Professional counselors

Enacts licensing laws for professional counselors.

THE SENATE                              S.B. NO.           2459
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that the profession of
 2 counseling is critical today as people are having many more
 3 problems as they are confronted with intensified violence and
 4 increased substance abuse.  In general, people who seek
 5 counseling are vulnerable and need protection from unskilled,
 6 untrained, and ill-prepared individuals.  At present, master's
 7 level counselors are unregulated in the State, and there are no
 8 special safeguards in place to assure consumers of the quality of
 9 service they are receiving.  Being in a vulnerable state, persons
10 who receive counseling services that may revictimize them or, in
11 other ways, harm them, are unlikely to share this with anyone.
12 Those that are revictimized are not empowered to come forward.
13 To do so would entail shame and further aggravate the situation.
14 Those few who may wish to make a formal complaint often do not
15 know where to go, as they would not be likely to receive a client
16 grievance procedure from their mental health practitioner.
17      Not many people in such a situation have even heard of, or
18 would think of approaching, the regulated industry complaints
19 office of the department of commerce and consumer affairs.  The

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 1 department of commerce and consumer affairs has concluded that
 2 since counselors are not regulated by licensure, the department
 3 cannot offer consumer protection in these situations.
 4      The Felix v. Cayetano consent decree demands substantial
 5 improvement in the children's mental health delivery system in
 6 Hawaii.  A key component of the decree is the inclusion of basic
 7 mental health and case management services.  These are areas
 8 requiring trained and qualified professional counselors.
 9 Presently, a lack of qualified mental health professionals costs
10 Hawaii thousands of dollars in transportation costs when
11 qualified professional counselors already residing on the
12 neighbor islands could provide services at a lesser cost and with
13 more community awareness.  Lack of regulation of professional
14 counselors prevents the citizens of Hawaii from the choice of
15 mental health practitioners if they use their medical insurance
16 plans to cover the cost of medically necessary counseling
17 services.  It also prevents the State, nonprofit agencies, and
18 providers from seeking third-party reimbursement from insurance
19 plans when a professional counselor provides counseling services.
20      There is approximately a thirty per cent savings in
21 reimbursement rates to professional counselors compared to the
22 reimbursement rates to licensed psychologists for comparable
23 counseling services.  At the same time, professional counselors

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 1 generally require fewer sessions.  It makes good economic sense
 2 for the State, and demonstrates a compassionate concern for the
 3 mental health needs of Hawaii's citizens, to regulate
 4 professional counselors.
 5      In 1998, Congress passed legislation to include professional
 6 counselors in the U.S. Public Health Service Act programs.  The
 7 federal government now recognizes professional counseling as one
 8 of the core helping professions, along with psychiatry,
 9 psychology, psychiatric nursing, social work, and marriage and
10 family therapy.
11      Both public and private universities in Hawaii have
12 established programs to train professional counselors in the
13 areas of mental health, rehabilitation, and career and school
14 counseling.  Because of the lack of regulation of this
15 profession, these institutions are unable to ensure the
16 employment of Hawaii's graduates of these programs once they are
17 trained in the State.
18      There are at least five hundred fifty counselors in the
19 State who would be eligible for licensure.  There are nationally
20 established criteria for the education, training, and practice of
21 counselors.  However, there is no regulation of professional
22 counselors even though in Hawaii, they are employed in the
23 public, nonprofit, private, and for-profit private sectors.

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 1 Regulation of the rehabilitation-counseling specialty is provided
 2 for in thirty-seven of the forty-six states and District of
 3 Columbia.
 4      The department of labor and industrial relations, which has
 5 a vendor list of rehabilitation counselors who work with workers'
 6 compensation claimants, has recently reduced its staff in the
 7 oversight unit from twelve to one.  Therefore, this department is
 8 unable to furnish the level of service monitoring previously
 9 provided.  With the exception of the State's workers'
10 compensation program, individuals, insurers, employers, and other
11 consumers of service cannot be assured of the credentials of any
12 person professing to be a counselor.  Licensure is sorely needed
13 to assure quality service.
14      The purpose of this Act is to:
15      (1)  Set standards of qualifications regarding education and
16           experience; and
17      (2)  Require licenses for those persons who seek to
18           represent themselves to the public as licensed
19           professional counselors.
20      SECTION 2.  The Hawaii Revised Statutes is amended by adding
21 a new chapter to be appropriately designated and to read as
22 follows:

