wa-law.org > bill > 2025-26 > SB 6059 > Original Bill
The legislature finds that:
The social work profession in Washington state maintains a strong fiscal position with a surplus fund balance of $1,310,000 as of fiscal year 2024, demonstrating the financial sustainability necessary to support an independent regulatory board.
The establishment of a separate board for licensed social workers will provide enhanced professional oversight, more focused regulatory attention, and improved public protection specific to social work practice.
The social work profession has distinct educational requirements, practice standards, and ethical considerations that warrant specialized governance separate from other behavioral health professions.
An independent board will strengthen the profession's ability to respond to evolving practice standards, emerging ethical issues, and public protection needs in a timely and effective manner.
The three-year transition period will ensure orderly implementation, adequate board training, comprehensive rule making, and seamless transfer of regulatory functions while maintaining continuous public protection.
The recommended board composition of seven members, including four licensed independent clinical social workers, two licensed advanced social workers, and one public member, provides appropriate professional representation while ensuring public accountability.
The legislature intends to establish the board of governors for licensed social workers to enhance public protection, strengthen professional regulation, and support the continued development of high quality social work practice in Washington state.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
"Advanced social work" means the application of social work theory and methods, including:
Emotional and biopsychosocial assessment;
Psychotherapy under the supervision of a licensed independent clinical social worker, psychiatrist, psychologist, psychiatric advanced registered nurse practitioner, psychiatric nurse, or other mental health professionals as may be defined by rules adopted by the secretary;
Case management;
Consultation;
Advocacy;
Counseling; or
Community organization.
"Associate" means a prelicensure candidate who has a graduate degree in a mental health field under section 9 of this act and is gaining the supervision and supervised experience necessary to become a licensed independent clinical social worker, a licensed advanced social worker, a licensed mental health counselor, or a licensed marriage and family therapist.
"Board" means the board of governors for licensed social workers.
"Department" means the department of health.
"Disciplining authority" means the board.
"Independent clinical social work" means the diagnosis and treatment of emotional and mental disorders based on knowledge of human development, the causation and treatment of psychopathology, psychotherapeutic treatment practices, and social work practice as defined in advanced social work. Treatment modalities include but are not limited to diagnosis and treatment of individuals, couples, families, groups, or organizations.
"Licensed social worker" means a person licensed under this chapter as a social worker, including licensed social workers, licensed advanced social workers, licensed independent clinical social workers, and social worker associates.
"Secretary" means the secretary of health or the secretary's designee.
A board of governors for licensed social workers is established, consisting of seven members appointed by the governor. Four members shall be licensed independent clinical social workers, two members shall be licensed advanced social workers or licensed independent clinical social workers, and one member shall be a member of the public.
Members are appointed for five-year terms. No member may serve more than two consecutive full terms. Members hold office until their successors are appointed. The governor may initially appoint the members to staggered terms to ensure an orderly rotation, so that no more than two members' terms expire each year; subsequent appointments are for full five-year terms.
The public members of the board may not be and have never been a licensed social worker or in training to be one; may not have any household member who is a licensed social worker or in training to be one; may not participate or have ever participated in a commercial or professional field related to social work, nor have a household member who has so participated; and may not have had, within two years before appointment, a substantial financial interest in a person regulated by the board.
Each licensed social worker member shall be licensed under this chapter at the appropriate level and shall have actively practiced social work in the state of Washington for at least three years of the prior five years immediately preceding appointment.
The board shall elect officers each year. The board shall meet at least twice each year and may hold additional meetings at the chair's discretion. Meetings of the board are open to the public, except that the board may hold executive sessions to the extent permitted by chapter 42.30 RCW. The department shall provide secretarial, clerical, and other assistance as required by the board.
Each member of the board shall be compensated in accordance with RCW 43.03.240. Members shall be reimbursed for travel expenses incurred in the actual performance of their duties, as provided in RCW 43.03.050 and 43.03.060.
A majority of the board members appointed and serving constitutes a quorum for the transaction of board business. The affirmative vote of a majority of a quorum of the board is required to carry a motion or resolution, to adopt a rule, or to pass a measure.
The board may appoint members to panels of at least three members. A quorum for the transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the board.
The board may adopt such rules as are consistent with this chapter as may be deemed necessary and proper to carry out the purposes of this chapter.
The governor may remove a member of the board for neglect of duty, misconduct, or malfeasance or misfeasance in office. Whenever the governor is satisfied that a member of the board has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, the governor shall file with the secretary of state a statement of the cause for and the order of removal from office, and the secretary shall immediately send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the board, the governor shall appoint a replacement to fill the remainder of the unexpired term.
In addition to any other authority provided by law, the board shall:
Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter with respect to licensed social workers;
Determine the minimum education and experience requirements for licensure as a licensed social worker at all levels, including approval of educational programs and supervised experience consistent with this chapter;
Prepare and administer, or approve the preparation and administration of, examinations for licensure, including acceptance of national examinations consistent with this chapter;
Establish by rule the procedures for an appeal of examination failure;
Determine whether alternative methods of training are equivalent to formal education, and establish forms, procedures, and criteria for evaluation of an applicant's equivalent alternative training to determine the applicant's eligibility to take the examination;
Adopt rules implementing a continuing competency program for licensed social workers, including continuing education requirements;
Keep complete records of its proceedings, the names and qualifications of all applicants, and the names and addresses of all licensed social workers;
By rule, adopt a code of ethics for licensed social workers designed to protect the public interest;
In conducting investigations and complaint resolution, the board may obtain the written consent of the complaining client or patient or their legal representative, or of any person who may be affected by the complaint, in order to obtain information which otherwise might be confidential or privileged.
The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter. For purposes of chapter 18.130 RCW, the board is the disciplining authority for licensed social workers under this chapter.
In addition to any other authority provided by law, the secretary has the authority to:
Set all license, examination, and renewal fees in accordance with RCW 43.70.250;
Establish forms and procedures necessary to administer this chapter;
Issue a license to any applicant who has met the education, training, and examination requirements for licensure as a licensed social worker, and deny a license to applicants who do not meet the minimum qualifications for licensure, except that denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;
Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and to hire individuals, including licensees under this chapter, to serve as examiners or consultants as necessary to implement and administer this chapter;
Maintain the official department record of all applicants and licensees; and
Conduct a hearing on an appeal of a denial of a license based on the applicant's failure to meet the minimum qualifications for licensure. The hearing shall be conducted pursuant to chapter 34.05 RCW.
The secretary, members of the board, or individuals acting on their behalf, are immune from suit in any civil action based on any act performed in the course of their duties.
The date and location of the examination shall be established by the board. Applicants who have been found to meet the education and experience requirements for licensure shall be scheduled for the next examination following the filing of the application. The board shall establish by rule the examination application deadline.
The examination shall contain subjects appropriate to the standards of competency and scope of practice for licensed social workers at the applicable level.
The board shall establish by rule the requirements for a reexamination if the applicant has failed the examination.
The board may approve an examination prepared or administered, or both, by a private testing agency or association of licensing boards.
The board shall establish by rule the standards for licensure by endorsement or reciprocity for applicants licensed in another jurisdiction as a licensed social worker or equivalent. The standards for reciprocity of licensure shall not be less than required for licensure in the state of Washington.
The secretary shall issue an associate license in the following categories to any applicant who graduates from a master's degree or doctoral degree educational program in social work accredited by the council on social work education and approved by the secretary based upon nationally recognized standards and submits a declaration that the applicant is working toward full licensure in that category:
Licensed social worker associate;
Advanced licensed social worker associate; or
Independent clinical licensed social work associate.
Associates may not provide independent social work for a fee, monetary or otherwise. Associates must work under the supervision of an approved supervisor. An applicant for an associate license under this section may practice without a license under the direct supervision of an approved supervisor for 120 days after the department receives the applicant's completed application or the applicant's license is issued or denied, whichever is sooner.
Associates shall provide each client or patient, during the first professional contact, with a disclosure form according to section 10 of this act, disclosing that he or she is an associate under the supervision of an approved supervisor.
