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Written on August 5, 2019 by Cathy Atkins, JD, Deputy Executive Director
The first year of this two-year California legislative session is nearing the last day for the California legislature to pass bills for 2019. With a new governor in office, Gavin Newsom, it’s exciting to see what bills he will sign or veto. Hundreds of bills have been introduced and have been reviewed and analyzed by CAMFT staff and CAMFT’s Legislative Committee in order to determine the impact on CAMFT members and the profession. This article provides a brief overview on the main pieces of legislation and/or regulation that CAMFT has prioritized for 2019.
CAMFT encourages all members to visit CAMFT’s Legislative Action Page to learn about all of the bills CAMFT is following, including in depth descriptions, legislative analyses, and up-to-date status. You can also subscribe to CAMFT’s Action E-lerts for CAMFT emails on key pieces of legislation.
SB 539 (Caballero) -- WET Funding: Co-sponsored by CAMFT, the California Council of Community Behavioral Health Agencies (CBHA), and the California Behavioral Health Planning Council (CBHPC), this bill helps address the mental health work force shortage by funding the Office of Statewide Health Planning and Development (OSHPD) 2020-2025 Workforce Education and Training (WET) Five-Year Plan. Access to services by California’s diverse population is essential to increase early identification and reduce years spent living with untreated mental illness. Workforce development, which includes recruiting, training and retaining behavioral health staff, is a top priority for CAMFT.
Although SB 539 was held in the Senate Appropriations Committee’s suspense file, CAMFT also submitted a budget proposal request to fund the implementation of the next five years of the WET program. CAMFT was successful in obtaining funding through the Governor’s proposed budget and the final budget bill will be voted on and signed by the Governor. After the final spending bill is signed, CAMFT will receive confirmation on when the funding will become effective and bill language outlining how to implement the allocated money.
AB 5 (Gonzalez) – Independent Contractors: 2018 case law, as established in the case of Dynamex Operations West, Inc. v. Superior Court of Los Angeles, creates a presumption that a worker who performs services for an employer is an employee (rather than an independent contractor) for purposes of claims for wages and benefits. This bill would state the intent of the Legislature is to codify the decision in the Dynamex case and clarify its application. The bill also contains exemptions for specified professions that are not subject to wage orders of the Industrial Welfare Commission or the ruling in the Dynamex case, including physicians, securities brokers, and other professionals. The California Chamber of Commerce has put together a coalition to add many California professionals, including mental health therapists, as exempted professions within AB 5. If exempted, these professionals would revert to the historical employee/independent contractor test that existed prior to the 2018 Dynamex case. CAMFT has received a large amount of member feedback expressing concerns about the effect the Dynamex case has had on their practice, and ability to contract. Both the CAMFT Legislative Committee and Board of Directors have supported that CAMFT sign onto the coalition’s efforts of the Chamber. NASW-CA, CALPCC, and the California Psychological Association have all joined the Chamber’s coalition as well.
AB 8 (Chu) – Mental Health in the K-12 Schools: The purpose of this bill is to increase mental health services geared towards children and youth. AB 8 would place paid mental health professionals onto campuses by 2023, both providing timely services for children as well as breaking down stigma surrounding mental health generally. CAMFT has taken a position of support on this bill. This bill has become a two-year bill and Asm. Chu can move it forward in 2020.
AB 630 (Low)—Consumer Notification: This BBS sponsored bill requires psychotherapy providers who provide services to give clients a notice disclosing where complaints against the therapist may be filed. This notification can be included within a provider’s general intake, disclosures or informed consent forms. CAMFT is in support of this legislation.
AB 680 (Jones-Sawyer)—Mental Health Training: This bill requires the Commission on Peace Officer Standards and Training (POST) to adopt two mental health training courses for local public safety dispatchers, a basic training course of at least four hours, and a continuing education course of at least one hour. According to the author, “AB 680 will provide dispatchers, who are often the first point of contact in a crisis, with valuable training to help identify a mental health crisis and inform law enforcement how to appropriately approach the situation on the ground…This bill will both better inform those on the ground and provide important health intervention procedure for the person in crisis.” CAMFT is in support of this bill.
AB 744 (Aguiar-Curry)—Telehealth Reimbursement: This bill would require health care service plans/insurers to reimburse a healthcare provider for the diagnosis, consultation, or treatment of an enrollee, subscriber, insured, or policyholder delivered through telehealth services on the same basis and to the same extent that the health care service plan/insurer is responsible for reimbursement for the same service through in-person diagnosis, consultation, or treatment. CAMFT is in support of this bill.
AB 769 (Wood)—LPCCs in FQHCs/RHCs: This bill adds licensed professional clinical counselors (LPCCs) to the list of health care professionals that qualify for a face-to-face encounter with a patient at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for purposes of a per-visit Medi-Cal payment under the prospective payment system (PPS). CAMFT sponsored similar legislation in 2016 that added LMFTs to the list of providers; that legislation was signed by the Governor. CAMFT is in support of this legislation. Unfortunately, AB 769 did not make it out of the Appropriations Committee.
AB 1145 (Garcia)—Child Abuse Reporting: The Child Abuse and Neglect Reporting Act requires a mandated reporter to make a report whenever the mandated reporter, in his or her professional capacity has knowledge of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect. Existing law provides that “child abuse or neglect” for these purposes includes “sexual assault,” that includes, among other things, the crimes of sodomy, oral copulation, and sexual penetration. This bill would provide that “sexual assault” for these purposes (mandated reporting) does not include voluntary sodomy, oral copulation, or sexual penetration, if there are no indicators of abuse, unless that conduct is between a person who is 21 years of age or older and a minor who is under 16 years of age. CAMFT supported similar legislation in 2015, and again is in support of AB 1145. Assemblyperson Garica has made AB 1145 a two year bill.
