Bill Text: HI SB1444 | 2024 | Regular Session | Amended
Bill Title: Relating To Mental Health.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2024-02-23 - The committee on CPN deferred the measure. [SB1444 Detail]
Download: Hawaii-2024-SB1444-Amended.html
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THE SENATE |
S.B. NO. |
1444 |
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THIRTY-SECOND LEGISLATURE, 2023 |
S.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO MENTAL HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
SECTION 1. The legislature finds that the State has repeatedly and consistently been recognized by the federal government as a health professional shortage area, meaning the State sorely lacks a sufficient number of mental health professionals, including psychiatrists, psychologists, social workers, marriage and family therapists, and mental health counselors having a focus on marriage and family life, to meet the overwhelming demand for these services in the State. These barriers to access create unnecessarily long wait times for appointments, causing many individuals, especially those individuals living in rural areas, to experience prolonged suffering or to choose not to seek any help at all. The result is a domino effect of mass losses in work force development, increased instances of abuse within families, statistically higher rates of substance abuse, and high debt loads.
Currently, associate-level practitioners who have completed rigorous educational and other professional development requirements are deemed capable of rendering professional services to clients seeking mental health treatment under licensed clinical supervision in order to complete the post‑degree, pre-license hours required for full licensure status. However, unlike many other professions and trades that have similar requirements, because no laws exist to allow for health insurance reimbursements of their services, almost all of these mental health professionals go unpaid for the lifechanging services that the professionals perform for residents of the State.
This flaw in regulatory oversight causes undue hardships on these individuals and their families as they are essentially forced to work one very difficult and taxing job for free and a second job to meet personal needs. Unfortunately, this model of living is unsustainable and causes too much homegrown talent to permanently move to one of the many other states in which insurance reimbursements are allowed.
Enabling and encouraging post-degree, pre-licensed mental health practitioners to remain in the State to complete the required hours of supervised work for full licensure will promote a diverse pool of homegrown providers that can best meet the needs of the people of Hawaii.
Accordingly, the purpose of this Act is to expand access to high quality mental health services by establishing provisional or associate-level licensure requirements and reimbursement allowances for certain mental health practitioners in training.
It is not the intent of the legislature to allow associate-level practitioners to perform acts that they are not currently permitted to perform, but to have their services billed through the insurance covering their supervisor's treatment and supervision.
PART II
SECTION 2. Chapter 451J, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
(1) Has
received from an accredited educational institution a master's or doctoral
degree in marriage and family therapy or an allied field related to the
practice of mental health counseling that includes, or is supplemented by,
graduate level course work comprising a minimum of thirty-three semester hours
or forty-four quarter hours in the following course areas:
(A) Marriage and family studies:
nine semester hours or twelve quarter hours;
(B) Marriage and family therapy studies: nine semester hours or twelve quarter hours;
(C) Human development: nine
semester hours or twelve quarter hours;
(D) Ethical and professional studies: three semester hours or four quarter hours;
and
(E) Research: three semester
hours or four quarter hours;
(2) Has
completed a one-year practicum that included three hundred hours supervised
client contact; and
(3) During
the period of time necessary to fulfill the requirements for licensure as a marriage
and family therapist pursuant to section 451J-7, engages in practice under the
clinical supervision of a licensed marriage and family therapist that is in
good standing.
(b)
Each provisional license issued pursuant to this section shall include
the name and title of each licensed marriage and family therapist described in
subsection (a)(3). The provisional
licensee or licensed associate marriage and family therapist shall only
practice marriage and family therapy under the direct supervision of the
licensed marriage and family therapist.
(c)
A provisional license issued pursuant to this section shall be valid for
one year from the date of issuance and may be renewed for an additional
one-year period if necessary to fulfill the requirements for licensure as a
marriage and family therapist pursuant to section 451J-7.
(d)
Services provided by a supervised licensed associate marriage and family
therapist shall be eligible for insurance reimbursement; provided that the
supervising licensed marriage and family therapist's services are eligible for
reimbursement as a contracted provider; provided further that the billed rate
for the licensed associate marriage and family therapist shall be commensurate
with the requisite level of training."
SECTION 3. Section 451J-1, Hawaii Revised Statutes, is amended as follows:
1. By adding a new definition to be appropriately inserted and to read:
""Associate
marriage and family therapist" or "licensed associate marriage and
family therapist" means a person who:
(1) Has completed all educational
requirements under section 451J- (a)(1);
(2) Has been issued a provisional
license under this chapter; and
(3) Is currently earning supervised clinical experience in marriage and family therapy under clinical supervision."