The board shall adopt by rule what constitutes adequate proof of compliance with the requirements of this section.
Applicants are subject to the denial of a license or issuance of a conditional license for the reasons set forth in chapter 18.130 RCW.
An associate license may be renewed. The applicant for renewal must have successfully completed, in the preceding year, continuing education requirements established in rule by the board. Beginning with the second renewal, the continuing education requirements established in rule by the board must require the applicant to complete a minimum number of continuing education hours in the preceding two years in professional ethics.
A person licensed under this chapter must provide clients at the commencement of any program of treatment with accurate disclosure information concerning the practice, in accordance with rules adopted by the board, including the right of clients to refuse treatment, the responsibility of clients to choose the provider and treatment modality which best suits their needs, and the extent of confidentiality provided by this chapter. The disclosure information must also include the license holder's professional education and training, the therapeutic orientation of the practice, the proposed course of treatment where known, financial requirements, and such other information as required by rule. The disclosure must be acknowledged in writing by the client and license holder.
A person licensed under this chapter shall not disclose the written acknowledgment of the disclosure statement pursuant to section 10 of this act, nor any information acquired from persons consulting the individual in a professional capacity when the information was necessary to enable the individual to render professional services to those persons except:
With the written authorization of that person or, in the case of death or disability, the person's personal representative;
If the person waives the privilege by bringing charges against the person licensed under this chapter;
In response to a subpoena from the secretary. The secretary may subpoena only records related to a complaint or report under RCW 18.130.050;
As required under chapter 26.44 or 74.34 RCW or RCW 71.05.217 (6) and (7);
When disclosure of health care information is permitted under chapter 70.02 RCW; or
To any individual if the person licensed under this chapter reasonably believes that disclosure will avoid or minimize an imminent danger to the health or safety of the individual or any other individual; however, there is no obligation on the part of the provider to so disclose.
A person must not represent himself or herself as a licensed advanced social worker, a licensed independent clinical social worker, a licensed social work associate, a licensed social work associate—advanced, or a licensed social work associate—independent clinical without being licensed by the department.
The provisions of this act are intended to be construed consistently with chapter 18.320 RCW. To the extent of any conflict between a rule of the board and a rule of the department relating to licensed social workers, the rule of the board controls.
Until such time as the board is fully constituted, has completed its initial rule making, adopted rules, and has assumed full regulatory authority, the secretary shall continue to exercise regulatory authority over licensed social workers under existing administrative rules and chapter 18.225 RCW. This temporary authority shall expire no later than three years from the effective date of this section, or upon the board's assumption of full regulatory authority, whichever occurs first.
Until such time as the board is fully constituted, has completed its initial rule making, adopted rules, and has assumed full regulatory authority, nothing in this chapter shall be construed to conflict with chapter 18.225 RCW.
The department shall provide an annual fiscal report to the legislature on the financial status of the social work licensing program and board operations.
Within six months of July 1, 2026, the governor shall appoint initial board members as provided in section 3 of this act.
Within nine months of July 1, 2026, the board shall hold its first meeting and elect officers.
Within 18 months of July 1, 2026, the board shall complete initial rule making necessary to assume regulatory authority.
Within 36 months of July 1, 2026, the board shall adopt rules to assume full regulatory authority over licensed social workers, including all disciplinary functions.
The board shall promulgate rules relating to issuance of a retired active license under RCW 18.130.250 for advanced social workers and independent clinical social workers.
If any provision of this chapter or its application to any person or circumstance is held invalid, the remainder of the chapter or the application of the provision to other persons or circumstances is not affected.
The legislature finds that:
The practice of social work by persons in the public and private sectors improves the lives of many people throughout the state through the application of a broad spectrum of social sciences to enhance the quality of life and develop the full potential of each client;
The practice of social work is a complex discipline that, appropriately undertaken, can address client problems, needs, and concerns, with the goal that clients achieve the maximum possible enhancement of their quality of life and develop to their full potential. However, improper assessment of client problems and needs by unqualified persons can lead to client harm;
It is in the state's interest to take steps to safeguard state residents from misrepresentations about qualifications for practicing social work. Because such misrepresentations could lead to the improper practice of social work by unqualified persons, those who represent themselves as social workers should have a qualifying degree from an accredited and approved social work program.
The legislature declares that chapter 89, Laws of 2011 to regulate social workers constitutes an exercise of the state's police power to protect and promote the health, safety, and welfare of the residents of the state in general. Accordingly, while chapter 89, Laws of 2011 is intended to protect the public generally, it does not create a duty owed by the state or its instrumentalities to any individual or entity.
The legislature further finds that licensed advanced social workers and licensed independent clinical social workers represent different specializations within the social work profession, with each license signifying the highest degree of licensure as it pertains to each specialty. The legislature further finds that practitioners in each specialty exercise independent judgment and operate independently within their area of practice.
Therefore, for purposes of job classification, licensed advanced social workers and licensed independent clinical social workers licensed under this chapter shall both be considered the top tier of licensure for the profession.
(1) This chapter applies only to the secretary and the boards and commissions having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
1.
"Applicant" means a person who completes the required application, pays the required fee, is at least 18 years of age, and meets any background check requirements and uniform disciplinary act requirements.
"Associate" means a prelicensure candidate who has a graduate degree in a mental health field under RCW 18.225.090 and is gaining the supervision and supervised experience necessary to become a licensed mental health counselor or a licensed marriage and family therapist.
"Committee" means the Washington state mental health counselorsand marriage and family therapists advisory committee.
"Department" means the department of health.
"Disciplining authority" means the department.
"Marriage and family therapy" means the diagnosis and treatment of mental and emotional disorders, whether cognitive, affective, or behavioral, within the context of relationships, including marriage and family systems. Marriage and family therapy involves the professional application of psychotherapeutic and family systems theories and techniques in the delivery of services to individuals, couples, and families for the purpose of treating such diagnosed nervous and mental disorders. The practice of marriage and family therapy means the rendering of professional marriage and family therapy services to individuals, couples, and families, singly or in groups, whether such services are offered directly to the general public or through organizations, either public or private, for a fee, monetary or otherwise.
"Mental health counseling" means the application of principles of human development, learning theory, psychotherapy, group dynamics, and etiology of mental illness and dysfunctional behavior to individuals, couples, families, groups, and organizations, for the purpose of treatment of mental disorders and promoting optimal mental health and functionality. Mental health counseling also includes, but is not limited to, the assessment, diagnosis, and treatment of mental and emotional disorders, as well as the application of a wellness model of mental health.
"Secretary" means the secretary of health or the secretary's designee.
A person must not represent himself or herself as a licensed mental health counselor, a licensed marriage and family therapist, a licensed mental health counselor associate, or a licensed marriage and family therapist associate, without being licensed by the department.
Nothing in this chapter shall be construed to prohibit or restrict:
The practice of marriage and family therapyor mental health counseling by an individual otherwise regulated under this title and performing services within the authorized scope of practice;
The practice of marriage and family therapyor mental health counseling by an individual employed by the government of the United States or state of Washington while engaged in the performance of duties prescribed by the laws of the United States or state of Washington;
The practice of marriage and family therapyor mental health counseling by a person who is a regular student in an educational program based on recognized national standards and approved by the secretary, and whose performance of services is pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor;
The practice of marriage and family therapyor mental health counseling under the auspices of a religious denomination, church, or religious organization.
The Washington state mental health counselorsand marriage and family therapists advisory committee is established.
The committee shall be comprised of seven members as follows:
Three members must be licensed mental health counselors;
Three members must be licensed marriage and family therapists; and
c.
One member must be a consumer and represent the public at large and may not be a licensed mental health care provider.
Three members shall be appointed for a term of one year, three members shall be appointed for a term of two years, and three members shall be appointed for a term of three years. Subsequent members shall be appointed for terms of three years. A person must not serve as a member for more than two consecutive terms.
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Each member must be a resident of the state of Washington.
Each member must not hold a governing office or board position in a professional association for mental health or marriage and family therapy and must not be employed by the state of Washington.
