Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Postsecondary Education & Workforce Committee
HB 1724
Brief Description: Increasing the trained behavioral health workforce.
Sponsors: Representatives Bateman, Macri, Taylor, Berry, Tharinger, Slatter, Callan, Leavitt, Reed and Shavers.
Brief Summary of Bill
  • Requires the Department of Health to examine licensing requirements for certain behavioral health professions, which must be implemented by relevant disciplining authorities.
  • Creates a program to facilitate placement of behavioral health associates with clinical supervision.
  • Creates a stipend program for out-of-pocket costs incurred by behavioral health associates completing supervised experience requirements.
  • Removes practice setting limitations for probationary licenses.
  • Makes changes to licensing requirements for certain behavioral health professions.
Hearing Date: 2/10/23
Staff: Jim Morishima (786-7191).
Background:

Several types of health providers are licensed to perform behavioral health services, including psychologists, substance use disorder professionals, advanced social workers, independent clinical social workers, mental health counselors, and marriage and family therapists.
 
Psychologists.
 
A psychologist is authorized to observe, evaluate, interpret, and modify human behavior by the application of psychological principles, methods, and procedures for the purposes of preventing or eliminating symptomatic or maladaptive behavior and promoting mental and behavioral health. 
 
To be a licensed psychologist, a person must hold a doctoral degree in psychology, have at least two years of supervised experience, pass an examination, and be of good moral character.
 
Substance Use Disorder Professionals.
 
A substance use disorder professional is authorized to employ the core competencies of substance use disorder counseling to assist or attempt to assist individuals with substance use disorder in their recovery. 
 
To be a certified substance use disorder professional, a person must complete an educational program, an apprenticeship program, or alternative training.  The person must also pass an examination and complete an experience requirement that establishes fewer hours of experience for applicants with higher levels of education.
 
Advanced Social Workers.
 
An advanced social worker is authorized to apply social work theory and methods, including emotional and biopsychosocial assessment, psychotherapy under the supervision of another mental health professional, case management, consultation, advocacy, counseling, and community organization.
 
To be an advanced social worker, a person must graduate from a master's or doctorate level social work educational program accredited by the Council on Social Work Education, pass an examination, and complete at least 3,200 hours of supervised experience.  The supervised experience hours must include at least 90 hours of direct supervision by a independent clinical social worker, an advanced social worker, or an equally qualified mental health professional.  At least 50 of the 90 hours must be supervised by a licensed advanced social worker or independent clinical social worker. 
 
Independent Clinical Social Workers.
 
An independent clinical social worker is authorized to perform the same services as an advanced social worker.  In addition, the independent clinical social worker may diagnose and treat emotional and mental disorders based on knowledge of human development, the causation and treatment of psychopathology, and psychotherapeutic treatment practices.
 
To be an independent clinical social worker, a person must graduate from a master's or doctorate level social work educational program accredited by the Council on Social Work Education, pass an examination, and complete at least 4,000 hours of supervised experience over a period of at least three years.  At least 130 of the 4,000 hours must be supervised by a licensed mental health practitioner.  At least 70 of the 130 hours must be under the supervision of an independent clinical social worker. 
 
Mental Health Counselors.
 
A mental health counselor is authorized to apply principles of human development, learning theory, psychotherapy, group dynamics, and etiology of mental illness and dysfunctional behavior to individuals, couples, families, groups, and organizations, for the purpose of treatment of mental disorders and promoting optimal mental health and functionality.  Mental health counseling also includes the assessment, diagnosis, and treatment of mental and emotional disorders, as well as the application of a wellness model of mental health. 
 
To be licensed as a mental health counselor, an applicant must graduate from a master's or doctoral program in mental health counseling or a related discipline, pass an examination, and complete a supervised experience requirement of at least 36 months or 3,000 hours.
 
Marriage and Family Therapists.
 
A marriage and family therapist is authorized to diagnose and treat mental and emotional disorders within the context of relationships, including marriage and family systems.
 
To be licensed as a marriage and family therapist, a person must graduate from a master's or doctoral program in marriage and family therapy or equivalent allied field, pass an examination, and complete a supervised experience requirement consisting of two calendar years of full-time marriage and family therapy totaling at least 3,000 hours.    
 