2. By amending the definition of "clinical
supervision" to read:
""Clinical
supervision" means the supervision of no more than six persons at the same
time who are acquiring and completing clinical experience in accordance with [section] sections 451J-7(2) and (3)[,] and 451J- (a)(3),
by a licensed marriage and family therapist whose license has been in good
standing in any state for two years preceding commencement and during the term
of supervision, or any licensed mental health professional whose license has
been in good standing in any state and who has been a clinical member in good
standing of the association for the two years preceding commencement and during
the term of supervision. Clinical
supervision includes but is not limited to case consultation of the assessment
and diagnosis of presenting problems, development and implementation of
treatment plans, and the evaluation of the course of treatment. Clinical supervision may include direct
observation by the qualified supervisor of the provision of marriage and family
therapy services."
3. By deleting the definition of "marriage and family therapy intern".
[""Marriage and family
therapy intern" means a person who has completed all educational
requirements stipulated in section 451J-7(1)(A) and who is currently earning
supervised clinical experience in marriage and family therapy under clinical
supervision."]
SECTION 4. Section 451J-3, Hawaii Revised Statutes, is amended to read as follows:
"§451J-3 Powers and duties of the director. In addition to any other powers and duties authorized by law, the director may:
(1) Examine and
approve the qualifications of all applicants under this chapter, and issue a
license to each successful applicant granting permission to use the title of
marriage and family therapist [or], licensed
marriage and family therapist, associate marriage
and family therapist, or licensed associate marriage and family therapist in this State pursuant to this
chapter and the rules adopted under this chapter;
(2) Adopt, amend, or repeal rules pursuant to chapter 91;
(3) Administer, coordinate, and enforce this chapter and rules;
(4) Discipline a
person licensed as a marriage and family therapist or
associate marriage and family therapist for any cause described by this
chapter, or for any violation of rules, or refuse to license a person for
failure to meet licensing requirements or for any cause that would be grounds
for disciplining a licensed marriage and family therapist[;]
or licensed associate marriage and family therapist; and
(5) Appoint an advisory committee of licensed marriage and family therapists and members of the public to assist with the implementation of this chapter and the rules; except that the initial members of the committee who are marriage and family therapists shall not be required to be licensed pursuant to this chapter."
SECTION 5. Section 451J-5, Hawaii Revised Statutes, is amended to read as follows:
"§451J-5 Prohibited acts. Except as
specifically provided elsewhere in this chapter, no person shall use the title
marriage and family therapist [or], licensed
marriage and family therapist, associate marriage
and family therapist, or licensed associate marriage and family therapist without first having secured a
license under this chapter. The
department shall investigate and prosecute any individual using the title of
marriage and family therapist [or], licensed
marriage and family therapist, associate marriage and family therapist, or
licensed associate marriage and family therapist without being
properly licensed as a marriage and family therapist[.]
or associate marriage and family therapist. Any person who violates this section
shall be subject to a fine of not more than $1,000 per violation. Each day's violation shall be deemed a
separate offense. Any action taken to
impose or collect the fine imposed under this section shall be a civil action."
SECTION 6. Section 451J-6, Hawaii Revised Statutes, is amended to read as follows:
"§451J-6 Exemptions. (a) Licensure shall not be required of:
(1) A person doing
work within the scope of practice or duties of the person's profession that
overlaps with the practice of marriage and family therapy; provided the person
does not purport to be a marriage and family therapist [or], licensed
marriage and family therapist[;], associate
marriage and family therapist, or licensed associate marriage and family
therapist; or
(2) Any student
enrolled in an accredited educational institution in a recognized program of
study leading toward attainment of a graduate degree in marriage and family
therapy or other professional field; provided that the student's activities and
services are part of a prescribed course of study supervised by the educational
institution and the student is identified by an appropriate title including but
not limited to "marriage and family therapy student or trainee",
"clinical psychology student or trainee", "clinical social work
student or trainee", or any title [which] that clearly
indicates training status[; or
(3) Any individual
who uses the title marriage and family therapy intern for the purpose of
obtaining clinical experience in accordance with section 451J-7(3)].
(b)
Nothing in this chapter shall be construed to prevent qualified members
of other licensed professions as defined by any law, rule, or the department,
including but not limited to social workers, psychologists, registered nurses,
or physicians, from doing or advertising that they assist or treat individuals,
couples, or families consistent with the accepted standards of their respective
licensed professions; provided that no person, unless the person is licensed as
a marriage and family therapist[,] or
associate marriage and family therapist, shall use the title of
marriage and family therapist [or], licensed
marriage and family therapist[.], associate
marriage and family therapist, or licensed associate marriage and family
therapist."
