DEPARTMENT OF HEALTH

(Board of Psychology)

[Filed March 18, 2020, 9:10 a.m.]

Preproposal statement of inquiry was filed as WSR 19-18-019.

Title of Rule and Other Identifying Information: Chapter 246-924 WAC, the examining board of psychology (board) is proposing amending and adding a new section to the chapter to implement the requirements of SB 5054 regarding probationary licensure and a reciprocity program between Washington and other United States states or territories. The board is proposing further amendments to the chapter to implement the requirements of ESSB [ESHB] 1768 regarding the reduction of supervised experience requirements for certain applicants and referencing administrative procedures for licensed psychologists to obtain a cooccurring disorder specialist enhancement. The board is also proposing changes to clarify terms and conditions in WAC 246-924-010, 246-924-049, 246-924-059, 246-924-095, 246-924-480, and 246-924-495 regarding telemedicine, and licensure requirements for practicum, postdoctoral supervised experience, exams, and temporary permits.

Hearing Location(s): On April 21, 2020, at 12:00 p.m. In response to the coronavirus disease 2019 (COVID-19) public health emergency, the board of psychology will not provide a physical location for this hearing to promote social distancing and the safety of the citizens of Washington state. A virtual public hearing, without a physical meeting space, will be held instead.

To access the meeting online, and register https://attendee.gotowebinar.com/register/5010885011238184205.

After registering, you will receive a confirmation email containing information about joining the webinar.

You can also dial-in using your phone: Call in: United States +1 914-614-3221. Access Code: 245-502-569.

Date of Intended Adoption: April 21, 2020.

Submit Written Comments to: Stacey Saunders, P.O. Box 47850, Olympia, WA 98504-7850, email https://fortress.wa.gov/doh/policyreview, by April 21, 2020.

Assistance for Persons with Disabilities: Nancy Delgado, phone 360-236-4951, TTY 711, email nancy.delgado@doh.wa.gov, by April 14, 2020.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule is to implement the statutory changes established in ESHB 1768 and SB 5054 as passed by the 2019 Washington state legislature. Changes specific to the legislation would address the creation of a reciprocity program and probationary license for out-of-state licensed psychologists to practice in Washington, establishing a process to transition from a probationary license into a permanent or full license, and reduction of supervised experience hours for certain psychology applicants with prior work experience as a licensed substance use disorder professional. For clarity and precision, the board is also looking to clarify additional rule sections regarding licensure requirements such a practicum, postdoctoral supervised experience and exams with the intent of further reducing barriers to licensure.

Reasons Supporting Proposal: Rule making would establish the administrative requirements necessary to implement recently passed statutes. The intent of the underlying statute and the proposed rules to implement them is the reduction of barriers to licensure of psychologists in Washington state. The proposed rule provides needed clarification of administrative procedures and provides enforceable standards for newly created license types (probationary licenses) to facilitate our newly created licensure reciprocity program, and license enhancement (cooccurring disorder specialists enhancement). Further barrier reductions include reduction in supervised experience requirements for certain behavioral health licensure applicants who also have a substance use disorder credential.

Statutory Authority for Adoption: SB 5054 (chapter 351, Laws of 2019), ESSB [ESHB] 1768 (chapter 444, Laws of 2019); RCW 18.83.050

Statute Being Implemented: SB 5054 (chapter 351, Laws of 2019), ESSB [ESHB] 1768 (chapter 444, Laws of 2019).

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Examining board of psychology, governmental.

Name of Agency Personnel Responsible for Drafting: Jeff Wise, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4987; Implementation and Enforcement: James Chaney, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2831.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Jeff Wise, P.O. Box 47850, Olympia, WA 98504-7850, phone 360-236-4987, TTY 711, email jeff.wise@doh.wa.gov.

The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. This rule proposal does not impact small businesses; these rules pertain only to providers.

