The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Rules
BILL: CS/SB 566
INTRODUCER: Health Policy Committee and Senator Gruters
SUBJECT: Mental Health Professional Licensure
DATE: January 25, 2022 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Rossitto-Van
Brown HP Fav/CS
Winkle
2. Delia Cox CF Favorable
3. Rossitto-Van
Phelps RC Favorable
Winkle
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 566 amends the minimum education requirements for licensure as a clinical social
worker, marriage and family therapist, or a mental health counselor in s. 491.005, F.S.
The bill allows marriage and family therapy applicants who graduated from a program not
accredited by the Commission on Accreditation for Marriage and Family Therapy Education
(CAMFTE), or from a Florida university program accredited by the Council for Accreditation of
Counseling and Related Educational Programs (CACREP), on July 1, 2020, when the current
s. 491.005, F.S., took effect, to now apply for licensure. Under the bill, marriage and family
therapy graduates would have until September 1, 2027, to meet the minimum education
requirements for licensure by earning a master’s degree from any institutionally-accredited
college or university, not just the CACREP.
The bill updates the education requirements for marriage and family therapists’ in reference to
accreditation by the Commission on Recognition of Postsecondary Accreditation (CORPA),
which was dissolved in 1997. CORPA is replaced it with its successor, the Council for Higher
Education Accreditation (CHEA), or its successors.
The bill also amends the minimum education requirements for licensure as a mental health
counselor to include a master’s degree from a program accredited by the Masters in Psychology
and Counseling Accreditation Council (MPCAC), or an equivalent accrediting body, as a degree
that qualifies an applicant for licensure.
BILL: CS/SB 566 Page 2
The bill deletes obsolete provisions regarding the Department of Health (DOH) purchasing
examinations for clinical social workers and Marriage and Family Therapists. Additionally, the
bill revises the nomenclature for the accrediting authorities for marriage and family therapists
and mental health counselors from a “regional” accrediting body, to an “institutional” accrediting
body, to align with the U.S. Department of Education’s current vernacular and eliminates any
perceived differences between regional and national accrediting bodies.
The bill takes effect upon becoming a law.
II. Present Situation:
The Department of Health
The Legislature created the DOH to protect and promote the health of all residents and visitors in
the state.1 The DOH is charged with the regulation of health care practitioners for the
preservation of the health, safety, and welfare of the public. The Division of Medical Quality
Assurance (MQA) is responsible for the boards2 and professions within the DOH.3
Mental Health Professionals Licensure
Section 491.005, F.S., sets out the educational and examination requirements for a clinical social
worker, marriage and family therapist, and mental health counselor to obtain a license by
examination in Florida. An individual applying for licensure by examination who has satisfied
the clinical experience requirements of s. 491.005, F.S., or an individual applying for licensure
by endorsement pursuant to s. 491.006, F.S., intending to provide clinical social work, marriage
and family therapy, or mental health counseling services in Florida, while satisfying coursework
or examination requirements for licensure, must obtain a provisional license in the profession for
which he or she is seeking licensure prior to beginning practice.4
An individual who has not satisfied the postgraduate or post-master’s level of experience
requirements under s. 491.005, F.S., must register as an intern in the profession for which he or
she is seeking licensure before commencing the post-master’s experience requirement. An
individual who intends to satisfy part of the required graduate-level practicum, internship, or
field experience outside the academic arena, must register as an intern in the profession for
which he or she is seeking licensure before commencing the practicum, internship, or field
experience.5
1
Section 20.43, F.S.
2
Under s. 456.001(1), F.S., the term “board” is defined as any board, commission, or other statutorily created entity, to the
extent such entity is authorized to exercise regulatory or rulemaking functions within the DOH or, in some cases, within the
MQA.
3
Section 20.43(3), F.S.
4
Section 491.0046, F.S.
5
Section 491.0045, F.S.
