Written on April 9, 2019
Catherine Atkins, JD
Deputy Executive Director

The first year of this two-year California legislative session is well underway. It’s an exciting year with a new governor in office, Gavin Newsom, and 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 made a priority for 2019. Additional bills are still being analyzed and will be reported on in the next Legislative update. 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 analysis, and up-to-date status. You can also subscribe to CAMFT’s Action E-lerts for CAMFT emails on key pieces of legislation.

ADVOCACY

CAMFT Sponsored 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) five-year plan. Access to services by California’s diverse population is essential to early identification and the reduction of years spent living with untreated mental illness. Workforce development, which includes recruiting, training and retaining behavioral health staff, is a top priority for CAMFT. SB 539 creates a trust fund (WET-TF) dedicated to funding the workforce efforts outlined in the Five-Year Plan. Examples of those efforts include funding for loan repayment programs/stipends for behavioral health clinicians, increasing capacity at universities to train and supervise behavioral health professionals, and regional partnerships where counties can pursue specific strategies to address their communities’ needs.

Other State Legislation
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 coalitions efforts of the Chamber. NASWCA, CALPCC, and the California Psychological Association have all joined the Chamber’s coalition as well. CAMFT has taken a support if amended position on this bill.

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 the campus 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.

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.

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.

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. CAMFT is working with the sponsors of this bill and has not yet taken a position.

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. CAMFT is currently monitoring this bill and will be further assessing the bill as it moves through the legislature.

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 would require 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. CAMFT is watching this bill and will work with the sponsors of the bill on the vague definition if the bill moves forward.

FEDERAL ADVOCACY

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 (DCA), 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.

Veterans Affairs: In May 2018, the Department of Veteran Affairs (VA) finally released their long awaited 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 COAMFTEaccredited programs in order to work at the VA. However, the VA did not implement the 2016 law until 2018. After review of the 2018 employment standards, CAMFT remains very concerned given the substantial limitation for promotion of LMFTs within the VA without a COAMFTE-accredited degree. In late 2018, CAMFT met with the VA to discuss our concerns and develop a staffing plan to hire more LMFTs within the VA. CAMFT remains vigilant on finding alternative avenues to more LMFT employment within the VA.

Catherine L. Atkins, JD, is an attorney and the Deputy Executive Director at CAMFT.