SECTION 7. Section 451J-9, Hawaii Revised Statutes, is amended to read as follows:
"[[]§451J-9[]]
Licensure fees. Licenses
shall be valid for three years and shall be renewed triennially[.]; provided that provisional licenses shall be
renewed pursuant to section 451J- . Any applicant for renewal of a license
that has expired within one year of the renewal deadline shall be required to
pay a restoration fee in addition to all renewal fees."
SECTION 8. Section 451J-10, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) [Licenses] Except as provided in
section 451J- , licenses shall be renewed triennially on
or before December 31, with the first renewal deadline occurring on December
31, 2001. Failure to renew a license
shall result in a forfeiture of the license.
Licenses that have been forfeited may be restored within one year of the
expiration date upon payment of renewal and restoration fees, and in the case of marriage and family therapists or
licensed marriage and family therapists
audited pursuant to subsection (f), documentation of continuing education
compliance. Failure to
restore a forfeited license within one year of the date of its expiration shall
result in the automatic termination of the license. Persons with terminated licenses shall be
required to reapply for licensure as a new applicant."
SECTION 9. Section 451J-12, Hawaii Revised Statutes, is amended to read as follows:
"[[]§451J-12[]]
Confidentiality and privileged communications. No person licensed as a marriage and family
therapist[,] or associate marriage and family
therapist, nor any of the person's employees or associates, shall be
required to disclose any information that the person may have acquired in
rendering marriage and family therapy services except in the following
circumstances:
(1) As required by law;
(2) To prevent a clear and immediate danger to a person or persons;
(3) In the course of a civil, criminal, or disciplinary action arising from the therapy where the therapist is a defendant;
(4) In a criminal proceeding where the client is a defendant and the use of the privilege would violate the defendant's right to a compulsory process of the right to present testimony and witnesses in the defendant's own behalf;
(5) In accordance with the terms of a client's previously written waiver of the privilege; or
(6) Where more than one person in a family jointly receives therapy and each family member who is legally competent executes a written waiver; in that instance, a marriage and family therapist or associate marriage and family therapist may disclose information received from any family member in accordance with the terms of the person's waiver."
SECTION 10. Section 451J-13, Hawaii Revised Statutes, is amended to read as follows:
"[[]§451J-13[]]
Therapist prohibited from testifying in alimony and divorce actions. If both parties to a marriage have obtained
marriage and family therapy by a licensed marriage and family therapist[,]
or licensed associate marriage and family therapist, the therapist shall
be prohibited from testifying in an alimony or divorce action concerning
information acquired in the course of therapy.
This section shall not apply to custody actions whether or not part of a
divorce proceeding."
SECTION 11. Chapter 453D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§453D- Provisional license; associate mental
health counselor; services reimbursable.
(a) The department shall grant, upon application
and payment of proper fees, provisional licensure as an associate mental health
counselor to an individual who:
(1) Has
received from an accredited educational institution a master's or doctoral
degree in counseling or in an allied field related to the practice of
mental health counseling that includes, or is supplemented by, graduate level
course work in counseling comprising a minimum of forty-eight semester hours or
seventy-two quarter hours in the following course areas, with a minimum of
three semester hours or five quarter hours in each course area as indicated
below:
(A) Human growth and development,
including the study of life span development; strategies to facilitate that
development and transitions; theories of learning and personality development;
and human behavior to include crisis, disabilities, addictive behavior, and
environmental factors;
(B) Social and cultural foundations,
including the study of issues and trends in a multicultural and diverse
society, including ages; races; religious or sexual preferences; physical
disabilities; ethnicities and cultures; genders; socioeconomics; intellectual
abilities; and individual, family, and group strategies of diverse groups;
(C) Counseling theories and
applications, including counseling and consultation, including both individual
and systems perspectives; interviewing; assessment; and counseling skills; and
applying principles, methods, and theories of counseling, treatment and
counseling of mental and emotional disorders, and educational techniques aimed
at preventing these disorders with individuals and families;
(D) Group theory and practice, including
principles of group dynamics, group process, group leadership styles, theories
and methods of group counseling, and the application of theory to the group
processes;
(E) Career and lifestyle development,
including the study of vocational development theories; decision-making models;
assessment instruments; and techniques, types, sources, and uses of
occupational and educational information systems, career development
applications, and career counseling processes, techniques, and resources;
(F) Appraisal of human behavior,
including assessment and diagnosis of disorders with an emphasis on the
Diagnostic and Statistical Manual of Mental Disorders' categories and an
understanding of these disorders relative to the counseling context;
(G) Tests and measurements, including
theoretical and historical bases for assessment techniques, and assessment
methods, including analysis of various types of tests to select, administer,
interpret, and use assessment and evaluation instruments and techniques in
counseling;
(H) Research and program evaluation,
including research design and methods, statistical analysis, principles,
practices, and application of needs assessment and program evaluation;
(I) Professional orientation and ethics,
including the history of the helping profession, professional roles and
functions, ethical standards, confidentiality, professional organizations, and
public policy process, including advocacy on behalf of the profession and its
clientele; and
(J) At least two academic terms of supervised
mental health practicum intern experience for graduate credit of at least six
semester hours or ten quarter hours in a mental health counseling setting, with
a total of three hundred hours of supervised client contact; provided that the
practicum experience shall be completed under the clinical supervision of a
person who is licensed as a mental health counselor, psychologist, clinical
social worker, advanced practice registered nurse with a specialty in mental
health, marriage and family therapist, or physician with a specialty in
psychiatry; and
(2) During the period of time necessary to fulfill the
requirements for licensure as a mental health counselor pursuant to section
453D-7, engages in practice under the clinical supervision of a
licensed mental health counselor that is in good standing.
