Bill Text: HI SB2829 | 2022 | Regular Session | Introduced

Hawaii Senate Bill 2829 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Relating To Mental Health.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Engrossed - Dead) 2022-03-10 - Referred to HHH, CPC, FIN, referral sheet 24 [SB2829 Detail]

Download: Hawaii-2022-SB2829-Introduced.html

THE SENATE	S.B. NO.	2829
THIRTY-FIRST LEGISLATURE, 2022
STATE OF HAWAII

A BILL FOR AN ACT

relating to mental health.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that there is great demand for high quality mental health practitioners in the State, which is especially acute with the ongoing coronavirus disease 2019 pandemic and its associated hardships.

Accordingly, the purpose of this Act is to expand access to high quality mental health services by:

(1) Establishing provisional or associate-level licensure requirements and reimbursement allowances for certain mental health practitioners in training; and

(2) Allowing psychologist license applicants to sit for the licensing examination before completing other requirements.

PART I

SECTION 2. Chapter 451J, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§451J- Provisional license; associate marriage and family therapist; services reimbursable. (a) The department shall grant, upon application and payment of proper fees, provisional licensure as an associate marriage and family therapist to an individual who:

(1) Has completed a master's degree or doctoral degree from an accredited educational institution in marriage and family therapy or in 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;

(D) Ethical and professional studies--three semester hours or four quarter hours; and

(E) Research--three semester hours or four quarter hours;

(2) Has one-year practicum with three hundred hours supervised client contact;

(3) Engages in practice under the clinical supervision of a licensed marriage and family therapist during the period of time necessary to fulfill the necessary requirements for licensure as a marriage and family therapist pursuant to section 451J-7; provided that the licensed marriage and family therapist is in good standing with the department; and

(4) Has passed the National Marriage and Family Therapy Exam in accordance with section 451J-8.

(b) Each provisional license shall include the name and title of the licensed marriage and family therapist or therapists described in subsection (a)(3). A provisional licensee or licensed associate marriage and family therapist may 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 needed 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; and provided further that the billed rate for the licensed associate marriage and family therapist is 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 stipulated in 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 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 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."

PART II

SECTION 11. 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) 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; and

(2) Is engaging in post-doctoral supervised experience in health service psychology pursuant to an organized health service training program approved by the director.

(b) Each provisional license shall include the name and title of the supervising licensed psychologist or psychologists in the program described in subsection (a)(2). A provisional licensee or licensed associate psychologist may only practice psychology under the direct supervision of the licensed psychologist; provided that the licensed psychologist is in good standing with the department.

(c) A provisional license issued pursuant to this section shall be valid for two years from the date of issuance and may be renewed for an additional one-year period if needed 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; and provided further that the billed rate for the licensed associate psychologist is commensurate with the requisite level of training."

SECTION 12. 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 stipulated in 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 director."

SECTION 13. 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 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 14. 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 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 15. 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 16. 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 17. 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 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[.]; provided that the applicant shall not be required to complete the requirements of paragraph (2) before applying to sit for the examination."

SECTION 18. 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 can demonstrate the delay was caused by circumstances beyond their 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 19. 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 20. Section 465-11, Hawaii Revised Statutes, is amended as follows:

1. By amending subsection (a) to read:

"(a) Every license issued under this chapter shall be renewed biennially on or before June 30 of each even-numbered year. Failure to renew a license shall result in forfeiture of the license; provided that a psychologist whose license has been forfeited for one year or less for failure to renew may restore the license by payment of the renewal fee and, in the case of a psychologist who is audited, pursuant to subsection (g), submission of documentation of continuing education compliance, for the biennium in which the failure occurred[.]; provided further that the board may grant waivers or extensions if the licensee can demonstrate a delay was due to circumstances beyond their control. If licensing has lapsed for more than one year, the person may reapply for a license in the manner prescribed in this chapter."

2. By amending subsection (d) to read:

"(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 21. 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 license 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 III

SECTION 22. Section 467E-7, Hawaii Revised Statutes, is amended to read as follows:

"§467E-7 Licensing requirements[.]; insurance reimbursement. (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 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 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 social work intern obtaining post masters clinical social work experience under the supervision of a licensed clinical social worker or individual identified in section 467E-7(a)(3)(D) in order to qualify for a license as a licensed clinical social worker shall be eligible for insurance reimbursement; provided that the supervising licensed clinical social worker's services are eligible for reimbursement as a contracted provider; provided further that the billed rate for the social work intern is commensurate with the requisite level of training."

PART IV

SECTION 23. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 24. This Act shall take effect upon its approval; provided that any provision in this Act authorizing insurance reimbursement for services shall be subject to approval by the Centers for Medicare and Medicaid Services.

INTRODUCED BY:	_____________________________

Report Title:

Mental Health; Provisional Licensure; Marriage and Family Therapists; Psychologists; Licensed Clinical Social Workers; Insurance Reimbursement

Description:

Establishes provisional or associate level licensure requirements for marriage and family therapists and psychologists and authorizes insurance reimbursements in certain circumstances. Allows psychologist license applicants to sit for the licensing examination before completing other requirements.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.