Rachaud Smith, Psy.D., Chair

Examining Board of Psychology

AMENDATORY SECTION(Amending WSR 91-04-020, filed 1/28/91, effective 2/28/91)

WAC 246-924-010Definitions.

The definitions in this section apply throughout this chapter unless the context clearly states otherwise.

(1) "Acquired immunodeficiency syndrome" or "AIDS" means the clinical syndrome of HIV-related illness as defined by the board of health by rule.

(2) "APA" means American Psychological Association.

(3) "APPIC" means Association of Psychology Postdoctoral and Internship Centers.

(4) "CPA" means Canadian Psychological Association.

(5) "Face to face" means in-person contact in the same physical space not assisted by technology.

(6) "Office on AIDS" means that section within the department of social and health services or any successor department with jurisdiction over public health matters as defined in chapter 70.24 RCW.

(7) "Out-of-state" means any state or territory of the United States.

(8) "Probationary license" means a temporary license issued to out-of-state applicants qualifying for licensure reciprocity in Washington state under the restrictions and conditions of RCW 18.225.140 and this chapter.

(9) "Reciprocity" means licensure of out-of-state licensed psychologists based on substantial equivalence between Washington state scope of practice and the scope of practice of the other state or territory, subject to a probationary licensure period to complete outstanding Washington state licensure requirements as determined necessary to gain full licensure.

AMENDATORY SECTION(Amending WSR 07-24-093, filed 12/5/07, effective 9/1/09)

WAC 246-924-043Education and experience requirements for licensure.

(1) To obtain a license, applicants must complete:

(a) A doctoral degree program as described in WAC 246-924-046.

(b) A practicum of at least 300 hours as described in WAC 246-924-049; and

(c) An experience requirement consisting of no fewer than two years supervised experience totaling 3000 hours that includes:

(i) A minimum of 1500 hours of supervised experience that must be completed as an internship experience as outlined in WAC 246-924-056.

(ii) The remaining 1500 supervised hours may be obtained through:

(A) A preinternship as described in WAC 246-924-053;

(B) Accumulation of supervised experience hours in excess of the 1500 hours required in (c)(i) of this subsection that meet the requirements in WAC 246-924-056;

(C)))(D) A combination of preinternship and postdoctoral experience.

(iii) For applicants who demonstrate proof of being credentialed as a substance use disorder professional for three years in the previous ten years, the total hours required in (c)(ii) of this subsection are reduced from 1500 to 1020 hours.

(2) The order of supervised experience must be graduated from more intensive to less intensive supervision.

AMENDATORY SECTION(Amending WSR 07-24-093, filed 12/5/07, effective 9/1/09)

WAC 246-924-049Practicum.

(1) Applied experience: The doctoral degree program required in WAC 246-924-046 must include a practicum of at least ((two semesters or three quarters))nine months and ((at least)) 300 hours of direct experience, 100 hours of which must ((be in))meet the requirements in subsection (2) of this section for supervision. No more than 300 practicum hours may count towards licensure requirements. Additional hours accrued following completion of the nine month practicum may count towards licensure requirements if the hours meet all preinternship requirements in WAC 246-924-053.

(2) Supervision must include the following:

(((1)))(a) Discussion of services provided by the student;

(((2)))(b) Selection of ((service))treatment plan for and review of each case or work unit of the student;

(3) Discussion of and instruction in theoretical concepts underlying the work;

(4) Discussion of the management of professional practice and other administrative or business issues;

(5) Evaluation of the supervisory process by the student and the supervisor;

(6) Discussion of coordination of services among the professionals involved in the particular cases or work units;

(7) Discussion of relevant state laws and rules;

(8) Discussion of ethical principles including principles applicable to the work;

(9) Review of standards for providers of psychological services; and

(10) Discussion of reading materials relevant to cases, ethical issues and the supervisory process.

AMENDATORY SECTION(Amending WSR 07-24-093, filed 12/5/07, effective 9/1/09)

WAC 246-924-059((Post-doctoral))Postdoctoral supervised experience.

