WSR 99-09-100

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed April 21, 1999, 11:32 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 98-15-086.

Title of Rule: Chapter 246-811 WAC, Certified chemical dependency professionals.

Purpose: There is a need to implement the 1998 legislation to further define what will be required for the minimum educational, experience, and examination standards for certification.

Statutory Authority for Adoption: RCW 18.205.060(1).

Statute Being Implemented: Chapter 18.205 RCW.

Summary: This statute required the department to establish minimum requirements to become certified as a chemical dependency professional. The proposed rules include definitions, educational requirements, experience requirements, examination, renewal, and established fees.

Reasons Supporting Proposal: A collaborative effort was made to include stakeholders, practicing CDP providers, the chemical dependency advisory committee, and the Department of Health. The proposed rules reflect this effort in setting minimum entry-level requirements for certification.

Name of Agency Personnel Responsible for Drafting: Tonya G. Stauffer, Program Manager, 1300 S.E. Quince, Olympia, WA, (360) 236-4906; Implementation and Enforcement: Shellie Pierce, Program Manager, 1300 S.E. Quince, Olympia, WA, (360) 236-4907.

Name of Proponent: Department of Health, governmental.

Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: Health professions must be self-supportive per RCW 43.70.250.

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

Explanation of Rule, its Purpose, and Anticipated Effects: These rules implement chapter 243, Laws of 1998 which requires the department to regulate chemical dependency professionals. The rule establishes the minimum education, experience, and supervision requirements for individuals who apply to the department for certification. The rule sets the fee structure for the chemical dependency program. The purpose of the rule is to set qualifications which will allow the department to evaluate and certify qualified applicants. The department anticipates that these rules will assure that only qualified individuals are certified to practice as chemical dependency professionals.

Proposal does not change existing rules.

A small business economic impact statement has been prepared under chapter 19.85 RCW.

Small Business Economic Impact Statement

Chemical dependency professionals are employed in facilities certified by the Department of Social and Health Services, the Division of Alcohol and Drug Abuse (DASA). There are currently 515 facilities certified by DASA. Most of these facilities are small businesses who employ less than fifty people, are non-profit health care organizations, or are part of county governments. It is estimated that 1% or less of DASA facilities are for profit businesses that employ more than fifty people.

An estimated 1926 credentialed providers will have to comply with the requirements of these rules. This number was derived from DASA's statistical report on how many counselors are currently working in state approved facilities.

The standard industrial code classifications used to determine the threshold for more than minor impact were:

STANDARD INDUSTRIAL CODEECONOMIC ACTIVITYMINOR COST THRESHOLD
806Hospitals$ 50.00
809Misc. Health 53.00
805Nursing and Personnel Care Facilities 50.00
A significant cost to comply with these rules is the educational requirements. This requirement will apply to applicants not previously certified by DASA1. The requirement for an associate degree, ninety quarter hours, or sixty semester hours from an accredited institution is estimated to cost $6000 -7000.

The cost of the college credits does exceed the minor cost threshold, however an educational program is required in statute, RCW 18.205.090 (1)(a). The purpose of the rule is to clarify the statutory mandate. The Regulatory Fairness Act states that mitigation is required only "where legal and feasible in meeting the stated objectives of the statutes upon which the rule is based," RCW 19.85.030(3). Since the statute requires an educational program, it would be contrary to the objectives of the statute to mitigate the educational requirement for small businesses.

Another significant cost to comply with these regulations is the experience requirement. The amount of experience required depends on the educational level of the applicant. This requirement will apply to applicants not previously certified by DASA. It is estimated that 85% of applicants are paid approximately $10.00 hour while acquiring the experience.

EDUCATIONAL LEVELEXPERIENCE REQUIREMENT
AA Degree2500 hours
BA Degree2000 hours
Masters Degree or Ph.D.1500 hours
The cost of the experience requirement is the lower wage applicants may receive while gaining the experience than they might receive in other employment. The exact cost of this is difficult to determine, but it is likely to exceed $50-$53.