(b)
Each provisional license issued pursuant to this section shall include
the name and title of the licensed mental health counselor or therapists
described in subsection (a)(2). The
provisional licensee or licensed associate mental health counselor shall only
practice mental health counseling under the direct supervision of the licensed
mental health counselor or therapist.
(c)
A provisional license issued pursuant to this section shall be valid for
one year from the date of issuance and may be renewed for an additional
one-year period if necessary to fulfill the requirements for licensure as a
mental health counselor pursuant to section 453D-7.
(d)
Services provided by a supervised licensed associate mental health
counselor shall be eligible for insurance reimbursement; provided that the
supervising licensed mental health counselor's services are eligible for
reimbursement as a contracted provider; provided further that the billed rate
for the licensed associate mental health counselor shall be commensurate with
the requisite level of training."
SECTION 12. Section 453D-1, Hawaii Revised Statutes, is amended as follows:
1. By adding a new definition to be appropriately inserted and to read:
""Associate
mental health counselor" or "licensed associated mental health
counselor" means a person who:
(1) Has completed all education
requirements under section 453D- (a)(1);
(2) Has been issued a provisional
license under this chapter; and
(3) Is currently earning supervised
clinical experience in mental health counseling."
2. By amending the definition of "clinical supervision" to read:
""Clinical
supervision" means supervision applied to all individuals who are gaining
the experience required for a license as a mental health counselor[.] or associate mental health counselor. "Clinical supervision" includes but
is not limited to:
(1) Case consultation on the assessment and presenting problem;
(2) Development and implementation of treatment plans;
(3) Enhancement of the supervisee's counseling techniques and treatment evaluation skills; and
(4) Evaluation of the course of treatment."
SECTION 13. Section 453D-3, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-3[]] Powers
and duties of the director. In
addition to any other powers and duties authorized by law, the director shall
have the powers and duties to:
(1) Grant permission to a person to use the title of "licensed mental health counselor" or "licensed associate mental health counselor" or a description indicating one is a licensed mental health counselor or licensed associate mental health counselor in this State pursuant to this chapter and the rules adopted pursuant thereto;
(2) Adopt, amend, or repeal rules pursuant to chapter 91 as the director finds necessary to carry out this chapter;
(3) Administer, coordinate, and enforce this chapter;
(4) Discipline a licensed mental health counselor or licensed associate mental health counselor for any due cause described by this chapter or violation of the rules;
(5) Refuse to license
a person for failure to meet licensing requirements or on grounds sufficient to
discipline a licensed mental health counselor[;]
or licensed associate mental health
counselor; and
(6) Appoint an advisory committee consisting of licensed mental health counselors and members of the public to assist with the implementation of this chapter and adopted rules; provided that the initial members of the committee who are mental health counselors shall not be required to be licensed pursuant to this chapter."
SECTION 14. Section 453D-5, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-5[]]
Prohibited acts. Except as
specifically provided in this chapter, no person shall engage in the practice
of mental health counseling or use the title of "licensed mental health
counselor" [or], "mental health
counselor", "licensed associate mental health counselor", or
"associate mental health counselor" without a valid license
issued under this chapter. Any person
who violates this section shall be subject to a fine of not more than $1,000
for each separate offense. Each day of
each violation shall constitute a separate offense. Any action taken to impose or collect the fine
imposed under this section shall be a civil action."