Each professional member must have been actively engaged as a mental health counseloror marriage and family therapist for five years immediately preceding appointment.
The consumer members must represent the general public and be unaffiliated directly or indirectly with the professions licensed under this chapter.
The secretary shall appoint the committee members.
Committee members are immune from suit in an action, civil or criminal, based on the department's disciplinary proceedings or other official acts performed in good faith.
Committee members shall be compensated in accordance with RCW 43.03.240, including travel expenses in carrying out his or her authorized duties in accordance with RCW 43.03.050 and 43.03.060.
The committee shall elect a chair and vice chair.
The department of health may seek the advice and assistance of the advisory committee in administering this chapter, including, but not limited to:
Advice and recommendations regarding the establishment or implementation of rules related to the administration of this chapter;
Advice, recommendations, and consultation regarding case disposition guidelines and priorities related to unprofessional conduct cases regarding licensed mental health counselors and licensed marriage and family therapists;
Assistance and consultation of individual committee members as needed in the review, analysis, and disposition of reports of unprofessional conduct and consumer complaints;
Assistance and recommendations to enhance consumer education; and
Assistance and recommendations regarding any continuing education and continuing competency programs administered under the provisions of this chapter.
The secretary shall issue a license to any applicant who demonstrates to the satisfaction of the secretary that the applicant meets the following education and experience requirements for the applicant's practice area.
a.
Licensed mental health counselor:
i.(A) Graduation from a master's or doctoral level educational program in counseling that consists of at least 60 semester hours or 90 quarter hours, or includes at least 60 semester hours or 90 quarter hours of graduate coursework that includes the following topic areas:
(I) Mental health counseling orientation and ethical practice;
(II) Social and cultural diversity;
(III) Human growth and development;
(IV) Career development;
(V) Counseling and helping relationships;
(VI) Group counseling and group work;
(VII) Diagnosis and treatment;
(VIII) Assessment and testing; and
(IX) Research and program evaluation; or
(B) Graduation from a master's or doctoral level educational program in a related discipline from a college or university approved by the secretary based upon nationally recognized standards. An applicant who satisfies the educational requirements for licensure under this subsection (1)(a)(i)(B) is not qualified to exercise the privilege to practice under the counseling compact established in chapter 18.17 RCW unless the master's or doctoral level educational program in a related discipline consists of at least 60 semester hours or 90 quarter hours, or includes at least 60 semester hours or 90 quarter hours of graduate coursework that includes the topic areas specified in (a)(i)(A)(I) through (IX) of this subsection;
ii. Successful completion of an approved examination;
iii. Successful completion of a supervised experience requirement. The experience requirement consists of a minimum of 36 months full-time counseling or 3,000 hours of postgraduate mental health counseling under the supervision of a qualified licensed mental health counselor or equally qualified licensed mental health practitioner, in an approved setting. The 3,000 hours of required experience includes a minimum of 100 hours spent in immediate supervision with the qualified licensed mental health counselor, and includes a minimum of 1,200 hours of direct counseling with individuals, couples, families, or groups; and
iv. Successful completion of continuing education requirements established in rule by the secretary in consultation with the committee, including a minimum number of hours in professional ethics.
b. Licensed marriage and family therapist:
i. Graduation from a master's degree or doctoral degree educational program in marriage and family therapy or graduation from an educational program in an allied field equivalent to a master's degree or doctoral degree in marriage and family therapy approved by the secretary based upon nationally recognized standards;
ii. Successful passage of an approved examination;
iii. Successful completion of a supervised experience requirement. The experience requirement consists of a minimum of 3,000 hours of marriage and family therapy. Of the total supervision, 100 hours must be with a licensed marriage and family therapist with at least two years' clinical experience; the other 100 hours may be with an equally qualified licensed mental health practitioner. Total experience requirements include:
(A) 1,000 hours of direct client contact; at least 500 hours must be gained in diagnosing and treating couples and families; plus
(B) At least 200 hours of qualified supervision with a supervisor. At least 100 of the 200 hours must be one-on-one supervision, and the remaining hours may be in one-on-one or group supervision.
Applicants who have completed a master's program accredited by the commission on accreditation for marriage and family therapy education of the American association for marriage and family therapy may be credited with 500 hours of direct client contact and 100 hours of formal meetings with an approved supervisor; and
iv. Successful completion of continuing education requirements established in rule by the secretary in consultation with the committee, including a minimum number of hours in professional ethics.
The department shall establish by rule what constitutes adequate proof of meeting the criteria. Only rules in effect on the date of submission of a completed application of an associate for her or his license shall apply. If the rules change after a completed application is submitted but before a license is issued, the new rules shall not be reason to deny the application.
In addition, applicants shall be subject to the grounds for denial of a license or issuance of a conditional license under chapter 18.130 RCW.
Any person certified under chapter 18.19 RCW who has met the applicable experience and education requirements under chapter 18.19 RCW prior to July 22, 2001, is eligible for a license as a marriage and family therapist or a mental health counselor under this chapter without taking the examination.
An applicant holding a credential in another state may be licensed to practice in this state without examination if the secretary determines that the other state's credentialing standards are substantially equivalent to the licensing standards in this state.
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The department shall establish a reciprocity program for applicants for licensure as a mental health counselor or a marriage and family therapist in Washington.
The reciprocity program applies to applicants for a license as a mental health counselor or a marriage and family therapist who:
(A) Hold or have held within the past 12 months a credential in good standing from another state or territory of the United States which has a scope of practice that is substantially equivalent to or greater than the scope of practice for the corresponding license as established under this chapter; and
(B) Have no disciplinary record or disqualifying criminal history.
b. The department shall issue a probationary license to an applicant who meets the requirements of (a)(ii) of this subsection. The department must determine what deficiencies, if any, exist between the education and experience requirements of the other state's credential and, after consideration of the experience and capabilities of the applicant, determine whether it is appropriate to require the applicant to complete additional education or experience requirements to maintain the probationary license and, within a reasonable time period, transition to a full license. The department may place a reasonable time limit on a probationary license and may, if appropriate, require the applicant to pass a jurisprudential examination.
c. The department must maintain and publish a list of credentials in other states and territories that the department has determined to have a scope of practice that is substantially equivalent to or greater than the scope of practice for licensed advanced social workers, independent clinical social workers, mental health counselors, or marriage and family therapists as established under this chapter. The department shall prioritize identifying and publishing the department's determination for the five states or territories that have historically had the most applicants for reciprocity under subsection (1) of this section with a scope of practice that is substantially equivalent to or greater than the scope of practice for mental health counselors and marriage and family therapists under this chapter.
The secretary shall issue an associate license to any applicant who demonstrates to the satisfaction of the secretary that the applicant meets the following requirements for the applicant's practice area and submits a declaration that the applicant is working toward full licensure in that category:
a.
Licensed mental health counselor associate: Graduation from a master's degree or doctoral degree educational program in mental health counseling or a related discipline from a college or university approved by the secretary based upon nationally recognized standards.
b. Licensed marriage and family therapist associate: Graduation from a master's degree or doctoral degree educational program in marriage and family therapy or graduation from an educational program in an allied field equivalent to a master's degree or doctoral degree in marriage and family therapy approved by the secretary based upon nationally recognized standards.
Associates may not provide independent mental health counseling or marriage and family therapy for a fee, monetary or otherwise. Associates must work under the supervision of an approved supervisor. Beginning October 1, 2025, an applicant for an associate license under this section may practice without a license under the direct supervision of an approved supervisor for 120 days after the department receives the applicant's completed application or the applicant's license is issued or denied, whichever is sooner.
Associates shall provide each client or patient, during the first professional contact, with a disclosure form according to RCW 18.225.100, disclosing that he or she is an associate under the supervision of an approved supervisor.
The department shall adopt by rule what constitutes adequate proof of compliance with the requirements of this section.
Applicants are subject to the denial of a license or issuance of a conditional license for the reasons set forth in chapter 18.130 RCW.
