SB2243

PART I

SECTION 1. The legislature finds that the State has repeatedly and consistently been recognized by the federal government as a health professional shortage area, meaning the State sorely lacks a sufficient number of mental health professionals, including psychiatrists, psychologists, social workers, marriage and family therapists, and mental health counselors having a focus on marriage and family life, to meet the overwhelming demand for these services in the State. These barriers to access create unnecessarily long wait times for appointments, causing many individuals, especially those individuals living in rural areas, to experience prolonged suffering or to choose not to seek any help at all. The result is a domino effect of mass losses in workforce development, increased instances of abuse within families, statistically higher rates of substance abuse, and high debt loads.

Currently, associate-level practitioners who have completed rigorous educational and other professional development requirements must render professional mental health treatment to clients to fulfill the post‑degree, pre-license hours required for full licensure. However, unlike many other professions and trades that have similar requirements, almost all of these mental health professionals go unpaid for the life-changing services because no laws exist to allow for health insurance reimbursements of their services.

This regulatory oversight causes undue hardships on these professionals and their families as they are essentially forced to work one very difficult and taxing job for free and a second job to meet personal needs. Unfortunately, this model of living is unsustainable and causes too much homegrown talent to permanently move to one of the many other states in which insurance reimbursements are allowed.

Accordingly, the purpose of this Act is to expand access to high-quality mental health services by:

(1) Establishing provisional, associate-level licensure requirements and reimbursement allowances for certain mental health practitioners in training; and

(2) Allowing psychologist license applicants to take licensing examinations before completing other requirements.

PART II

SECTION 2. Chapter 451J, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:

"§451J-A Application for license as an associate marriage and family therapist. (a) Any person who files an application with the department shall be issued an associate marriage and family therapist license if the applicant provides satisfactory evidence to the department that the applicant meets the following qualifications:

(1) Has received from an accredited educational institution a master's or doctoral degree in marriage and family therapy or an allied field related to the practice of mental health counseling that includes, or is supplemented by, graduate-level coursework comprising a minimum of thirty-three semester hours or forty-four quarter hours in the following course areas:

(A) Marriage and family studies: nine semester hours or twelve quarter hours;

(B) Marriage and family therapy studies: nine semester hours or twelve quarter hours;

(D) Ethical and professional studies: three semester hours or four quarter hours; and

(E) Research: three semester hours or four quarter hours;

(2) Has completed a one-year practicum that includes three hundred hours of supervised client contact;

(3) Has an agreement to be supervised by a marriage and family therapist; and

(4) Has passed the Marital and Family Therapy National Examination in accordance with section 451J-8.

(b) Each application for a license issued pursuant to this section shall include the name and title of each licensed marriage and family therapist described in subsection (a)(3).

§451J-B Associate marriage and family therapist. (a) Each associate marriage and family therapist shall only practice marriage and family therapy under the direct supervision of the respective licensed marriage and family therapist specified pursuant to section 451J-A(b).

(b) Services provided by an associate marriage and family therapist shall be eligible for insurance reimbursement in the same manner that the supervising licensed marriage and family therapist's services would be eligible for reimbursement as a contracted provider; provided that the billed rate for the licensed associate marriage and family therapist shall be commensurate with the requisite level of training.

(c) A license issued pursuant to this section shall be valid for one year from the date of issuance and may be renewed for an additional one-year period if necessary to fulfill the requirements for licensure as a marriage and family therapist pursuant to section 451J-7."

SECTION 3. Section 451J-1, Hawaii Revised Statutes, is amended as follows:

1. By adding a new definition to be appropriately inserted and to read:

""Associate marriage and family therapist" means a person who has a valid license issued under section 451J-A."

2. By deleting the definition of "marriage and family therapy intern".

[""Marriage and family therapy intern" means a person who has completed all educational requirements stipulated in section 451J-7(1)(A) and who is currently earning supervised clinical experience in marriage and family therapy under clinical supervision."]

