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 Appropriations
BILL: CS/CS/SB 358
INTRODUCER: Appropriations Subcommittee on Health and Human Services; Health Policy Committee;
and Senator Rodriguez
SUBJECT: Professional Counselors Licensure Compact
DATE: March 2, 2022 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Smith Brown HP Fav/CS
2. Howard Money AHS Recommend: Fav/CS
3. Howard Sadberry AP Fav/CS
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/CS/SB 358 authorizes Florida to participate in the Professional Counselors Licensure
Compact (counseling compact or compact) for the licensure of mental health counselors and
makes changes to the practice acts for mental health counselors, a clinical social workers, and
marriage and family therapists. The compact takes effect upon its enactment by 10 states, and to
date, only two states have enacted the compact. The bill grants a licensed professional counselor
who is licensed in his or her primary state of residence (the licensee’s “home state”) the ability to
apply and be granted a privilege to practice professional counseling in another member state,
both in-person and through telehealth.
The bill also:
 Requires the Department of Health (department) to report any significant investigatory
information relating to a health care practitioner practicing under the compact to the
compact’s licensure data system.
 Provides for the participation of impaired practitioners who are practicing under the compact
in impaired practitioner programs.
 Requires the Board of Clinical Social Work, Marriage and Family Therapy, and Mental
Health Counseling (Board) to appoint an individual to serve as Florida’s delegate on the
Counseling Compact Commission (commission).
 Authorizes the Board to take adverse action against a mental health counselor’s privilege to
practice under the compact and authorizes the Board to impose grounds for discipline.
BILL: CS/CS/SB 358 Page 2
 Designates the state delegate and other members or employees of the commission as state
agents for the purpose of applying waivers of sovereign immunity.
According to the department, the provisions of the bill relating to the compact will have a
significant fiscal impact on the department requiring one additional full-time equivalent (FTE)
position to support the workload associated with processing applications and issuing initial and
renewal licenses and privileges to practice. The bill authorizes member states to charge a fee for
granting a privilege to practice under the compact. The number of applicants for compact
licensure is indeterminate and the department indicates that the fiscal impact cannot be
calculated.1
The commission may collect an annual assessment from each member state or impose fees on
other parties to cover the cost of operations and activities. The annual membership cost with the
Professional Counselors Licensure Compact is unknown at this time.
The bill amends a provision authorizing the Board to make a one-time exception for mental
health counselor, clinical social worker, and marriage and family therapist intern registration
requirements for emergency or hardship cases by removing the requirement that the candidate
pass a theory and practice examination, effective upon the act becoming a law.
The bill amends the practice acts for mental health counselors, a clinical social workers, and
marriage and family therapists to replace the words “intern” and “internship” with “associate”
and “associateship,” effective July 1, 2022.
The bill provides an effective date contingent on the enactment of the compact into law by 10
states, except as otherwise expressly provided in the bill, and requires the department to notify
the Division of Law Revision in that event.
II. Present Situation:
Occupational Licensure Compacts
Interstate compacts are authorized under the U.S. Constitution, Article I, Section 10, cl. 3.2
Compacts that affect a power delegated to the federal government or that affect or alter the
political balance within the federal system require the consent of Congress.3 The licensing of
professions is predominantly a state responsibility as each state has developed its own
regulations, oversight boards, and requirements for dozens of professions and occupations.
In September 2018, the Federal Trade Commission (FTC) looked at the issue of state-by-state
occupational licensure and its unintended consequences. In particular, the FTC noted that state-
by-state licensing can have a particularly hard effect on those in the military and their spouses
who are required to move frequently, those who provide services across state lines, or deliver
1
Department of Health, 2022 Senate Bill 358 Legislative Bill Analysis (Oct. 25, 2021) (on file with the Senate Committee on
Health Policy).
2
“No state shall, without the Consent of Congress…enter into any Agreement or Compact with another State, or with a
foreign Power[.]” see U.S. CONST. art. I, s. 10, cl. 3. While the language of the provision says congressional approval is
required, not all compacts require congressional approval.
3
Virginia v. Tennessee, 148 U.S. 503 (1893).