BILL: CS/SB 566 Page 3
Clinical Social Workers
Section 491.005(1), F.S., relates to licensure by examination for clinical social workers. The
DOH must issue a license to an applicant as a clinical social worker if the Board of Clinical
Social Work, Marriage and Family Therapy, and Mental Health Counseling (Board) certifies that
the applicant:
Has submitted an application and appropriate fees;
Has earned a doctoral degree in social work from a graduate school of social work accredited
by an accrediting agency recognized by the U.S. Department of Education, or a master’s
degree in social work from a graduate school of social work which:
o Was accredited by the Council on Social Work Education (CSWE);
o Was accredited by the Canadian Association of Schools of Social Work (CASSW); or
o Has been determined to be an equivalent program to programs approved by the CSWE by
the Foreign Equivalency Determination Service of the CSWE;
o Completed all of the following coursework:
A supervised field placement during which the applicant provided clinical services
directly to clients; and
Twenty-four semester hours or thirty-two quarter hours in theory of human behavior
and practice methods as courses in clinically oriented services, with a minimum of
one course in psychopathology and no more than one course in research;
Has completed at least two post graduate years of clinical social work experience under the
supervision of a licensed clinical social worker or the equivalent supervisor as determined by
the Board;6
Has passed a theory and practice examination; and
Demonstrates, in a manner designated by Board rule, knowledge of the laws and rules
governing the practice of clinical social work, marriage and family therapy, and mental
health counseling.
Marriage and Family Therapists
Section 491.005(3), F.S., relates to licensure by examination for marriage and family therapists.
The DOH must issue a license to an applicant as a marriage and family therapist if the Board
certifies that the applicant has:
Submitted an application and appropriate fee;
A minimum of a master’s degree with major emphasis in marriage and family therapy or a
closely related field from a:
o Program accredited by the CAMFTE; or
o Florida university program accredited by the CACREP;
Documentation of the completion of graduate courses approved by the Board;7
Completed at least two years of clinical experience during which 50 percent of the
applicant’s clients were receiving marriage and family therapy services:
6
Section 491.005(1)(c), F.S. An individual who intends to practice in Florida to satisfy clinical experience requirements must
register with the DOH pursuant to s. 491.0045, F.S., before commencing practice.
7
Section 491.005(3)(b), F.S. If the course title that appears on the applicant’s transcript does not clearly identify the content
of the coursework, the applicant must provide additional documentation, including, but not limited to, a syllabus or catalog
description published for the course.
BILL: CS/SB 566 Page 4
o At the post-master’s level; and
o Under the supervision of a licensed marriage and family therapist with at least five years
of experience, or the equivalent; and whom the Board determines is a qualified
supervisor;
Passed a theory and practice examination provided by the DOH;8
Demonstrated, in a manner designated by Board rule, knowledge of the laws and rules
governing the practice of clinical social work, marriage and family therapy, and mental
health counseling.9
The required master’s degree must have been earned at an institution of higher education that, at
the time the applicant graduated, was fully accredited by a regional accrediting body recognized
by:
The Commission on Recognition of Postsecondary Accreditation (CRPA);
A member in good standing with the Association of Universities and Colleges of Canada; or
An institution of higher education located outside the United States and Canada which, at the
time the applicant attended and graduated, maintained a standard of training substantially
equivalent to the standards of training of those institutions in the United States which are
accredited by a regional accrediting body recognized by the CRPA.10
The applicant has the burden of establishing that all above requirements for licensure are met.
An applicant who has a master’s degree from a program that did not emphasize marriage and
family therapy may complete the coursework requirement in an institution fully accredited by the
CAMFTE, and recognized by the U.S. Department of Education.11
To satisfy the clinical experience requirements, an individual who intends to practice in Florida
must register with the DOH before he or she may commence practice.12
If a graduate has a master’s degree with a major emphasis in marriage and family therapy or a
closely related field which did not include all of the coursework required by the Board, the post-
master’s level clinical experience may not commence until the applicant has completed a
minimum of ten of the courses required, as determined, by the Board. At least six semester
hours, or nine quarter hours, must have been completed in the area of marriage and family
systems, theories, or techniques.13
8
See s. 491.004(5), F.S., and Fla. Admin. Code R. 64B4-3.003(2)(c) and 3 (2021). The DOH no longer provides the theory
and practice examination for Marriage and Family Therapists. The examination used is the one developed by the
Examination Advisory Committee of the Association of Marital and Family Therapy Regulatory Board (AMFTRB). The
minimum passing score is established by that provider as well.