SECTION 4. Section 451J-3, Hawaii Revised Statutes, is amended to read as follows:

"§451J-3 Powers and duties of the director. In addition to any other powers and duties authorized by law, the director may:

(1) Examine and approve the qualifications of all applicants under this chapter, and issue a license to each successful applicant granting permission to use the title of marriage and family therapist [or], licensed marriage and family therapist, associate marriage and family therapist, or licensed associate marriage and family therapist in this State pursuant to this chapter and the rules adopted under this chapter;

(2) Adopt, amend, or repeal rules pursuant to chapter 91;

(3) Administer, coordinate, and enforce this chapter and rules;

(4) Discipline a person licensed as a marriage and family therapist or associate marriage and family therapist for any cause described by this chapter, or for any violation of rules, or refuse to license a person for failure to meet licensing requirements or for any cause that would be grounds for disciplining a [~~licensed~~] marriage and family therapist[;] or associate marriage and family therapist; and

(5) Appoint an advisory committee of licensed marriage and family therapists and members of the public to assist with the implementation of this chapter and the rules; except that the initial members of the committee who are marriage and family therapists shall not be required to be licensed pursuant to this chapter."

SECTION 5. Section 451J-5, Hawaii Revised Statutes, is amended to read as follows:

"§451J-5 Prohibited acts. Except as specifically provided elsewhere in this chapter, no person shall use the title marriage and family therapist [or], licensed marriage and family therapist, associate marriage and family therapist, or licensed associate marriage and family therapist without first having secured a license under this chapter. The department shall investigate and prosecute any individual using the title of marriage and family therapist [or], licensed marriage and family therapist, associate marriage and family therapist, or licensed associate marriage and family therapist without being properly licensed as a marriage and family therapist[.] or associate marriage and family therapist. Any person who violates this section shall be subject to a fine of not more than $1,000 per violation. Each day's violation shall be deemed a separate offense. Any action taken to impose or collect the fine imposed under this section shall be a civil action."

SECTION 6. Section 451J-6, Hawaii Revised Statutes, is amended to read as follows:

"§451J-6 Exemptions. (a) Licensure shall not be required of:

(1) A person doing work within the scope of practice or duties of the person's profession that overlaps with the practice of marriage and family therapy; provided the person does not purport to be a marriage and family therapist [or], licensed marriage and family therapist[;], associate marriage and family therapist, or licensed associate marriage and family therapist; or

(2) Any student enrolled in an accredited educational institution in a recognized program of study leading toward attainment of a graduate degree in marriage and family therapy or other professional field; provided that the student's activities and services are part of a prescribed course of study supervised by the educational institution and the student is identified by an appropriate title including but not limited to "marriage and family therapy student or trainee", "clinical psychology student or trainee", "clinical social work student or trainee", or any title [~~which~~] that clearly indicates training status[~~; or~~

~~(3)~~ ~~Any individual who uses the title marriage and family therapy intern for the purpose of obtaining clinical experience in accordance with section 451J-7(3)~~].

(b) Nothing in this chapter shall be construed to prevent qualified members of other licensed professions as defined by any law, rule, or the department, including but not limited to social workers, psychologists, registered nurses, or physicians, from doing or advertising that they assist or treat individuals, couples, or families consistent with the accepted standards of their respective licensed professions; provided that no person, unless the person is licensed as a marriage and family therapist[,] or associate marriage and family therapist, shall use the title of marriage and family therapist [or], licensed marriage and family therapist[.], associate marriage and family therapist, or licensed associate marriage and family therapist."

SECTION 7. Section 451J-7, Hawaii Revised Statutes, is amended to read as follows:

"§451J-7 Application for licensure. Any person who files an application with the department after December 31, 1998, shall be issued a license by the department if the applicant provides satisfactory evidence to the department that the applicant is qualified for licensure pursuant to the requirements of this chapter and meets the following qualifications:

(1) Has [~~completed~~] received from an accredited educational institution a master's degree or doctoral degree [~~from an accredited educational institution~~] in marriage and family therapy or in an allied field related to the practice of mental health counseling [~~which~~] that includes, or is supplemented by [~~graduate level course work~~], graduate-level coursework comprising a minimum of thirty-three semester[,] hours or forty-four quarter hours in the following course areas:

(A) Marriage and family [~~studies--nine~~] studies: nine semester or twelve quarter hours;

(B) Marriage and family therapy [~~studies--nine~~] studies: nine semester or twelve quarter hours;

(D) Ethical and professional [~~studies--three~~] studies: three semester or four quarter hours; and

(E) [~~Research--three~~] Research: three semester or four quarter hours;

(2) Has completed a one year practicum [~~with~~] that includes three hundred hours of supervised client contact;

(3) [~~Completes~~] Has completed one thousand hours of direct marriage and family therapy, and two hundred hours clinical supervision in not less than twenty-four months; and

(4) Has passed the [~~National Marriage~~] Marital and Family Therapy [~~Exam~~] National Examination in accordance with section 451J-8.