Since the cost of the experience requirement likely exceeds the minor cost threshold, however an experience requirement is required in statute, RCW 18.205.090 (1)(c). The purpose of the rule is to clarify the statutory mandate which requires fewer hours of experience for those providers with higher levels of relevant education. Since mitigation is required only when feasible in meeting the stated objectives of the statute, it would be contrary to the objectives of the statute to mitigate the experience requirement for small businesses.

The final significant cost is [of] the fee to become certified by the Department of Health is $225.00. The cost of the renewal is $125.00 per year. The cost of the experience requirement does exceed the minor cost threshold, however all programs are required to be supported by fees. RCW 43.70.250 states license fees for professions must be fully borne by the members of that profession. The secretary shall establish the amount of all application fees and license fees for each program at a sufficient level to defray the costs of administering that program. Since mitigation is required only when feasible in meeting the stated objectives of the statute, it would be contrary to the objectives of the statute to mitigate the fees for small businesses.

Public involvement was solicited through three mailings from the Department of Health (DOH), two mailings from the Department of Social and Health Services (DSHS), seven presentations at colleges and national associations from DOH staff and DSHS staff, four workgroup meetings, six committee meetings and a survey of 500 professionals.

Opportunity for written comments was provided during different stages of the development of the rules. Comments were received from Chemical Dependency Counselors, two national Chemical Dependency Certification Boards, National Counselor Associations, Chemical Dependency Advisory Committee members and Educational Institutions.


1 The Department of Social and Health Services (DSHS), Division of Alcohol and Substance Abuse (DASA), in 1994, implemented chapter 440-22 WAC. This WAC required individuals who worked in a state approved agency, as a chemical dependency counselor, to have educational and experience requirements.

A copy of the statement may be obtained by writing to Tonya G. Stauffer, Program Manager, CDP Program, P.O. Box 47869, Olympia, WA 98504-7869, phone (360) 236-4906, fax (360) 236-4909.

RCW 34.05.328 applies to this rule adoption. These rules are significant under RCW 34.05.238 [34.05.328] because they require applicants to show proof of education, experience, and take a national examination. The agency has conducted the additional analysis required by RCW 34.05.328.

Hearing Location: Cavanaughs Gateway Hotel, 9 North 9th Street, Yakima, WA 98901, on May 25, 1999, at 2:00 p.m.

Assistance for Persons with Disabilities: Contact Tonya G. Stauffer by May 17, 1999, TDD 1-800-833-6388, or (360) 236-4906.

Submit Written Comments to: Tonya G. Stauffer, Program Manager, CDP Program, P.O. Box 47869, Olympia, WA 98504-7869, fax (360) 236-4909, by May 17, 1999.

Date of Intended Adoption: May 26, 1999.

April 21, 1999

Kristine Van Gorkom

Deputy Secretary

OTS-2964.2

Chapter 246-811 WAC

CHEMICAL DEPENDENCY PROFESSIONALS

Definitions
NEW SECTION
WAC 246-811-010
What definitions should I know?

(1) Approved supervisor is an individual who meets the education and experience requirements described in WAC 246-811-030 and 246-811-045 through 246-811-049 and who is available to the person being supervised.

(2) Approved school means any college or university accredited by a national or regional accrediting body recognized by the commission on recognition of postsecondary accreditation, at the time the applicant completed the required education.

(3) Official transcript is defined as the transcript from an approved college or university, in an envelope readily identified as having been sealed by the school.

(4) Individual formal meetings is defined as a meeting with an approved supervisor, involving one approved supervisor and no more than four supervisees.

(5) Addiction counseling competencies means the knowledge, skills, and attitudes of chemical dependency counselor professional practice as described in Technical Assistance publication No. 21, Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services 1998.

