Titles of Regulations: 18VAC115-20. Regulations Governing the Practice of Professional Counseling (amending 18VAC115-20-105).

18VAC115-50. Regulations Governing the Practice of Marriage and Family Therapy (amending 18VAC115-50-95).

18VAC115-60. Regulations Governing the Practice of Licensed Substance Abuse Treatment Practitioners (amending 18VAC115-60-50, 18VAC115-60-115).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: December 13, 2017.

Effective Date: December 28, 2017.

Agency Contact: Jaime Hoyle, Executive Director, Board of Counseling, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4406, FAX (804) 527-4435, or email jaime.hoyle@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia provides the Board of Counseling the authority to promulgate regulations to administer the regulatory system.

Specific authority for regulation of the profession of counseling is found in § 54.1-3503 of the Code of Virginia, which mandates that the board regulate the practice of counseling, substance abuse treatment, and marriage and family therapy; § 54.1-3506 of the Code of Virginia, which requires individuals who engage in the practice of counseling or marriage and family therapy or in the independent practice of substance abuse treatment to hold a license; and § 54.1-103 of the Code of Virginia, which authorizes the board to promulgate regulations specifying additional training or conditions for individuals seeking certification or licensure, or for the renewal of certificates or licenses.

Purpose: The purpose of the amendments is to open a pathway for those individuals who hold another mental health license to be licensed in substance abuse treatment if they have specific coursework and training in the field. With the crisis of substance abuse being experienced in the Commonwealth, a regulatory action to encourage more treatment providers, who can offer services as a licensee and supervise the services of certified or registered providers, may increase access to care and ultimately offer greater protection for the safety, health, and welfare of all citizens.

The exemption from continuing education for newly licensed persons will not affect the public health and safety since their competency to practice has been determined by examination, education, and a supervised residency within the period immediately prior to licensure.

Rationale for Using Fast-Track Rulemaking Process: The amendments are permissive and less restrictive than current regulations. They will benefit first-time licensees and some applicants for licensure by endorsement for the substance abuse treatment professional license; therefore, they are not expected to be controversial.

Substance: The amendments (i) provide that a person who was licensed by examination is exempt from meeting continuing competency requirements for the first renewal following initial licensure; (ii) eliminate the requirement for official transcripts documenting completion of all the education requirements, so an applicant for licensure by endorsement will not need to obtain an additional master's degree in substance abuse; (iii) require an official transcript to indicate completion of a 60-hour master's degree in mental health and completion of 12 hours of didactic training in substance abuse competencies; and (iv) delete subsection B of 18VAC115-60-50 because the credentials registry referenced in that subsection no longer exists.

Issues: There are no disadvantages to the public. Less restrictive regulation for licensure by endorsement for the Licensed Substance Abuse Treatment Practitioners license may result in more licensed providers to both deliver and supervise substance abuse services.

There are no advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Counseling (Board) proposes to 1) eliminate continuing education requirements for the first renewal of a license issued by examination; and 2) amend the licensure by endorsement requirements to make it possible for persons who hold other behavioral health licenses to obtain a substance abuse treatment professional license.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The Board proposes to no longer require continuing education for the first renewal of a license issued by examination. This change applies to licensed professional counselors, marriage and family therapists, and substance abuse treatment practitioners. Currently, affected professionals are required to complete 20 hours of continuing education for each yearly license renewal cycle. The requirement could be satisfied many different ways including taking academic courses, continuing education classes, participating in workshops, seminars, conferences, publication of articles, books, etc. The proposed change will provide different types of benefits to different individuals. Some may benefit not having to pay fees for courses or classes; some may benefit from not having to spend the time to complete the activity required; some may benefit from not having to travel; some may benefit from a combination of all of these choices. The Board has determined that the exemption from continuing education for newly licensed persons will not affect the public health and safety since their competency to practice has been determined by examination, education and a supervised residency within the period immediately prior to licensure. Thus, this change is expected to provide a net benefit.