An individual who is a clinical member of the association shall be deemed to have met the educational and clinical experience requirements of this section."

SECTION 8. Section 451J-8, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) The department shall administer the [~~National Marriage~~] Marital and Family Therapy [~~Exam~~] National Examination in compliance with the Association of Marital and Family Therapy Regulatory Board standards."

SECTION 9. Section 451J-9, Hawaii Revised Statutes, is amended to read as follows:

"[[]§451J-9[]] Licensure fees. The department may establish fees for licensure under this chapter. Licenses shall be valid for three years and shall be renewed triennially[.]; provided that licenses under section 451J-A shall be renewed pursuant to section 451J-A. Any applicant for renewal of a license that has expired within one year of the renewal deadline shall be required to pay a restoration fee in addition to all renewal fees."

SECTION 10. Section 451J-10, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) [~~Licenses~~] Except as provided in section 451J-A, licenses shall be renewed triennially on or before December 31, with the first renewal deadline occurring on December 31, 2001. Failure to renew a license shall result in a forfeiture of the license. Licenses that have been forfeited may be restored within one year of the expiration date upon payment of renewal and restoration fees, and in the case of marriage and family therapists or licensed marriage and family therapists audited pursuant to subsection (f), documentation of continuing education compliance. Failure to restore a forfeited license within one year of the date of its expiration shall result in the automatic termination of the license. Persons with terminated licenses shall be required to reapply for licensure as a new applicant."

SECTION 11. Section 451J-12, Hawaii Revised Statutes, is amended to read as follows:

"[[]§451J-12[]] Confidentiality and privileged communications. No person licensed as a marriage and family therapist[,] or associate marriage and family therapist, nor any of the person's employees or associates, shall be required to disclose any information that the person may have acquired in rendering marriage and family therapy services except in the following circumstances:

(1) As required by law;

(2) To prevent a clear and immediate danger to a person or persons;

(3) In the course of a civil, criminal, or disciplinary action arising from the therapy where the therapist is a defendant;

(4) In a criminal proceeding where the client is a defendant and the use of the privilege would violate the defendant's right to a compulsory process of the right to present testimony and witnesses in the defendant's own behalf;

(5) In accordance with the terms of a client's previously written waiver of the privilege; or

(6) Where more than one person in a family jointly receives therapy and each family member who is legally competent executes a written waiver; in that instance, a marriage and family therapist or associate marriage and family therapist may disclose information received from any family member in accordance with the terms of the person's waiver."

SECTION 12. Section 451J-13, Hawaii Revised Statutes, is amended to read as follows:

"[[]§451J-13[]] Therapist prohibited from testifying in alimony and divorce actions. If both parties to a marriage have obtained marriage and family therapy by a licensed marriage and family therapist[,] or licensed associate marriage and family therapist, the therapist shall be prohibited from testifying in an alimony or divorce action concerning information acquired in the course of therapy. This section shall not apply to custody actions whether or not part of a divorce proceeding."

PART III

SECTION 13. Chapter 453D, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:

"§453D-A Application for license as an associate mental health counselor. (a) Any person who files an application with the department shall be issued an associate mental health counselor license if the applicant provides satisfactory evidence to the department that the applicant meets the following qualifications:

(1) Has received from an accredited educational institution a master's or doctoral degree in counseling or in an allied field related to the practice of mental health counseling that includes, or is supplemented by, graduate-level coursework in counseling comprising a minimum of forty-eight semester hours or seventy-two quarter hours in the following course areas, with a minimum of three semester hours or five quarter hours in each course area as indicated below:

(A) Human growth and development, including the study of life span development, strategies to facilitate that development and transitions, theories of learning and personality development, and human behavior to include crisis, disabilities, addictive behavior, and environmental factors;

(B) Social and cultural foundations, including the study of issues and trends in a multicultural and diverse society, such as ages; races; religious or sexual preferences; physical disabilities; ethnicities and cultures; genders; socioeconomics; intellectual abilities; and individual, family, and group strategies of diverse groups;

(C) Counseling theories and applications, including counseling and consultation, such as both individual and systems perspectives, interviewing, assessment, and counseling skills, and applying principles, methods, and theories of counseling, treatment and counseling of mental and emotional disorders, and educational techniques aimed at preventing these disorders with individuals and families;

(D) Group theory and practice, including principles of group dynamics, group process, group leadership styles, theories and methods of group counseling, and the application of theory to the group processes;