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An associate license may be renewed. Until October 1, 2025, the applicant for renewal must have successfully completed 18 hours of continuing education in the preceding year. After October 1, 2025, the applicant for renewal must have successfully completed, in the preceding year, continuing education requirements established in rule by the secretary in consultation with the committee. Beginning with the second renewal, the continuing education requirements established in rule by the secretary in consultation with the committee must require the applicant to complete a minimum number of continuing education hours in the preceding two years in professional ethics.
A person whose associate license was not renewed due to the person exceeding the six-renewal limit in place prior to June 6, 2024, shall be treated as if the person's license expired. The secretary shall allow such a person to return the person's associate license to active status pursuant to standard rules and procedures in place for returning an expired credential to active status.
The secretary of the department of health shall promulgate rules relating to issuance of a retired active license under RCW 18.130.250 for mental health counselorsand marriage and family therapists.
A spouse or domestic partner shall not be examined for or against his or her spouse or domestic partner, without the consent of the spouse or domestic partner; nor can either during marriage or during the domestic partnership or afterward, be without the consent of the other, examined as to any communication made by one to the other during the marriage or the domestic partnership. But this exception shall not apply to a civil action or proceeding by one against the other, nor to a criminal action or proceeding for a crime committed by one against the other, nor to a criminal action or proceeding against a spouse or domestic partner if the marriage or the domestic partnership occurred subsequent to the filing of formal charges against the defendant, nor to a criminal action or proceeding for a crime committed by said spouse or domestic partner against any child of whom said spouse or domestic partner is the parent or guardian, nor to a proceeding under chapter 71.05 or 71.09 RCW: PROVIDED, That the spouse or the domestic partner of a person sought to be detained under chapter 71.05 or 71.09 RCW may not be compelled to testify and shall be so informed by the court prior to being called as a witness.
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An attorney or counselor shall not, without the consent of his or her client, be examined as to any communication made by the client to him or her, or his or her advice given thereon in the course of professional employment.
A parent or guardian of a minor child arrested on a criminal charge may not be examined as to a communication between the child and his or her attorney if the communication was made in the presence of the parent or guardian. This privilege does not extend to communications made prior to the arrest.
A member of the clergy, a Christian Science practitioner listed in the Christian Science Journal, or a priest shall not, without the consent of a person making the confession or sacred confidence, be examined as to any confession or sacred confidence made to him or her in his or her professional character, in the course of discipline enjoined by the church to which he or she belongs.
Subject to the limitations under RCW 71.05.217 (6) and (7), a physician or surgeon or osteopathic physician or surgeon or podiatric physician or surgeon shall not, without the consent of his or her patient, be examined in a civil action as to any information acquired in attending such patient, which was necessary to enable him or her to prescribe or act for the patient, except as follows:
In any judicial proceedings regarding a child's injury, neglect, or sexual abuse or the cause thereof; and
Ninety days after filing an action for personal injuries or wrongful death, the claimant shall be deemed to waive the physician-patient privilege. Waiver of the physician-patient privilege for any one physician or condition constitutes a waiver of the privilege as to all physicians or conditions, subject to such limitations as a court may impose pursuant to court rules.
A public officer shall not be examined as a witness as to communications made to him or her in official confidence, when the public interest would suffer by the disclosure.
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A peer supporter shall not, without consent of the peer support services recipient making the communication, be compelled to testify about any communication made to the peer supporter by the peer support services recipient while receiving individual or group services. The peer supporter must be designated as such by their employing agency prior to providing peer support services. The privilege only applies when the communication was made to the peer supporter while acting in his or her capacity as a peer supporter. The privilege applies regardless of whether the peer support services recipient is an employee of the same agency as the peer supporter. Peer support services may be coordinated or designated among first responder agencies pursuant to chapter 10.93 RCW, interlocal agreement, or other similar provision, provided however that a written agreement is not required for the privilege to apply. The privilege does not apply if the peer supporter was an initial responding first responder, department of corrections staff person, or jail staff person; a witness; or a party to the incident which prompted the delivery of peer support services to the peer support services recipient.
For purposes of this section:
(A) A law enforcement officer;
(B) A limited authority law enforcement officer;
(C) A firefighter;
(D) An emergency services dispatcher or recordkeeper;
(E) Emergency medical personnel, as licensed or certified by this state;
(F) A member or former member of the Washington national guard acting in an emergency response capacity pursuant to chapter 38.52 RCW;
(G) A coroner or medical examiner, or a coroner's or medical examiner's agent or employee; or
(H) An individual engaged in co-response services, as defined in RCW 71.24.025.
ii. "Law enforcement officer" means a general authority Washington peace officer as defined in RCW 10.93.020.
iii. "Limited authority law enforcement officer" means a limited authority Washington peace officer as defined in RCW 10.93.020 who is employed by the department of corrections, state parks and recreation commission, department of natural resources, liquor and cannabis board, or Washington state gambling commission.
iv. "Peer support services recipient" means:
(A) A first responder;
(B) A department of corrections staff person; or
(C) A jail staff person.
v. "Peer supporter" means:
(A) A first responder, retired first responder, department of corrections staff person, or jail staff person or a civilian employee of a first responder entity or agency, local jail, or state agency who has received training to provide emotional and moral support and services to a peer support services recipient who needs those services as a result of an incident or incidents in which the peer support services recipient was involved while acting in his or her official capacity or to deal with other stress that is impacting the peer support services recipient's performance of official duties; or
(B) A nonemployee who has been designated by the first responder entity or agency, local jail, statewide organization focused on co-response outreach, or state agency to provide emotional and moral support and counseling to a peer support services recipient who needs those services as a result of an incident or incidents in which the peer support services recipient was involved while acting in his or her official capacity.
A sexual assault advocate may not, without the consent of the victim, be examined as to any communication made between the victim and the sexual assault advocate.
For purposes of this section, "sexual assault advocate" means the employee or volunteer from a community sexual assault program or underserved populations provider, victim assistance unit, program, or association, that provides information, medical or legal advocacy, counseling, or support to victims of sexual assault, who is designated by the victim to accompany the victim to the hospital or other health care facility and to proceedings concerning the alleged assault, including police and prosecution interviews and court proceedings.
A sexual assault advocate may disclose a confidential communication without the consent of the victim if failure to disclose is likely to result in a clear, imminent risk of serious physical injury or death of the victim or another person. Any sexual assault advocate participating in good faith in the disclosing of records and communications under this section shall have immunity from any liability, civil, criminal, or otherwise, that might result from the action. In any proceeding, civil or criminal, arising out of a disclosure under this section, the good faith of the sexual assault advocate who disclosed the confidential communication shall be presumed.
A domestic violence advocate may not, without the consent of the victim, be examined as to any communication between the victim and the domestic violence advocate.
For purposes of this section, "domestic violence advocate" means an employee or supervised volunteer from a community‑based domestic violence program or human services program that provides information, advocacy, counseling, crisis intervention, emergency shelter, or support to victims of domestic violence and who is not employed by, or under the direct supervision of, a law enforcement agency, a prosecutor's office, or the child protective services section of the department of children, youth, and families as defined in RCW 26.44.020.
A domestic violence advocate may disclose a confidential communication without the consent of the victim if failure to disclose is likely to result in a clear, imminent risk of serious physical injury or death of the victim or another person. This section does not relieve a domestic violence advocate from the requirement to report or cause to be reported an incident under RCW 26.44.030(1) or to disclose relevant records relating to a child as required by RCW 26.44.030(15). Any domestic violence advocate participating in good faith in the disclosing of communications under this subsection is immune from liability, civil, criminal, or otherwise, that might result from the action. In any proceeding, civil or criminal, arising out of a disclosure under this subsection, the good faith of the domestic violence advocate who disclosed the confidential communication shall be presumed.
