H.B. 587
GENERAL ASSEMBLY OF NORTH CAROLINA
Apr 6, 2023
SESSION 2023 HOUSE PRINCIPAL CLERK
H D
HOUSE BILL DRH10292-NBf-87
Short Title: NC Genetic Counselors Workforce Act. (Public)
Sponsors: Representative Potts.
Referred to:
1 A BILL TO BE ENTITLED
2 AN ACT TO ESTABLISH THE GENETIC COUNSELORS LICENSURE BOARD AND TO
3 REGULATE THE PRACTICE OF GENETIC COUNSELING.
4 The General Assembly of North Carolina enacts:
5 SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article
6 to read:
7 "Article 44.
8 "Genetic Counselor Licensure.
9 "§ 90-750. Definitions.
10 The following definitions apply in this Article:
11 (1) ABGC. – The American Board of Genetic Counseling, its successor or
12 equivalent.
13 (2) ACGC. – Accreditation Council for Genetic Counseling.
14 (3) ACS. – Active Candidate Status conferred by the American Board of Genetic
15 Counseling.
16 (4) Active Candidate Status. – A person who has met the requirements established
17 by the ABGC to take the ABGC certification examinations in general genetics
18 and genetic counseling and has been granted this designation by ABGC.
19 (5) Board. – The Genetic Counselors Licensing Board.
20 (6) CEU. – The Continuing Education Unit as defined by the NSGC.
21 (7) Department. – The Department of Health and Human Services.
22 (8) Examination. – The ABGC certification exam.
23 (9) Genetic counseling. – The provision of services by an individual who qualifies
24 for a license under this Article.
25 (10) Genetic counseling intern. – A student enrolled in a genetic counseling
26 program accredited by ACGC.
27 (11) Genetic counselor. – An individual who is licensed under this Article to
28 engage in the competent practice of genetic counseling.
29 (12) NSGC. – The National Society of Genetic Counselors, its successor or
30 equivalent.
31 (13) Qualified supervisor. – Any person who is a licensed genetic counselor or a
32 physician licensed to practice medicine under Article 1 of this Chapter.
33 (14) Reciprocity. – The issuance of a license by the Board to an individual who has
34 been granted a license under the laws of another state, territory, or jurisdiction
35 of the United States that currently imposes substantially similar licensure
36 requirements as those imposed by this Article.
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1 (15) Referral. – A written or telecommunicated authorization for genetic
2 counseling services from a physician licensed to practice medicine in all its
3 branches, an advanced practice nurse who has a collaborative agreement with
4 a physician that authorizes referrals to a genetic counselor, or a physician
5 assistant who has been delegated authority to make referrals to genetic
6 counselors.
7 (16) Supervisee. – A genetic counselor with a temporary license.
8 (17) Supervision. – A qualified supervisor who has the overall responsibility to
9 assess the work of the supervisee, including regular meetings and chart
10 review; provided that an annual supervision contract signed by the qualified
11 supervisor and supervisee be on file with both parties. The qualified
12 supervisor's presence is not required during the performance of the service.
13 (18) Temporary license. – A license to practice genetic counseling in accordance
14 with this Article.
15 "§ 90-751. Genetic Counselors Licensure Board.
16 (a) Establishment. – The Genetic Counselors Licensure Board is established. The Board
17 shall consist of five members who shall serve staggered terms. The initial Board shall be selected
18 as follows:
19 (1) One member, who is a licensed genetic counselor, shall be appointed by the
20 General Assembly, upon the recommendation of the Speaker of the House of
21 Representatives, to serve a three-year term.
22 (2) One member, who is a licensed genetic counselor, shall be appointed by the
23 General Assembly, upon the recommendation of the President Pro Tempore
24 of the Senate, to serve a three-year term.
25 (3) The Governor shall appoint the following three members:
26 a. One licensed genetic counselor to serve a three-year term.
27 b. One licensed genetic counselor to serve a two-year term.
28 c. One public member to serve a one-year term.