SECTION 15. Section 453D-6, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) This chapter shall not apply to:
(1) A person doing work within the
duties of the person's profession that overlaps with the practice of mental
health counseling; provided that no [such] person shall use a title
stating or implying that the person is a "licensed
mental health counselor" [or], "mental health counselor", "licensed
associate mental health counselor", or "associate mental health
counselor" or describe or refer to the
person's services as mental health counseling;
(2) Any person who is a duly
recognized member of the clergy; provided that the person functions only within
the person's capacity as a member of the clergy; [and] provided further
that the person does not represent the person to be a "licensed mental health counselor" [or], "mental health counselor", "licensed
associate mental health counselor", or "associate mental health
counselor" or describe or refer to the
person's services as mental health counseling;
(3) Any student enrolled in an
accredited educational institution in a recognized program of study leading
towards attainment of a graduate degree in mental health counseling or other
professional field; provided that the student's activities and services are
part of a prescribed course of study supervised by the accredited educational
institution and the student is identified by an appropriate title, including
but not limited to "mental health
counseling student" or "trainee", "clinical psychology student" or "trainee", "social work student"
or "trainee", "marriage and
family counseling student" or
"trainee", or any title that clearly indicates training status;
[(4) Any individual who uses the
title of "mental health counselor intern" for the purpose of
obtaining clinical experience in accordance with section 453D‑7(a)(2);
(5)] (4) Any person
employed by a federal, state, or county government agency in a counseling
position, but only at those times when the employee is carrying out the duties
and responsibilities as a counselor in governmental employment; or
[(6)] (5)
Any person who is obtaining supervised clinical experience for licensure
as a psychologist, social worker, marriage and family therapist, or as another
licensed professional; provided that the person's title indicates a trainee or
intern status; and provided further that the person does not purport to be a "licensed mental health counselor" [or], "mental health counselor"[.], "licensed
associate mental health counselor", or "associate mental health
counselor"."
SECTION 16. Section 453D-10, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-10[]]
Licensure; fees. A license
shall be issued to a person deemed to be qualified under [section] sections
453D-7 or 453D- upon the payment of a license fee to
be determined by the department and shall be valid for three years[.];
provided that provisional licenses shall be renewed pursuant to section
453D- ."
SECTION 17. Section 453D-11, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-11[]]
Renewal of license; fees. [Licenses] Except as
provided in section 453D- , licenses shall be renewed, upon the payment of a renewal fee, triennially not
earlier than ninety days before June 30, with the first renewal deadline
occurring on June 30, 2008. Failure to
renew a license shall result in a forfeiture of the license. Licenses that have been forfeited may be
restored within one year of the expiration date upon payment of renewal and
restoration fees. Failure to restore a
forfeited license within one year of the date of its expiration shall result in
the automatic termination of the license and the person may be required to
reapply for licensure as a new applicant.
All renewal and restoration fees shall be determined by the
department."
SECTION 18. Section 453D-13, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-13[]]
Confidentiality and privileged communications. No person licensed as a mental health
counselor[,] or associate mental health counselor, nor any of the
person's employees or associates, shall be required to disclose any information
that the person may have acquired in rendering mental health counseling
services, except in the following circumstances:
(1) As required by law;
(2) To prevent a clear and imminent danger to a person or persons;
(3) In accordance with the terms of a previously written waiver of the privilege where the waiver is executed by the client or by the client's legally recognized representative;
(4) Where more than one person jointly receives counseling and each person who is legally competent executes a written waiver. In that instance, a mental health counselor or associate mental health counselor may disclose information from any person in accordance with that person's waiver; or
(5) In the course of a disciplinary action or pursuant to a duly authorized subpoena issued by the department."
SECTION 19. Section 453D-14, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453D-14[]]
Mental health counselor or associate mental health counselor
prohibited from testifying in alimony and divorce actions. If both parties to a marriage have obtained
mental health counseling from a licensed mental health counselor[,] or
licensed associate mental health counselor, the counselor shall be
prohibited from testifying in an alimony or divorce action concerning
information acquired in the course of mental health counseling. This section shall not apply to custody
actions whether or not part of a divorce proceeding."
PART IV
SECTION 20. Chapter 465, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§465- Provisional
license; associate psychologist; services reimbursable. (a) The board shall grant, upon
application and payment of proper fees, provisional licensure as an associate
psychologist to an individual who:
(1) Has received a
doctoral degree from:
(A) An
American Psychological Association-approved program in clinical psychology,
counseling psychology, school psychology, or programs offering combinations of
two or more of these areas; or
(B) A
professional psychology training program provided by an institution of higher
education or from a regionally accredited institution; and
(2) Is engaging in
post-doctoral, supervised experience in health service psychology pursuant to
an organized health service training program approved by the board.
(b) Each provisional license issued pursuant to
this section shall include the name and title of the supervising licensed
psychologist or psychologists in the training program described in subsection
(a)(2). The provisional licensee or
licensed associate psychologist shall only practice psychology under the direct
supervision of the licensed psychologist having a current, active, and
unencumbered license issued by the board; provided that the
supervising licensed psychologist shall notify the board within ten days of the
termination or completion of the supervision.