(6) Related field is defined as health education, behavioral science, sociology, psychology, marriage and family therapy, mental health counseling, social work, psychiatry, nursing, divinity, criminal justice, and counseling education.

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Education
NEW SECTION
WAC 246-811-030
What are the minimum education requirements for chemical dependency professional certification?

(1) The minimum education requirements are:

(a) An associate's degree in human services or related field from an approved school; or

(b) Successful completion of ninety quarter or sixty semester college credits in courses from an approved school.

(2) At least forty-five quarter or thirty semester credits must be in courses relating to the chemical dependency profession and shall include the following topics:

(a) Understanding addiction;

(b) Pharmacological actions of alcohol and other drugs;

(c) Substance abuse and addiction treatment methods;

(d) Understanding addiction placement, continuing care, and discharge criteria, including American Society of Addiction Medicine (ASAM) criteria;

(e) Cultural diversity including people with disabilities and its implication for treatment;

(f) Chemical dependency clinical evaluation (screening and referral to include comorbidity);

(g) HIV/AIDS brief risk intervention for the chemically dependent;

(h) Chemical dependency treatment planning;

(i) Referral and use of community resources;

(j) Service coordination (implementing the treatment plan, consulting, continuing assessment and treatment planning);

(k) Individual counseling;

(l) Group counseling;

(m) Chemical dependency counseling for families, couples and significant others;

(n) Client, family and community education;

(o) Developmental psychology;

(p) Psychopathology/abnormal psychology;

(q) Documentation, to include, screening, intake, assessment, treatment plan, clinical reports, clinical progress notes, discharge summaries, and other client related data;

(r) Chemical dependency confidentiality;

(s) Professional and ethical responsibilities;

(t) Relapse prevention;

(u) Adolescent chemical dependency assessment and treatment;

(v) Chemical dependency case management; and

(w) Chemical dependency rules and regulations.

(3) All applicants, including individuals who are licensed under chapter 18.83 RCW, Psychologists; and chapter 18.79 RCW, Advance nurse practitioner, must also meet the requirements in subsection (2) of this section.

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Experience Requirements
NEW SECTION
WAC 246-811-045
How will my experience be counted?

(1) The department of health will consider experience up to seven years prior to the date of application.

(2) Accumulation of the experience hours is not required to be consecutive. Experience that will count toward certification must meet the requirements outlined in WAC 246-811-046 through 246-811-049.

(3) Supervised experience is the practice as referred to in RCW 18.205.090 (1)(c) and is the experience received under an approved supervisor. A practicum or internship taken while acquiring the degree or semester/quarter hours is applicable.

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NEW SECTION
WAC 246-811-046
How many hours of experience will I need for certification?

You will be required to complete two thousand five hundred, two thousand or one thousand five hundred hours of supervised experience depending upon your formal education level.

(1) Two thousand five hundred hours of chemical dependency counseling as defined in RCW 18.205.020(3), for individuals who possess an associate degree; or

(2) Two thousand hours of chemical dependency counseling for individuals who possess a baccalaureate degree in human services or a related field from an approved school; or

(3) One thousand five hundred hours of chemical dependency counseling for individuals who possess a master or doctoral degree in human services or a related field from an approved school; or

(4) One thousand five hundred hours of chemical dependency counseling for individuals who are licensed as advanced registered nurse practitioners under chapter 18.79 RCW; or

(5) One thousand five hundred hours of chemical dependency counseling for individuals who are licensed as a psychologist under chapter 18.83 RCW.

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NEW SECTION
WAC 246-811-047
What competencies must I become proficient at during my experience?

(1) It is the intent that individuals become competent in addiction counseling competencies, as defined in WAC 246-811-010(5), through the experience requirement.

(2) Individuals must experience the addiction counseling competencies listed in (a) through (i) of this subsection.

(a) Two hundred hours of clinical evaluation. One hundred hours of the two hundred must be face-to-face patient contact hours.

