Amended  IN  Assembly  April 06, 2017
Amended  IN  Assembly  March 20, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 700

Introduced by Assembly Member Jones-Sawyer

February 15, 2017

An act to amend Sections 11833 and 11834.27 of, and to add Chapter 7.7 (commencing with Section 11834.75) to Part 2 of Division 10.5 of, the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 700, as amended, Jones-Sawyer. Public health: alcoholism or drug abuse recovery: substance use disorder counseling.
Existing law provides for the licensure of adult alcoholism or drug abuse recovery or treatment facilities by the State Department of Health Care Services. Existing law provides the department the sole authority to determine the qualifications of personnel working within alcoholism or drug abuse recovery and treatment programs, as specified. Existing law requires an individual providing counseling services working within a program to be registered with, or certified by, a certifying organization approved by the department to register and certify counselors.
This bill would establish a career ladder and a recommended scope of practice for substance use disorder counseling, as defined, to be created and maintained and updated by the State Department of Health Care Services. The bill would establish classifications for substance use disorder (SUD) counselor certification or registration, as specified, to be implemented by the certifying organizations, as defined. The bill would require any person who engages in the practice of SUD counseling to be certified by, or registered with, a certifying organization, as specified. The bill would establish additional standards for registrants and interns, as specified, and impose additional requirements on SUD counselors, as specified. The bill would provide authority to the department to discipline a certificate holder or registrant under specified circumstances, as specified. The bill would authorize the department to implement these provisions by regulation. The bill would make conforming changes to related provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 (a) The Legislature finds and declares all of the following:
(1) Substance use disorders are a complex problem with biological, behavioral, and social dimensions. There are an estimated 3.5 million persons with diagnosable substance use disorders receiving treatment in more than 2,500 private or public alcohol and drug treatment programs throughout California.
(2) Substance use disorder (SUD) counselors serve a vulnerable population in California. In addition to professional counseling, treatment often includes medically assisted treatment and treatment for cooccurring disorders.
(3) In California, there are no uniform standards for counselor certification.
(4) The State Department of Health Care Services oversees certified SUD counselors and registrants indirectly through certain certifying organizations. However, each certifying organization currently has its own levels of education and experience required for certification or registration.
(5) A standardized career ladder would correct this problem by providing employers with what they need to hire SUD counselors or registrants with appropriate levels of education and experience.
(6) To address the changes in business practices and workforce standards required by substance use parity, and in order to integrate these services into the mainstream health care delivery system, the Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal Department of Health and Human Services released a report in September 2011 titled “Scopes of Practice and Career Ladder for Substance Use Disorder Counseling.” The SAMHSA report identifies a model career ladder for SUD counseling. Each category includes specific minimums for addiction studies education, supervised clinical experience, and the passing of an examination.
(b) Therefore, in enacting this act, it is the intent of the Legislature to do all of the following:
(1) Bring the state’s SUD counselor certification and registration requirements up to national standards, as updated to meet our state’s workforce needs.
(2) Protect Californians, consumers of addiction services, and families from complex, inconsistent SUD counselor certification and registration standards.
(3) Provide a single, consistent, standardized system of certification and registration that recognizes levels of higher education.
(4) Introduce a tiered system that protects the existing workforce, recognizes multiple levels of SUD counselor education and experience, and provides recommended scopes of practice a career ladder and supervision appropriate for each level.

SEC. 2.

 Section 11833 of the Health and Safety Code is amended to read:

11833.
 (a) The department shall have the sole authority in state government to determine the qualifications, including the appropriate skills, education, training, and experience of personnel working within alcoholism or drug abuse recovery and treatment programs licensed, certified, or funded under this part, consistent with Chapter 7.7 (commencing with Section 11834.75).
(b) (1) Except for licensed professionals, as defined by the department, the department shall require that an individual providing counseling services working within a program described in subdivision (a) be registered with or certified by a certifying organization approved by the department to register and certify counselors, consistent with Chapter 7.7 (commencing with Section 11834.75).
(2) The department shall not approve a certifying organization that does not, prior to registering or certifying an individual, contact other department-approved certifying organizations to determine whether the individual has ever had his or her registration or certification revoked.
(c) If a counselor’s registration or certification has been previously revoked, the certifying organization shall deny the request for registration and shall send the counselor a written notice of denial. The notice shall specify the counselor’s right to appeal the denial in accordance with applicable statutes and regulations.
(d) The department shall have the authority to conduct periodic reviews of certifying organizations to determine compliance with all applicable laws and regulations, including subdivision (c), and to take actions for noncompliance, including revocation of the department’s approval.
(e) (1) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time that regulations are adopted.
(2) The department shall adopt regulations by December 31, 2017, in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

SEC. 3.