The Board also proposes to delete language requiring transcripts documenting certain education for licensure by endorsement of substance abuse treatment practitioners. According to the Department of Health Professions (DHP), as written, the current requirement amounts to requiring an additional master's degree in substance abuse as a condition of licensure by endorsement. That requirement negates the possibility of licensure by endorsement as it requires the applicants to satisfy the same education requirements as those who are initially licensed through examination. Thus, removal of this language will eliminate a barrier to practicing in Virginia if one has satisfied the educational requirements in another jurisdiction. The proposed regulation would benefit substance abuse treatment professionals licensed in another state who are seeking licensure in the Commonwealth. Additionally, making it easier to obtain licensure may encourage more substance abuse professionals to come to Virginia to practice. This change opens a new pathway for those licensed in another jurisdiction who have specific coursework and training in the field. Therefore, it should not introduce risks of unqualified applicants becoming licensed in Virginia.

Businesses and Entities Affected. The proposed regulation applies to licensed professional counselors, marriage and family therapists, and substance abuse treatment practitioners. DHP reports that in the first nine months of 2017, there were 443 licenses issued. Most of those were likely first time licensees and will qualify for an exemption on their first renewal.

Localities Particularly Affected. The proposed regulation will not affect any particular locality more than others.

Projected Impact on Employment. The proposed elimination of continuing education during the first renewal cycle will reduce the demand for such services. The proposed regulation may also encourage substance abuse treatment professionals licensed in other states to come to Virginia to practice and increase their supply. However, the magnitude of any such effect is not known.

Effects on the Use and Value of Private Property. No effect on the use and value of private property is expected.

Real Estate Development Costs. No impact on real estate development costs is expected.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed regulation does not directly apply to small businesses. However, if an affected practitioner works for a small business it may be indirectly beneficial to that small business as the proposed regulation eliminates continuing education requirement in the first renewal cycle and makes it easier to obtain a substance abuse treatment license by endorsement. The majority of affected professionals are estimated to operate their practices within a small business.

Alternative Method that Minimizes Adverse Impact. The proposed regulation does not introduce an adverse impact on small businesses.

Adverse Impacts:

Businesses. The proposed regulation does not have an adverse impact on businesses.

Localities. The proposed regulation will not adversely affect localities.

Other Entities. The proposed regulation will not adversely affect other entities.

Agency's Response to Economic Impact Analysis: The Board of Counseling concurs with the analysis of the Department of Planning and Budget.

Summary:

The amendments (i) eliminate continuing education requirements for the first renewal of a license issued by examination for licensed professional counselors, marriage and family therapists, and substance abuse treatment practitioners; and (ii) amend the licensure by endorsement requirements to make it possible for persons who hold other behavioral health licenses to obtain a substance abuse treatment professional license.

18VAC115-20-105. Continued competency requirements for renewal of a license.

A. Licensed professional counselors shall be required to have completed a minimum of 20 hours of continuing competency for each annual licensure renewal. A minimum of two of these hours shall be in courses that emphasize the ethics, standards of practice, or laws governing behavioral science professions in Virginia.

B. The board may grant an extension for good cause of up to one year for the completion of continuing competency requirements upon written request from the licensee prior to the renewal date. Such extension shall not relieve the licensee of the continuing competency requirement.

C. The board may grant an exemption for all or part of the continuing competency requirements due to circumstances beyond the control of the licensee such as temporary disability, mandatory military service, or officially declared disasters.

D. Those individuals dually licensed by this board will not be required to obtain continuing competency for each license. Dually licensed individuals will only be required to provide the hours set out in subsection A of this section, subsection A of 18VAC115-50-95 in the Regulations Governing the Practice of Marriage and Family Therapy, or subsection A of 18VAC115-60-115 in the Regulations Governing the Practice of Licensed Substance Abuse Treatment Practitioners.

E. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of counseling services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for three hours of providing such volunteer services, as documented by the health department or free clinic.

F. A professional counselor who was licensed by examination is exempt from meeting continuing competency requirements for the first renewal following initial licensure.

18VAC115-50-95. Continued competency requirements for renewal of a license.

A. Marriage and family therapists shall be required to have completed a minimum of 20 hours of continuing competency for each annual licensure renewal. A minimum of two of these hours shall be in courses that emphasize the ethics, standards of practice, or laws governing behavioral science professions in Virginia.

B. The board may grant an extension for good cause of up to one year for the completion of continuing competency requirements upon written request from the licensee prior to the renewal date. Such extension shall not relieve the licensee of the continuing competency requirement.

C. The board may grant an exemption for all or part of the continuing competency requirements due to circumstances beyond the control of the licensee such as temporary disability, mandatory military service, or officially declared disasters.

D. Those individuals dually licensed by this board will not be required to obtain continuing competency for each license. Dually licensed individuals will only be required to provide the hours set out in subsection A of this section, subsection A of 18VAC115-20-105 in the Regulations Governing the Practice of Professional Counseling, or subsection A of 18VAC115-60-115 in the Regulations Governing the Practice of Licensed Substance Abuse Treatment Practitioners.

E. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of counseling services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for three hours of providing such volunteer services, as documented by the health department or free clinic.

F. A marriage and family therapist who was licensed by examination is exempt from meeting continuing competency requirements for the first renewal following initial licensure.

18VAC115-60-50. Prerequisites for licensure by endorsement.

A. Every applicant for licensure by endorsement shall submit:

1. A completed application;

2. The application processing and initial licensure fee as prescribed in 18VAC115-60-20;

3. Verification of all mental health or health professional licenses or certificates ever held in any other jurisdiction. In order to qualify for endorsement, the applicant shall have no unresolved disciplinary action against a license or certificate. The board will consider history of disciplinary action on a case-by-case basis;

4. Further documentation of one of the following:

a. A current substance abuse treatment license in good standing in another jurisdiction obtained by meeting requirements substantially equivalent to those set forth in this chapter; or

b. A mental health license in good standing in a category acceptable to the board which that required completion of a master's degree in mental health to include 60 graduate semester hours in mental health as documented by an official transcript; and

(1) Board-recognized national certification in substance abuse treatment;

(2) If the master's degree was in substance abuse treatment, two years of post-licensure experience in providing substance abuse treatment;

(3) If the master's degree was not in substance abuse treatment, five years of post-licensure experience in substance abuse treatment plus 12 credit hours of didactic training in the substance abuse treatment competencies set forth in 18VAC115-60-70 C as documented by an official transcript; or

(4) Current substance abuse counselor certification in Virginia in good standing or a Virginia substance abuse treatment specialty licensure designation with two years of post-licensure or certification substance abuse treatment experience; or

c. Documentation of education and supervised experience that met the requirements of the jurisdiction in which he was initially licensed as verified by an official transcript and a certified copy of the original application materials and evidence of post-licensure clinical practice for 24 of the last 60 months immediately preceding his licensure application in Virginia. Clinical practice shall mean the rendering of direct clinical substance abuse treatment services or clinical supervision of such services.

5. Verification of a passing score on a substance abuse licensure examination as established by the jurisdiction in which licensure was obtained. The examination is waived for an applicant who holds a current and unrestricted license as a professional counselor within the Commonwealth of Virginia;

6. Official transcripts documenting the applicant's completion of the education requirements prescribed in 18VAC115-60-60 and 18VAC115-60-70;

7. 6. An affidavit of having read and understood the regulations and laws governing the practice of substance abuse treatment in Virginia; and

8. 7. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).

B. In lieu of transcripts verifying education and documentation verifying supervised experience, the board may accept verification from the credentials registry of the American Association of State Counseling Boards or any other board-recognized entity.

18VAC115-60-115. Continued competency requirements for renewal of a license.

A. Licensed substance abuse treatment practitioners shall be required to have completed a minimum of 20 hours of continuing competency for each annual licensure renewal. A minimum of two of these hours shall be in courses that emphasize the ethics, standard of practice, or laws governing behavioral science professions in Virginia.

B. The board may grant an extension for good cause of up to one year for the completion of continuing competency requirements upon written request from the licensee prior to the renewal date. Such extension shall not relieve the licensee of the continuing competency requirement.

C. The board may grant an exemption for all or part of the continuing competency requirements due to circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.

D. Those individuals dually licensed by this board will not be required to obtain continuing competency for each license. Dually licensed individuals will only be required to provide the hours set out in subsection A of this section, subsection A of 18VAC115-50-95 in the Regulations Governing the Practice of Marriage and Family Therapy, or subsection A of 18VAC115-20-105 in the Regulations Governing the Practice of Professional Counseling.

E. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of counseling services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for three hours of providing such volunteer services, as documented by the health department or free clinic.

F. A substance abuse treatment practitioner who was licensed by examination is exempt from meeting continuing competency requirements for the first renewal following initial licensure.