29 (b) Appointment. – Upon the expiration of the terms of the initial Board members, each
30 member shall be appointed by the appointing authorities designated in subdivisions (a)(1)
31 through (3) of this section for a three-year term and shall serve until a successor is appointed and
32 qualified. All members appointed to the Board, except for the public member appointed by the
33 Governor under subdivision (a)(3) of this section, shall be required to be licensed under this
34 Article and shall seek licensure in this State as soon as the first application period begins. No
35 member may serve more than two consecutive terms. Each member shall be a resident of this
36 State. A former member shall be eligible for appointment after a period of one year of not being
37 a member of the Board.
38 (c) Vacancies; Qualifications. – If a member of the Board cannot complete a term of
39 office, the vacancy shall be filled in the same manner as the original appointment for the
40 remainder of the unexpired term. No Board member shall participate in any matter before the
41 Board in which the member has a pecuniary interest or similar conflict of interest.
42 (d) Removal. – A member may be removed by the Governor for any of the following:
43 (1) Ceases to meet the qualifications specified in this section.
44 (2) Fails to attend three successive Board meetings without just cause as
45 determined by the remainder of the Board.
46 (3) Is found by the remainder of the Board to be in violation of the provisions of
47 this Article or to have engaged in immoral, dishonorable, unprofessional, or
48 unethical conduct, and the conduct is deemed to compromise the integrity of
49 the Board.
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1 (4) Is found guilty of a felony or an unlawful act involving moral turpitude by a
2 court of competent jurisdiction or is found to have entered a plea of nolo
3 contendere to a felony or an unlawful act involving moral turpitude.
4 (5) Is found guilty of malfeasance, misfeasance, or nonfeasance regarding Board
5 duties by a court of competent jurisdiction.
6 (6) Is incapacitated and without reasonable likelihood of resuming Board duties,
7 as determined by the Board.
8 (e) Meetings. – The Board shall elect annually a chair, vice-chair, and secretary to carry
9 out the purposes of this Article. The Board shall meet at least two times annually. The Board may
10 hold additional meetings upon the call of the chair or any two board members. A majority of the
11 Board shall constitute a quorum.
12 (f) Compensation of Members; Expenses; Employees. – Members of the Board shall
13 receive no compensation for their services but shall receive per diem and necessary travel and
14 subsistence expenses as provided in G.S. 138-5 and G.S. 138-6. The Board may employ
15 necessary personnel for the performance of its functions and fix the compensation. The Board
16 shall not employ any of its members to perform inspectional or similar ministerial tasks for the
17 Board. In no event shall the State of North Carolina be liable for expenses incurred by the Board
18 in excess of the income derived from this Article.
19 "§ 90-752. Powers and duties of Board.
20 (a) Powers. – The Board shall have the following powers and duties:
21 (1) Administer, coordinate, and enforce the provisions of this Article.
22 (2) Adopt, amend, or repeal rules to administer and enforce this Article.
23 (3) Establish and determine qualification and fitness of applicants for licensure
24 under this Article.
25 (4) Issue, renew, deny, suspend, revoke, or refuse to issue or renew any license
26 under this Article.
27 (5) Establish fees for applications, initial and renewal licenses, and other services
28 provided by the Board.
29 (6) Discipline individuals licensed under this Article.
30 (b) Investigation. – The Board may empower any member to conduct any proceeding or
31 investigation necessary to its purposes and may empower its agent or counsel to conduct any
32 investigation necessary to its purposes, but any final action requires a quorum of the Board.
33 (c) Seal. – The Board shall adopt an official seal, which shall be affixed to all licenses
34 issued by it.
35 "§ 90-753. Annual report.
36 On June 30 of each year, the Board shall submit a report to the Governor of the Board's
37 activities since the preceding July 1, including (i) the names of all licensed genetic counselors to
38 whom licenses have been granted under this Article, (ii) any cases heard and decisions rendered
39 in matters before the Board, (iii) the recommendations of the Board as to future actions and
40 policies, and (iv) a financial report. Each member of the Board shall review and sign the report
41 before its submission to the Governor. Any Board member shall have the right to record a
42 dissenting view.
43 "§ 90-754. Qualification for licensure; application.
44 (a) Application; Qualification. – Each individual desiring to obtain a license under this
45 Article shall apply to the Board in accordance with the procedure and rules prescribed by the
46 Board. Each applicant shall furnish evidence satisfactory to the Board that the applicant meets
47 all of the following criteria:
48 (1) Submit an application prescribed by the Board.
49 (2) Pay a fee determined by the Board in accordance with G.S. 90-756.