(E) Career and lifestyle development, including the study of vocational development theories; decision-making models; assessment instruments; and techniques, types, sources, and uses of occupational and educational information systems, career development applications, and career counseling processes, techniques, and resources;

(F) Appraisal of human behavior, including assessment and diagnosis of disorders with an emphasis on the Diagnostic and Statistical Manual of Mental Disorders' categories and an understanding of these disorders relative to the counseling context;

(G) Tests and measurements, including theoretical and historical bases for assessment techniques, and assessment methods, such as analysis of various types of tests to select, administer, interpret, and use assessment and evaluation instruments and techniques in counseling;

(H) Research and program evaluation, including research design and methods, statistical analysis, principles, practices, and application of needs assessment and program evaluation;

(I) Professional orientation and ethics, including the history of the helping profession, professional roles and functions, ethical standards, confidentiality, professional organizations, and public policy process such as advocacy on behalf of the profession and its clientele; and

(J) At least two academic terms of supervised mental health practicum intern experience for graduate credit of at least six semester hours or ten quarter hours in a mental health counseling setting, with a total of three hundred hours of supervised client contact; provided that the practicum experience shall be completed under the clinical supervision of a person who is licensed as a mental health counselor, psychologist, clinical social worker, advanced practice registered nurse with a specialty in mental health, marriage and family therapist, or physician having a specialty in psychiatry;

(2) During the period of time to fulfill the requirements for licensure as a mental health counselor pursuant to section 453D-7, engages in practice under the clinical supervision of a licensed mental health counselor that is in good standing with the department; and

(3) Has passed the National Counselor Examination for Licensure and Certification.

(b) Each application for a license issued pursuant to this section shall include the name and title of the licensed mental health counselor described in subsection (a)(2).

§453D-B Associate mental health counselor. (a) Each associate mental health counselor shall only practice mental health counseling under the direct supervision of the respective licensed mental health counselor specified in section 453D-A(b).

(b) Services provided by an associate mental health counselor shall be eligible for insurance reimbursement in the same manner that the supervising licensed mental health counselor's services would be eligible for reimbursement as a contracted provider; provided that the billed rate for the licensed associate mental health counselor shall be commensurate with the requisite level of training.

(c) A license issued pursuant to this section shall be valid for one year from the date of issuance and may be renewed for an additional one-year period if necessary to fulfill the requirements for licensure as a mental health counselor pursuant to section 453D-7."

SECTION 14. Section 453D-1, Hawaii Revised Statutes, is amended by adding a new definition to be appropriately inserted and to read:

""Associate mental health counselor" or "licensed associated mental health counselor" means a person who has a valid license issued under section 453D-A."

SECTION 15. Section 453D-3, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-3[]] Powers and duties of the director. In addition to any other powers and duties authorized by law, the director shall have the powers and duties to:

(1) Grant permission to a person to use the title of "licensed mental health counselor" or "licensed associate mental health counselor" or a description indicating one is a licensed mental health counselor or licensed associate mental health counselor in this State pursuant to this chapter and the rules adopted pursuant thereto;

(2) Adopt, amend, or repeal rules pursuant to chapter 91 as the director finds necessary to carry out this chapter;

(3) Administer, coordinate, and enforce this chapter;

(4) Discipline a [~~licensed~~] mental health counselor or associate mental health counselor for any due cause described by this chapter or violation of the rules;

(5) Refuse to license a person for failure to meet licensing requirements or on grounds sufficient to discipline a [~~licensed~~] mental health counselor[;] or associate mental health counselor; and

(6) Appoint an advisory committee consisting of licensed mental health counselors and members of the public to assist with the implementation of this chapter and adopted rules; provided that the initial members of the committee who are mental health counselors shall not be required to be licensed pursuant to this chapter."

SECTION 16. Section 453D-5, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-5[]] Prohibited acts. Except as specifically provided in this chapter, no person shall engage in the practice of mental health counseling or use the title of "licensed mental health counselor" [or], "mental health counselor", "licensed associate mental health counselor", or "associate mental health counselor" without a valid license issued under this chapter. Any person who violates this section shall be subject to a fine of not more than $1,000 for each separate offense. Each day of each violation shall constitute a separate offense. Any action taken to impose or collect the fine imposed under this section shall be a civil action."