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 1                           "CHAPTER  
 2                      PROFESSIONAL COUNSELORS
 3       -1 Definitions.  As used in this chapter, unless the
 4 context clearly requires:
 5      "Accredited institution" means a university or college
 6 accredited by a nationally recognized accrediting agency of
 7 institutions of higher education.
 8      "Advertise" means the issuing of or causing to be
 9 distributed any card, sign, or device to any person, or the
10 causing, permitting, or allowing of any sign or marking on or in
11 any building, on radio or television, or by using any other means
12 designed to secure public attention.
13      "Appraisal" means the use of nonstandardized methods and
14 techniques, such as observation and interviewing, for
15 understanding human behavior in relation to coping with, adapting
16 to, or changing life situations of a physical, mental, or
17 emotional nature.
18      "Assessment" means selecting, administering, scoring, and
19 interpreting instruments designed to assess an individual's
20 aptitudes, attitudes, abilities, achievements, interests,
21 personal characteristics, and current emotional or mental state
22 by appropriately educated, trained, and experienced clinicians.

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 1      "Clinical supervision" is supervision applied to all
 2 individuals who are gaining the experience required for a license
 3 as a professional counselor.  Clinical supervision requires
 4 extensive involvement on the part of the supervisor to help the
 5 supervisee improve and learn new professional counseling skills.
 6 It includes but is not limited to:
 7      (1)  Case consultation of the assessment and of the
 8           presenting problem;
 9      (2)  Development and implementation of treatment plans;
10      (3)  Enhancement of the supervisee's counseling techniques
11           and evaluation of the course of treatment; and
12      (4)  Evaluation of the course of treatment.
13      "Clinical supervisor" includes licensed psychiatrists,
14 psychologists, professional counselors, social workers, and
15 marriage and family therapists with at least two years of post-
16 graduate experience.
17      "Consulting" means the application of scientific principles
18 and procedures in psychotherapeutic counseling, guidance, and
19 human development to provide assistance in understanding and
20 solving a problem that the consultee may have in relation to a
21 third party.
22      "Counseling treatment interventions" means the application
23 of cognitive, affective, behavioral, and systemic counseling

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 1 strategies that include principles of development, wellness, and
 2 pathology that reflect a pluralistic society.  Counseling
 3 treatment interventions are specifically implemented in the
 4 context of a professional counseling relationship.
 5      "Department" means the department of commerce and consumer
 6 affairs.
 7      "Director" means the director of commerce and consumer
 8 affairs.
 9      "Licensed professional counselor" means a person who uses
10 the title of licensed professional counselor, who has been issued
11 a license under this chapter, and whose license is in effect and
12 not revoked or suspended.
13      "Professional counseling" means the application of mental
14 health, psychological, and human development principles to:
15      (1)  Facilitate human development and adjustment throughout
16           the lifespan;
17      (2)  Prevent, appraise, and treat mental, emotional, or
18           behavioral disorders and associated distresses that
19           interfere with mental health;
20      (3)  Conduct appraisals and assessments for the purpose of
21           establishing treatment goals and objectives; and
22      (4)  Plan, implement, and evaluate treatment plans using
23           counseling treatment interventions.

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 1      "Referral" means the evaluation of information to identify
 2 the needs of the person being counseled to:
 3      (1)  Determine the advisability of sending the person being
 4           counseled to other specialists;
 5      (2)  Inform the person being counseled of such judgment; and
 6      (3)  Communicate the information to other counseling
 7           services as deemed appropriate.
 8      "Rehabilitation counseling" means a systematic process,
 9 using the counseling model, to assist the physically, mentally,
10 developmentally, cognitively, and emotionally disabled to set and
11 realize realistic vocational goals.  The process includes:
12      (1)  Evaluation of medical, psychological, educational, and
13           vocational data together with interview behavior to
14           determine skills, abilities, and potential
15           opportunities;
16      (2)  Utilization of individual group and behavioral
17           techniques to foster adjustment to disability and
18           achievement of greater self-awareness, knowledge of
19           environment, and judgment; and
20      (3)  Coordination of multi-disciplinary community resources
21           and job placement.
22      "Use a title or description of" means to hold oneself out to
23 the public as having a particular status by stating the status on

