Room 121A
Madison, Wisconsin
Appearances at the Hearing
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Legal Counsel, P.O. Box 8935, Madison, Wisconsin 53708. Written comments must be received by September 14, 2007, to be included in the record of rule-making proceedings.
Analysis Prepared by Dept. of Regulation and Licensing
Statutes interpreted
Statutory authority
Explanation of agency authority
Subchapter VII of ch 440, Stats., was enacted on July 25, 2005. It was amended by Act 407 which was enacted on May 10, 2006. Under subch.
VII of ch. 440, Stats., the Department of Regulation and Licensing is required to promulgate rules relating to the issuance and renewal of credentials, requirements for certification, supervised practice, scope of practice, education approval, grounds for discipline and professional liability insurance.
Related statute or rule
Section
MPSW 1.09, Wis. Adm. Code, which relates to certification of social workers, professional counselors and marriage and family therapists to treat substance use disorder patients as a specialty.
Chapter
HFS 75, Wis. Adm. Code, which relates to the certification of substance use disorder treatment clinics and programs.
Plain language analysis
2005 Wisconsin Act 25 created Subchapter VII of chapter 440, Stats., Substance Abuse Counselors, Clinical Supervisors, and Prevention Specialists. This Act transferred the certification and regulation of Alcohol and Other Drug Abuse (AODA) counselors from the Department of Health and Family Services to the Department of Regulation and Licensing, effective 2006. This proposed rule-making order creates rules relating to definitions, requirements for certification, supervised practice, scope of practice, education approval, and professional liability insurance for substance abuse professionals. Please refer to the “Summary of factual data and analytical methodologies" section and the section on “Analysis and supporting documentation used to determine effect on small business or in preparation of economic impact report."
Chapter
RL 160 is being created to include definitions of terms that are used in subch.
VII of ch. 440, Stats., and in chs.
RL 160 to
167. The proposed rules include definitions for “accredited," “assessment," “behavioral science field," “CEH," “clinical substance abuse counselor," “clinical supervision," “clinical supervisor,." “clinical supervisor-in-training," “comprehensive program," “core functions," “credential," “department," “DSM," “hour," “independent clinical supervisor," “intermediate clinical supervisor," “patient," “practice dimensions," “prevention," “prevention domains," “prevention specialist," “prevention specialist-in-training," “substance," “substance abuse counselor," “substance abuse counselor-in-training," “substance use disorder" and “transdisciplinary foundations."
Chapter
RL 161 is being created to identify the requirements and procedures for submitting applications for licenses.
Chapter
RL 162 is being created to identify the restrictions and minimum requirements for supervision of counselors by clinical supervisors.
Chapter
163 is being created to identify the scope and restrictions on the practice of the credential holders.
Chapter
RL 166 is being created to identify the approval process and educational requirements for educational coursework and continuing education opportunities.
Chapter
RL 167 is being created to require credential holders to have liability insurance in effect.
Chapter
RL 168 is being created to identify the requirements for continuing education.
Comparison with federal regulations
There is no existing or proposed federal regulation that is intended to address the activities to be regulated by this rule.
Comparison with adjacent states
Illinois:
The state of Illinois does not credential AODA or Substance Abuse Professionals, but does mandate the certification and use of those professions in their state certified alcohol and drug abuse clinics. This is similar to the status in Wisconsin prior to
2005 Wisconsin Act 25. Under Illinois code: Title 77: Chapter 2060.309 part of the staffing requirements of their clinics require counselors to hold clinical certification as a Certified Alcohol and Drug Counselor issued by the Illinois Alcoholism and Other Drug Abuse Professional Certification Association (IAODAPCA). This is a private, not-for-profit association, which was similar to the defunct Wisconsin Certification Board. Certification is still largely voluntary as certification is not required outside the clinics and there are broad exemptions in the code for certification requirements, which allow other professionals including clinical psychologists, licensed professional counselors, licensed clinical professional counselors, licensed clinical social workers, advanced practice nurses and licensed practical nurses to practice without an AODA certification.