(b) Six hundred hours of face-to-face counseling to include:

Individual counseling;

Group counseling;

Counseling family, couples, and significant others.

(c) Fifty hours of discussion of professional and ethical responsibilities.

(d) Transdisciplinary foundations:

Understanding addiction;

Treatment knowledge;

Application to practice;

Professional readiness.

(e) Treatment planning.

(f) Referral.

(g) Service coordination.

(h) Client, family, and community education.

(i) Documentation, to include, screening, intake, assessment, treatment plan, clinical reports, clinical progress notes, discharge summaries, and other client related data.

(3) Eight hundred fifty hours of experience are designated to subsection (2)(a) through (c) of this subsection, the remaining experience hours must be divided among subsection (2)(d) through (i) of this subsection as determined by the supervisor.

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NEW SECTION
WAC 246-811-048
How much of the experience requirement needs to be under supervision?

(1) All of the experience must be under an approved supervisor as defined in WAC 246-811-010(1). The first fifty hours of any face-to-face client contact must be under direct observation of an approved supervisor or a chemical dependency professional. Supervision shall be based on assisting the person being supervised in acquiring proficiency in the addiction counseling competencies as defined in WAC 246-811-010(5).

(2) Approved supervisors shall attest to the department of the supervised person's satisfactory progress in becoming proficient in the addiction counseling competencies as listed in WAC 246-811-047 (2)(a) through (i) on forms provided by the department.

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NEW SECTION
WAC 246-811-049
Who may act as an approved supervisor?

(1) An approved supervisor is a certified chemical dependency professional or a person who meets or exceeds the requirements of a certified chemical dependency professional in the state of Washington, and who would be eligible to take the examination required for certification; and

(2) An approved supervisor has at least four thousand hours of experience in a state approved chemical dependency treatment agency.

(a) The four thousand hours are in addition to the supervised experience hours required to be eligible to become a chemical dependency professional.

(b) Twenty-eight clock hours of recognized supervisory training may be substituted for one thousand hours of experience; and

(3) An approved supervisor is not a blood or legal relative, significant other, cohabitant of the supervisee, or someone who has acted as the person supervised's primary counselor.

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National Certifications
NEW SECTION
WAC 246-811-070
To what extent will my national certification be recognized by the department?

(1) A person who is certified through the National Association of Alcoholism and Drug Abuse Counselors (NAADAC) or the International Certification and Reciprocity Consortium (ICRC), is considered to have met the experience requirements of WAC 246-811-046.

(2) A person who is certified through NAADAC or ICRC is considered to have met the requirements of WAC 246-811-030 pertaining to the forty-five quarter or thirty semester credits in courses covering the subject content described in WAC 246-811-030(2). Verification of the additional forty-five quarter or thirty semester credits will be required upon application to the department.

(3) Verification of certification must be sent directly to the department from NAADAC or ICRC.

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AIDS Requirement
NEW SECTION
WAC 246-811-075
How many hours of AIDS prevention and information education do I need?

Applicants must complete four clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.

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Expired Credential
NEW SECTION
WAC 246-811-080
What happens if my certification expires?

(1) If the certification has expired for five years or less the individual must meet the requirements of chapter 246-12 WAC, Part 2.

(2) If a certification has lapsed for more than five years, the applicant will be required to demonstrate continued competency and shall be required to take an examination if an examination was not taken and passed for the initial certification. In addition, the requirements of chapter 246-12 WAC, Part 2, must be met.

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Fees
NEW SECTION
WAC 246-811-990
How often do I need to renew and what are the costs for certification?

(1) Certificates must be renewed every year on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

(2) The following nonrefundable fees will be charged for certified chemical dependency professional:


Title of FeeFee
Application$100.00
Initial certification125.00
Renewal125.00
Late renewal penalty62.50
Expired certification reissuance62.50
Duplicate certification10.00
Certification of certificate10.00
Wall certificate10.00

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Washington State Code Reviser's Office