SECTION 17. Section 453D-6, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) This chapter shall not apply to:

(1) A person doing work within the duties of the person's profession that overlaps with the practice of mental health counseling; provided that no [~~such~~] person shall use a title stating or implying that the person is a "licensed mental health counselor" [or], "mental health counselor", "licensed associate mental health counselor", "associate mental health counselor" or describe or refer to the person's services as mental health counseling;

(2) Any person who is a duly recognized member of the clergy; provided that the person functions only within the person's capacity as a member of the clergy; and provided further that the person does not represent the person to be a "licensed mental health counselor" [or], "mental health counselor", "licensed associate mental health counselor", or "associate mental health counselor" or describe or refer to the person's services as mental health counseling;

(3) Any student enrolled in an accredited educational institution in a recognized program of study leading towards attainment of a graduate degree in mental health counseling or other professional field; provided that the student's activities and services are part of a prescribed course of study supervised by the accredited educational institution and the student is identified by an appropriate title, including but not limited to "mental health counseling student" or "trainee", "clinical psychology student" or "trainee", "social work student" or "trainee", "marriage and family counseling student" or "trainee", or any title that clearly indicates training status;

[~~(4)~~ ~~Any individual who uses the title of "mental health counselor intern" for the purpose of obtaining clinical experience in accordance with section 453D‑7(a)(2);~~

~~(5)~~] (4) Any person employed by a federal, state, or county government agency in a counseling position, but only at those times when the employee is carrying out the duties and responsibilities as a counselor in governmental employment; or

[~~(6)~~] (5) Any person who is obtaining supervised clinical experience for licensure as a psychologist, social worker, marriage and family therapist, or as another licensed professional; provided that the person's title indicates a trainee or intern status; and provided further that the person does not purport to be a "licensed mental health counselor" [or], "mental health counselor"[.], "licensed associate mental health counselor", or "associate mental health counselor"."

SECTION 18. Section 453D-10, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-10[]] Licensure; fees. A license shall be issued to a person deemed to be qualified under [~~section~~] sections 453D-7 or 453D-A upon the payment of a license fee to be determined by the department and shall be valid for three years[.]; provided that provisional licenses shall be renewed pursuant to section 453D-A."

SECTION 19. Section 453D-11, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-11[]] Renewal of license; fees. [~~Licenses~~] Except as provided in section 453D-A, licenses shall be renewed, upon the payment of a renewal fee, triennially not earlier than ninety days before June 30, with the first renewal deadline occurring on June 30, 2008. Failure to renew a license shall result in a forfeiture of the license. Licenses that have been forfeited may be restored within one year of the expiration date upon payment of renewal and restoration fees. Failure to restore a forfeited license within one year of the date of its expiration shall result in the automatic termination of the license and the person may be required to reapply for licensure as a new applicant. All renewal and restoration fees shall be determined by the department."

SECTION 20. Section 453D-13, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-13[]] Confidentiality and privileged communications. No person licensed as a mental health counselor[,] or associate mental health counselor, nor any of the person's employees or associates, shall be required to disclose any information that the person may have acquired in rendering mental health counseling services, except in the following circumstances:

(1) As required by law;

(2) To prevent a clear and imminent danger to a person or persons;

(3) In accordance with the terms of a previously written waiver of the privilege where the waiver is executed by the client or by the client's legally recognized representative;

(4) Where more than one person jointly receives counseling and each person who is legally competent executes a written waiver. In that instance, a mental health counselor or associate mental health counselor may disclose information from any person in accordance with that person's waiver; or

(5) In the course of a disciplinary action or pursuant to a duly authorized subpoena issued by the department."

SECTION 21. Section 453D-14, Hawaii Revised Statutes, is amended to read as follows:

"[[]§453D-14[]] Mental health counselor or associate mental health counselor prohibited from testifying in alimony and divorce actions. If both parties to a marriage have obtained mental health counseling from a licensed mental health counselor[,] or licensed associate mental health counselor, the counselor shall be prohibited from testifying in an alimony or divorce action concerning information acquired in the course of mental health counseling. This section shall not apply to custody actions whether or not part of a divorce proceeding."

PART IV

SECTION 22. Chapter 465, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:

"§465-A Application for license as an associate psychologist. (a) Any person who files an application with the board shall be issued an associate psychologist license if the applicant provides satisfactory evidence to the department that the applicant meets the following qualifications:

(1) Has received a doctoral degree from:

(A) An American Psychological Association-approved program in clinical psychology, counseling psychology, or school psychology, or programs offering combinations of two or more of these areas; or

(B) A professional psychology training program provided by an institution of higher education or from a regionally accredited institution; and

(2) Is engaging in post-doctoral, supervised experience in health service psychology pursuant to an organized health service training program approved by the board.

