Original Notice.

Preproposal statement of inquiry was filed as WSR 98-16-063.

Title of Rule: WAC 246-810-600 through 246-810-660 continuing education.

Purpose: There is a need to implement the 1998 legislation to mandate and further define what will be required for continuing education for certified marriage and family therapists, mental health counselors, and social workers.

Statutory Authority for Adoption: RCW 18.19.170.

Statute Being Implemented: Chapter 18.19 RCW.

Summary: This rule requires certified counselors to obtain continuing education.

Reasons Supporting Proposal: The proposed rules are necessary to further define the continuing education requirement.

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

Name of Proponent: Department of Health, governmental.

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

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

Explanation of Rule, its Purpose, and Anticipated Effects: The purpose of these rules is to further define the continuing education requirement for certified counselors.

Proposal does not change existing rules.

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

A telephone survey was taken of association representatives, professionals who corresponded with the counselor programs office, nonprofit agencies, private/county health agencies, chemical dependency agencies and randomly selected individuals.

Costs to Business. The survey showed that most were employed by agencies ranging from 35 to 350 total employees and having counselor staffs ranging from 3% to 65% of their employees. Agencies paid for all or part of the education; some had in-house training; some were already taking CE from associations wherein they hold membership; or for other state agencies already requiring CE - such as for chemical dependency counselors and vocational rehabilitation counselors. Only three of the forty-nine surveyed (6%) were individuals in private practice.

The survey revealed that most counselors were currently taking from eight to thirty-five clock hours of CE per year. Most were already taking twenty hours; individuals in private practice averaged about nine hours in a year.

Of the thirty-six hours of CE required every two years the statute requires four hours in ethics and law. (Assume for purposes of an annual calculation: Eighteen total CE hours, two of which must be in ethics and law.) It might be presumed that CE currently taken does not incorporate this component. This would reduce the estimates of CE currently being taken each year from twenty to seventeen for those working in agencies; and from nine to six for individuals in private practice.

For purposes of calculating costs, an average of these two figures is used, or twelve clock hours of CE currently being taken. The difference between this and the required eighteen hours per year is six. Thus, it could be estimated that counselors might need to take an additional six hours of CE a year.

The survey revealed that an hourly fee charged by counselors in private practice averages about $55; counselors working in an agency averaged about $38 per hour. It was estimated that a counselor in private practice can see about four clients a day; those in an agency, about five.

The costs associated with implementation of the CE requirement in this regulation are as follows:

Direct Costs	$96
Average cost for one clock hour of Continuing Education = $16
$16 x 6 hours = $96
Indirect Costs	$137
Time loss attending CE training -- 1-2 days per year (1 day usually a weekend) $38. hour x 18 hours > 1 day is usually a Friday, when most counselors schedule few clients; these clients can easily be rescheduled. > 1 day is usually a Saturday, when no clients are scheduled. 20% of Counselors with time loss = $137 > Therapist who work for agencies often have training time built into their schedules. 80% of Counselors offered training through agency = no time loss Therefore, indirect costs are $137
Total Costs for additional CE per year	$233

Costs to an individual counselor involved with audit of CE records by the department:

Direct Costs				$2
Copies of CE verification documents:
1 document per 3 hours of CE; maximum of 12 copies
	12 copies x .10/copy	=	$1.20
Postage to mail documents:			.55
			$1.75
Indirect Costs				$93
Time to gather documents, copy and mail them to department: 2 hours
Counselor in private practice:		$55 x 2 = $110
Counselor working in an agency:		$38 x 2 = $76
Average time cost for both types of employment:			$93
Total Costs to comply with CE audit				$95

The "large" businesses surveyed were hospitals and mental health agencies. Even the largest hospitals (with staff as high as 3800 employees) had counselor staff of no more than forty employees. Therefore, the "large" businesses compared here represent mental health agencies, who had total staffs averaging 207 employees, of which an average of ninety-two were counselors.

The following represents a per-employee cost comparison of a large business (mental health agencies) versus a small business (individual counselor):

	Small Businesses	Large Businesses
Direct Costs:
$96/6 additional CE hours per year	$96
$96 x 92 counselors/yr.		$8,832
Indirect Costs:	$137	$0
Number of employees	1	207
Cost per employee	$137	$43

According to appropriate Standard Industrial Code Classification, the cost difference would be considered a borderline minor cost to a small business. (Major impact can fall between $50 and $300.)

The department has made an effort to mitigate this by drafting the rule to allow for CE from many varied sources (while still requiring certain standards be met) in hopes that a counselor may acquire good training at a minimal cost or at no charge. Some of these allowable sources include distance learning, in-house training; and such things as participation on a panel, board or council, community service or publication of articles relating to the profession; and sources may be from various industry-recognized local, state, national, international organizations. Further mitigation is not possible since RCW 18.19.170 requires thirty-six hours of continuing education.