BILL: CS/CS/SB 358 Page 3
services through telehealth.4 The FTC also suggested that improved licensed portability would
enhance competition, choice, and access for consumers, especially where services may be in
short supply.5
According to the Council of State Governments (CSG), since January 2016, 170 separate pieces
of licensure compact legislation have been passed in the United States.6 To date, 42 states and
territories have enacted occupational licensure compacts for nurses, physicians, physical
therapists, emergency medical technicians, psychologists, speech therapists, audiologists,
occupational therapists, and counselors.7
Nurse Licensure Compact
On January 19, 2018, licensed Florida nurses became eligible to apply for a multi-state license
under the enhanced Nurse Licensure Compact (eNLC.)8 The eNLC allows registered nurses and
licensed practical nurses who hold licensure in one Compact state to practice in any of the 27
Compact states without obtaining additional state licenses. The Department of Health
(department) reports that the eNLC has effectively reduced regulatory requirements by
eliminating the need for nurses to obtain a separate license to practice in different states.9 Florida
joined the Nurse Licensure Compact upon the passage of HB 1061 during the 2016 regular
Legislative Session.10 The eNLC was officially enacted when North Carolina Governor Roy
Cooper, signed legislation to become the 26th state to join the compact on July 20, 2017. 11 That
date became the effective date for the start of the compact commission, an agency governing the
compact.12
Interstate Compact for Licensed Professional Counselors
The Interstate Compact for Licensed Professional Counselors (counseling compact or compact)
will become effective after 10 states enact the legislation for the compact. The counseling
compact has passed and been signed into law in two states. On May 10, 2021, Georgia Governor
Brian Kemp signed HB 395 and subsequently on May 18, 2021, Maryland Gov. Larry Hogan
signed SB 571/HB 736.13 The compact has also been introduced this year in Tennessee (SB 1027
HB 0959), Nebraska (LB 554), Ohio (SB 204), and North Carolina (HB 791).14
4
Federal Trade Commission, Policy Perspectives, Options to Enhance Occupational License Portability (September 2018),
available at https://www.ftc.gov/system/files/documents/reports/options-enhance-occupational-license-
portability/license_portability_policy_paper.pdf (last visited Oct. 31, 2021).
5
Id.
6
Supra note 1.
7
Id.
8
Id.
9
Id.
10
Chapter 2016-139, Laws of Fla.
11
Debra Wood, RN., The Enhanced Nurse Licensure (July 28, 2017) available at
https://www.nursechoice.com/blog/profiles-and-features/the-enhanced-nurse-licensure-compact-explained/ (last visited Oct.
31, 2021).
12
Id.
13
Counseling Compact, News, available at https://counselingcompact.org/news/ (last visited Oct. 31, 2021).
14
Counseling Compact, Maps, available at https://counselingcompact.org/map/ (last visited Oct. 31, 2021).
BILL: CS/CS/SB 358 Page 4
Interstate Licensure Compact for Social Work15
The National Association of Social Workers is beginning to pursue its own Interstate Licensure
Compact for Social Work. That draft compact has not yet been finalized.
Model of Marriage and Family Therapy License Portability16
Rather than pursue a compact, the American Association for Marriage and Family Therapy has
created a Model of Marriage and Family Therapy (MFT) License Portability. This portability
model is a full endorsement model, meaning that a state will license an applicant as a licensed
marriage and family therapist if the applicant has a valid and unrestricted license to practice
marriage and family therapy in another state.
Mental Health Counseling in Florida
The licensed Mental Health Counseling profession continues to expand in Florida and has
reported an average growth in recent years of more than 1,000 new licensees per year, increasing
the total licensed population to 15,518 practitioners.17
Florida law delineates between an application by examination for initial licensure and application
by endorsement for mental health counselors who have previously held an active, unencumbered,
license in another state. The application for licensure as a mental health counselor includes a
mandatory disclosure of criminal history, but applicants are not required to submit fingerprints to
complete a criminal background check.18 Section 456.0135, F.S., provides the department with
authority to mandate criminal background checks for specified professions and mental health
professions regulated by ch. 491, F.S., are not included in the list of specified professions.
Licensure of Mental Health Counselors by Examination
Pursuant to s. 491.005(4), F.S., the department shall license an applicant as a mental health
counselor, if he or she:
 Pays the appropriate fee;
 Possesses a minimum of a master’s degree from a regionally accredited program in Mental
Health Counseling or a closely related field that consists of at least 60 semester hours or 80
quarter hours and specific graduate coursework, including: Counseling Theories and Practice,
Human Growth and Development, Diagnosis and Treatment of Psychopathology, Human
Sexuality, Group Theories and Practice, Individual Evaluation and Assessment, Career and
Lifestyle Assessment, Research and Program Evaluation, Social and Cultural Foundations,
Substance Abuse, and Legal, Ethical, and Professional Standards Issues. Beginning July 1,
2025, an applicant must have a master’s degree from a program that is accredited by the
15
National Association of Social Workers, Interstate Licensure Compact, https://www.socialworkers.org/Advocacy/Social-
Justice/Interstate-Licensure-Compact-for-Social-Work (last visited Oct. 31, 2021).