(b) Each application for a license issued pursuant to this section shall include the name and title of the supervising licensed psychologist or psychologists in the training program described in subsection (a)(2).

§465-B Associate psychologist. (a) Each associate psychologist shall only practice psychology under the direct supervision of the respective licensed psychologist having a current, active, and unencumbered license issued by the board; provided that the supervising licensed psychologist shall notify the board within ten days of the termination or completion of the supervision.

(b) Services provided by an associate psychologist shall be eligible for insurance reimbursement in the same manner that the supervising licensed psychologist's services would be eligible for reimbursement as a contracted provider; provided that the billed rate for the licensed associate psychologist shall be commensurate with the requisite level of training.

(c) A license issued pursuant to this section shall be valid for one year to fulfill the requirements for full licensure as a psychologist under section 465-7."

SECTION 23. Section 465-1, Hawaii Revised Statutes, is amended by adding a new definition to be appropriately inserted and to read as follows:

""Associate psychologist" or "licensed associate psychologist" means a person who has a valid license issued under section 465-A."

SECTION 24. Section 465-2, Hawaii Revised Statutes, is amended to read as follows:

"§465-2 License required. Except as otherwise provided in this chapter, it shall be unlawful to represent [~~one's self~~] oneself as a psychologist or associate psychologist or engage in the practice of psychology without having first obtained a license as provided in this chapter."

SECTION 25. Section 465-3, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) This chapter shall not apply to:

(1) Any person teaching, lecturing, consulting, or engaging in research in psychology insofar as the activities are performed as part of or are dependent upon employment in a college or university; provided that the person shall not engage in the practice of psychology outside the responsibilities of the person's employment;

(2) Any person who performs any, or any combination of the professional services defined as the practice of psychology under the direction of a licensed psychologist in accordance with rules adopted by the board; provided that the person may use the term "psychological assistant", but shall not identify the person's self as a psychologist or imply that the person is licensed to practice psychology;

(3) Any person employed by a local, state, or federal government agency in a school psychologist or psychological examiner position, or a position that does not involve diagnostic or treatment services, but only at those times when that person is carrying out the functions of [~~such~~] the government employment;

(4) Any person who is a student of psychology[, a psychological intern, or a resident in psychology preparing for the profession of psychology under supervision in a training institution or facility and who is designated by a title as "psychology trainee", "psychology student", "psychology intern", or "psychology resident", that indicates the person's training status]; provided that the person shall not identify the person's self as a psychologist or associate psychologist or imply that the person is licensed to practice psychology;

(5) Any person who is a member of another profession licensed under the laws of this jurisdiction to render or advertise services, including psychotherapy, within the scope of practice as defined in the statutes or rules regulating the person's professional practice; provided that, notwithstanding section 465-1, the person does not represent the person's self to be a psychologist or associate psychologist or does not represent that the person is licensed to practice psychology;

(6) Any person who is a member of a mental health profession not requiring licensure; provided that the person functions only within the person's professional capacities; and provided further that the person does not represent the person to be a psychologist[,] or associate psychologist, or the person's services as psychological;

(7) Any person who is a duly recognized member of the clergy; provided that the person functions only within the person's capacities as a member of the clergy; and provided further that the person does not represent the person to be a psychologist[,] or associate psychologist, or the person's services as psychological; or

(8) Any psychologist employed by the United States Department of Defense, while engaged in the discharge of the psychologist's official duty and providing direct telehealth support or services, as defined in section 431:10A-116.3, to neighbor island beneficiaries within a Hawaii National Guard armory on the island of Kauai, Hawaii, Molokai, or Maui; provided that the psychologist employed by the United States Department of Defense is credentialed by Tripler Army Medical Center[~~; or~~

~~(9)~~ ~~Any supervisee of a licensed psychologist as defined in section 465D‑7~~]."

SECTION 26. Section 465-3.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) Notwithstanding other provisions in this chapter the director of health may certify that there is an absence or shortage of licensed psychologists or associate psychologists for government employment in a particular locality. Upon receiving certification of the absence or shortage, the board shall authorize the director to hire and retain persons currently in government employment to fill the absence or shortage; provided persons hired or retained have been duly licensed as a psychologist by written examination under the laws of another state or territory of the United States prior to 1977."

