Written on February 3, 2019

Catherine Atkins, JD

Deputy Executive Director

The California legislative session for 2017-2018 just ended and 2019- 2020 is just getting started. In 2017-2018, hundreds of bills were introduced and many were signed or vetoed by the Governor. Over the next month, hundreds of bills will be introduced and become part of the 2019-2020 session. This article provides a brief overview on CAMFT’s legislative priorities/outcomes for 2018, and CAMFT will report in more depth on the 2019-2020 session in the next issue. For more information on what bills CAMFT is sponsoring or taking a position, we encourage members to review CAMFT’s Legislative Action Center.

2018 STATE ADVOCACY

AB 2088 (Santiago)—Minor’s Records: This CAMFT-sponsored 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 went into effect January 1, 2019.

AB 93 (Medina)—Supervision Requirements: This bill, sponsored by the Board of Behavioral Sciences (BBS), revises some LMFT supervised experience requirements. CAMFT participated in all stakeholder meetings and supported 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.

This bill was signed by the Governor and went into effect January 1, 2019. CAMFT has produced a summary of these changes in The Therapist and has a six hour education session via online learning. AB1436 (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 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, 2020. 

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 went into effect January 1, 2019. 

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 went into effect January 1, 2019.  

2019 STATE ADVOCACY

CAMFT’s priority for 2019 is to educate newly elected and appointed state leadership on what an MFT is, the scope of practice, and various working settings. CAMFT has observed that recent turnover in state leadership has left many departments unknowledgeable about the vast number of work settings MFTs are qualified to work at, as well as that the MFT license title does not equate to the full scope of practice of an MFT. CAMFT will dedicate 2019 to an educational tour of the California leadership.

CAMFT will additionally be monitoring and advocating on all pieces of legislation and regulation that affect the MFT profession and mental health care generally. Deadline for legislative introduction is late February 2019, and CAMFT will assess all bills at that time and report bills of interest to the membership in the next issue.

FEDERAL ADVOCACY

Medicare: In the 2017-2018 legislative season, CAMFT’s Medicare coalition introduced bi-partisan legislation in both houses of Congress that would allow LMFTs and LPCCs to reimburse as Medicare  providers. S 1879 and HR 3032 were introduced by Sen. Barrasso (R-WY), Sen. Stabenow (D-WY), and Rep. Thompson (D-CA), and Rep. Katko (R-NY), respectfully. At the close of 2018, HR 3032 had 74 co-sponsors, and S 1879 had 15 co-sponsors. In January 2019, identical legislation was introduced--The Mental Health Access Improvement Act of 2019 (S 286 and HR 945). CAMFT will be asking members to write their Congressperson and Senators in the coming weeks, advocating for co-sponsorship of the newly introduced Medicare bills.

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 COAMFTE-accredited degree. CAMFT recently met with the VA to discuss our concerns and will use 2019 to advocate the VA develop a different staffing plan to hire more MFTs within the VA.

Department of Homeland Security (DHS): In 2018, CAMFT observed an increase in 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. To date, the DHS has been silent, but in 2019, 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.