IAODAPCA bases their requirements of those of the International Certification and Reciprocity (IC&RC). To obtain certification as a certified alcohol and drug counselor, an applicant must: hold a high school diploma or GED; complete 225 hours of education; complete 2 years of supervised practice; pass the IC&RC counselor examination. To achieve the certified reciprocal level of drug and alcohol counselor, the applicant must: have a high school diploma or GED; complete 3 years of supervised practice; complete 300 hours of training; complete 300 hours of education; pass the reciprocal level counselor examination as well as the case presentation method (CPM – a written and oral examination provided by the IC&RC). To achieve the supervisor credential, the counselor applicant must demonstrate 5 years of practice as counselor, including 1 year as a clinical counselor, 350 hours of education and the passage of the clinical supervisor examination.
See: §20 ILCS 301/15-5, 77 Ill. Adm. Code 2060.20 et. seq.
Iowa:
The state of Iowa does not credential AODA or Substance Abuse Professionals, but does mandate the certification and use of those professions in their state certified alcohol and drug abuse clinics. Under Iowa administrative code: 641 IAC 155.21 (8) i part of the staffing requirements of their clinics require that persons providing screening, evaluations, assessments or treatment shall be certified through the Iowa board of substance abuse certification, or certified by an international certification and reciprocity consortium member board in the states of Illinois, Minnesota, Nebraska, Missouri, South Dakota, and Wisconsin. The Iowa board appears to be a private organization, which is similar to the defunct Wisconsin Certification Board. Certification appears voluntary in practice outside of their certified clinics.
The Iowa Board is a member of the IC&RC and as such bases their credentials and requirement off those of the IC&RC. To obtain counselor certifications in Iowa, a person may apply through the educational path or through an experiential pathway. The Iowa certification as a drug and alcohol counselor requires a high school degree or GED and at least 24 semester hours in substance abuse or a related behavioral science, 150 clock hours of substance abuse specific education and training, and 1000 hours of supervised training. The experiential route requires the high school diploma or GED, 150 clock hours of education and 3,000 hours of supervised training. The advanced level of the certified drug and alcohol counselor requires 700 clock hours of substance abuse related education, 6,000 hours of supervised practice, and passage of the IC&RC counselor examination. There are no supervisor credentials in Iowa, instead a counselor at an equal or higher level of certification may be eligible to supervise.
For reciprocity, if an Iowa certified advanced alcohol and drug abuse counselor wishes to achieve a reciprocal credential, they must complete the written and oral portion of the IC&RC CPM examination.
See: §641 IAC chapter 155
Minnesota:
Licensed Alcohol and Drug Counselors (LADC's) are governed by Minnesota Statutes section 148C and Minnesota Administrative Code Chapter 4747.
In Minnesota, although licensure is available through the state and certification through the Minnesota Certification Board (MCB – a private organization), state licensure is required for practice, with exemptions for other professional licenses. The certification offered by the MCB is not recognized by the state. Exemption for licensure requirements includes, but is not limited to: licensed physicians; registered nurses; licensed practical nurses; licensed psychological practitioners; members of the clergy; American Indian medicine men and women; licensed attorneys; probation officers; licensed marriage and family therapists; licensed social workers; social workers employed by city, county, or state agencies; licensed professional counselors; licensed school counselors; registered occupational therapists or occupational therapy assistants; city, county, or state employees when providing assessments or case management.
Licensure through the state requires substance abuse education in an accredited school setting, supervised practice hours and a counselor examination provided by the IC&RC or a counselor examination provided by the National Association of Alcohol and Drug Abuse Counselors (NAADAC). The MCB offers certification based upon the standards of the IC&RC, which includes supervised practice requirements, specialized education and training in substance abuse counseling, and counselor examinations. Minnesota, in part to satisfy the standards of the licensure, will accept the certificates provided by the MCB as fulfilling their licensure requirements.
Licensure in Minnesota requires the following (before July 1, 2008): an associate degree or equivalent credit hours; 270 hours of substance abuse related education; completed either the case presentation method (an IC&RC) designed written and Oral examination) or 2,000 hours of supervised practice; passage of the NAADAC or IC&RC Counselor Examination. After July 1, 2008, Minnesota requires: a bachelor's degree including 18 semester credits or 270 clock hours of substance abuse related education; either the case presentation method, or a plan for 2000 hours of professional practice or proof of 2000 hours of professional practice; passage of the NAADAC or IC&RC counselor examination.