AB 1651 (Medina)—LEP Supervision of Associates and Trainees: Currently, an MFT Associate or Trainee can receive supervision under an LMFT, LPCC, LCSW, psychologist or psychiatrist. This bill would expand the definition of “supervisor” to include a licensed educational psychologist who has provided psychological counseling pursuant to the Educational Psychologist Practice Act. In the current language, up to 1,200 hours could be gained under an LEP working within the school setting. The sponsor’s rationale for allowing LEPs to serve as supervisors is that they have qualifications to supervise in school educations settings that other types of supervisors are unlikely to have. CAMFT is always striving to obtain more supervision opportunities for pre-licensees while ensuring consumer protection. CAMFT has received mixed reactions from the membership and therapists working within the school system on the prospect of LEPs providing supervision. Although CAMFT did express its concerns about LEP direct work experience with DSM diagnoses and severe mental health issues, the Board of Behavioral Sciences has supported AB 1651 and indicated no concerns of consumer protection. Accordingly, AB 1651 will move forward. CAMFT will continue to reach out to the sponsors of the bill, as well as the BBS to encourage additional training for LEP supervisors in these situations.
SB 360 (Hill)—Mandated Reporters, Clergy: Existing law, the Child Abuse and Neglect Reporting Act, makes certain persons, including clergy, mandated reporters. Under existing law, clergy are required to report whenever the clergy, in their professional capacity has knowledge of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect, except when the clergy acquires the knowledge or reasonable suspicion of child abuse or neglect during a penitential communication. Failure by a mandated reporter to report an incident of known or reasonably suspected child abuse or neglect is a misdemeanor. This bill would delete that exception for a penitential communication, thereby requiring clergy to make a mandated report even if they acquired the knowledge or reasonable suspicion of child abuse or neglect during a penitential communication. This bill has been pulled by the author, which was being monitored by CAMFT.
SB 428 (Leyva)--Mental Health Training: This bill would add completion of a course in youth mental health first aid to the list of requirements for obtaining a clear multiple or single subject teaching credential. According to the author, “California is in the midst of a youth mental health crisis…Teachers are on the frontlines of these crises and as such should be trained to identify and help students who are suffering. Research shows that the sooner people get help for mental health and substance use concerns, the more likely they are to have positive outcomes.” CAMFT is in support of this bill.
SB 660 (Pan)—Mental Health Counselors: This bill originally created a requirement for higher educational entities in California to hire one fulltime equivalent mental health counselor per 1,500 students enrolled at each of their campuses. A similar bill was introduced in 2018 that was vetoed by Governor Brown. The bill, as currently written, does not define “mental health counselor” as to whether LMFTs, or MFT pre-licensees would be included. While CAMFT is supportive of adding additional mental health to the higher education system, we want to ensure that MFTs are included as mental health counselors. Because the author changed the requirement to a general goal, CAMFT is watching this bill and will work with the sponsors of the bill on the vague definition if the bill moves forward as a requirement.
Supervision Regulation Package: The BBS’s rulemaking proposal pertaining to supervision was approved by the BBS at its meeting in November 2016 and was held aside while awaiting passage of AB 93, the BBS’s supervision legislation. The proposal was submitted to DCA for review on April 18, 2019. The packet will need to go back to the BBS Board for some language edits, however, BBS staff does not anticipate the changes to delay the process.
Private Practice Definition: The BBS Policy & Advocacy Committee is recommending changes to the licensing laws for LMFTs, LPCCs, and LCSWs, which will be reviewed by the BBS Board of Directors at its next meeting in September. The proposal includes changes to the definitions of the various types of practice settings that licensees and applicants may be working in, the supervision of associates in private practice settings, and the increase in number of supervisees in private practice. If the Board approves the Committee’s recommendations, the changes will be introduced as 2020 legislation.
Licensure Fees: The BBS Policy & Advocacy Committee is also recommending for the Board to approve increase in Board licensure fees for LMFTs, LPCCs, and LCSWs.
Future Issues of Interest: The BBS Policy & Advocacy Committee is also recommending the Board convene the Exam and Licensing Committee in the near future (possibly 2020) to have further discussions on substantial changes to the subsequent registration number, clinical exam limits, and requiring continuing education for registered associates.
Medicare (HR 945 and S 286): CAMFT’s priority on the federal landscape is to pass legislation that will allow LMFTs to receive reimbursement as Medicare providers. For the 2019-2020 Congress, CAMFT obtained bi-partisan co-authors in both the House and Senate (Sen. Barrasso (R-WY), Sen. Stabenow (D-MI), Rep. Thompson (D-CA), and Rep. Katko (R-NY)). CAMFT has reached out to all members asking that they encourage their elected officials to co-sponsor HR 945 and S 286. If you have not already done so, please contact your legislator today to allow LMFTs to be Medicare providers. HR 945 currently has 61 co-sponsors and S 286 has 25.
Veterans Affairs: In May 2018, the Department of Veteran Affairs (VA) released their long employment standards for LMFT hiring within the VA. This was a two year delay, following the 2016 law, removing the requirement that LMFTs must be graduates of COAMFTE-accredited programs. CAMFT is very concerned about the make-up of the 2018 standards, especially the inability of LMFTs to be promoted above G-11 without a COAMFTE degree. CAMFT has had little success over the last year influencing the VA to amend their standards and will be seeking congressional action in 2020.