SECTION 27. Section 465-6, Hawaii Revised Statutes, is amended to read as follows:

"§465-6 Powers and duties. In addition to any other powers and duties authorized by law, the board shall:

(1) Examine the qualifications of applicants for licensing under this chapter to determine their eligibility for licensing as psychologists[;] or associate psychologists;

(2) Administer and grade examinations for applicants as may be required for the purposes of this chapter. The board shall determine the examinations and the score that shall be deemed a passing score. Examinations shall be scheduled at least once annually;

(3) Keep a record of action taken on all applicants for licensing; the names of all persons licensed; petitions for temporary permits; actions involving suspension, revocation, or denial of licenses; decisions on waiver of examination in whole or in part and receipt and disbursal of any moneys; and

(4) Adopt, amend, and repeal pursuant to chapter 91, rules as it deems proper for the purposes of this chapter."

SECTION 28. Section 465-7, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) Every applicant for a license as a psychologist shall submit evidence satisfactory to the board that the applicant meets the following requirements:

(1) The applicant for licensure shall possess a doctoral degree from:

(A) An American Psychological [~~Association approved~~] Association-approved program in clinical psychology, counseling psychology, school psychology, or programs offering combinations of two or more of these areas; or

(B) A professional psychology training program, awarded by an institution of higher education, or from a regionally accredited institution;

(2) The applicant for licensure shall demonstrate that the applicant has completed one year of [~~post doctoral~~] post-doctoral supervised experience in health service in psychology, and:

(A) An internship approved by the American Psychological Association; or

(B) One year of supervised experience in health service in psychology, in an internship or residency program in an organized health service training program; and

(3) The applicant for licensure has passed an examination as may be prescribed by the board[.];

provided that nothing in this subsection shall be construed as requiring the applicant to complete the requirements of paragraph (2) to be eligible to take the examination required in paragraph (3)."

SECTION 29. Section 465-7.6, Hawaii Revised Statutes, is amended to read as follows:

"§465-7.6 Licensure of state employed clinical psychologists. (a) A psychologist employed in a civil service clinical psychologist position in this State after January 1, 1988, shall be licensed subject to:

(1) Meeting the requirements of section 465-7; and

(2) Obtaining licensure within two years from the date of employment[.];

provided that, if the psychologist is not able to obtain licensure within two years, the board may grant a waiver if the psychologist is able to demonstrate that the delay was caused by circumstances beyond the psychologist's control.

(b) [~~After~~] Absent a waiver obtained pursuant to subsection (a), after the time period in subsection (a)(2) has expired, a psychologist, employed in a civil service clinical psychologist position rendering diagnostic or treatment services, who has not obtained a license, shall immediately cease and desist the practice of psychology until a license is obtained pursuant to this chapter."

SECTION 30. Section 465-8, Hawaii Revised Statutes, is amended to read as follows:

"§465-8 Licenses, issuance, display. Upon the board forwarding to the director the name of each applicant who is entitled to a license under this chapter and upon receipt of the prescribed fee, the director shall promptly issue to each applicant a license authorizing the applicant to engage in the practice of psychology for a period of two years. The license shall be in the form as the director shall determine. A licensed psychologist or associate psychologist shall display the license in a conspicuous place in the psychologist's or associate psychologist's principal place of business[.]; provided that a license shall include the name and title of the supervising licensed psychologist or psychologists."

SECTION 31. Section 465-11, Hawaii Revised Statutes, is amended as follows:

1. By amending subsection (a) to read:

"(a) Every license issued under this chapter shall be renewed biennially on or before June 30 of each even-numbered year. Failure to renew a license shall result in forfeiture of the license; provided that a psychologist whose license has been forfeited for one year or less for failure to renew may restore the license by payment of the renewal fee and, in the case of a psychologist who is audited, pursuant to subsection (g), submission of documentation of continuing education compliance, for the biennium in which the failure occurred[.]; provided further that the board may grant waivers or extensions if the licensee is able to demonstrate that the delay was due to circumstances beyond the licensee's control. If licensing has lapsed for more than one year, the person may reapply for a license in the manner prescribed in this chapter."

2. By amending subsection (d) to read:

"(d) First-time licensees and provisional licensees pursuant to section 465-A shall not be subject to the continuing education requirement established under subsection (c)(2) for the first license renewal."