9
See Fla. Admin. Code R. 64B4-3.0035 (2021).
10
Id. Such foreign education and training must have been received in an institution or program of higher education officially
recognized by the government of the country in which it is located as an institution or program to train students to practice as
professional marriage and family therapists or psychotherapists.
11
Section 491.005(3)(b), F.S.
12
Section 491.005(3)(c), F.S.
13
Id.
BILL: CS/SB 566 Page 5
During the two years of required clinical experience, the applicant must provide direct
individual, group, or family therapy and counseling, including cases involving:
Unmarried dyads;
Married couples;
Separating and divorcing couples; and
Family groups that include children.14
A doctoral internship may be applied toward the clinical experience requirements.
A licensed mental health professional must be on the premises when clinical services are
provided by a registered intern in a private practice setting.15
The DOH must issue a dual license to persons licensed as psychologists, clinical social workers,
mental health counselors, and psychiatric advanced practice registered nurses, if the candidate
has:
A valid, active license for at least three years; and
Passed the examination provided by the DOH for marriage and family therapy.16
Mental Health Counselors
Section 491.005(4), F.S., relates to licensure by examination for mental health counselors.
Education and training in mental health counseling must have been received in an institution of
higher education that, at the time the applicant graduated, was fully accredited by:
A regional accrediting body recognized by the Council for Higher Education Accreditation
(CHEA) or its successor;
A publicly recognized member in good standing with the Association of Universities and
Colleges of Canada; or
An institution of higher education located outside the United States and Canada which, at the
time the applicant was enrolled and at the time the applicant graduated, was officially
recognized by the government of the country in which it is located as an institution or
program, to train students to practice as mental health counselors that maintained a standard
of training substantially equivalent to the standards of training of those institutions in the
United States which are accredited by a regional accrediting body recognized by the CHEA
or its successor.
The DOH must issue a license to an applicant as a mental health counselor if the Board certifies
that the applicant has:
Submitted an application and appropriate fees;
Earned a minimum of a master’s degree from:
14
Id.
15
Id.
16
Id. For the purposes of dual licensure, the department shall license as a marriage and family therapist any person who
meets the requirements of s. 491.0057, F.S. Fees for dual licensure may not exceed those stated in this section.
BILL: CS/SB 566 Page 6
o A mental health counseling program accredited by the CACREP17 which includes clinical
and didactic instruction, including courses in human sexuality and substance abuse; or
o A non-CACREP accredited program related to the practice of mental health counseling,
but with coursework and practicum, internship, or fieldwork that meet all of the
following:
Thirty-three semester hours, or forty-four quarter hours, which must include a minimum of
three semester hours, or four quarter hours, of graduate-level coursework in 11 specified
content areas;18 or
A minimum of one graduate level course emphasizing the diagnostic processes, including
differential diagnosis and the use of the current diagnostic tools, such as the current edition of
the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders. the common core curricular experience; or
An equivalent program to the two previously described options, as determined by the Board,
including at least 700 hours of university-sponsored supervised clinical practicum, internship,
or field work, that includes at least 280 hours of direct client services, as required by
CACREP accrediting standards for mental health counseling programs. This experience may
not be used to satisfy the post-master’s clinical experience requirement;
Had at least two years of clinical experience in mental health counseling, which must be at
the post-master’s level under the supervision of a licensed mental health counselor or the
equivalent who is a Board qualified supervisor;19
Passed a theory and practice examination provided by the DOH;20 and
Demonstrated, in a manner designated by Board rule, knowledge of the laws and rules
governing the practice of clinical social work, marriage and family therapy, and mental
health counseling.21
17
Council for Accreditation of Counseling & Related Educational Programs, 2016 CACREP Standards, available at
http://www.cacrep.org/wp-content/uploads/2018/05/2016-Standards-with-Glossary-5.3.2018.pdf (last visited January 6,
2022).
18<