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 1 signs, mailboxes, address plates, stationery, announcements,
 2 telephone directory advertising, business cards, or other
 3 instruments of professional identification.
 4         -2  Professional counselors licensing program.  There is
 5 established a professional counselors licensing program within
 6 the department to be administered by the director.
 7         -3 Powers and duties of the director.  In addition to
 8 any other powers and duties authorized by law, the director shall
 9 have the following powers and duties:
10      (1)  Grant permission to a person to use the title or
11           description of licensed professional counselor in this
12           State pursuant to this chapter and the rules adopted
13           pursuant thereto;
14      (2)  Adopt, amend, or repeal rules pursuant to chapter 91 as
15           the director finds necessary to carry out the
16           provisions of this chapter;
17      (3)  Administer, coordinate, and enforce this chapter and
18           rules adopted pursuant thereto;
19      (4)  Discipline a licensed professional counselor for any
20           cause described by this chapter or for any violation of
21           the rules, or refuse to license a person for failure to
22           meet licensing requirements or for grounds for
23           disciplining a licensed professional counselor; and

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 1      (5)  Appoint an advisory committee consisting of licensed
 2           professional counselors and members of the public, or
 3           as determined by the director, to assist with the
 4           implementation of this chapter and the rules adopted
 5           pursuant thereto; provided that the initial members of
 6           the committee who are professional counselors shall not
 7           be required to be licensed pursuant to this chapter.
 8         -4 Fees; disposition.(a)  Application, examination,
 9 reexamination, license, renewal, restoration, penalty, and any
10 other fees relating to administration of this chapter, none of
11 which are refundable, shall be as provided in rules adopted by
12 the director pursuant to chapter 91.
13      (b)  Fees assessed shall defray costs incurred by the
14 director to support the operation of the professional counselor
15 licensing program.  Fees collected shall be managed in accordance
16 with section 26-9(l).
17         -5 Prohibited acts.  Except as specifically provided in
18 this chapter, no person shall use the title licensed professional
19 counselor or describe oneself as a licensed professional
20 counselor without first having secured a license under this
21 chapter.  The department shall investigate and prosecute any
22 individual using the title or description of licensed
23 professional counselor without the proper license as a

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 1 professional counselor.  Any person who violates this section
 2 shall be subject to a fine of not more than $1,000.  Each day's
 3 violation shall be deemed a separate offense.  Any action taken
 4 to impose or collect the fine imposed under this section shall be
 5 a civil action.
 6         -6 Exemptions.(a)  Licensure shall not be required
 7 of:
 8      (1)  A person doing work within the scope of practice or
 9           duties of the person's profession that overlaps with
10           the practice of professional counseling (for example,
11           the clergy); provided the person does not purport to be
12           a professional counselor;
13      (2)  Any full-time student enrolled in a regionally
14           accredited educational institution in a recognized
15           program of study leading toward attainment of a
16           graduate degree in professional counseling or other
17           professional field; provided that the student's
18           activities and services are part of a prescribed course
19           of study supervised by the educational institution and
20           the student is identified by an appropriate title
21           including but not limited to "professional counseling
22           student" or "trainee", "clinical psychology student" or
23           "trainee", "clinical social work student" or "trainee",

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 1           "marriage and family counseling student" or "trainee",
 2           or any title that clearly indicates training status; or
 3      (3)  Any individual who uses the title "counselor intern"
 4           for the purpose of obtaining clinical experience in
 5           accordance with section    -7(a)(3).
 6      (b)  Nothing in this chapter shall be construed to prevent
 7 qualified members of other licensed professions as defined by any
 8 law or rule of the department, including but not limited to
 9 social workers, registered nurses, psychologists, marriage and
10 family therapists, or physicians, from doing or advertising that
11 they assist or treat individuals, couples, or families consistent
12 with the accepted standards of their respective licensed
13 professions; provided that no such persons shall use a title or
14 description stating or implying that they are a licensed
15 professional counselor.
16         -7 Application for licensure as a professional
17 counselor.(a)  Any person who applies to the department after
18 July 1, 2000, shall be issued a license by the department if the
19 applicant provides satisfactory evidence to the department that
20 the applicant is qualified for licensure pursuant to the
21 requirements of this chapter and meets the following
22 qualifications:

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 1      (1)  Has a master's degree or doctoral degree from a
 2           regionally-accredited institution in counseling or in
 3           an allied field related to the practice of professional
 4           counseling that includes or is supplemented by graduate
 5           level course work comprising a minimum of forty-eight
 6           semester or seventy-two quarter hours in the following
 7           course areas:
 8           (A)  Human growth and development;
 9           (B)  Social and cultural foundations;
10           (C)  Counseling theories and applications;
11           (D)  Group theory and practice;
12           (E)  Career and lifestyle development;
13           (F)  Appraisal of human behavior;
14           (G)  Tests and measurements;
15           (H)  Research and program evaluation; and
16           (I)  Professional orientation and ethics.
17      (2)  Has at least two academic terms of practicum experience
18           in a counseling setting with three hundred hours of
19           supervised client contact;
20      (3)  Completes three thousand hours of post-graduate direct
21           counseling work with six hundred hours of clinical
22           supervision; and