Provisional Licenses.
 
The Department of Health grants probationary licenses to applicants from other states who seek a credential in Washington as a psychologist, substance use disorder professional, advanced social worker, independent clinical social worker, mental health counselor, or marriage and family therapist.  A person with a probationary license may only practice in a behavioral health agency.

Summary of Bill:

Examination of Licensure Requirements.
 
By December 1, 2023, the Workforce Training and Education Coordinating Board (WTECB) must examine licensure requirements for psychologists, substance use disorder professionals, advanced social workers, independent clinical social workers, mental health counselors, and marriage and family therapists.  The WTECB must make recommendations to the Legislature and the relevant disciplining authorities for changes to statutes and rules that would remove barriers to entering and remaining in the workforce.
 
The requirements that the WTECB must examine include examinations, continuing education, administrative requirements for license application and renewal, English language proficiency, supervised experience, supervisor requirements, and the costs of completing required experience.  The WTECB must consider the following:

  • the availability of peer-reviewed research and other evidence indicating the necessity of specific licensure requirements for ensuring that behavioral health professionals are prepared to practice with reasonable skill and safety;
  • changes that would facilitate licensure of qualified out-of-state and international applicants to promote reciprocity, including the adoption of compacts;
  • changes that would promote greater consistency across licensure requirements for advanced social workers, independent clinical social workers, mental health counselors, and marriage and family therapists and allow for prior professional experience within relevant fields to be counted towards supervised experience requirements; and
  • any rules that pose excessive administrative requirements for application or renewal or place a disproportionate burden on applicants from disadvantaged communities.

 
The WTECB may contract with a private entity or third-party consultant to assist in the development of the recommendations.
 
By July 1, 2024, all disciplining authorities that receive recommendations from the WTECB must adopt rules to implement the recommendations.
 
Clinical Supervision Programs.
 
Subject to appropriated funds, by October 1, 2023, the Department of Health (DOH) must develop a program to facilitate placement of associates with clinical supervision services.  The program must include a database of license holders with the required qualifications who are willing to serve as approved supervisors and agencies or facilities that offer supervision services through their facilities to associates seeking to satisfy supervised experience requirements.
 
Subject to appropriated funds, by July 1, 2024, the DOH must establish a stipend program to defray out-of-pocket expenses incurred by associates completing supervised experience requirements.  Expenses eligible for defrayment include costs incurred in order to obtain supervised experience, such as fees or charges imposed by the individual or entity providing supervision and any other expenses the DOH deems appropriate.  Associates must document their out-of-pocket expenses in a manner specified by the DOH.
 
Licensing Requirements.
 
Changes are made to the licensing requirements for advanced social workers, independent clinical social workers, mental health counselors, and marriage and family therapists.  An applicant may use prior professional experience gained before graduation from a master's or doctoral level educational program to satisfy up to 50 percent of a supervised experience requirement if the professional experience was gained under the supervision of an approved supervisor for the applicant's practice area. 
 
In addition, the following changes are made to licensing requirements for the professions:

  • Advanced Social Workers.  An applicant's doctoral degree may be from any university accredited by a recognized accrediting organization, instead of only the Council on Social Work Education.  The supervised experience hours are reduced from 3,200 hours to 3,000 hours.  The requirement that at least 50 hours be supervised by a licensed advanced social worker or licensed independent clinical social worker is eliminated.
  • Independent Social Workers.  An applicant's doctoral degree may be from any university accredited by a recognized accrediting organization, instead of only the Council on Social Work Education.  The supervised experience hours are reduced from 4,000 hours to 3,000 hours over two years instead of three years.  The hours of experience that must be directly supervised are reduced from 130 hours to 100 hours. 
  • Marriage and Family Therapists.  The requirement that the 3,000 hours of experience be completed within two calendar years of full-time work is eliminated.

 
Provisional Licenses.
 
The requirement that probationary licensees practice in a behavioral health agency is eliminated.

 

Appropriation: None.
Fiscal Note: Requested on February 8, 2023.
Effective Date: The bill contains an emergency clause and takes effect immediately.