16
American Association for Marriage and Family Therapy, MFT License Portability,
https://www.aamft.org/AAMFT/ADVANCE_the_Profession/License_Portability/Advocacy/MFT%20License%20Portability
.aspx (last visited Nov. 4, 2021).
17
Supra note 1.
18
Id.
BILL: CS/CS/SB 358 Page 5
Council for Accreditation of Counseling and Related Educational Programs (CACREP)
which consists of at least 60 semester hours or 80 quarter hours to be licensed;19
 Has had at least two years of clinical experience in mental health counseling. Initial
applicants must provide documentation to demonstrate completion of a 700-hour university-
sponsored clinical practicum or internship with at least 280 hours of direct client services.
After graduation, registered mental health counselor interns are required to complete post-
graduate supervised experience conducted under the supervision of a board-approved
qualified supervisor with at least 100 hours of supervision in no less than 100 weeks.
Supervision experience hours are accrued on an hour-for-hour basis by providing face-to-
face psychotherapy with clients. Registered interns are required to meet with their qualified
supervisor every two weeks to review cases and to receive guidance;
 Has passed the National Clinical Mental Health Counseling Examination (NCMHCE)
developed by the National Board for Certified Counselors (NBCC);20
 Completes a three-hour course on HIV/Aids pursuant to s. 491.0065, F.S.; and
 Agrees to complete a two-hour domestic violence course within six months of licensure.21
Licensure of Mental Health Counselors by Endorsement
Applicants by endorsement who have practiced mental health counseling in another state for at
least three out of the last five years are considered to have completed all minimum education,
practicum, and supervision requirements and are required to provide limited documentation to
become licensed.22 As a method to streamline licensure for experienced mental health
counselors, Florida law does not require endorsement candidates to provide proof of education
nor demonstrate completion of supervised experience.23 Pursuant to s. 491.006, F.S., the
department shall license an applicant as a mental health counselor if he or she:
 Pays the appropriate fee;
 Holds a valid license to practice in another state and have practiced for at least three out of
the last five years preceding licensure;
 Demonstrates, in a manner designated by rule of the Board, knowledge of the laws and rules
governing the practice of mental health counseling in Florida. Rule 64B4-3.0035 requires
these applicants to complete an eight hour course and obtain a passing score on a
corresponding examination;
 Has passed the NCMHCE or a licensing examination substantially equivalent to the
NCMHCE in another state or in this state;
 Completes a three-hour course on HIV/Aids pursuant to s. 491.0065, F.S.;
 Agrees to complete a two-hour domestic violence course within six months of licensure;24
and
 Holds a license in good standing and is not under investigation in Florida or another
jurisdiction for an act which would constitute a violation of ch. 491, F.S.
19
Id.
20
Id.
21
Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling, Licensed Mental
Health Counselor: Requirements available at https://floridasmentalhealthprofessions.gov/licensing/licensed-mental-health-
counselor/#tab-requirements (last accessed Oct. 31, 2021).
22
Supra note 1.
23
Id.
24
Id. at 20.
BILL: CS/CS/SB 358 Page 6
Mental Health Counseling in Florida through Telehealth
In 2019, the Legislature passed and the Governor approved CS/CS/HB 23, which created s.
456.47, F.S. The bill became effective on July 1, 2019.25 It authorized Florida-licensed health
care providers, including mental health counselors who are either Florida-licensed or licensed
under a multi-state health care licensure compact of which Florida is a member state,26 to use
telehealth to deliver health care services within their respective scopes of practice.
The bill also authorized out-of-state health care providers to use telehealth to deliver health care
services to Florida patients if they register with the department or the applicable board27 and
meet certain eligibility requirements.28 A registered out-of-state telehealth provider may use
telehealth, within the relevant scope of practice established by Florida law and rule, to provide
health care services to Florida patients but is prohibited from opening an office in Florida and
from providing in-person health care services to patients located in Florida.
The Legislature also passed HB 7067 in 2019