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 1      (4)  Has passed the national certified counselor examination
 2           or the national certified rehabilitation counselor
 3           certification exam.
 4      (b)  An individual who holds a current certification as a
 5 national certified counselor or a national certified
 6 rehabilitation counselor prior to the effective date of this
 7 chapter shall be deemed to have met the educational and clinical
 8 experience requirements of this section.
 9         -8 Examination.  (a)  The department shall conduct a
10 licensing examination of applicants at least once a year at a
11 time and place designated by the department.
12      (b)  The department shall administer the national certified
13 counselor examination and the certified rehabilitation counselor
14 examination in compliance with each regulatory board's standards.
15      (c)  An applicant shall be held to have passed an
16 examination by obtaining a passing score as determined by the
17 director.
18         -9 Licensure fees.  Licenses shall be valid for three
19 years and shall be renewed triennially, with the renewal fee
20 being determined by the department.  Any applicant for renewal of
21 a license that has expired within one year of the renewal
22 deadline shall be required to pay a restoration fee in addition
23 to all renewal fees determined by the department.

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 1         -10  Renewal of license.  Licenses shall be renewed
 2 triennially not earlier than ninety days before June 30, with the
 3 first renewal deadline occurring on June 30, 2003.  Failure to
 4 renew a license shall result in a forfeiture of the license.
 5 Licenses that have been so forfeited may be restored within one
 6 year of the expiration date upon payment of renewal and
 7 restoration fees.  Failure to restore a forfeited license within
 8 one year of the date of its expiration shall result in the
 9 automatic termination of the license and the person may be
10 required to reapply for licensure as a new applicant.
11         -11  Denial, revocation, or suspension of license.(a)
12 The department shall deny, revoke, condition, or suspend a
13 license granted pursuant to this chapter on the following
14 grounds:
15      (1)  Conviction by a court of competent jurisdiction of a
16           crime that the department has determined by rules
17           adopted pursuant to chapter 91 to be of such nature as
18           to render the person convicted unfit to practice
19           professional counseling;
20      (2)  Failure to report in writing to the director any
21           disciplinary decision related to the provision of
22           mental health services issued against the licensee or
23           the applicant in another jurisdiction within thirty

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 1           days of the disciplinary decision or within thirty days
 2           of licensure;
 3      (3)  Violation of recognized ethical standards for
 4           professional counselors as set by each discipline's
 5           association;
 6      (4)  Fraud or misrepresentation in obtaining a license;
 7      (5)  Revocation, suspension, or other disciplinary action by
 8           another state or federal agency against a licensee or
 9           applicant for any reason provided by this section; or
10      (6)  Other just and sufficient cause which renders a person
11           unfit to practice professional counseling.
12      (b)  Any licensee who violates this section may also be
13 fined not more than $1,000 per violation.
14         -12  Practice of professional counseling.  The practice
15 of professional counseling includes but is not limited to:
16      (1)  Individual and group counseling;
17      (2)  Assessment and appraisal of persons with mental and
18           emotional disorders using adjunctive resources and
19           consultations;
20      (3)  Plan treatment and counsel persons with mental and
21           emotional disorders using adjunctive resources and
22           consultants;
23      (4)  Crisis intervention;

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 1      (5)  Guidance and consulting to facilitate normal growth and
 2           development, including educational and career
 3           development;
 4      (6)  Utilization of functional assessment and counseling for
 5           persons requesting assistance in adjustment to a
 6           disability;
 7      (7)  Consulting;
 8      (8)  Research; and
 9      (9)  Referral.
10      The use of specific methods, techniques, or modalities
11 within the practice of professional counseling is restricted to
12 professional counselors appropriately trained in the use of such
13 methods, techniques, and modalities."
14      SECTION 3.  There is appropriated out of the general
15 revenues of the State of Hawaii the sum of $43,000 or so much
16 thereof as may be necessary for fiscal year 2000-2001 to
17 implement the professional counselor licensing program
18 established by this Act.
19      The sum shall be expended by the department of commerce and
20 consumer affairs for the purpose of this Act.
21      SECTION 4.  This Act shall take effect on July 1, 2000.
23                           INTRODUCED BY:  _______________________