Costs to Agency. There would be costs incurred to the DOH to conduct random audits of compliance with CE. Estimates of these costs are as follows:

Work Requirement	Time or Item	Cost/Item	Annual Volume	Annual Cost
Conduct audits of CE (5 audit letters per mo)
Supplies* OAS	5 ltrs/mo 15 mins/audit	$1 $9.81/hr	60 15 hrs	$60 $147.15
Follow-up on delinquent audits (1 fol-up letter per mo)
Supplies* OAS HPM1	1 ltr/mo ½ hr ea 2@ 1hr ea	$1 $9.81/hr $19.65/hr	12 6 hrs 3 hrs	$12 $58.86 $58.95
Corrective action resulting from delinquent CE (2 per year)
HE2 HPM2 AA1	½ hr ea ½ hr ea 1 hr ea	$29.83/hr $24.27/hr $16.01/hr	1 hr 1 hr 2 hrs	$29.83 $24.27 $32.02
Paper, envelope, postage
Total Costs				$423.08

A copy of the statement may be obtained by writing to Shellie Pierce, Program Manager, Department of Health, Counselor Programs, P.O. Box 47869, Olympia, WA 98504-7869, phone (360) 236-4907, fax (360) 236-4909.

RCW 34.05.328 applies to this rule adoption. These rules are significant under RCW 34-05.238 [34.05.328] because they require certified counselors to obtain additional education. The agency has conducted the additional analysis required by RCW 34.05.328.

Hearing Location: Department of Health, 1101 South Eastside Street, Room 6A, Olympia, WA, on December 9, 1999, at 9:00 a.m.

Assistance for Persons with Disabilities: Contact Shellie Pierce by December 6, 1999, TDD (800) 833-6388, or (360) 236-4907.

Submit Written Comments to: Shellie Pierce, fax (360) 236-4909, by December 7, 1999.

Date of Intended Adoption: December 10, 1999.

November 1, 1999

M. C. Selecky

Secretary

OTS-2805.8

CONTINUING EDUCATION
NEW SECTION
WAC 246-810-600
Who is required to have continuing education?

(1) Certified marriage and family therapists, certified mental health counselors, and certified social workers are required to have continuing education.

(2) The effective date for reporting the required continuing education shall begin with the 2001 renewal cycle.

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The continuing education (CE) program or course shall contribute to the advancement, extension and enhancement of the professional competence of the certified counselor. Courses or workshops primarily designed to increase practice income or office efficiency are specifically not eligible for CE credit. Counselors are encouraged to take CE relating to the various phases of their professional career.

(1) Acceptable CE courses (including distance learning), seminars, workshops and postgraduate institutes are those which are:

(a) Programs having a featured instructor, speaker(s) or panel approved by an industry-recognized local, state, national, international organization or institution of higher learning; or

(b) Distance learning programs, approved by an industry-recognized local, state, national or international organization or institution of higher learning. These programs must require tests of comprehension upon completion.

(2) Training programs sponsored by the agency where a counselor is employed are acceptable if:

(a) The experience can be shown to contribute to the advancement, extension and enhancement of the professional competence of the certified counselor; and

(b) The training programs are limited to twenty-six hours per reporting period.

(3) Other learning experience, such as serving on a panel, board or council, community service, or publishing articles for professional publications, are acceptable if:

(a) The experience can be shown to contribute to the advancement, extension and enhancement of the professional competence of the certified counselor; and

(b) The experiences are limited to six hours per reporting period.

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They are, but not limited to, the following organizations:

(1) American Association of Marriage and Family Therapists;

(2) Clinical Social Work Federation;

(3) National Association of Social Workers;

(4) National Association of Mental Health Counselors;

(5) National Board for Certified Counselors; or

(6) Institutions of higher learning that are accredited by a national or regional accrediting body recognized by the Commission on Recognition of Postsecondary Accreditation.

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OTS-3237.4

NEW SECTION
WAC 246-810-630
How many hours do I need and in what time period?

Certified counselors must complete thirty-six hours of continuing education every two years. At least four of the thirty-six hours must be in professional ethics and law.

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The certificate holder who prepares and presents lectures or education that contributes to the professional competence of a certified counselor may accumulate the same number of hours obtained for continuing education purposes by attendees as required in WAC 246-12-220. The hours for presenting a specific topic lecture or education may only be used for continuing education credit once during each renewal period.

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OTS-3238.4

NEW SECTION
WAC 246-810-650
How do I document my courses?

Acceptable documentation shall include transcripts, letters from course instructors, certificate of completion, or other formal certification, as required in chapter 246-12 WAC, Part 7.

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The certificate holder returning to active status from temporary retirement pursuant to RCW 18.19.160(2) must provide a written declaration that the continuing education requirements for the two most recent years have been met.

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