A mental health counselor or marriage and family therapist licensed under chapter 18.225 RCW or an independent clinical social worker licensed under chapter 18.320 RCW may not disclose, or be compelled to testify about, any information acquired from persons consulting the individual in a professional capacity when the information was necessary to enable the individual to render professional services to those persons except:
With the written authorization of that person or, in the case of death or disability, the person's personal representative;
If the person waives the privilege by bringing charges against the mental health counselor licensed under chapter 18.225 RCW;
In response to a subpoena from the secretary of health. The secretary may subpoena only records related to a complaint or report under RCW 18.130.050;
As required under chapter 26.44 or 74.34 RCW or RCW 71.05.217 (6) or (7); or
To any individual if the mental health counselor or marriage and family therapist licensed under chapter 18.225 RCW reasonably believes that disclosure will avoid or minimize an imminent danger to the health or safety of the individual or any other individual; however, there is no obligation on the part of the provider to so disclose.
An individual who acts as a sponsor providing guidance, emotional support, and counseling in an individualized manner to a person participating in an alcohol or drug addiction recovery fellowship may not testify in any civil action or proceeding about any communication made by the person participating in the addiction recovery fellowship to the individual who acts as a sponsor except with the written authorization of that person or, in the case of death or disability, the person's personal representative.
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Neither a union representative nor an employee the union represents or has represented shall be examined as to, or be required to disclose, any communication between an employee and union representative or between union representatives made in the course of union representation except:
To the extent such examination or disclosure appears necessary to prevent the commission of a crime that is likely to result in a clear, imminent risk of serious physical injury or death of a person;
In actions, civil or criminal, in which the represented employee is accused of a crime or assault or battery;
In actions, civil or criminal, where a union member is a party to the action, the union member may obtain a copy of any statement previously given by that union member concerning the subject matter of the action and may elicit testimony concerning such statements. The right of the union member to obtain such statements, or the union member's possession of such statements, does not render them discoverable over the objection of the union member;
In actions, regulatory, civil, or criminal, against the union or its affiliated, subordinate, or parent bodies or their agents; or
When an admission of, or intent to engage in, criminal conduct is revealed by the represented union member to the union representative.
The privilege created in this subsection (11) does not apply to any record of communications that would otherwise be subject to disclosure under chapter 42.56 RCW.
The privilege created in this subsection (11) may not interfere with an employee's or union representative's applicable statutory mandatory reporting requirements, including but not limited to duties to report in chapters 26.44, 43.101, and 74.34 RCW.
For purposes of this subsection:
"Employee" means a person represented by a certified or recognized union regardless of whether the employee is a member of the union.
"Union" means any lawful organization that has as one of its primary purposes the representation of employees in their employment relations with employers, including without limitation labor organizations defined by 29 U.S.C. Sec. 152(5) and 5 U.S.C. Sec. 7103(a)(4), representatives defined by 45 U.S.C. Sec. 151, and bargaining representatives defined in RCW 41.56.030, and employee organizations as defined in RCW 28B.52.020, 41.59.020, 41.80.005, 41.76.005, 47.64.011, and 53.18.010.
"Union representation" means action by a union on behalf of one or more employees it represents in regard to their employment relations with employers, including personnel matters, grievances, labor disputes, wages, rates of pay, hours of employment, conditions of work, or collective bargaining.
"Union representative" means a person authorized by a union to act for the union in regard to union representation.
"Communication" includes any oral, written, or electronic communication or document containing such communication.
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
The department shall develop training standards for the creation of a co-occurring disorder specialist enhancement which may be added to the license or registration held by one of the following:
Psychologists licensed under chapter 18.83 RCW;
Independent clinical social workers licensed under chapter 18.320 RCW;
Marriage and family therapists licensed under chapter 18.225 RCW;
Mental health counselors licensed under chapter 18.225 RCW; and
An agency affiliated counselor licensed under chapter 18.19 RCW.
To obtain the co-occurring disorder specialist enhancement, the applicant must meet training standards and experience requirements. The training standards must be designed with consideration of the practices of the health professions listed in subsection (1) of this section and consisting of 60 hours of instruction consisting of (a) 30 hours in understanding the disease pattern of addiction and the pharmacology of alcohol and other drugs; and (b) 30 hours in understanding addiction placement, continuing care, and discharge criteria, including the American society of addiction medicine criteria; treatment planning specific to substance abuse; relapse prevention; and confidentiality issues specific to substance use disorder treatment.
In developing the training standards, the department shall consult with the examining board of psychology established in chapter 18.83 RCW, the Washington state mental health counselorsand marriage and family therapists advisory committee established in chapter 18.225 RCW, the substance use disorder certification advisory committee established in chapter 18.205 RCW, the Washington state board of governors for licensed social workers established in chapter 18.320 RCW, and educational institutions in Washington state that train psychologists, marriage and family therapists, mental health counselors, independent clinical social workers, and substance use disorder professionals.
The department shall approve educational programs that meet the training standards, and must not limit its approval to university-based courses.
The secretary shall issue a co-occurring disorder specialist enhancement to any applicant who demonstrates to the secretary's satisfaction that the following requirements have been met:
Completion of the training standards;
Successful completion of an approved examination based on core competencies of substance use disorder counseling;
Successful completion of an experience requirement of:
Eighty hours of supervised experience for an applicant listed under subsection (1) of this section with fewer than five years of experience; or
Forty hours of supervised experience for an applicant listed under subsection (1) of this section with five or more years of experience; and
Payment of any fees that may be established by the department.
An applicant for the co-occurring disorder specialist enhancement may receive supervised experience from any person who meets or exceeds the requirements of a certified substance use disorder professional in the state of Washington and who would be eligible to take the examination required for substance use disorder professional certification.
A person who has obtained a co-occurring disorder specialist enhancement may provide substance use disorder counseling services which are equal in scope with those provided by substance use disorder professionals under this chapter, subject to the following limitations:
A co-occurring disorder specialist may only provide substance use disorder counseling services if the co-occurring disorder specialist is employed by:
An agency that provides counseling services;
A federally qualified health center; or
A hospital;
Following an initial intake or assessment, a co-occurring disorder specialist may provide substance use disorder treatment only to clients diagnosed with a substance use disorder and a mental health disorder;
Prior to providing substance use disorder treatment to a client assessed to be in need of 2.1 or higher level of care according to American society of addiction medicine criteria, a co-occurring disorder specialist must make a reasonable effort to refer and connect the client to the appropriate care setting, as indicated by the client's American society of addiction medicine level of care; and
A co-occurring disorder specialist must comply with rules promulgated by the department under subsection (11) of this section.
The secretary shall establish by rule what constitutes adequate proof of meeting the criteria.
Applicants are subject to the grounds for denial of a certificate or issuance of a conditional certificate under chapter 18.130 RCW.
The department may adopt a fee to defray the cost of regulatory activities related to the issuance of co-occurring disorder specialist enhancements and any related disciplinary activities.
The department shall adopt rules regarding the role of co-occurring disorder specialists across the American society of addiction medicine continuum of care.
Any increase in fees necessary to cover the cost of regulating co-occurring disorder specialists who receive an enhancement under this section must be borne by persons licensed as psychologists under chapter 18.83 RCW, independent clinical social workers under chapter 18.320 RCW, marriage and family therapists under chapter 18.225 RCW, or mental health counselors under chapter 18.225 RCW. The cost of regulating co-occurring disorder specialists who receive an enhancement under this section may not be borne by substance use disorder professionals or substance use disorder professional trainees certified under this chapter and may not be included in the calculation of fees for substance use disorder professionals or substance use disorder professional trainees certified under this chapter.
Subject to amounts appropriated for this purpose, the psilocybin therapy services pilot program is established within, and administered by, the University of Washington department of psychiatry and behavioral sciences. No later than January 1, 2025, the University of Washington department of psychiatry and behavioral sciences must implement this section.
