SENATE BILL REPORT

2ESHB 1340

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Amended Bill

Renames chemical dependency (CD) as substance use disorder (SUD), and chemical dependency professionals (CDP) or chemical dependency professional trainees (CDPT) as substance use disorder professionals (SUDP) or substance use disorder professional trainees (SUDPT).
Clarifies that a person certified and holding the title of CDP or CDPT is considered to hold the title of SUDP or SUDPT until such time as the person's present certification expires or is renewed.
Removes language stating that CD counseling must be oriented to achieve and maintain abstinence from alcohol and mood-altering drugs.

Background: The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a manual that provides a classification system for clinicians, insurance providers, researchers, and policymakers to use in matters related to the diagnosis, research, and treatment of mental disorders, including substance use. The DSM, 4th edition was replaced with the 5th edition in 2013. At that time, the terms substance abuse and substance dependence were eliminated and were replaced with a single diagnosis of SUD.

CDPs are health care providers who assist persons to develop and maintain abstinence from alcohol and other drugs. The Department of Health (DOH) certifies CDPs and establishes education, examination, and experience requirements for this certification. These include completion of courses relating to the CDP such as: understanding addiction, pharmacological actions of alcohol or other drugs, substance abuse and addiction treatment methods, individual and group counseling, and other topics established in DOH rule.

CDPs use the core competencies of chemical dependency counseling which include the assessment and diagnosis of chemical dependency, chemical dependency treatment planning and referral, patient and family education, individual and group counseling, relapse prevention counseling, and case management. These activities are to be performed with the stated goal of assisting patients in achieving and maintaining abstinence from alcohol and mood-altering drugs, and developing independent support systems.

Summary of Amended Bill: CDPs are renamed SUDPs, and CDPTs are renamed SUDPTs. Statutory references to these professions are changed accordingly. A person certified and holding the title of CDP or CDPT is considered to hold the title of SUDP or SUDPT until such time as the person's present certification expires or is renewed. CD is changed to SUD throughout the code.

The core competencies of SUD counseling are modified to remove the requirement that they be oriented to assist an alcohol or drug addicted person to achieve and maintain abstinence from mood-altering substances and develop independent support systems.

In the event that either HB 1388 (2017) or SB 5259 (2017) is enacted, provisions are made to have the director of the Health Care Authority, instead of the secretary of the Department of Social and Health Services, serve on the Substance Use Disorder Certification Advisory Committee.

EFFECT OF HUMAN SERVICES & CORRECTIONS COMMITTEE AMENDMENT(S):

Clarifies that current chemical dependency professionals or chemical dependency professional trainees are considered to hold the title of substance use disorder professional or substance use disorder professional trainee.

Staff Summary of Public Testimony on Second Engrossed Substitute House Bill: The committee recommended a different version of the bill than what was heard. PRO: This is a step forward and is about making improvements. This creates a no wrong door for substance use disorder services. Medication assisted treatment does not mean people are using. Abstinence language was removed at the request of the current CDPs, wanting to ensure that they are complying with statute. We have numerous thoughts on abstinence versus harm reduction. We are very supportive of these improvements and this supports the movement forward.

OTHER: The only issue is how the bill fails to address the title for current CDPs and CDPTs. We are offering clarifying language to amend the bill. Is there a middle ground on the abstinence language? The change from CDP to SUDP is not an issue.