Minnesota does not offer separate supervisor credentials other than those through the MCB, which are based off IC&RC supervisory standards. Adequate supervision is provided by a licensed alcohol and drug counselor or another qualified professional (as determined by the Board), 4 years of substance abuse counseling and 12 hours of training in clinical and ethical supervision.
Minnesota has reciprocity provisions in their statutes. Reciprocity in Minnesota allows applicants with credentials in good standing from other jurisdictions that have substantially equivalent requirements to that of Minnesota's licensure to be licensed. Minnesota requires 40 hours of continuing education for renewal.
Michigan:
In Michigan, although certification is not required for most employment, some substance abuse counselors choose to be tested by Michigan's Center for Substance Abuse, within the Michigan Dept. of Community Health. Passage of an examination is required of substance abuse counselors employed by agencies receiving the funding from the office of substance abuse services. Recognition is also available as an apprentice counselor or an addictions counselor. Written examinations must also be passed for certification. In addition, to become a certified addictions counselor (CAC), applicants must demonstrate 3 years of supervised experience within an 8 year period, supply 3 professional references, make a written and oral case presentation, submit 270 hours of substance abuse education, and have completed an approved practicum. They must also sign a code of ethics statement.
Summary of factual data and analytical methodologies
The professions had previously been under the authority of the Department of Health and Family Services (under ch.
HFS 75), who contracted the regulation and certification of substance abuse professionals to the Wisconsin Certification Board, Inc. The Legislative Audit Bureau performed a limited review of the Wisconsin Certification Board, Inc. and issued a report on May 11, 2005.
The rules proposed represent a re-codification of existing standards for certification developed by the Wisconsin Certification Board, Inc. The legislature, under
2005 Wisconsin Act 25 and later amended by
2005 Wisconsin Act 407, set the statutory requirements for the new levels of licensure and mandated that the Department of Regulation and Licensing draft language for certification and regulation of substance abuse professionals.
To assist in promulgation of the rules, the department has held regular meetings with the Substance Abuse Counselors Advisory Committee for recommendations and development of the draft rules. Subsequently, the department promulgated emergency rules effective December 15, 2006 which includes chs.
RL 160 to
163 and chs.
RL 166 to
168 (the department had promulgated chs.
RL 164 and
165 as permanent rules on January 1, 2007). As the emergency rules were promulgated in December of 2006, the final permanent rules (below) are essentially a redraft of the emergency rules, with changes made for errors in the initial drafting, changes in timelines for effective dates of applicability and minor policy changes where prudent - again at the recommendation of the advisory committee.
Analysis and supporting documents used to determine effect on small business
The Department of Regulation and Licensing, based upon the advice of the advisory committee is proposing changes to the existing standards of certification and regulation of substance abuse professionals. The department, to minimize impact on the profession, and preserve the experiential pathway into the profession, has attempted to minimize drastic changes, and make changes only where the advice of the committee and the protection of the public are preserved.
These proposed rules will affect the existing 4,631 credential holders regulated by the department (Database count of in state active and inactive substance abuse credential holders, as of February 2007). These credential holders may operate at state departmental locations (e.g. Department of Corrections) as well as state certified AODA treatment clinics under ch.
HFS 75 (DHFS). An unknown number of certificate holders are likely to be operating in public, not-for-profit private treatment centers and for-profit treatment centers.
There were significant “grandparenting" provisions within the statutes that will ensure that existing (active and renewal) certificate holders will not lose their certification upon transfer if they do not meet the requirements for the new certificate (e.g. higher educational requirements). The grandparenting provisions do not apply for new applicants after December 15, 2006. Those who applied (new applicants) after December 15, 2006 were under the jurisdiction of the department, and as such were required to meet the requirements specified in our rules. Additionally, the department has instituted substantial grace periods for supervision of substance abuse counselors which would allow clinics one year's time for the supervisors to attain appropriate credentials required for supervision in their clinics.