(c) A provisional license issued pursuant to this
section shall be valid for one year to fulfill the requirements for full licensure
as a psychologist under section 465-7.
(d) Services provided by a supervised licensed
associate psychologist shall be eligible for insurance reimbursement; provided
that the supervising licensed psychologist's services are eligible for
reimbursement as a contracted provider; provided further that the billed rate
for the licensed associate psychologist shall be commensurate with the
requisite level of training."
SECTION 21. Section 465-1, Hawaii Revised Statutes, is amended by adding a new definition to be appropriately inserted and to read as follows:
""Associate psychologist" or "licensed associate psychologist" means a person who:
(1) Has completed
all educational requirements under section 465- (a)(1);
(2) Has been issued
a provisional license under this chapter; and
(3) Is currently
engaging in post-doctoral, supervised experience in health service in
psychology pursuant to an organized health service training program approved by
the board."
SECTION 22. Section 465-2, Hawaii Revised Statutes, is amended to read as follows:
"§465-2 License required. Except as otherwise provided in this chapter,
it shall be unlawful to represent [one's self] oneself as a
psychologist or associate psychologist or engage in the practice of
psychology without having first obtained a license as provided in this
chapter."
SECTION 23. Section 465-3, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) This chapter shall not apply to:
(1) Any person teaching, lecturing, consulting, or engaging in research in psychology insofar as the activities are performed as part of or are dependent upon employment in a college or university; provided that the person shall not engage in the practice of psychology outside the responsibilities of the person's employment;
(2) Any person who performs any, or any combination of the professional services defined as the practice of psychology under the direction of a licensed psychologist in accordance with rules adopted by the board; provided that the person may use the term "psychological assistant", but shall not identify the person's self as a psychologist or imply that the person is licensed to practice psychology;
(3) Any person
employed by a local, state, or federal government agency in a school
psychologist or psychological examiner position, or a position that does not
involve diagnostic or treatment services, but only at those times when that
person is carrying out the functions of [such] the government
employment;
(4) Any person who is
a student of psychology[, a psychological intern, or a resident in
psychology preparing for the profession of psychology under supervision in a
training institution or facility and who is designated by a title as
"psychology trainee", "psychology student",
"psychology intern", or "psychology resident", that
indicates the person's training status]; provided that the person shall not
identify the person's self as a psychologist or associate psychologist
or imply that the person is licensed to practice psychology;
(5) Any person who is a member of another profession licensed under the laws of this jurisdiction to render or advertise services, including psychotherapy, within the scope of practice as defined in the statutes or rules regulating the person's professional practice; provided that, notwithstanding section 465-1, the person does not represent the person's self to be a psychologist or associate psychologist or does not represent that the person is licensed to practice psychology;
(6) Any person who is
a member of a mental health profession not requiring licensure; provided that
the person functions only within the person's professional capacities; and
provided further that the person does not represent the person to be a
psychologist[,] or associate psychologist, or the person's
services as psychological;
(7) Any person who is
a duly recognized member of the clergy; provided that the person functions only
within the person's capacities as a member of the clergy; and provided further
that the person does not represent the person to be a psychologist[,] or
associate psychologist, or the person's services as psychological; or
(8) Any psychologist
employed by the United States Department of Defense, while engaged in the
discharge of the psychologist's official duty and providing direct telehealth
support or services, as defined in section 431:10A-116.3, to neighbor island
beneficiaries within a Hawaii National Guard armory on the island of Kauai,
Hawaii, Molokai, or Maui; provided that the psychologist employed by the United
States Department of Defense is credentialed by Tripler Army Medical Center[;
or
(9) Any supervisee
of a licensed psychologist as defined in section 465D‑7]."
SECTION 24. Section 465-3.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) Notwithstanding other provisions in this chapter, the director of health may certify that there is an absence or shortage of licensed psychologists or associate psychologists for government employment in a particular locality. Upon receiving certification of the absence or shortage, the board shall authorize the director to hire and retain persons currently in government employment to fill the absence or shortage; provided that persons hired or retained have been duly licensed as a psychologist by written examination under the laws of another state or territory of the United States prior to 1977."