 Section 11834.27 of the Health and Safety Code is amended to read:

11834.27.
 (a)  The department shall have the sole authority in state government to establish the appropriate minimum qualifications of the licensee or designated administrator, and the staff of a provider of any of the services specified in subdivision (a) of Section 11834.26. These qualifications may include, but not be limited to, education, skills, life experience, and training.
(b)  This section does not apply to credentialing or licensing of individuals or to certification qualifications established pursuant to Chapter 7 (commencing with Section 11830) or Chapter 7.7 (commencing with Section 11834.75).

SEC. 4.

 Chapter 7.7 (commencing with Section 11834.75) is added to Part 2 of Division 10.5 of the Health and Safety Code, to read:
CHAPTER  7.7. Scopes of Practice and Career Ladder for Substance Use Disorder Counseling: Registration and Certification

11834.75.
 For purposes of this chapter:
(a) “BPPE” means the Bureau for Private Postsecondary Education.
(b) “Certified addiction counselor intern” or “intern” means an uncertified person who has fulfilled the testing and education requirements in Section 11834.76 to become certified, who is seeking to meet the supervised experience requirements of this chapter, and is registered with an approved certifying organization for this purpose.
(c) “Certifying organization” means an organization approved to register or certify individuals as SUD counselors, as listed in Section 13035 of Title 9 of the California Code of Regulations. counselors in accordance with Section 11833.
(d) “Clinical supervision” means the ongoing process performed by a supervisor or monitoring the performance of one or more supervisees to ensure high-quality service delivery across domains of addiction counselor development, professional and ethical standards, program development, quality assurance, performance evaluation, and administration.
(e) “Clock hour” means 50 continuous minutes of instruction. Fifteen clock hours are equal to one semester unit of college credit or one and one-half quarter units of college credit.
(f) “Department” means the State Department of Health Care Services.
(g) “NCCA/ICE” means the National Commission for Certifying Agencies of the Institute for Credentialing Excellence.
(h) “Practicum” means a school or college course that is designed to give students supervised practical experience in previously studied theories of addiction treatment.
(i) “Programmatic accrediting organization” means an accreditation entity that is recognized by the Council for Higher Education Accreditation (CHEA) or the State of California, including, but not limited to, the California Association for Alcohol/Drug Education. California. Recognition by CHEA affirms that the standards and processes of the accrediting organization are consistent with the academic quality, improvement improvement, and accountability expectations that CHEA has established, including the eligibility standard that the majority of institutions or programs each accredits are degree-granting.
(j) “Regional accrediting organization” means an accreditation entity for higher education accreditation as recognized by the United States Department of Education and the Council for Higher Education Accreditation, including, but not limited to: Middle States Association of Colleges and Schools (Middle States Commission on Higher Education), New England Association of Schools and Colleges (Commission on Institutions of Higher Education and the Commission on Technical and Career Institutions), North Central Association of Colleges and Schools (Higher Learning Commission), Northwest Commission on Colleges and Universities, Southern Association of Colleges and Schools (Southern Association of Colleges and Schools Commission on Colleges), and Western Association of Schools and Colleges (Accrediting Commission for Community and Junior Colleges and Accrediting Commission for Senior Colleges and Universities).
(k) “Registrant” means an individual who has registered with one of the approved certifying organizations for purposes of providing substance use disorder counseling, and who is seeking to become certified as a SUD counselor.
(l) “Substance use disorder counseling” or “SUD” means and includes any or all of the following:
(1) Evaluating a person’s alcohol or other drug treatment or recovery needs, including screening prior to admission, intake, and assessment of need for services.
(2) Developing and updating a treatment or recovery plan.
(3) Implementing a treatment or recovery plan.
(4) Continuing assessment or treatment planning.
(5) Conducting individual counseling sessions, group counseling sessions, face-to-face interviews, or counseling for families, couples, and other individuals.
(6) Documenting counseling activities, assessments, treatment and recovery planning, clinical reports related to treatment provided, progress notes, discharge summaries, and all other client-related data.
(m) “Substance use disorder counselor” or “SUD counselor” means a person who is certified as an alcohol or other drug counselor by an approved certifying organization and who provides services or treatment at an adult alcoholism or drug abuse recovery or treatment facility.
(n) “TAP 21” means the “Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice,” Technical Assistance Publication Series 21 (TAP 21), published by the Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services, reprinted 2002. “TAP 21” means the nationally accepted, evidence-based standard for addiction studies education curriculum and means the educational foundation for California SUD counselor certification, pursuant to Chapter 8 (commencing with Section 13000) of Division 4 of Title 9 of the California Code of Regulations.