50 (3) Provide satisfactory evidence of having certification as a genetic counselor by
51 the ABGC.
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1 (4) Is at least 18 years of age.
2 (5) Is of good moral character and conducts all professional activities in
3 accordance with accepted professional and ethical standards.
4 (6) Has not engaged in any practice at any time that would be a ground for denial,
5 revocation, or suspension of a license under G.S. 90-742.
6 (7) Has submitted the required criminal history record, as required by law.
7 (8) Is qualified for licensure under the requirements of this Article.
8 (c) Temporary Licensure. – A temporary license may be issued to an applicant who meets
9 all of the requirements for licensure except for subdivision (b)(3) of this section and has been
10 granted ACS by the ABGC. A temporary license shall be valid for one year from the date of
11 issuance and may be renewed for an additional year if an applicant fails the first sitting of the
12 ABGC certification exam. A temporary license shall expire automatically upon the earliest of the
13 following:
14 (1) Issuance of a full license.
15 (2) Thirty days after the applicant fails to pass the complete certification
16 examination without renewing it in accordance with this subsection.
17 (3) The date printed on the temporary license.
18 An application for extension of the temporary license shall be signed by a qualified
19 supervisor. A temporary licensed genetic counselor shall work under the general supervision of
20 a qualified supervisor at all times during which the temporary licensed genetic counselor
21 performs genetic counseling.
22 (d) Reciprocity. – An applicant who satisfies the Board that the applicant is licensed or
23 registered under the laws of another state, territory, or jurisdiction of the United States, which in
24 the opinion of the Board imposes substantially the same licensing requirements as this Article,
25 may be licensed by the Board pursuant to this Article.
26 (e) Alternative Application for Licensure. – An individual may apply to the Board for
27 licensure who does not qualify for licensure under this Article but who has worked as a genetic
28 counselor for a minimum of 10 years preceding the enactment of this Article and who provides
29 documentation of all of the following:
30 (1) Has a master's or higher degree in genetics or a related field of study.
31 (2) Has never passed the ABGC certification examination.
32 (3) Submits three letters of recommendation from at least one genetic counselor
33 who qualifies for licensure under this Article and a licensed physician. All
34 individuals submitting letters of recommendation must have worked with the
35 applicant in an employment setting during the last 10 years and can attest to
36 the applicant's competency in providing genetic counseling services.
37 (4) Can provide documentation of attending NSGC-approved CEU programs
38 within the last five years.
39 (f) Issuance; Renewal. – Except in the case of a temporary license, all licenses shall be
40 issued for a two-year period upon the payment of the licensing fee prescribed by the Board and
41 shall be renewed upon the filing of a renewal application and the payment of the licensing
42 renewal fee.
43 (g) Suspension; Revocation. – A genetic counselor whose license is suspended or
44 revoked or whose surrender of license with or without prejudice has been accepted by the Board
45 or the committee shall promptly deliver the original license to the Board.
46 "§ 90-755. Scope of practice.
47 The practice of genetic counseling constitutes all of the following:
48 (1) Obtain and evaluate individual, family, and medical histories to determine
49 genetic risk for genetic or medical conditions and diseases in a patient, the
50 patient's children, and other family members.
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1 (2) Discuss the features, natural history, means of diagnosis, genetic and
2 environmental factors, and management of risk for genetic or medical
3 conditions.
4 (3) Identify, order, and coordinate genetic laboratory tests and other diagnostic
5 studies as appropriate for the genetic assessment.
6 (4) Integrate genetic laboratory test results and other diagnostic studies with
7 personal and family medical history to assess and communicate risk factors
8 for genetic or medical conditions and diseases.
9 (5) Explain the clinical implications of genetic laboratory tests and other
10 diagnostic studies and their results.
11 (6) Evaluate the client's or family's responses to the condition or risk of recurrence
12 and provide client-centered counseling and anticipatory guidance.
13 (7) Identify and utilize community resources that provide medical, educational,
14 financial, and psychosocial support and advocacy.
15 (8) Provide written documentation of medical, genetic, and counseling
16 information for families and health care professionals.
17 "§ 90-756. Fees.
18 The Board may collect fees established by its rules, but those fees shall not exceed the
19 amounts listed below:
20 (1) Application fee for licensure ..........