SECTION 25. Section 465-6, Hawaii Revised Statutes, is amended to read as follows:
"§465-6 Powers and duties. In addition to any other powers and duties authorized by law, the board shall:
(1) Examine the
qualifications of applicants for licensing under this chapter to determine
their eligibility for licensing as psychologists[;] or associate psychologists;
(2) Administer and grade examinations for applicants as may be required for the purposes of this chapter. The board shall determine the examinations and the score that shall be deemed a passing score. Examinations shall be scheduled at least once annually;
(3) Keep a record of action taken on all applicants for licensing; the names of all persons licensed; petitions for temporary permits; actions involving suspension, revocation, or denial of licenses; decisions on waiver of examination in whole or in part and receipt and disbursal of any moneys; and
(4) Adopt, amend, and repeal pursuant to chapter 91, rules as it deems proper for the purposes of this chapter."
SECTION 26. Section 465-7, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) Every applicant for a license as a psychologist shall submit evidence satisfactory to the board that the applicant meets the following requirements:
(1) The applicant for licensure shall possess a doctoral degree from:
(A) An American Psychological Association approved program in clinical psychology, counseling psychology, school psychology, or programs offering combinations of two or more of these areas; or
(B) A professional psychology training program, awarded by an institution of higher education, or from a regionally accredited institution;
(2) The applicant for
licensure shall demonstrate that the applicant has completed one year of [post
doctoral] post-doctoral supervised experience in health service in psychology,
and:
(A) An internship approved by the American Psychological Association; or
(B) One year of supervised experience in health service in psychology, in an internship or residency program in an organized health service training program; and
(3) The applicant for
licensure has passed an examination as may be prescribed by the board."
SECTION 27. Section 465-7.6, Hawaii Revised Statutes, is amended to read as follows:
"§465-7.6 Licensure of state employed clinical psychologists. (a) A psychologist employed in a civil service clinical psychologist position in this State after January 1, 1988, shall be licensed subject to:
(1) Meeting the requirements of section 465-7; and
(2) Obtaining
licensure within two years from the date of employment[.];
provided that, if the psychologist is not able to
obtain licensure within two years, the board may grant a waiver if the
psychologist is able to demonstrate that the delay was caused by circumstances
beyond the psychologist's control.
(b)
[After] Absent a waiver obtained pursuant to subsection (a),
after the time period in subsection (a)(2) has expired, a psychologist,
employed in a civil service clinical psychologist position rendering diagnostic
or treatment services, who has not obtained a license, shall immediately cease
and desist the practice of psychology until a license is obtained pursuant to
this chapter."
SECTION 28. Section 465-8, Hawaii Revised Statutes, is amended to read as follows:
"§465-8 Licenses, issuance, display. Upon the board forwarding to the director the
name of each applicant who is entitled to a license under this chapter and upon
receipt of the prescribed fee, the director shall promptly issue to each
applicant a license authorizing the applicant to engage in the practice of
psychology for a period of two years.
The license shall be in the form as the director shall determine. A licensed psychologist or associate
psychologist shall display the license in a conspicuous place in the
psychologist's or associate psychologist's principal place of business[.];
provided that a provisional license shall include the name and title of the
supervising licensed psychologist or psychologists."
SECTION 29. Section 465-11, Hawaii Revised Statutes, is amended by amending subsection (d) to read as follows:
"(d) First-time licensees and provisional licensees pursuant to section 465- shall not be subject to the continuing education requirement established under subsection (c)(2) for the first license renewal."
SECTION 30. Section 465-15, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) No person shall:
(1) Use in connection with the person's name any designation tending to imply that the person is a licensed psychologist or licensed associate psychologist unless the person is duly licensed and authorized under this chapter;
(2) Represent oneself as a licensed psychologist or licensed associate psychologist during the time the person's license issued under this chapter is suspended or revoked;
(3) Advertise or make
a representation, either publicly or privately, as being a psychologist[,]
or associate psychologist, licensed or otherwise, or as being able to
perform professional services described in section 465-1, except as
otherwise provided in this chapter, without having a valid unrevoked license or
temporary permit issued by the director; or
(4) Otherwise violate this chapter."
PART V
SECTION 31. Section 467E-7, Hawaii Revised Statutes, is amended to read as follows:
"§467E-7 Licensing requirements[.]; services
reimbursable. (a) Every applicant for a license as a social
worker shall submit evidence satisfactory to the director that the applicant
meets the following requirements:
(1) For the licensed bachelor social worker, the applicant:
(A) Holds a bachelor's degree from a college or university in a social work program accredited by or deemed to be equivalent to a program accredited by the Council on Social Work Education; and
(B) Has passed the basic level national examination given by the Association of Social Work Boards;
(2) For the licensed social worker, the applicant:
(A) Holds a master's degree from a college or university in a social work program accredited by or deemed to be equivalent to an accredited program by the Council on Social Work Education or a doctoral degree from a doctoral degree program in social work accredited by the Western Association of Schools and Colleges or a comparable regional accreditation body; and
(B) Has passed the
intermediate or [higher level] higher-level national examination
given by the Association of Social Work Boards; and
(3) For the licensed clinical social worker, the applicant:
(A) Has met the educational requirements in paragraph (2);
(B) Has passed the clinical level national examination given by the Association of Social Work Boards;
(C) Has provided evidence of successful completion of at least three thousand hours of post masters clinical social work experience under supervision completed within no fewer than two years, but within no more than five years. Clinical social work experience shall include a minimum of two thousand hours of assessment, clinical diagnosis, and psychotherapy; no more than a maximum of nine hundred hours of client-centered advocacy, consultation, and evaluation; and at least one hundred hours of supervision as follows:
(i) At least sixty of the one hundred hours of direct face-to-face supervision shall have been individualized supervision; and
(ii) Not more than forty hours of direct face‑to‑face supervision may have been under small group (up to six supervisees) supervision.
