Background:

Music therapists use musical interventions to achieve therapeutic goals by assessing an individual's functioning through response to music; designing music interventions and therapy sessions based on treatment goals, objectives, and the individual's needs; and evaluating and documenting treatment outcomes. Music therapists may practice as part of an interdisciplinary team that includes medical, mental health, occupational therapy, physical therapy, or educational professionals. Music therapists may work in hospitals, clinics, rehabilitative facilities, mental health centers, residential and day facilities, substance use disorder treatment facilities, correctional facilities, schools, or in private practice. Music therapists are not regulated in Washington.

In December 2012 the Department of Health issued a sunrise review related to a proposal to certify music therapists. In the review, the Department recognized the therapeutic benefit of music to address the cognitive, emotional, physical, social, or functional needs of clients, but found that the proposal did not meet the sunrise criteria to support certification.

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Summary of Amended Bill:

Music therapists are created as a new health profession to be regulated by the Secretary of Health (Secretary). Beginning January 1, 2021, to practice music therapy, one must hold a certificate issued by the Secretary. To receive a certificate to practice music therapy, an applicant must pay a fee; be at least 18 years old; hold a bachelor's degree or higher in music therapy from a program approved by the Secretary; have completed a minimum of 1,200 hours of clinical training, including at least 180 hours in preinternship experience and at least 900 hours in internship experience; and pass an examination approved by the Secretary. In addition, if the applicant is a credentialed music therapist in another jurisdiction, the applicant must be in good standing in that jurisdiction. Alternatively, an applicant may receive a certificate if the applicant is credentialed in good standing in another jurisdiction where the qualifications are equal to or greater than those in Washington.

"Music therapy" is defined as the clinical and evidence-based use of music interventions to accomplish individualized goals for people within a therapeutic relationship. Music therapy interventions may include music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music. Music therapy does not include the screening, diagnosis, or assessment of any physical, mental, or communication disorder. Music therapy may include:

accepting referrals for music therapy services;
conducting a music therapy assessment of a client to determine if treatment is indicated;
developing an individualized music therapy treatment plan that is based on the music therapy assessment;
implementing an individualized music therapy treatment plan;
evaluating the client's response to music therapy and the music therapy treatment plan;
developing a plan for determining when music therapy services are no longer needed;
minimizing barriers to provide services in the least restrictive environment;
collaborating with and educating the client and the family on the needs of the client that are being addressed in music therapy; and
determining the appropriate actions for each specific clinical setting.

Beginning January 1, 2021, a person may not use the title "music therapist" if the person is not certified as a music therapist. Exemptions from certification requirements are established for: (1) persons credentialed in another profession that uses music incidental to the practice of that profession; (2) persons whose training and certification attest to the person's preparation and ability to practice the person's certified profession; (3) the practice of music therapy by students enrolled in an accredited music therapy program; or (4) persons who practice music therapy under the supervision of a certified music therapist.

Music therapists are subject to the Uniform Disciplinary Act. Health carriers are not required to contract with music therapists.

The Music Therapy Advisory Committee (Committee) is established. The Secretary shall appoint the five members of the Committee. The Committee is comprised of three music therapists who practice in Washington, one licensed health care provider other than a music therapist, and a person who is or has been in a therapeutic relationship with a music therapist. The Committee may facilitate the development of materials to educate the public concerning music therapist certification, the benefits of music therapy, and use of music therapy by individuals and in facilities or institutional settings. The Committee may facilitate the statewide dissemination of information between music therapists, the American Music Therapy Association, the Certification Board for Music Therapists, and the Secretary. The Committee shall analyze disciplinary actions taken, appeals and denials, or revocations of certificates at least annually. The Secretary must consult with the Committee prior to setting or changing fees and seek its advice on issues related to music therapy.

Statements of legislative intent are made related to recognizing that music therapy affects public health, safety, and welfare; assuring professional conduct by music therapists; guaranteeing the availability of music therapy services by qualified professionals; and protecting the public from the practice of music therapy by unqualified individuals.

Amended Bill Compared to Engrossed Substitute Bill:

The amended bill changes music therapists from a licensed profession to a certified profession. Health carriers are not required to contract with music therapists.

The amended bill removes the requirement that music therapists pass the examination of the Certification Board for Music Therapists and instead requires that they pass an examination approved by the Secretary of Health (Secretary). The Secretary may approve an examination prepared or administered by a private testing agency or association of licensing agencies. The requirement that music therapists show proof of certification with the Certification Board for Music Therapists is removed.

The amended bill replaces the requirement that the American Music Therapy Association approve education programs and internships with the Secretary approving programs and internships based upon nationally recognized standards.

The amended bill specifies that the practice of music therapy does not include screening. Music therapists must review the client's diagnosis and treatment plan with any health care provider involved in the client's care, not just a primary care provider. Prior to providing services to a student for an education need, a music therapist must review the student's diagnosis, treatment needs, and treatment plans with the individual family service plan team or individualized education program plan. Music therapists must collaborate and review the music therapy treatment plan with the client's audiologist or speech-language pathologist.

Staff Summary of Public Testimony:

(In support) Music therapy is an important facet of the health care delivery system that looks at brain development and redevelopment. Music therapists identify safe and effective musical inputs for clients by understanding how the brain processes music and may affect behavior or moods. Music therapy is an interactional process between a music therapist and a client to work directly on a client's goals. This bill is about improving services for people with conditions like autism, Parkinson's disease, traumatic brain injury, dementia, or post-traumatic stress disorder. The bill will recognize the clinical value of music therapy. The state's failure to license music therapy casts doubt on the profession and forces practitioners to spend their time educating people about music therapy rather than seeing clients.

Music therapists are highly trained musicians that have completed courses in psychology, anatomy, and physiology, as well as core classes such as music in medicine. This bill ensures that those who present themselves as music therapists are trained, equipped, held to high standards of ethics and professional practice, and able to demonstrate competency. Music therapists work alongside other professionals to provide their mutual clients with optimal benefits. This bill does not intend to replace the work of other health professionals, but to help clients by creating easier access to music therapy.

This bill supports access to music therapy services and public protection by distinguishing music therapy from the generalized use of music. A state license for music therapy will support families who specifically want access and confidence in the high standards and ethics in the professional practice in this field. Music therapists still have issues with state recognition for hiring practices and insurance companies requiring them to be licensed. Restrictions have meant that music therapy services are frequently funded through charitable funds or out-of-pocket.

(Opposed) None.

(Other) The bill should require music therapy treatment plans that are addressing a communication disorder to be reviewed by the client's audiologist or speech language pathologist.