The pilot program must:
Offer psilocybin therapy services through pathways approved by the federal food and drug administration, to populations including first responders and veterans who are:
21 years of age or older; and
Experiencing posttraumatic stress disorder, mood disorders, or substance use disorders;
Offer psilocybin therapy services facilitated by:
A mental health counselor licensed under chapter 18.225 RCW;
A physician licensed under chapter 18.71 RCW; or
A psychiatric advanced practice registered nurse licensed under chapter 18.79 RCW as defined in RCW 71.05.020; or
An advanced social worker or independent clinical social worker licensed under chapter 18.320 RCW;
Ensure psilocybin therapy services are safe, accessible, and affordable;
Require an initial assessment to understand participant goals and expectations, and assess the participant's history for any concerns that require further intervention or information before receiving psilocybin therapy services, and an integration session after receiving psilocybin therapy services; and
Use outreach and engagement strategies to include participants from communities or demographic groups that are more likely to be historically marginalized and less likely to be included in research and clinical trials represented by race, sex, sexual orientation, socioeconomic status, age, or geographic location.
The secretary shall charge fees to the licensee for obtaining a license. Physicians regulated pursuant to chapter 18.71 RCW who reside and practice in Washington and obtain or renew a retired active license are exempt from such fees. Municipal corporations providing emergency medical care and transportation services pursuant to chapter 18.73 RCW shall be exempt from such fees, provided that such other emergency services shall only be charged for their pro rata share of the cost of licensure and inspection, if appropriate. The secretary may charge different fees for registered nurses licensed under chapter 18.79 RCW, licensed practical nurses licensed under chapter 18.79 RCW, and nurses who hold a valid multistate license issued by the state of Washington under chapter 18.80 RCW. The secretary may waive the fees when, in the discretion of the secretary, the fees would not be in the best interest of public health and safety, or when the fees would be to the financial disadvantage of the state.
Except as provided in subsection (3) of this section, fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection.
License fees shall include amounts in addition to the cost of licensure activities in the following circumstances:
For registered nurses and licensed practical nurses licensed under chapter 18.79 RCW, and for nurses who hold a valid multistate license issued by the state of Washington under chapter 18.80 RCW, support of a central nursing resource center as provided in RCW 18.79.202;
For all health care providers licensed under RCW 18.130.040, the cost of regulatory activities for retired volunteer medical worker licensees as provided in RCW 18.130.360; and
For physicians licensed under chapter 18.71 RCW, physician assistants licensed under chapter 18.71A RCW, osteopathic physicians licensed under chapter 18.57 RCW, naturopaths licensed under chapter 18.36A RCW, podiatrists licensed under chapter 18.22 RCW, chiropractors licensed under chapter 18.25 RCW, psychologists and psychological associates licensed under chapter 18.83 RCW, registered nurses and licensed practical nurses licensed under chapter 18.79 RCW, nurses who hold a valid multistate license issued by the state of Washington under chapter 18.80 RCW, optometrists licensed under chapter 18.53 RCW, mental health counselors and mental health counselor associates licensed under chapter 18.225 RCW, massage therapists licensed under chapter 18.108 RCW, advanced social workers licensed under chapter 18.320 RCW, independent clinical social workers and independent clinical social worker associates licensed under chapter 18.320 RCW, midwives licensed under chapter 18.50 RCW, marriage and family therapists and marriage and family therapist associates licensed under chapter 18.225 RCW, occupational therapists and occupational therapy assistants licensed under chapter 18.59 RCW, dietitians and nutritionists certified under chapter 18.138 RCW, speech-language pathologists licensed under chapter 18.35 RCW, acupuncturists or acupuncture and Eastern medicine practitioners licensed under chapter 18.06 RCW, and veterinarians and veterinary technicians licensed under chapter 18.92 RCW, the license fees shall include up to an additional $25 to be transferred by the department to the University of Washington for the purposes of RCW 43.70.112.
Department of health advisory committees may review fees established by the secretary for licenses and comment upon the appropriateness of the level of such fees.
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Each of the following professionals certified or licensed under Title 18 RCW shall, at least once every six years, complete training in suicide assessment, treatment, and management that is approved, in rule, by the relevant disciplining authority:
An adviser or counselor certified under chapter 18.19 RCW;
A substance use disorder professional licensed under chapter 18.205 RCW;
A marriage and family therapist licensed under chapter 18.225 RCW;
A mental health counselor licensed under chapter 18.225 RCW;
An occupational therapy practitioner licensed under chapter 18.59 RCW;
A psychologist licensed under chapter 18.83 RCW;
An advanced social worker or independent clinical social worker licensed under chapter 18.320 RCW; and
A social worker associateadvanced or social worker associateindependent clinical licensed under chapter 18.320 RCW.
The requirements in (a) of this subsection apply to a person holding a retired active license for one of the professions in (a) of this subsection.
The training required by this subsection must be at least six hours in length, unless a disciplining authority has determined, under subsection (10)(b) of this section, that training that includes only screening and referral elements is appropriate for the profession in question, in which case the training must be at least three hours in length.
Beginning July 1, 2017, the training required by this subsection must be on the model list developed under subsection (6) of this section. Nothing in this subsection (1)(d) affects the validity of training completed prior to July 1, 2017.
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Except as provided in (b) of this subsection:
A professional listed in subsection (1)(a) of this section must complete the first training required by this section by the end of the first full continuing education reporting period after January 1, 2014, or during the first full continuing education reporting period after initial licensure or certification, whichever occurs later.
Beginning July 1, 2021, the second training for a psychologist, a marriage and family therapist, a mental health counselor, an advanced social worker, an independent clinical social worker, a social worker associate-advanced, or a social worker associate-independent clinical must be either: (A) An advanced training focused on suicide management, suicide care protocols, or effective treatments; or (B) a training in a treatment modality shown to be effective in working with people who are suicidal, including dialectical behavior therapy, collaborative assessment and management of suicide risk, or cognitive behavior therapy-suicide prevention. If a professional subject to the requirements of this subsection has already completed the professional's second training prior to July 1, 2021, the professional's next training must comply with this subsection. This subsection (2)(a)(ii) does not apply if the licensee demonstrates that the training required by this subsection (2)(a)(ii) is not reasonably available.
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A professional listed in subsection (1)(a) of this section applying for initial licensure may delay completion of the first training required by this section for six years after initial licensure if he or she can demonstrate successful completion of the training required in subsection (1) of this section no more than six years prior to the application for initial licensure.
Beginning July 1, 2021, a psychologist, a marriage and family therapist, a mental health counselor, an advanced social worker, an independent clinical social worker, a social worker associate-advanced, or a social worker associate-independent clinical exempt from his or her first training under (b)(i) of this subsection must comply with the requirements of (a)(ii) of this subsection for his or her first training after initial licensure. If a professional subject to the requirements of this subsection has already completed the professional's first training after initial licensure, the professional's next training must comply with this subsection (2)(b)(ii). This subsection (2)(b)(ii) does not apply if the licensee demonstrates that the training required by this subsection (2)(b)(ii) is not reasonably available.
The hours spent completing training in suicide assessment, treatment, and management under this section count toward meeting any applicable continuing education or continuing competency requirements for each profession.
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A disciplining authority may, by rule, specify minimum training and experience that is sufficient to exempt an individual professional from the training requirements in subsections (1) and (5) of this section. Nothing in this subsection (4)(a) allows a disciplining authority to provide blanket exemptions to broad categories or specialties within a profession.
A disciplining authority may exempt a professional from the training requirements of subsections (1) and (5) of this section if the professional has only brief or limited patient contact.
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Each of the following professionals credentialed under Title 18 RCW shall complete a one-time training in suicide assessment, treatment, and management that is approved by the relevant disciplining authority:
A chiropractor licensed under chapter 18.25 RCW;
A naturopath licensed under chapter 18.36A RCW;
A licensed practical nurse, registered nurse, or advanced practice registered nurse, other than a certified registered nurse anesthetist, licensed under chapter 18.79 RCW;
An osteopathic physician and surgeon licensed under chapter 18.57 RCW, other than a holder of a postgraduate osteopathic medicine and surgery license issued under RCW 18.57.035;
A physical therapist or physical therapist assistant licensed under chapter 18.74 RCW;
A physician licensed under chapter 18.71 RCW, other than a resident holding a limited license issued under RCW 18.71.095(3);
A physician assistant licensed under chapter 18.71A RCW;
A pharmacist licensed under chapter 18.64 RCW;
ix. A dentist licensed under chapter 18.32 RCW;
An athletic trainer licensed under chapter 18.250 RCW;
An optometrist licensed under chapter 18.53 RCW;
An acupuncture and Eastern medicine practitioner licensed under chapter 18.06 RCW;
A dental therapist licensed under chapter 18.265 RCW; and
A person holding a retired active license for one of the professions listed in (a)(i) through (xiv) of this subsection.