The department is proposing changes as follows:
Educational standards:
• The proposed rules require a minimum of an associate's degree in a behavioral science to qualify for the clinical level counselor, and by extension, qualification for supervisory certification. This is an increase in educational requirements; however, an underlying degree is often a standard for professional requirements in other professions. This may prevent existing non-clinical substance abuse counselors from accessing higher levels of credentials until they achieve the underlying degree; however, the advisory committee has recommended that for protection of the public, a minimum of an associate's degree in a related behavioral science field should be instituted.
• The proposed rules reduce the required level of continuing education from 48 hours in the biennium to 40 for both substance abuse counselors and clinical substance abuse counselors. This is a reduction for applicable credential holders.
• The proposed rules eliminate the existing system of pre-certification education and training from multiple and separate sources, including Wisconsin Certification Board, Inc. accredited programs, endorsed trainings, seminars and home study (etc.), and require that the core training for the effective treatment of substance use disorder treatment be obtained from comprehensive and cohesive programs.
Note: The changes to the educational structure may be the primary area affecting the practice of small business. As per above, companies that operate as a small business do sell home study programs and trainings to the Wisconsin substance abuse professional education market. One such business, Laban's Trainings of Pennsylvania (
http://www.last-homestudy.com 3 employees, unknown earnings), sells home study programs to the AODA counselor community nationwide. They were an endorsed trainer of the WCB, prior to the transference of AODA regulation from the WCB to the DRL, and home study programs such as theirs could be counted for over 200 hours of the 360 hours of training required. The remainder was required to come from association sponsored workshops, seminars and school-based coursework.
Under the new rules, program providers like Laban's still have access to the certificate holders through the offering of continuing education programs required for recertification. For substance abuse counselors, that means 40 hours of continuing education is required in the biennium (a reduction from 48 hours to 40). In addition, Laban's and other home study providers may still access the market held by "comprehensive program providers" because the rules are written to restrict individuals from assembling their own education from untracked or uncoordinated sources, however, the rules allow those program providers to assemble the comprehensive program of 360 hours that they provide to their students. This assembled program may include a local provider which could source a 3rd party such as Laban's to supplement the coursework requirement.
Practice restrictions:
The proposed rules contain scope of practice and restrictions which include:
• Restrictions on the practice of substance abuse counselors-in-training: This credential does not assure competency; therefore, a clinical supervisor will be required to authorize the in-training counselor to provide functions when adequately trained to assure competency.
• The supervision of in-training counselors may not be done by clinical supervisors-in-training.
• Clinical supervisors will be legally and ethically responsible for the practice of their supervisees, shall have the authority and responsibility to provide emergency consultation, interrupt/stop unsafe practice and to terminate the supervised relationship if necessary.
• New definitions of who may provide supervision or qualify as a clinical supervisor: Supervision may only be provided by those with exemptions under the statutes (psychologists, psychiatrists, clinical substance abuse supervisors, or ch.
457, Stats., credential holders who have obtained a clinical supervision certification via their specialty AODA certification under s.
MPSW 1.09).
These changes may affect small business; however, where standards were increased, the department is proposing grace periods for these requirements. Additionally, these changes were seen as necessary to achieve the minimal competency required for safe practice and protection of the public.
Section
227.137, Stats., requires an “agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an “agency" in this section.
Anticipated Costs Incurred by Private Sector
The department finds that this rule has no significant fiscal effect on the private sector.
Fiscal Estimate
The Department estimates that this rule will require staff time in the Divisions of Management Services, Professional Credentialing, Office of Legal Counsel and Office of Examinations. The one-time salary and fringe costs in the Division of Professional Credentialing, Office of Legal Counsel and Office of Examinations are estimated at $22,900. The on-going salary, fringe, supplies and services costs in the Division of Professional Credentialing, Division of Board Services and the Office of Examinations are estimated at $77,300.
Effect on Small Business
These proposed rules will have no significant economic impact on small businesses, as defined in s.
227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@drl.state.wi.us, or by calling (608) 266-8608.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708-8935. Telephone: (608) 266-0495. Email:
pamela.haack@drl.state.wi.us. Copies of the emergency rules can be obtained from Ms. Haack.
