funded facility or a mental health professional shortage area for at least 24 months as marriage and family therapists (LMFTs), associate marriage and family therapists (AMFTs), licensed clinical social workers (LFSWs), associate clinical social workers (ACSWs), licensed professional clinical counselors (LPCCs), or associate professional clinical counselors (APCCs). 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. CAMFT took a position of oppose on this legislation for the reasons stated above. AB 2608 was signed by the Governor, and goes into effect January 1, 2019.
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. CAMFT took a position of support on this bill. In August 2018, the author held this bill in Committee.
AB 3087 (Kalra)—Health Care in California: This bill establishes the Health Care Cost, Quality, and Equity Commission (Commission), in an attempt to control instate 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. CAMFT took a position of oppose to this legislation. AB 3087 was held in Committee.
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 prohibits 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. Although CAMFT worked with the author on amendments to avoid any unintended consequences, CAMFT ultimately took a position of oppose on this bill. SB 399 was vetoed by the Governor.
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 full-time 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 attempted to work with the author to ensure there were no unintended consequences, and ultimately took a position of neutral on the bill. This bill was vetoed by the Governor.
SB 974 (Lara)—Health for All: This bill extends eligibility for full-scope 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 took a position of support. This bill was held in Committee.
Medicare (HR 3032 and S 1879): CAMFT’s priority on the federal landscape is to pass legislation that will allow LMFTs to reimburse as Medicare providers. For the 2017-2018 Congress, CAMFT obtained bi-partisan coauthors in both the House and Senate (Sen. Barrasso (R-WY), Sen. Stabenow (D-WY), Rep. Thompson (D-CA), and Rep. Katko (RNY)). As we close 2018, HR 3032 has 74 cosponsors and S 1879 has 15 co-sponsors—this is the most co-sponsors to date on CAMFT’s Medicare reimbursement bill. Sen. Harris (DCA) signed onto S 1879 at the end of 2018.
In addition, CAMFT’s bill was attached to a larger legislative opioid legislative package, HR 5531. Although HR 5531 was not brought to the full Congress, we are hopeful that any 2019 federal opioid legislation will again include CAMFT’s bill.
CAMFT will introduce similar legislation in 2019 starting with the co-sponsors mentioned above. The goal of 2019 is to center the next bill on workforce requirements to deal with opioid addiction that may open up greater opportunity for MFTs to participate in Medicare.
Veterans Affairs: In May 2018, the Department of Veteran Affairs (VA) finally released their new employment standards for LMFT hiring. As background, signed into law in 2016, was the removal of 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, began drafting the employment standards for LMFT hiring in early 2017. After review of the resulting standards, CAMFT remains very concerned given the substantial limitation for promotion of LMFTs within the VA without a COAMFTEaccredited degree. CAMFT will be meeting with the VA to discuss our concerns and develop a staffing plan to hire more MFTs within the VA.
Department of Homeland Security (DHS): Over the last year, CAMFT has become aware of the difficulties deportation and asylum defendants have had when utilizing MFTs as the therapist attesting to mental health status— the difficulties resulting from the DHS arguing that MFTs are not able to provide testimony related to diagnosis (arguing it is outside the scope of practice). CAMFT has reached out to DHS to advocate against this misinformation; as well as provided individual defendants, and their attorneys, amicus briefs and letters to the court to provide education and background on MFT’s ability to treat and diagnose. CAMFT is hopeful its advocacy to the DHS will result in a reversal of their standard legal argument against the usage of MFTs within deportation and asylum hearings.
Catherine L. Atkins, JD, is an attorney and the Deputy Executive Director at CAMFT.