If 3000 hours of supervised experience has not been completed at the end of the doctoral degree program, then up to 1500 hours of supervised ((post-doctoral))postdoctoral experience can be used to satisfy the total requirement. ((Post-doctoral))Postdoctoral supervised experience must be completed only if an applicant does not already have 3000 hours of supervised experience.

(1) Organization of the ((post-doctoral))postdoctoral supervised experience.

(a) The supervisor is ethically and legally responsible for all supervisee work covered by the supervision agreement. Therefore, the supervisor has authority to alter service plans and direct the course of psychological work.

(b) Supervisees must use titles indicating their training status, such as "psychological resident," "psychological intern," or "psychological supervisee."

(c) Clients must be informed of the identity and responsibilities of the supervisor and how they can speak directly to the supervisor.

(d) Services rendered by the supervisee must not be represented to third parties as having been rendered by the supervisor. Insurance forms must be filled out indicating the nature of the supervisory relationship.

(2) The supervisor and supervisee must have a written agreement for supervision, including:

(a) The area(s) of professional activity in which supervision will occur;

(b) Hours of supervision and/or ratio of supervision to professional activity;

(d) Processes for supervision including mode(s) of supervision, expectations for recordkeeping, evaluation, and feedback;

(e) Relevant business arrangements;

(f) How the supervisee will represent himself or herself; and

(g) How disagreements will be handled.

(3) Mode of supervision.

(a) The preferred mode of supervision is face-to-face discussion between the supervisor and the supervisee.

(b) The nature of the supervision may depend on the following:

(i) The theoretical orientation of the supervisor;

(ii) The training and experience of the supervisee; and

(iii) The duration of the supervisory relationship.

(4) Some direct observation of the supervisee's work is required and the supervisor may use the following:

(a) Detailed process notes and progress reports;

(b) Audio and/or videotapes;

(d) One-way mirror observation.

(5) Supervised experience must be appropriate to the area(s) of professional activity the person intends to practice.

(6) There must be at least one hour of individual supervision for every twenty hours of psychological work.

(7) The supervisor and the supervisee must keep records of experience and supervision hours.

(8) At the end of the supervision period, the supervisor must prepare and forward to the board a written evaluation, including the number of successfully completed supervised hours of psychological work and any hours not successfully completed.

If any hours were not successfully completed, the board may require additional hours of supervision.

(9) Supervision of the ((post-doctoral))postdoctoral supervised experience.

(a) At least fifty percent of the ((post-doctoral))postdoctoral supervision must be provided by a licensed psychologist.

(b) Up to fifty percent of the supervision may be provided by the following:

(i) A licensed psychologist with two years post-license experience;

(ii) A psychiatrist with three years of experience beyond residency;

(iii) A licensed mental health counselor, a licensed marriage and family therapist, a licensed advanced social worker, or a licensed independent clinical social worker, if the supervisor has five years post-license experience;

(iv) A doctoral level psychologist with three years ((post-doctoral))postdoctoral experience who is exempt from licensure under RCW 18.83.200 (1), (2), (3) or (4), if the supervision occurs in the exempt setting.

(10) Supervision must include the following:

(a) Discussion of services provided by the student;

(b) Selection, service plan, and review of each case or work unit of the student;

(d) Discussion of the management of professional practice and other administrative or business issues;

(e) Evaluation of the supervisory process by the student and the supervisor;

(f) Discussion of coordination of services among the professionals involved in the particular cases or work units;

(g) Discussion of relevant Washington laws and rules;

(h) Discussion of ethical principles including principles applicable to the work;

(i) Review of standards for providers of psychological services; and

(j) Discussion of reading materials relevant to cases, ethical issues and the supervisory process.

(11) An applicant may not sign off as supervising their own postdoctoral hours.