11834.76.
 Prior to certification as a SUD counselor, a certifying organization shall require each registrant to comply with the following:
(a) Complete a minimum of 315 documented hours of formal classroom SUD education, which shall include at least the following subjects:
(1) The curriculum contained in TAP 21. 21 related to clinical evaluation, treatment planning, referrals, service coordination, counseling, client, family, and community education, case management, and professional and ethical responsibilities.
(2) Provision of services to special populations, such as aging individuals, individuals with cooccurring disorders, such as alcoholism and mental illness, individuals with post-traumatic stress disorder (PTSD), individuals with disabilities, diverse populations, individuals with cultural differences, or individuals on probation or parole.
(3) Ethics.
(4) Communicable diseases, including tuberculosis, HIV disease, and hepatitis C.
(5) Prevention of sexual harassment.
(b) Complete a minimum of 250 documented hours of supervised SUD training based on the curriculum contained in TAP 21 field work based on specified curriculum and supervised on-site onsite by a SUD counselor. As used in this subdivision, “supervised” means that the individual supervising the training shall do both of the following:
(1) Be physically present and available on site onsite or at an immediately adjacent site, but not necessarily in the same room at all times.
(2) Document in the registrant’s record that the registrant has completed the supervised training required by this subdivision.
(c) Complete an additional 2,080 or more documented hours (dependent on level of certification) of paid or unpaid supervised work experience or internship providing counseling services in a SUD program prior to, after, or at the same time as completion of the education required in subdivision (a) and the supervised SUD training required in subdivision (b).
(d) Obtain a score of at least 70 percent on a written or oral examination approved by the certifying organization.
(e) Sign a statement documenting whether his or her prior certification as a SUD counselor has ever been revoked.
(f) Sign an agreement to abide by the certifying organization’s code of conduct.

11834.765.
 Registration shall be renewed annually until certification is complete. A registrant has five years from the date of registration with a certifying organization to become certified.

11834.766.
 In addition to any other requirement imposed by any other regulation or this chapter, a certified addiction counselor intern may conduct substance use disorder counseling under this chapter, and meet his or her documented hour requirements under Section 11834.76, if subject to clinical supervision.

11834.767.
 A SUD counselor shall additionally comply with the following requirements:
(a) Biennially complete a minimum of 40 hours of continuing education in addiction specific addiction-specific topics, of which nine hours shall include addiction specific addiction-specific laws and ethics.
(b) Receive a passing score on a an NCCA/ICE-approved or nationally recognized addiction counseling examination as approved by the department.
(c) (1) Possess an earned degree in addiction counseling, psychology, social work, counseling, marriage and family therapy, counseling psychology, clinical psychology, human services, anthropology, biology, physiology, education, management, business administration, counseling, nursing, medicine, pharmacology, public health, sociology, criminal justice, kinesiology, jurisprudence, or other clinically focused major or an equivalent degree recognized by the certifying organization.
(A) Paragraph (1) includes all degrees that lead to clinical licenses.
(B) Innovative, cross-disciplinary fields, such as social ecology, may be accepted under paragraph (1) after examination of course content.
(2) The degree described under paragraph (1) shall be from an institution of higher learning accredited by a regional accrediting organization, a programmatic accrediting organization, or a BPPE-approved degree-granting institution that had a BPPE-approved addiction studies degree-granting program in place as of January 1, 2015.
(d) (1) Complete TAP 21 education, as follows:
(A) Complete 315 clock hours (or 21 semester units) of addiction specific addiction-specific education based on the TAP 21.
(B) Complete a supervised practicum of no less than 250 hours performed in an addiction treatment setting. The practical experience shall include the TAP 21 practice dimensions demonstrating the application of knowledge and skills in a practice setting essential to professional addiction counseling.
(C) Complete a supervised internship performed in an addiction treatment setting. The practical experience shall include the TAP 21 practice dimensions demonstrating the application of knowledge and skills in a practice setting essential to professional addiction counseling.
(2) For subparagraphs (B) and (C) of paragraph (1), the applicant shall provide proof of completion to the certifying organization, including a summary of hours completed with an original signed letter from the clinical supervisor.

11834.77.
 (a) There is hereby further established a career ladder and a recommended scope of practice for substance use disorder counseling, as set forth in this section. The career ladder shall be created, maintained, maintained and updated by the department, as necessary, in conformance with the requirements set forth in this section.
(b) The following classifications shall be established for SUD counselor certification in this state:
(1) Certified Addiction Counselor 5 (CAC 5).
(2) Certified Addiction Counselor 4 (CAC 4).
(3) Certified Addiction Counselor 3 (CAC 3).
(4) Certified Addiction Counselor 2 (CAC 2).
(5) Certified Addiction Counselor 1 (CAC 1).
(6) Certified Addiction Counselor (CAC).
(c) (1) The CAC 5 shall meet all of the following requirements:
(A) Have a doctorate degree in addiction studies or related discipline or have a medical degree.
(B) Meet the minimum education requirements for the CAC.
(C) Have 3,000 hours of post-doctoral postdoctoral or equivalent supervised work experience.