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A professional listed in (a)(i) through (vii) of this subsection or a person holding a retired active license for one of the professions listed in (a)(i) through (vii) of this subsection must complete the one-time training by the end of the first full continuing education reporting period after January 1, 2016, or during the first full continuing education reporting period after initial licensure, whichever is later. Training completed between June 12, 2014, and January 1, 2016, that meets the requirements of this section, other than the timing requirements of this subsection (5)(b), must be accepted by the disciplining authority as meeting the one-time training requirement of this subsection (5).
A licensed pharmacist or a person holding a retired active pharmacist license must complete the one-time training by the end of the first full continuing education reporting period after January 1, 2017, or during the first full continuing education reporting period after initial licensure, whichever is later.
A licensed dentist, a licensed dental hygienist, or a person holding a retired active license as a dentist shall complete the one-time training by the end of the full continuing education reporting period after August 1, 2020, or during the first full continuing education reporting period after initial licensure, whichever is later. Training completed between July 23, 2017, and August 1, 2020, that meets the requirements of this section, other than the timing requirements of this subsection (5)(b)(iii), must be accepted by the disciplining authority as meeting the one-time training requirement of this subsection (5).
A licensed optometrist or a licensed acupuncture and Eastern medicine practitioner, or a person holding a retired active license as an optometrist or an acupuncture and Eastern medicine practitioner, shall complete the one-time training by the end of the full continuing education reporting period after August 1, 2021, or during the first full continuing education reporting period after initial licensure, whichever is later. Training completed between August 1, 2020, and August 1, 2021, that meets the requirements of this section, other than the timing requirements of this subsection (5)(b)(iv), must be accepted by the disciplining authority as meeting the one-time training requirement of this subsection (5).
The training required by this subsection must be at least six hours in length, unless a disciplining authority has determined, under subsection (10)(b) of this section, that training that includes only screening and referral elements is appropriate for the profession in question, in which case the training must be at least three hours in length.
Beginning July 1, 2017, the training required by this subsection must be on the model list developed under subsection (6) of this section. Nothing in this subsection (5)(d) affects the validity of training completed prior to July 1, 2017.
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The secretary and the disciplining authorities shall work collaboratively to develop a model list of training programs in suicide assessment, treatment, and management. Beginning July 1, 2021, for purposes of subsection (2)(a)(ii) of this section, the model list must include advanced training and training in treatment modalities shown to be effective in working with people who are suicidal.
The secretary and the disciplining authorities shall update the list at least once every two years.
By June 30, 2016, the department shall adopt rules establishing minimum standards for the training programs included on the model list. The minimum standards must require that six-hour trainings include content specific to veterans and the assessment of issues related to imminent harm via lethal means or self-injurious behaviors and that three-hour trainings for pharmacists or dentists include content related to the assessment of issues related to imminent harm via lethal means. By July 1, 2024, the minimum standards must be updated to require that both the six-hour and three-hour trainings include content specific to the availability of and the services offered by the 988 crisis hotline and the behavioral health crisis response and suicide prevention system and best practices for assisting persons with accessing the 988 crisis hotline and the system. Beginning September 1, 2024, trainings submitted to the department for review and approval must include the updated information in the minimum standards for the model list as well as all subsequent submissions. When adopting the rules required under this subsection (6)(c), the department shall:
Consult with the affected disciplining authorities, public and private institutions of higher education, educators, experts in suicide assessment, treatment, and management, the Washington department of veterans affairs, and affected professional associations; and
Consider standards related to the best practices registry of the American foundation for suicide prevention and the suicide prevention resource center.
Beginning January 1, 2017:
The model list must include only trainings that meet the minimum standards established in the rules adopted under (c) of this subsection and any three-hour trainings that met the requirements of this section on or before July 24, 2015;
The model list must include six-hour trainings in suicide assessment, treatment, and management, and three-hour trainings that include only screening and referral elements; and
A person or entity providing the training required in this section may petition the department for inclusion on the model list. The department shall add the training to the list only if the department determines that the training meets the minimum standards established in the rules adopted under (c) of this subsection.
By January 1, 2021, the department shall adopt minimum standards for advanced training and training in treatment modalities shown to be effective in working with people who are suicidal. Beginning July 1, 2021, all such training on the model list must meet the minimum standards. When adopting the minimum standards, the department must consult with the affected disciplining authorities, public and private institutions of higher education, educators, experts in suicide assessment, treatment, and management, the Washington department of veterans affairs, and affected professional associations.
The department shall provide the health profession training standards created in this section to the professional educator standards board as a model in meeting the requirements of RCW 28A.410.226 and provide technical assistance, as requested, in the review and evaluation of educator training programs. The educator training programs approved by the professional educator standards board may be included in the department's model list.
Nothing in this section may be interpreted to expand or limit the scope of practice of any profession regulated under chapter 18.130 RCW.
The secretary and the disciplining authorities affected by this section shall adopt any rules necessary to implement this section.
For purposes of this section:
"Disciplining authority" has the same meaning as in RCW 18.130.020.
"Training in suicide assessment, treatment, and management" means empirically supported training approved by the appropriate disciplining authority that contains the following elements: Suicide assessment, including screening and referral, suicide treatment, and suicide management. However, the disciplining authority may approve training that includes only screening and referral elements if appropriate for the profession in question based on the profession's scope of practice. The board of occupational therapy may also approve training that includes only screening and referral elements if appropriate for occupational therapy practitioners based on practice setting.
A state or local government employee is exempt from the requirements of this section if he or she receives a total of at least six hours of training in suicide assessment, treatment, and management from his or her employer every six years. For purposes of this subsection, the training may be provided in one six‑hour block or may be spread among shorter training sessions at the employer's discretion.
An employee of a community mental health agency licensed under chapter 71.24 RCW or a chemical dependency program certified under chapter 71.24 RCW is exempt from the requirements of this section if he or she receives a total of at least six hours of training in suicide assessment, treatment, and management from his or her employer every six years. For purposes of this subsection, the training may be provided in one six-hour block or may be spread among shorter training sessions at the employer's discretion.
The department, in consultation with the workforce training and education coordinating board and the examining board of psychology, shall examine licensure requirements for the following professions to identify changes to statutes and rules that would remove barriers to entering and remaining in the health care workforce and to streamline and shorten the credentialing process:
Advanced social workers and independent clinical social workers licensed under chapter 18.320 RCW;
Marriage and family therapists licensed under chapter 18.225 RCW;
Mental health counselors licensed under chapter 18.225 RCW;
Substance use disorder professionals certified under chapter 18.205 RCW; and
Psychologists licensed under chapter 18.83 RCW.
The licensure requirements to be examined by the department shall include examinations, continuing education requirements, administrative requirements for license application and renewal, English language proficiency requirements, and supervised experience requirements, including supervisor requirements and costs associated with completing supervised experience requirements.
When conducting the review required in subsection (1) of this section, the department shall at a minimum consider the following:
The availability of peer-reviewed research and other evidence, including requirements in other states, indicating the necessity of specific licensure requirements for ensuring that behavioral health professionals are prepared to practice with reasonable skill and safety;
Changes that would facilitate licensure of qualified, out-of-state and international applicants to promote reciprocity, including the adoption of applicable interstate compacts;
Changes that would promote greater consistency across licensure requirements for professions licensed under chapters 18.225 and 18.320 RCW and allow for applicants' prior professional experience within relevant fields to be counted towards supervised experience requirements established under chapters 18.225 and 18.320 RCW, including the extent to which an applicant may use prior professional experience gained before graduation from a master's or doctoral level educational program to satisfy the applicant's supervised experience requirement;
Technical assistance programs, such as navigators or dedicated customer service lines, to facilitate the completion of licensing applications;
In consultation with the examining board of psychology and a statewide organization representing licensed psychologists, the creation of an associate-level license for psychologists;
Whether agency affiliated counselors should be allowed to practice in federally qualified health centers; and
Any rules that pose excessive administrative requirements for application or renewal or that place a disproportionate burden on applicants from disadvantaged communities.