WAC 246-924-085Co-occurring disorder enhancement specialist eligibility.

A psychologist licensed under chapter 18.83 RCW and this chapter is eligible to apply for a co-occurring disorder specialist enhancement to their existing license according to the conditions of RCW 18.205.105 and chapter 246-804 WAC.

AMENDATORY SECTION(Amending WSR 08-09-100, filed 4/21/08, effective 5/22/08)

WAC 246-924-095Failure of written examinations.

An applicant who fails ((either))the examination for professional practice in psychology required under WAC 246-924-070 may sit for reexamination as follows:

(1) First reexamination: At any following examination administration date;

(2) Second or subsequent reexamination: A minimum of two months after the failure of the previous examination.

AMENDATORY SECTION(Amending WSR 16-16-026, filed 7/22/16, effective 8/22/16)

WAC 246-924-480Temporary permits.

(1) Temporary permits are:

(a) Issued under RCW 18.83.082; and

(b) Valid for no more than ninety days within one calendar year from the date they are issued.

(2) If the board finds that another state's licensing requirements are deemed not equivalent because a stated requirement is omitted or deficient, the applicant is not eligible for the temporary permit unless the applicant demonstrates proof of graduation from an APA- or CPA-accredited doctoral program and successful completion of an APA-, APPIC-, or CPA-approved internship.

(3) There is no charge for a temporary permit.

(4) Candidates applying for a temporary permit must:

(a) Verify that he or she is credentialed to practice psychology in another state that has been deemed substantially equivalent by the board, or is a member of an organization listed in WAC 246-924-100(3); and

(b) Submit a completed application on a form provided by the board.

WAC 246-924-493Probationary license.

(1) The department shall issue a probationary license to out-of-state applicants seeking licensure in Washington state as a psychologist according to the conditions and restrictions of the reciprocity program established in RCW 18.83.170 and this chapter.

(2) The out-of-state license must be from a state or territory identified on a list published by the department as eligible for reciprocity for the purposes of a probationary license for the practice of psychology.

(3) An initial probationary license is valid for one year. To receive an initial probationary license, an applicant must submit to the department a completed application to include:

(a) Verification of their out-of-state license;

(b) Proof of passing the jurisprudence exam according to WAC 246-924-070; and

(4) A probationary license may be renewed a single time and is valid for one year after the date of renewal. To renew a probationary license, an applicant must submit to the department a completed application to include:

(a) Completion of four hours of education in ethics according to WAC 246-924-240;

(b) Training in suicide assessment, treatment, and management according to WAC 246-924-990;

(d) The fee according to WAC 246-924-990.

(5) Continuing education. With the exception of the requirements in subsection (4) of this section, continuing education requirements will apply once a probationary licensee transitions to a full license.

(6) Supervised experience. If it is determined additional supervised experience is required for full licensure, the supervised experience hours must meet the requirements for postdoctoral supervised experience in WAC 246-924-059.

AMENDATORY SECTION(Amending WSR 08-09-100, filed 4/21/08, effective 5/22/08)

WAC 246-924-495Qualifications for granting a license.

Candidates applying for initial licensure under RCW 18.83.170 must meet the following requirements:

(1) Submit a completed application form provided by the department.

(2) Pay the application and examination fees described in WAC 246-924-990.

(3) Provide evidence of completing a doctoral degree program described in WAC 246-924-046.

(4) Provide evidence of completing the practicum requirement set forth in WAC 246-924-049.

(5) Provide evidence of completing the internship experience requirement as defined in WAC 246-924-056.

(6) Provide evidence of completion of supervised experience requirement as defined in WAC ((246-924-053 and 246-924-059))246-924-043 (1)(c)(ii) and, if applicable, WAC 246-924-043 (1)(c)(iii).

(7) Pass the national Examination of Professional Practice of Psychology (EPPP) described in WAC 246-924-070.

(8) Pass the jurisprudence examination in WAC 246-924-070.