(2)The scope of practice of a CAC 5 may include any or all of the following:

(A)Clinical evaluation, treatment planning, referrals, education, documentation, service coordination and case management, counseling, psychoeducation, and services for cooccurring mental health disorders.

(B)Individual or group counseling.

(3)

(2) The CAC 5 may engage in private practice if he or she also holds a license under Division 2 (commencing with Section 500) of the Business and Professions Code.
(d) (1) The CAC 4 shall meet all of the following requirements:
(A) Have a master’s degree in addiction studies or related discipline.
(B) Meet the minimum education requirements for the CAC.
(C) Have 3,000 hours of post-master’s supervised work experience.

(2)The scope of practice of a CAC 4 may include any or all of the following:

(A)Clinical evaluation, treatment planning, referrals, education, documentation, service coordination and case management, counseling, psychoeducation, and services for cooccurring mental health disorders.

(B)Individual or group counseling.

(3)

(2) The CAC 4 may engage in private practice if he or she also holds a license under Division 2 (commencing with Section 500) of the Business and Professions Code.
(e) (1) The CAC 3 shall meet all of the following requirements:
(A) Have a bachelor’s degree in addiction studies or a related degree.
(B) Meet the minimum education requirements for the CAC.
(C) Have 2,080 hours of supervised work experience.

(2)The scope of practice of a CAC 3 may include any or all of the following:

(A)Screenings, brief interventions, referrals, treatment planning, education, documentation, service coordination, case management, and psychoeducation.

(B)Individual or group addiction counseling.

(3)

(2) The CAC 3 may not engage in private practice.
(f) (1) The CAC 2 shall meet all of the following requirements:
(A) Have an associate’s degree in addiction studies or related discipline.
(B) Meet the minimum education requirements for the CAC.
(C) Have 2,080 hours of supervised work experience.

(2)The scope of practice of a CAC 2 may include any or all of the following:

(A)Screenings, brief interventions, referrals, treatment plan monitoring, education, service coordination, case management, and psychoeducation.

(B)Individual or group addiction counseling.

(3)

(2) The CAC 2 may not engage in private practice.
(g) (1) The CAC 1 shall meet all of the following requirements:
(A) Have a high school degree or GED.
(B) Have a 39-unit community college certificate in addiction studies from a chancellor approved chancellor-approved program in a regionally accredited college, which includes the minimum education requirements for a CAC.
(C) Have 2,080 hours of supervised work experience.

(2)The scope of practice of a CAC 1 may include screening, pyschoeducation, participation in treatment planning and documentation, and case management.

(3)

(2) The CAC 1 may not engage in private practice.
(h) (1) The CAC shall meet both of the following requirements:
(A) Have a high school degree or GED.
(B) Have 315 clock hours (21 units) of addiction studies education.
(C) Have 6,000 hours of supervised work experience.

(2)The scope of practice of a CAC may include screening, pyschoeducation, participation in treatment planning and documentation, and case management.

(3)

(2) The CAC may not engage in private practice.

11834.78.
 (a) Any person who engages in the practice of substance use disorder counseling shall be certified by, or registered with, a certifying organization pursuant to the categories established pursuant to Section 11834.77, including registrants and interns.
(b) Each certifying organization shall establish an application process to implement the requirements established under this chapter. Each certifying organization may establish a reasonable application fee for certification or registration at an amount that is sufficient to cover, but shall not exceed, the reasonable costs of implementing this chapter.
(c) (1) This section shall apply to individuals who first apply for certification or registration on and after January 1, 2018.
(2) This section shall only apply to a person who is currently certified by, or registered with, a certifying organization as of January 1, 2018, at the time of renewal of his or her certification or registration. At that time, the certifying organization shall determine which category of substance use disorder counseling the person is qualified to practice pursuant to Section 11834.77.

11834.79.
 The department has the authority to discipline a person who is certified or registered under this chapter consistent with the requirements and procedures set forth in Sections 13060 to 13070, inclusive, of Title 9 of the California Code of Regulations.

11834.795.
 (a) The department may adopt regulations to implement this chapter.
(b) When developing regulations, the department shall consider the TAP 21 standards for substance abuse counselors described in subdivision (n) of Section 11834.75.