An applicant who submits
evidence of certification as a qualified clinical social worker or diplomate in
clinical social work by the National Association of Social Workers or as a [board
certified] board-certified diplomate by the American Board of
Examiners shall be deemed to have satisfied the experience requirements of this
subparagraph;
(D) For the purposes of subparagraph (C), shall have had clinical supervision as follows:
(i) The supervisor shall have been a licensed clinical social worker with at least four thousand five hundred hours of post masters clinical social work experience;
(ii) For the first five years after July 1, 2004, the following individuals shall be deemed to have satisfied the requirements of a supervisor: a person with a master's degree in social work with at least four thousand five hundred hours post masters clinical social work experience; an individual who holds a diplomate in clinical social work or a board certified diplomate certification; or a board certified psychiatrist, psychologist, advanced practice registered nurse who has a minimum of four thousand five hundred hours of post masters clinical experience in assessment, clinical diagnosis, and psychotherapy; and
(iii) Supervision shall have included review of assessment, clinical diagnosis, and psychotherapy; and
(E) In collaboration with the supervisor, may elect to fulfill some or all of the supervision requirements set forth in subparagraph (C) through face-to-face supervision that is conducted electronically through a video conference service that is compliant with all federal and state privacy, security, and confidentiality laws, including the Health Insurance Portability and Accountability Act of 1996. Prior to making such an election, it is incumbent upon the applicant to review the laws and rules of other jurisdictions to determine the impact, if any, that electronic supervision may have on license by endorsement in other states.
(b) Services provided by a supervised licensed social worker or licensed social worker who is working to obtain post masters clinical social work experience under the supervision of a Hawaii licensed clinical social worker, or individual identified in subsection (a)(3)(D) to qualify for a license as a licensed clinical social worker, shall be eligible for insurance reimbursement through the insurance of the applicable client through reimbursements of claims submitted by the supervising licensed clinical social worker while listed under the supervising licensed clinical social worker's treatment authority and supervision; provided that the licensed supervising clinical social worker's services are eligible for reimbursement as a contracted provider; provided further that the billed rate for the supervised licensed social worker shall be commensurate with the requisite level of training."
PART VI
SECTION 32. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in Act 164, Regular Session of 2023, and this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ or per cent. This current declaration takes into account general fund appropriations authorized for fiscal year 2024-2025 in Act 164, Regular Session of 2023, and this Act only. The reasons for exceeding the general fund expenditure ceiling are that:
(1) The appropriation made in this Act is necessary to serve the public interest; and
(2) The appropriation made in this Act meets the needs addressed by this Act.
SECTION 33. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2024-2025 for the implementation of this Act; provided that:
(1) $ shall be used to establish, recruit, and hire an office assistant V to process provisional license applications; and
(2) $ shall be used to make appropriate updates to the department of commerce and consumer affairs internal database for the new license types and associated requirements.
The sum appropriated shall be expended by the department of commerce and consumer affairs for the purposes of this Act.
SECTION 34. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 35. This Act shall take effect upon its approval; provided that parts II, III, IV, and V of this Act shall take effect on July 1, 2026; provided further that any provision in this Act authorizing insurance reimbursement for services shall be subject to approval by the Centers for Medicare and Medicaid Services.
Report Title:
Department of Commerce and Consumer Affairs; Mental Health; Provisional Licensure; Marriage and Family Therapists; Mental Health Counselors; Psychologists; Licensed Clinical Social Workers; Insurance Reimbursement; Expenditure Ceiling; Appropriation
Description:
Establishes provisional or associate level licensure requirements for marriage and family therapists, mental health counselors, and psychologists and authorizes insurance reimbursements in certain circumstances. Declares that the general fund expenditure ceiling has been exceeded. Makes an appropriation. Parts II, III, IV, and V takes effect on 7/1/2026. (SD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