By November 1, 2023, the department shall provide a progress report and initial findings to the appropriate committees of the legislature on actions and recommendations to remove licensing barriers and improve credentialing time frames.
By November 1, 2024, the department shall provide a final report to the appropriate committees of the legislature on actions and recommendations to remove licensing barriers and improve credentialing time frames.
For purposes of this section:
"Health carrier" includes disability insurers regulated under chapter 48.20 or 48.21 RCW, health care services contractors regulated under chapter 48.44 RCW, plans operating under the health care authority under chapter 41.05 RCW, the basic health plan operating under chapter 70.47 RCW, the state health insurance pool operating under chapter 48.41 RCW, insuring entities regulated under this chapter, and health maintenance organizations regulated under chapter 48.46 RCW.
"Intermediary" means a person duly authorized to negotiate and execute provider contracts with health carriers on behalf of mental health care practitioners.
Consistent with their lawful scopes of practice, "mental health care practitioners" includes only the following: Any generally recognized medical specialty of practitioners licensed under chapter 18.57 or 18.71 RCW who provide mental health services, advanced practice psychiatric nurses as authorized by the state board of nursing under chapter 18.79 RCW, psychologists licensed under chapter 18.83 RCW, mental health counselorsand marriage and family therapists licensed under chapter 18.225 RCW, and social workers licensed under chapter 18.320 RCW.
"Mental health services" means outpatient services.
Consistent with federal and state law and rule, no contract between a mental health care practitioner and an intermediary or between a mental health care practitioner and a health carrier that is written, amended, or renewed after June 6, 1996, may contain a provision prohibiting a practitioner and an enrollee from agreeing to contract for services solely at the expense of the enrollee as follows:
On the exhaustion of the enrollee's mental health care coverage;
During an appeal or an adverse certification process;
When an enrollee's condition is excluded from coverage; or
For any other clinically appropriate reason at any time.
If a mental health care practitioner provides services to an enrollee during an appeal or adverse certification process, the practitioner must provide to the enrollee written notification that the enrollee is responsible for payment of these services, unless the health carrier elects to pay for services provided.
This section does not apply to a mental health care practitioner who is employed full time on the staff of a health carrier.
Mental health counselorsand marriage and family therapists licensed under chapter 18.225 RCW and social workers licensed under chapter 18.320 RCW are subject to this chapter.
The authority must contract with an association that represents designated crisis responders in Washington to develop and begin delivering by July 1, 2025, a training program for social workers licensed under chapter 18.320 RCW who practice in an emergency department with responsibilities related to civil commitments under this chapter. The training must include instruction emphasizing standards and procedures relating to the civil commitment of persons with substance use disorders and mental illness, including which clinical presentations warrant summoning a designated crisis responder. The training must emphasize the manner in which a patient with a primary substance use disorder may present as a risk of harm to self or others, or gravely disabled. Each hospital shall ensure that, by July 1, 2026, or within three months of hire, all social workers employed in the emergency department with responsibilities relating to civil commitments under this chapter complete the training every three years.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
(1) A juvenile offender is eligible for the special sex offender disposition alternative when:
An individual or group of individuals duly licensed or otherwise legally authorized to render the same professional services within this state may organize and become a shareholder or shareholders of a professional corporation for pecuniary profit under the provisions of Title 23B RCW for the purpose of rendering professional service. One or more of the legally authorized individuals shall be the incorporators of the professional corporation.
Notwithstanding any other provision of this chapter, registered architects and registered engineers may own stock in and render their individual professional services through one professional service corporation.
Licensed health care professionals, providing services to enrolled participants either directly or through arrangements with a health maintenance organization registered under chapter 48.46 RCW or federally qualified health maintenance organization, may own stock in and render their individual professional services through one professional service corporation.
Professionals may organize a nonprofit nonstock corporation under this chapter and chapter 24.03A RCW to provide professional services, and the provisions of this chapter relating to stock and referring to Title 23B RCW shall not apply to any such corporation.
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Notwithstanding any other provision of this chapter, health care professionals who are licensed or certified pursuant to chapters 18.06, 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A, 18.50, 18.53, 18.55, 18.57, 18.59, 18.64, 18.71, 18.71A, 18.74, 18.79, 18.83, 18.89, 18.108, 18.138, and 18.320 RCW may own stock in and render their individual professional services through one professional service corporation and are to be considered, for the purpose of forming a professional service corporation, as rendering the "same specific professional services" or "same professional services" or similar terms.
Formation of a professional service corporation under this subsection does not restrict the application of the uniform disciplinary act under chapter 18.130 RCW, or applicable health care professional statutes under this title, including but not limited to restrictions on persons practicing a health profession without being appropriately credentialed and persons practicing beyond the scope of their credential.
A person or group of persons licensed or otherwise legally authorized to render professional services, as defined in RCW 18.100.030, within this state may organize and become a member or members of a limited liability partnership under the provisions of this chapter for the purposes of rendering professional service. Nothing in this section prohibits a person duly licensed or otherwise legally authorized to render professional services in any jurisdiction other than this state from becoming a member of a limited liability partnership organized for the purpose of rendering the same professional services. Nothing in this section prohibits a limited liability partnership from rendering professional services outside this state through individuals who are not duly licensed or otherwise legally authorized to render such professional services within this state.
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Notwithstanding any other provision of this chapter, health care professionals who are licensed or certified pursuant to chapters 18.06, 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A, 18.50, 18.53, 18.55, 18.64, 18.79, 18.83, 18.89, 18.108, 18.138, and 18.320 RCW may join and render their individual professional services through one limited liability partnership and are to be considered, for the purpose of forming a limited liability partnership, as rendering the "same specific professional services" or "same professional services" or similar terms.
Notwithstanding any other provision of this chapter, health care professionals who are licensed pursuant to chapters 18.57 and 18.71 RCW may join and render their individual professional services through one limited liability partnership and are to be considered, for the purpose of forming a limited liability partnership, as rendering the "same specific professional services" or "same professional services" or similar terms.
Formation of a limited liability partnership under this subsection does not restrict the application of the uniform disciplinary act under chapter 18.130 RCW, or any applicable health care professional statutes under Title 18 RCW, including but not limited to restrictions on persons practicing a health profession without being appropriately credentialed and persons practicing beyond the scope of their credential.
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It is unlawful for an employer to obtain individually identifiable information regarding an employee's participation in an employee assistance program. Individually identifiable information gathered in the process of conducting an employee assistance program must be kept confidential.
Subsection (1)(a) of this section does not apply to:
Authorized disclosures under RCW 41.04.730;
Disclosures to an employer regarding an employee's attendance in an employee assistance program, which the employee was required to attend as a condition of continued employment; and
Disclosures that are:
(A) Made to prevent or lessen a perceived threat to the health or safety of an individual or the public; or
(B) Permitted or required under RCW 18.225.105, 70.02.050, 71.05.120, or section 11 of this act.
Upon adoption of a fully integrated managed health care system pursuant to chapter 71.24 RCW, regional service areas:
Must allow reimbursement for time spent supervising persons working toward satisfying supervision requirements established for the relevant practice areas pursuant to RCW 18.225.090 and chapter 18.320 RCW; and
May allow reimbursement for services delivered through a partial hospitalization or intensive outpatient program as described in RCW 71.24.385.
Sections 2 through 18 take effect July 1, 2026.
Sections 19 through 47 of this act take effect July 1, 2027, or later, contingent upon the Washington state board of governors for licensed social workers adopting rules and assuming full regulatory authority from the secretary. The department of health must provide written notice of the effective date of these sections to affected parties, the chief clerk of the house of representatives, the secretary of the senate, the office of the code reviser, and others as deemed appropriate by the department.