SECTION 32. Section 465-15, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) No person shall:

(1) Use in connection with the person's name any designation tending to imply that the person is a licensed psychologist or licensed associate psychologist unless the person is duly licensed and authorized under this chapter;

(2) Represent oneself as a licensed psychologist or licensed associate psychologist during the time the person's license issued under this chapter is suspended or revoked;

(3) Advertise or make a representation, either publicly or privately, as being a psychologist[,] or associate psychologist, licensed or otherwise, or as being able to perform professional services described in section 465-1, except as otherwise provided in this chapter, without having a valid unrevoked license or temporary permit issued by the director; or

(4) Otherwise violate this chapter."

PART V

SECTION 33. Section 467E-7, Hawaii Revised Statutes, is amended to read as follows:

"§467E-7 Licensing requirements[.]; services reimbursable. (a) Every applicant for a license as a social worker shall submit evidence satisfactory to the director that the applicant meets the following requirements:

(1) For the licensed bachelor social worker, the applicant:

(A) Holds a bachelor's degree from a college or university in a social work program accredited by or deemed to be equivalent to a program accredited by the Council on Social Work Education; and

(B) Has passed the basic level national examination given by the Association of Social Work Boards;

(2) For the licensed social worker, the applicant:

(A) Holds a master's degree from a college or university in a social work program accredited by or deemed to be equivalent to an accredited program by the Council on Social Work Education or a doctoral degree from a doctoral degree program in social work accredited by the Western Association of Schools and Colleges or a comparable regional accreditation body; and

(B) Has passed the intermediate or [~~higher level~~] higher-level national examination given by the Association of Social Work Boards; and

(3) For the licensed clinical social worker, the applicant:

(A) Has met the educational requirements in paragraph (2);

(B) Has passed the clinical level national examination given by the Association of Social Work Boards;

(C) Has provided evidence of successful completion of at least three thousand hours of post masters clinical social work experience under supervision completed within no fewer than two years, but within no more than five years. Clinical social work experience shall include a minimum of two thousand hours of assessment, clinical diagnosis, and psychotherapy; no more than a maximum of nine hundred hours of client-centered advocacy, consultation, and evaluation; and at least one hundred hours of supervision as follows:

(i) At least sixty of the one hundred hours of direct face-to-face supervision shall have been individualized supervision; and

(ii) Not more than forty hours of direct face‑to‑face supervision may have been under small group (up to six supervisees) supervision.

An applicant who submits evidence of certification as a qualified clinical social worker or diplomate in clinical social work by the National Association of Social Workers or as a [~~board certified~~] board-certified diplomate by the American Board of Examiners shall be deemed to have satisfied the experience requirements of this subparagraph;

(D) For the purposes of subparagraph (C), shall have had clinical supervision as follows:

(i) The supervisor shall have been a licensed clinical social worker with at least four thousand five hundred hours of post masters clinical social work experience;

(ii) For the first five years after July 1, 2004, the following individuals shall be deemed to have satisfied the requirements of a supervisor: a person with a master's degree in social work with at least four thousand five hundred hours post masters clinical social work experience; an individual who holds a diplomate in clinical social work or a board certified diplomate certification; or a board certified psychiatrist, psychologist, advanced practice registered nurse who has a minimum of four thousand five hundred hours of post masters clinical experience in assessment, clinical diagnosis, and psychotherapy; and

(iii) Supervision shall have included review of assessment, clinical diagnosis, and psychotherapy; and

(E) In collaboration with the supervisor, may elect to fulfill some or all of the supervision requirements set forth in subparagraph (C) through face-to-face supervision that is conducted electronically through a video conference service that is compliant with all federal and state privacy, security, and confidentiality laws, including the Health Insurance Portability and Accountability Act of 1996. Prior to making [~~such an~~] the election, it is incumbent upon the applicant to review the laws and rules of other jurisdictions to determine the impact, if any, that electronic supervision may have on license by endorsement in other states.

(b) Services provided by a supervised social worker who is working to obtain post-masters clinical social work experience under the supervision of a licensed clinical social worker or individual identified in section 467E-7(a)(3)(D) in order to qualify for a license as a licensed clinical social worker shall be eligible for insurance reimbursement through the insurance of the applicable client through reimbursements of claims submitted by the supervising licensed clinical social worker while listed under the supervising licensed clinical social worker's treatment authority and supervision; provided that the licensed supervising clinical social worker's services shall be eligible for reimbursement as a contracted provider; provided further that the billed rate for the licensed social worker shall be commensurate with the requisite level of training."

PART VI

SECTION 34. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 35. This Act shall take effect upon its approval; provided that any provision in this Act authorizing insurance reimbursement for services shall be subject to approval by the Centers for Medicare and Medicaid Services.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	2243
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII