SB 6232

S-3991.2
  SENATE BILL 6232
State of Washington  69th Legislature  2026 Regular Session
By Senators   Bateman,   Hasegawa,   Nobles,   Riccelli,   Saldaña,   and   C.
Wilson
Read first time 01/20/26.     Referred to Committee on Health & Long-
Term Care.
1      AN ACT Relating to creating the Washington state board of
2  licensed   mental   health  counselors;    amending   RCW 18.225.010,
3  18.225.020,    18.225.030,   18.225.060,     18.225.070,  18.225.090,
4  18.225.130, 18.225.140, 18.225.145, 18.225.170, 5.60.060, 18.100.050,
5  18.205.090, 18.205.105, 19.410.010, 25.05.510, 43.70.110, 43.70.442,
6  43.70.903, 48.43.087, 49.44.220, 70.02.180, and 74.09.748; reenacting
7  and amending RCW 13.40.162, 18.120.020, 18.130.040, and 71.24.025;
8  adding a new chapter to Title 18 RCW; providing an effective date;
9  and providing a contingent effective date.
10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
11     NEW SECTION. Sec. 1. (1) The legislature finds that:
12     (a) The licensed mental health counseling profession has distinct
13 educational requirements, practice standards, ethical considerations,
14 and scope of practice that warrant specialized governance.
15     (b) Licensed mental health counselors play a crucial role in
16 providing mental health services to Washington state residents, and
17 the profession has grown significantly in scope, complexity, and
18 public impact.
19     (c) The establishment of an independent licensing board will
20 provide stronger professional oversight, more targeted regulatory
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1 focus, and enhanced public protection specifically related to mental
2 health counseling practice.
3     (d) An independent board will enhance the profession's ability to
4 respond promptly and effectively to evolving practice standards,
5 emerging ethical issues, and public protection needs.
6     (e) As Washington prepares to adopt the counseling compact, an
7 independent licensing board becomes necessary to manage the state's
8 regulatory duties under the compact. A licensing board provides the
9 authority, infrastructure, and accountability needed to evaluate and
10 grant practice privileges, set and enforce standards, and oversee
11 compact practitioners practicing in Washington. Moving to a licensing
12 board model ensures consistent regulation, facilitates effective
13 participation in the compact, and enhances consumer protection within
14 an expanded interstate practice environment.
15     (f) Professional self-regulation through an independent licensing
16 board improves accountability, encourages professional excellence,
17 and guarantees that regulatory decisions are based on current
18 practice standards and clinical expertise.
19     (g) The creation of an independent licensing board aligns with
20 the regulatory structure of other health care professions in
21 Washington state and demonstrates the maturity and independence of
22 the mental health counseling profession.
23     (2) The legislature intends to establish the board of licensing
24 of licensed mental health counselors to improve public safety,
25 strengthen professional oversight, support the ongoing growth of
26 high-quality mental health counseling in Washington, and ensure that
27 mental health services meet the highest standards of safety, ethics,
28 and clinical skill.
29     NEW SECTION.    Sec. 2.    The definitions in this section apply
30 throughout   this  chapter   unless  the   context  clearly  requires
31 otherwise.
32     (1) "Applicant" means a person who completes the required
33 application, pays the required fee, is at least 18 years of age, and
34 meets any background check requirements and uniform disciplinary act
35 requirements.
36     (2) "Associate" means a prelicensure candidate who has a graduate
37 degree in a mental health field under RCW 18.225.090 and is gaining
38 the supervision and supervised experience necessary to become a
39 licensed mental health counselor.
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1     (3) "Board" means the board of licensed mental health counselors.
2     (4) "Department" means the department of health.
3     (5) "Disciplining authority" means the board.
4     (6)   "Mental   health   counseling"   means   the  application  of
5 principles of human development, learning theory, psychotherapy,
6 group dynamics, and etiology of mental illness and dysfunctional
7 behavior    to    individuals,    couples,    families,   groups,   and
8 organizations, for the purpose of treatment of mental disorders and
9 promoting optimal mental health and functionality. "Mental health
10 counseling" also includes, but is not limited to, the assessment,
11 diagnosis, and treatment of mental and emotional disorders, as well
12 as the application of a wellness model of mental health.
13     (7) "Secretary" means the secretary of the department of health
14 or the secretary's designee.
15     NEW SECTION.   Sec. 3.    (1) A board of licensed mental health
16 counselors is established, consisting of nine members appointed by
17 the governor. Seven members shall be licensed mental health
18 counselors, and two members shall be members of the public.
19     (2) Members are appointed for three-year terms. No member may
20 serve more than two consecutive full terms. Members hold office until
21 their successors are appointed. The governor may initially appoint
22 the members to staggered terms to ensure an orderly rotation, so that
23 no more than three members' terms expire each year; subsequent
24 appointments are for full three-year terms.
25     (3) The public members of the board may not be and have never
26 been a licensed mental health counselor or in training to be one; may
27 not have any household member who is a licensed mental health
28 counselor or in training to be one; may not participate or have ever
29 participated in a commercial or professional field related to mental
30 health, nor have a household member who has so participated; and may
31 not have had, within two years before appointment, a substantial
32 financial interest in a person regulated by the board.
33     (4) Each mental health counselor member shall be licensed under
34 this chapter and shall have actively practiced mental health
35 counseling in the state of Washington for at least three years
36 immediately preceding appointment.
37     (5) The board shall elect officers each year. The board shall
38 meet at least six times each year and may hold additional meetings at
39 the chair's discretion. Meetings of the board are open to the public,
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1 except that the board may hold executive sessions to the extent
2 permitted by chapter 42.30 RCW. The department shall provide
3 secretarial, clerical, and other assistance as required by the board.
4     (6) Each member of the board shall be compensated in accordance
5 with RCW 43.03.240. Members shall be reimbursed for travel expenses
6 incurred in the actual performance of their duties, as provided in
7 RCW 43.03.050 and 43.03.060.
8     (7) A majority of the board members appointed and serving
9 constitutes a quorum for the transaction of board business. The
10 affirmative vote of a majority of a quorum of the board is required
11 to carry a motion or resolution, to adopt a rule, or to pass a
12 measure.
13     (8) The board may appoint members to panels of at least three
14 members. A quorum for the transaction of any business by a panel is a
15 minimum of three members. A majority vote of a quorum of the panel is
16 required to transact business delegated to it by the board.
17     (9) The board may adopt such rules as are consistent with this
18 chapter as may be deemed necessary and proper to carry out the
19 purposes of this chapter.
20     (10) The governor may remove a member of the board for neglect of
21 duty, misconduct, or malfeasance or misfeasance in office. Whenever
22 the governor is satisfied that a member of the board has been guilty
23 of neglect of duty, misconduct, or malfeasance or misfeasance in
24 office, the governor shall file with the secretary of state a
25 statement of the cause for and the order of removal from office, and
26 the secretary shall immediately send a certified copy of the order of
27 removal and statement of causes by certified mail to the last known
28 post office address of the member. If a vacancy occurs on the board,
29 the governor shall appoint a replacement to fill the remainder of the
30 unexpired term.
31     NEW SECTION.   Sec. 4.   (1) In addition to any other authority
32 provided by law, the board shall:
33     (a) Adopt rules, in accordance with chapter 34.05 RCW, necessary
34 to implement this chapter with respect to licensed mental health
35 counselors;
36     (b) Determine the minimum education and experience requirements
37 for licensure as a mental health counselor, including approval of
38 educational programs and supervised experience consistent with this
39 chapter;
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1     (c) Prepare and administer, or approve the preparation and
2 administration of, examinations for licensure, including acceptance
3 of national examinations consistent with this chapter;
4     (d) Establish by rule the procedures for an appeal of examination
5 failure;
6     (e) Determine whether alternative methods of training are
7 equivalent to formal education, and establish forms, procedures, and
8 criteria for evaluation of an applicant's equivalent alternative
9 training to determine the applicant's eligibility to take the
10 examination;
11     (f) Adopt rules implementing a continuing competency program for
12 licensed mental health counselors, including continuing education
13 requirements;
14     (g) Keep complete records of its proceedings; the names and
15 qualifications of all applicants; and the names and addresses of all
16 licensed mental health counselors;
17     (h) By rule, adopt a code of ethics for mental health counselors
18 designed to protect the public interest;
19     (i) By rule, require that persons licensed as mental health
20 counselors obtain and maintain professional liability insurance in
21 amounts determined by the board to be practicable and reasonably
22 available;
23     (j) Serve as members of standing committees when appointed; and
24     (k) Establish by rule uniform standards of supervision and
25 requirements for mental health counselor associates.
26     (2) In conducting investigations and complaint resolution, the
27 board may obtain the written consent of the complaining client or
28 patient or their legal representative, or of any person who may be
29 affected by the complaint, in order to obtain information which
30 otherwise might be confidential or privileged.
31     (3) The uniform disciplinary act, chapter 18.130 RCW, governs
32 unlicensed practice, the issuance and denial of licenses, and the
33 discipline of licensees under this chapter. For purposes of chapter
34 18.130 RCW, the board is the disciplining authority for mental health
35 counselors under this chapter.
36     NEW SECTION.    Sec. 5.     In addition to any other authority
37 provided by law, the secretary has the authority to:
38     (1) Set all license, examination, and renewal fees in accordance
39 with RCW 43.70.250;
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1     (2) Establish forms and procedures necessary to administer this
2 chapter;
3     (3) Issue a license to any applicant who has met the education,
4 training, and examination requirements for licensure as a mental
5 health counselor, and deny a license to applicants who do not meet
6 the minimum qualifications for licensure; except that denial of
7 licenses based on unprofessional conduct or impaired practice shall
8 be governed by the uniform disciplinary act, chapter 18.130 RCW;
9     (4) Hire clerical, administrative, and investigative staff as
10 needed to implement and administer this chapter and to hire
11 individuals, including licensees under this chapter, to serve as
12 examiners or consultants as necessary to implement and administer
13 this chapter;
14     (5) Maintain the official department record of all applicants and
15 licensees; and
16      (6) Conduct a hearing on an appeal of a denial of a license based
17 on the applicant's failure to meet the minimum qualifications for
18 licensure. The hearing shall be conducted pursuant to chapter 34.05
19 RCW.
20     NEW SECTION.   Sec. 6.   The secretary, members of the board, or
21 individuals acting on their behalf, are immune from suit in any civil
22 action based on any act performed in the course of their duties.
23     NEW SECTION.    Sec. 7.   The board shall establish by rule an
24 examination prepared or administered, or both, by a private testing
25 agency or association of licensing boards for use by a licensed
26 mental   health  counselor   applicant   in  meeting the  licensing
27 requirement. The examination shall contain subjects appropriate to
28 the standards of competency and scope of practice.
29     NEW SECTION.   Sec. 8.    The board shall establish by rule the
30 standards for licensure by endorsement or reciprocity for applicants
31 licensed in another jurisdiction as a mental health counselor or
32 equivalent. The standards for reciprocity of licensure shall not be
33 less than required for licensure in the state of Washington.
34     NEW SECTION. Sec. 9. (1) The secretary shall issue an associate
35 license to any applicant who graduates from a master's degree or
36 doctoral degree educational program in mental health counseling or a
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1 related discipline from a college or university approved by the
2 secretary based upon nationally recognized standards and submits a
3 declaration that the applicant is working toward full licensure in
4 that category.
5     (2) Associates may not provide independent mental health
6 counseling for a fee, monetary or otherwise. Associates must work
7 under the supervision of an approved supervisor. An applicant for an
8 associate license under this section may practice without a license
9 under the direct supervision of an approved supervisor for 120 days
10 after the department receives the applicant's completed application
11 or the applicant's license is issued or denied, whichever is sooner.
12     (3) Associates shall provide each client or patient, during the
13 first professional contact, with a disclosure form according to
14 section 10 of this act, disclosing that he or she is an associate
15 under the supervision of an approved supervisor.
16     (4) The board shall adopt by rule what constitutes adequate proof
17 of compliance with the requirements of this section.
18      (5) Applicants are subject to the denial of a license or issuance
19 of a conditional license for the reasons set forth in chapter 18.130
20 RCW.
21      (6) An associate license may be renewed. The applicant for
22 renewal must have successfully completed, in the preceding year,
23 continuing education requirements established in rule by the board.
24 Beginning   with   the  second   renewal,  the   continuing  education
25 requirements established in rule by the board must require the
26 applicant to complete a minimum number of continuing education hours
27 in the preceding two years in professional ethics.
28     NEW SECTION. Sec. 10. A person licensed under this chapter must
29 provide clients at the commencement of any program of treatment with
30 accurate   disclosure  information   concerning   the  practice,   in
31 accordance with rules adopted by the board, including the right of
32 clients to refuse treatment, the responsibility of clients to choose
33 the provider and treatment modality which best suits their needs, and
34 the extent of confidentiality provided by this chapter. The
35 disclosure information must also include the license holder's
36 professional education and training, the therapeutic orientation of
37 the practice, the proposed course of treatment where known, financial
38 requirements, and such other information as required by rule. The
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1  disclosure must be acknowledged in writing by the client and license
2  holder.
3     NEW SECTION.    Sec. 11.   A person licensed under this chapter
4 shall not disclose the written acknowledgment of the disclosure
5 statement pursuant to section 10 of this act, nor any information
6 acquired from persons consulting the individual in a professional
7 capacity when the information was necessary to enable the individual
8 to render professional services to those persons except:
9     (1) With the written authorization of that person or, in the case
10 of death or disability, the person's personal representative;
11     (2) If the person waives the privilege by bringing charges
12 against the person licensed under this chapter;
13     (3) In response to a subpoena from the secretary. The secretary
14 may subpoena only records related to a complaint or report under RCW
15 18.130.050;
16     (4) As required under chapter 26.44 or 74.34 RCW or RCW 71.05.217
17 (6) and (7);
18     (5) When disclosure of health care information is permitted under
19 chapter 70.02 RCW; or
20     (6) To any individual if the person licensed under this chapter
21 reasonably believes that disclosure will avoid or minimize an
22 imminent danger to the health or safety of the individual or any
23 other individual; however, there is no obligation on the part of the
24 provider to so disclose.
25     NEW SECTION.   Sec. 12.   A person must not represent himself or
26 herself as a mental health counselor or mental health counselor
27 associate without being licensed by the department.
28     NEW SECTION. Sec. 13. (1) Until such time as the board is fully
29 constituted, has completed its initial rule making, adopted rules,
30 and has assumed full regulatory authority, the secretary shall
31 continue to exercise regulatory authority over mental health
32 counselors under existing administrative rules and chapter 18.225
33 RCW. This temporary authority shall expire no later than three years
34 from the effective date of this section, or upon the board's
35 assumption of full regulatory authority, whichever occurs first.
36     (2) Until such time as the board is fully constituted, has
37 completed its initial rule making, adopted rules, and has assumed
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1 full regulatory authority, nothing in this chapter shall be construed
2 to conflict with chapter 18.225 RCW.
3      NEW SECTION.   Sec. 14.   The department shall provide an annual
4  fiscal report to the legislature on the financial status of the
5  mental health counselor licensing program and board operations.
6     NEW SECTION.   Sec. 15.   (1) Within six months of July 1, 2026,
7 the governor shall appoint initial board members as provided in
8 section 3 of this act.
9     (2) Within nine months of July 1, 2026, the board shall hold its
10 first meeting and elect officers.
11     (3) Within 18 months of July 1, 2026, the board shall complete
12 initial rule making necessary to assume regulatory authority.
13     (4) Within 36 months of July 1, 2026, the board shall adopt rules
14 to assume full regulatory authority over mental health counselors,
15 including all disciplinary functions.
16     NEW SECTION. Sec. 16. The board shall promulgate rules relating
17 to issuance of a retired active license under RCW 18.130.250 for
18 mental health counselors.
19     Sec. 17. RCW 18.225.010 and 2025 c 58 s 5082 are each amended to
20 read as follows:
21     The definitions in this section apply throughout this chapter
22 unless the context clearly requires otherwise.
23     (1) "Advanced social work" means the application of social work
24 theory and methods, including:
25     (a) Emotional and biopsychosocial assessment;
26     (b) Psychotherapy under the supervision of a licensed independent
27 clinical social worker, psychiatrist, psychologist, psychiatric
28 advanced practice registered nurse, psychiatric nurse, or other
29 mental health professionals as may be defined by rules adopted by the
30 secretary;
31     (c) Case management;
32     (d) Consultation;
33     (e) Advocacy;
34     (f) Counseling; or
35     (g) Community organization.
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1     (2) "Applicant" means a person who completes the required
2 application, pays the required fee, is at least eighteen years of
3 age, and meets any background check requirements and uniform
4 disciplinary act requirements.
5     (3) "Associate" means a prelicensure candidate who has a graduate
6 degree in a mental health field under RCW 18.225.090 and is gaining
7 the supervision and supervised experience necessary to become a
8 licensed independent clinical social worker, a licensed advanced
9 social worker, ((a licensed mental health counselor,)) or a licensed
10 marriage and family therapist.
11     (4) "Committee" means the Washington state ((mental health
12 counselors,)) marriage and family therapists((,)) and social workers
13 advisory committee.
14     (5) "Department" means the department of health.
15     (6) "Disciplining authority" means the department.
16     (7) "Independent clinical social work" means the diagnosis and
17 treatment of emotional and mental disorders based on knowledge of
18 human development, the causation and treatment of psychopathology,
19 psychotherapeutic treatment practices, and social work practice as
20 defined in advanced social work. Treatment modalities include but are
21 not limited to diagnosis and treatment of individuals, couples,
22 families, groups, or organizations.
23     (8) "Marriage and family therapy" means the diagnosis and
24 treatment of mental and emotional disorders, whether cognitive,
25 affective, or behavioral, within the context of relationships,
26 including marriage and family systems. Marriage and family therapy
27 involves the professional application of psychotherapeutic and family
28 systems theories and techniques in the delivery of services to
29 individuals, couples, and families for the purpose of treating such
30 diagnosed nervous and mental disorders. The practice of marriage and
31 family therapy means the rendering of professional marriage and
32 family therapy services to individuals, couples, and families, singly
33 or in groups, whether such services are offered directly to the
34 general public or through organizations, either public or private,
35 for a fee, monetary or otherwise.
36     (9) (("Mental health counseling" means the application of
37 principles of human development, learning theory, psychotherapy,
38 group dynamics, and etiology of mental illness and dysfunctional
39 behavior   to    individuals,   couples,    families,   groups,   and
40 organizations, for the purpose of treatment of mental disorders and
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1 promoting optimal mental health and functionality. Mental health
2 counseling also includes, but is not limited to, the assessment,
3 diagnosis, and treatment of mental and emotional disorders, as well
4 as the application of a wellness model of mental health.
5     (10))) "Secretary" means the secretary of health or the
6 secretary's designee.
7     Sec. 18. RCW 18.225.020 and 2008 c 135 s 12 are each amended to
8 read as follows:
9     A person must not represent himself or herself as a licensed
10 advanced social worker, a licensed independent clinical social
11 worker, ((a licensed mental health counselor,)) a licensed marriage
12 and family therapist, a licensed social work associate—advanced, a
13 licensed   social   work   associate—independent   clinical,   ((a   licensed
14 mental health counselor associate,)) or a licensed marriage and
15 family therapist associate, without being licensed by the department.
16     Sec. 19. RCW 18.225.030 and 2001 c 251 s 3 are each amended to
17 read as follows:
18     Nothing in this chapter shall be construed to prohibit or
19 restrict:
20     (1) The practice of marriage and family therapy((, mental health
21 counseling,)) or social work by an individual otherwise regulated
22 under this title and performing services within the authorized scope
23 of practice;
24     (2) The practice of marriage and family therapy((, mental health
25 counseling,)) or social work by an individual employed by the
26 government of the United States or state of Washington while engaged
27 in the performance of duties prescribed by the laws of the United
28 States or state of Washington;
29     (3) The practice of marriage and family therapy((, mental health
30 counseling,)) or social work by a person who is a regular student in
31 an educational program based on recognized national standards and
32 approved by the secretary, and whose performance of services is
33 pursuant to a regular course of instruction or assignments from an
34 instructor and under the general supervision of the instructor;
35     (4) The practice of marriage and family therapy((, mental health
36 counseling,)) or social work under the auspices of a religious
37 denomination, church, or religious organization.
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1     Sec. 20.   RCW 18.225.060 and 2025 c 20 s 1 are each amended to
2 read as follows:
3     The Washington state ((mental health counselors,)) marriage and
4 family therapists((,)) and social workers advisory committee is
5 established.
6     (1) The committee shall be comprised of ((nine)) seven members as
7 follows:
8     (a) ((Two members must be licensed mental health counselors;
9     (b) Two)) Three members must be licensed marriage and family
10 therapists;
11     (((c) One member must be a licensed independent clinical social
12 worker;
13     (d) One member must be either a licensed advanced social worker
14 or a licensed independent clinical social worker; and
15     (e) Three members must be consumers)) (b) Three members must be
16 licensed independent clinical social workers or licensed independent
17 clinical social workers; and
18     (c) One member must be a consumer and represent the public at
19 large and may not be a licensed mental health care provider((s)).
20     (2) Three members shall be appointed for a term of one year,
21 three members shall be appointed for a term of two years, and three
22 members shall be appointed for a term of three years. Subsequent
23 members shall be appointed for terms of three years. A person must
24 not serve as a member for more than two consecutive terms.
25     (3)(a) Each member must be a resident of the state of Washington.
26     (b) Each member must not hold a governing office or board
27 position in a professional association for ((mental health,)) social
28 work((,)) or marriage and family therapy and must not be employed by
29 the state of Washington.
30     (c) Each professional member must have been actively engaged as a
31 ((mental health counselor,)) marriage and family therapist((,)) or
32 social worker for five years immediately preceding appointment.
33     (d) The consumer members must represent the general public and be
34 unaffiliated directly or indirectly with the professions licensed
35 under this chapter.
36     (4) The secretary shall appoint the committee members.
37     (5) Committee members are immune from suit in an action, civil or
38 criminal, based on the department's disciplinary proceedings or other
39 official acts performed in good faith.
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1      (6) Committee members shall be compensated in accordance with RCW
2  43.03.240, including travel expenses in carrying out his or her
3  authorized duties in accordance with RCW 43.03.050 and 43.03.060.
4      (7) The committee shall elect a chair and vice chair.
5     Sec. 21. RCW 18.225.070 and 2001 c 251 s 7 are each amended to
6 read as follows:
7     The department of health may seek the advice and assistance of
8 the advisory committee in administering this chapter, including, but
9 not limited to:
10     (1) Advice and recommendations regarding the establishment or
11 implementation of rules related to the administration of this
12 chapter;
13     (2) Advice, recommendations, and consultation regarding case
14 disposition guidelines and priorities related to unprofessional
15 conduct cases regarding ((licensed mental health counselors,))
16 licensed clinical social workers, licensed advanced social workers,
17 and licensed marriage and family therapists;
18     (3) Assistance and consultation of individual committee members
19 as needed in the review, analysis, and disposition of reports of
20 unprofessional conduct and consumer complaints;
21     (4) Assistance and recommendations to enhance consumer education;
22 and
23     (5) Assistance and recommendations regarding any continuing
24 education and continuing competency programs administered under the
25 provisions of ((the [this])) this chapter.
26     Sec. 22. RCW 18.225.090 and 2025 c 58 s 1003 are each amended to
27 read as follows:
28     (1) The secretary shall issue a license to any applicant who
29 demonstrates to the satisfaction of the secretary that the applicant
30 meets the following education and experience requirements for the
31 applicant's practice area.
32     (a) Licensed social work classifications:
33     (i) Licensed advanced social worker:
34     (A) Graduation from a master's social work educational program
35 accredited by the council on social work education or a social work
36 doctorate program at a university accredited by a recognized
37 accrediting organization, and approved by the secretary based upon
38 nationally recognized standards;
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1     (B) Successful completion of an approved examination;
2     (C) Successful completion of a supervised experience requirement.
3 The supervised experience requirement consists of a minimum of 3,000
4 hours with supervision by an approved supervisor who has been
5 licensed for at least two years. Of those supervised hours:
6     (I) At least 90 hours must include direct supervision as
7 specified in this subsection by a licensed independent clinical
8 social worker, a licensed advanced social worker, or an equally
9 qualified licensed mental health professional. Of those hours of
10 directly supervised experience at least 40 hours must be in one-to-
11 one supervision and 50 hours may be in one-to-one supervision or
12 group supervision; and
13     (II) 800 hours must be in direct client contact; and
14     (D) Successful completion of continuing education requirements
15 established in rule by the secretary in consultation with the
16 committee, including a minimum number of hours in professional
17 ethics.
18     (ii) Licensed independent clinical social worker:
19     (A) Graduation from a master's level social work educational
20 program accredited by the council on social work education or a
21 social work doctorate program at a university accredited by a
22 recognized accrediting organization, and approved by the secretary
23 based upon nationally recognized standards;
24     (B) Successful completion of an approved examination;
25     (C) Successful completion of a supervised experience requirement.
26 The supervised experience requirement consists of a minimum of 3,000
27 hours of experience, over a period of not less than two years, with
28 supervision by an approved supervisor who has been licensed for at
29 least two years and, as specified in this subsection, may be either a
30 licensed independent clinical social worker who has had at least one
31 year of experience in supervising the clinical social work of others
32 or an equally qualified licensed mental health practitioner. Of those
33 supervised hours:
34     (I) At least 1,000 hours must be direct client contact; and
35     (II) Hours of direct supervision must include:
36     (1) At least 100 hours by a licensed mental health practitioner;
37     (2) At least 70 hours of supervision with a licensed independent
38 clinical social worker meeting the qualifications under this
39 subsection (1)(a)(ii)(C); the remaining hours may be supervised by an
40 equally qualified licensed mental health practitioner; and
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1     (3) At least 60 hours must be in one-to-one supervision and the
2 remaining   hours  may   be  in   one-to-one   supervision  or   group
3 supervision; and
4     (D) Successful completion of continuing education requirements
5 established in rule by the secretary in consultation with the
6 committee, including a minimum number of hours in professional
7 ethics.
8     (b) ((Licensed mental health counselor:
9     (i)(A) Graduation from a master's or doctoral level educational
10 program in counseling that consists of at least 60 semester hours or
11 90 quarter hours, or includes at least 60 semester hours or 90
12 quarter hours of graduate coursework that includes the following
13 topic areas:
14     (I) Mental health counseling orientation and ethical practice;
15     (II) Social and cultural diversity;
16     (III) Human growth and development;
17     (IV) Career development;
18     (V) Counseling and helping relationships;
19     (VI) Group counseling and group work;
20     (VII) Diagnosis and treatment;
21     (VIII) Assessment and testing; and
22     (IX) Research and program evaluation; or
23     (B) Graduation from a master's or doctoral level educational
24 program in a related discipline from a college or university approved
25 by the secretary based upon nationally recognized standards. An
26 applicant who satisfies the educational requirements for licensure
27 under this subsection (1)(b)(i)(B) is not qualified to exercise the
28 privilege to practice under the counseling compact established in
29 chapter 18.17 RCW unless the master's or doctoral level educational
30 program in a related discipline consists of at least 60 semester
31 hours or 90 quarter hours, or includes at least 60 semester hours or
32 90 quarter hours of graduate coursework that includes the topic areas
33 specified in (b)(i)(A)(I) through (IX) of this subsection;
34     (ii) Successful completion of an approved examination;
35     (iii)   Successful   completion   of   a   supervised  experience
36 requirement. The experience requirement consists of a minimum of 36
37 months full-time counseling or 3,000 hours of postgraduate mental
38 health counseling under the supervision of a qualified licensed
39 mental health counselor or equally qualified licensed mental health
40 practitioner, in an approved setting. The 3,000 hours of required
  p. 15  SB 6232
1 experience includes a minimum of 100 hours spent in immediate
2 supervision with the qualified licensed mental health counselor, and
3 includes a minimum of 1,200 hours of direct counseling with
4 individuals, couples, families, or groups; and
5     (iv) Successful completion of continuing education requirements
6 established in rule by the secretary in consultation with the
7 committee, including a minimum number of hours in professional
8 ethics.
9     (c))) Licensed marriage and family therapist:
10     (i) Graduation from a master's degree or doctoral degree
11 educational program in marriage and family therapy or graduation from
12 an educational program in an allied field equivalent to a master's
13 degree or doctoral degree in marriage and family therapy approved by
14 the secretary based upon nationally recognized standards;
15     (ii) Successful passage of an approved examination;
16     (iii)   Successful   completion   of   a   supervised   experience
17 requirement. The experience requirement consists of a minimum of
18 3,000 hours of marriage and family therapy. Of the total supervision,
19 100 hours must be with a licensed marriage and family therapist with
20 at least two years' clinical experience; the other 100 hours may be
21 with an equally qualified licensed mental health practitioner. Total
22 experience requirements include:
23     (A) 1,000 hours of direct client contact; at least 500 hours must
24 be gained in diagnosing and treating couples and families; plus
25     (B) At least 200 hours of qualified supervision with a
26 supervisor. At least 100 of the 200 hours must be one-on-one
27 supervision, and the remaining hours may be in one-on-one or group
28 supervision.
29     Applicants who have completed a master's program accredited by
30 the commission on accreditation for marriage and family therapy
31 education of the American association for marriage and family therapy
32 may be credited with 500 hours of direct client contact and 100 hours
33 of formal meetings with an approved supervisor; and
34     (iv) Successful completion of continuing education requirements
35 established in rule by the secretary in consultation with the
36 committee, including a minimum number of hours in professional
37 ethics.
38     (2) The department shall establish by rule what constitutes
39 adequate proof of meeting the criteria. Only rules in effect on the
40 date of submission of a completed application of an associate for her
  p. 16  SB 6232
1  or his license shall apply. If the rules change after a completed
2  application is submitted but before a license is issued, the new
3  rules shall not be reason to deny the application.
4      (3) In addition, applicants shall be subject to the grounds for
5  denial of a license or issuance of a conditional license under
6  chapter 18.130 RCW.
7     Sec. 23. RCW 18.225.130 and 2001 c 251 s 13 are each amended to
8 read as follows:
9     Any person certified under chapter 18.19 RCW who has met the
10 applicable experience and education requirements under chapter 18.19
11 RCW prior to July 22, 2001, is eligible for a license as an advanced
12 social worker, an independent clinical social worker, or a marriage
13 and family therapist((, or a mental health counselor)) under this
14 chapter without taking the examination.
15     Sec. 24. RCW 18.225.140 and 2023 c 425 s 4 are each amended to
16 read as follows:
17      (1) An applicant holding a credential in another state may be
18 licensed to practice in this state without examination if the
19 secretary determines that the other state's credentialing standards
20 are substantially equivalent to the licensing standards in this
21 state.
22     (2)(a)(i) The department shall establish a reciprocity program
23 for applicants for licensure as an advanced social worker, an
24 independent clinical social worker, ((a mental health counselor,)) or
25 a marriage and family therapist in Washington.
26      (ii) The reciprocity program applies to applicants for a license
27 as an advanced social worker, an independent clinical social worker,
28 ((a mental health counselor,)) or a marriage and family therapist
29 who:
30      (A) Hold or have held within the past 12 months a credential in
31 good standing from another state or territory of the United States
32 which has a scope of practice that is substantially equivalent to or
33 greater than the scope of practice for the corresponding license as
34 established under this chapter; and
35      (B) Have no disciplinary record or disqualifying criminal
36 history.
37      (b) The department shall issue a probationary license to an
38 applicant who meets the requirements of (a)(ii) of this subsection.
  p. 17  SB 6232
1 The department must determine what deficiencies, if any, exist
2 between the education and experience requirements of the other
3 state's credential and, after consideration of the experience and
4 capabilities of the applicant, determine whether it is appropriate to
5 require the applicant to complete additional education or experience
6 requirements to maintain the probationary license and, within a
7 reasonable time period, transition to a full license. The department
8 may place a reasonable time limit on a probationary license and may,
9 if appropriate, require the applicant to pass a jurisprudential
10 examination.
11     (c) The department must maintain and publish a list of
12 credentials in other states and territories that the department has
13 determined to have a scope of practice that is substantially
14 equivalent to or greater than the scope of practice for licensed
15 advanced social workers, independent clinical social workers,
16 ((mental health counselors,)) or marriage and family therapists as
17 established under this chapter. The department shall prioritize
18 identifying and publishing the department's determination for the
19 five states or territories that have historically had the most
20 applicants for reciprocity under subsection (1) of this section with
21 a scope of practice that is substantially equivalent to or greater
22 than the scope of practice for licensed advanced social workers,
23 independent clinical social workers, ((mental health counselors,))
24 and marriage and family therapists under this chapter.
25     Sec. 25. RCW 18.225.145 and 2024 c 371 s 15 are each amended to
26 read as follows:
27     (1) The secretary shall issue an associate license to any
28 applicant who demonstrates to the satisfaction of the secretary that
29 the applicant meets the following requirements for the applicant's
30 practice area and submits a declaration that the applicant is working
31 toward full licensure in that category:
32    (a) Licensed social worker associate—advanced or licensed social
33 worker associate—independent clinical: Graduation from a master's
34 degree or doctoral degree educational program in social work
35 accredited by the council on social work education and approved by
36 the secretary based upon nationally recognized standards.
37     (b) ((Licensed mental health counselor associate: Graduation from
38 a master's degree or doctoral degree educational program in mental
39 health counseling or a related discipline from a college or
  p. 18  SB 6232
1 university approved by the secretary based upon nationally recognized
2 standards.
3     (c)))   Licensed   marriage  and   family   therapist  associate:
4 Graduation from a master's degree or doctoral degree educational
5 program in marriage and family therapy or graduation from an
6 educational program in an allied field equivalent to a master's
7 degree or doctoral degree in marriage and family therapy approved by
8 the secretary based upon nationally recognized standards.
9     (2) Associates may not provide independent social work((, mental
10 health counseling,)) or marriage and family therapy for a fee,
11 monetary or otherwise. Associates must work under the supervision of
12 an approved supervisor. Beginning October 1, 2025, an applicant for
13 an associate license under this section may practice without a
14 license under the direct supervision of an approved supervisor for
15 120 days after the department receives the applicant's completed
16 application or the applicant's license is issued or denied, whichever
17 is sooner.
18     (3) Associates shall provide each client or patient, during the
19 first professional contact, with a disclosure form according to RCW
20 18.225.100, disclosing that he or she is an associate under the
21 supervision of an approved supervisor.
22     (4) The department shall adopt by rule what constitutes adequate
23 proof of compliance with the requirements of this section.
24     (5) Applicants are subject to the denial of a license or issuance
25 of a conditional license for the reasons set forth in chapter 18.130
26 RCW.
27     (6)(a) An associate license may be renewed. Until October 1,
28 2025, the applicant for renewal must have successfully completed
29 eighteen hours of continuing education in the preceding year. After
30 October 1, 2025, the applicant for renewal must have successfully
31 completed, in the preceding year, continuing education requirements
32 established in rule by the secretary in consultation with the
33 committee. Beginning with the second renewal, the continuing
34 education requirements established in rule by the secretary in
35 consultation with the committee must require the applicant to
36 complete a minimum number of continuing education hours in the
37 preceding two years in professional ethics.
38     (b) A person whose associate license was not renewed due to the
39 person exceeding the six-renewal limit in place prior to June 6,
40 2024, shall be treated as if the person's license expired. The
  p. 19  SB 6232
1  secretary shall allow such a person to return the person's associate
2  license to active status pursuant to standard rules and procedures in
3  place for returning an expired credential to active status.
4     Sec. 26.   RCW 18.225.170 and 2012 c 58 s 1 are each amended to
5 read as follows:
6     The secretary of the department of health shall promulgate rules
7 relating to issuance of a retired active license under RCW 18.130.250
8 for ((mental health counselors,)) marriage and family therapists,
9 advanced social workers, and independent clinical social workers.
10     Sec. 27.   RCW 5.60.060 and 2025 c 346 s 3 are each amended to
11 read as follows:
12     (1) A spouse or domestic partner shall not be examined for or
13 against his or her spouse or domestic partner, without the consent of
14 the spouse or domestic partner; nor can either during marriage or
15 during the domestic partnership or afterward, be without the consent
16 of the other, examined as to any communication made by one to the
17 other during the marriage or the domestic partnership. But this
18 exception shall not apply to a civil action or proceeding by one
19 against the other, nor to a criminal action or proceeding for a crime
20 committed by one against the other, nor to a criminal action or
21 proceeding against a spouse or domestic partner if the marriage or
22 the domestic partnership occurred subsequent to the filing of formal
23 charges against the defendant, nor to a criminal action or proceeding
24 for a crime committed by said spouse or domestic partner against any
25 child of whom said spouse or domestic partner is the parent or
26 guardian, nor to a proceeding under chapter 71.05 or 71.09 RCW:
27 PROVIDED, That the spouse or the domestic partner of a person sought
28 to be detained under chapter 71.05 or 71.09 RCW may not be compelled
29 to testify and shall be so informed by the court prior to being
30 called as a witness.
31     (2)(a) An attorney or counselor shall not, without the consent of
32 his or her client, be examined as to any communication made by the
33 client to him or her, or his or her advice given thereon in the
34 course of professional employment.
35     (b) A parent or guardian of a minor child arrested on a criminal
36 charge may not be examined as to a communication between the child
37 and his or her attorney if the communication was made in the presence
  p. 20  SB 6232
1 of the parent or guardian. This privilege does not extend to
2 communications made prior to the arrest.
3     (3) A member of the clergy, a Christian Science practitioner
4 listed in the Christian Science Journal, or a priest shall not,
5 without the consent of a person making the confession or sacred
6 confidence, be examined as to any confession or sacred confidence
7 made to him or her in his or her professional character, in the
8 course of discipline enjoined by the church to which he or she
9 belongs.
10     (4) Subject to the limitations under RCW 71.05.217 (6) and (7), a
11 physician or surgeon or osteopathic physician or surgeon or podiatric
12 physician or surgeon shall not, without the consent of his or her
13 patient, be examined in a civil action as to any information acquired
14 in attending such patient, which was necessary to enable him or her
15 to prescribe or act for the patient, except as follows:
16     (a) In any judicial proceedings regarding a child's injury,
17 neglect, or sexual abuse or the cause thereof; and
18     (b) Ninety days after filing an action for personal injuries or
19 wrongful death, the claimant shall be deemed to waive the physician-
20 patient privilege. Waiver of the physician-patient privilege for any
21 one physician or condition constitutes a waiver of the privilege as
22 to all physicians or conditions, subject to such limitations as a
23 court may impose pursuant to court rules.
24     (5) A public officer shall not be examined as a witness as to
25 communications made to him or her in official confidence, when the
26 public interest would suffer by the disclosure.
27     (6)(a) A peer supporter shall not, without consent of the peer
28 support services recipient making the communication, be compelled to
29 testify about any communication made to the peer supporter by the
30 peer support services recipient while receiving individual or group
31 services. The peer supporter must be designated as such by their
32 employing agency prior to providing peer support services. The
33 privilege only applies when the communication was made to the peer
34 supporter while acting in his or her capacity as a peer supporter.
35 The privilege applies regardless of whether the peer support services
36 recipient is an employee of the same agency as the peer supporter.
37 Peer support services may be coordinated or designated among first
38 responder agencies pursuant to chapter 10.93 RCW, interlocal
39 agreement, or other similar provision, provided however that a
40 written agreement is not required for the privilege to apply. The
  p. 21  SB 6232
1 privilege does not apply if the peer supporter was an initial
2 responding first responder, department of corrections staff person,
3 or jail staff person; a witness; or a party to the incident which
4 prompted the delivery of peer support services to the peer support
5 services recipient.
6     (b) For purposes of this section:
7     (i) "First responder" means:
8     (A) A law enforcement officer;
9     (B) A limited authority law enforcement officer;
10     (C) A firefighter;
11     (D) An emergency services dispatcher or recordkeeper;
12     (E) Emergency medical personnel, as licensed or certified by this
13 state;
14     (F) A member or former member of the Washington national guard
15 acting in an emergency response capacity pursuant to chapter 38.52
16 RCW;
17     (G) A coroner or medical examiner, or a coroner's or medical
18 examiner's agent or employee; or
19     (H) An individual engaged in co-response services, as defined in
20 RCW 71.24.025.
21     (ii) "Law enforcement officer" means a general authority
22 Washington peace officer as defined in RCW 10.93.020.
23     (iii) "Limited authority law enforcement officer" means a limited
24 authority Washington peace officer as defined in RCW 10.93.020 who is
25 employed by the department of corrections, state parks and recreation
26 commission, department of natural resources, liquor and cannabis
27 board, or Washington state gambling commission.
28     (iv) "Peer support services recipient" means:
29     (A) A first responder;
30     (B) A department of corrections staff person; or
31     (C) A jail staff person.
32     (v) "Peer supporter" means:
33     (A) A first responder, retired first responder, department of
34 corrections staff person, or jail staff person or a civilian employee
35 of a first responder entity or agency, local jail, or state agency
36 who has received training to provide emotional and moral support and
37 services to a peer support services recipient who needs those
38 services as a result of an incident or incidents in which the peer
39 support services recipient was involved while acting in his or her
  p. 22  SB 6232
1 official capacity or to deal with other stress that is impacting the
2 peer support services recipient's performance of official duties; or
3     (B) A nonemployee who has been designated by the first responder
4 entity or agency, local jail, statewide organization focused on co-
5 response outreach, or state agency to provide emotional and moral
6 support and counseling to a peer support services recipient who needs
7 those services as a result of an incident or incidents in which the
8 peer support services recipient was involved while acting in his or
9 her official capacity.
10     (7) A sexual assault advocate may not, without the consent of the
11 victim, be examined as to any communication made between the victim
12 and the sexual assault advocate.
13     (a) For purposes of this section, "sexual assault advocate" means
14 the employee or volunteer from a community sexual assault program or
15 underserved populations provider, victim assistance unit, program, or
16 association, that provides information, medical or legal advocacy,
17 counseling, or support to victims of sexual assault, who is
18 designated by the victim to accompany the victim to the hospital or
19 other health care facility and to proceedings concerning the alleged
20 assault, including police and prosecution interviews and court
21 proceedings.
22     (b) A sexual assault advocate may disclose a confidential
23 communication without the consent of the victim if failure to
24 disclose is likely to result in a clear, imminent risk of serious
25 physical injury or death of the victim or another person. Any sexual
26 assault advocate participating in good faith in the disclosing of
27 records and communications under this section shall have immunity
28 from any liability, civil, criminal, or otherwise, that might result
29 from the action. In any proceeding, civil or criminal, arising out of
30 a disclosure under this section, the good faith of the sexual assault
31 advocate who disclosed the confidential communication shall be
32 presumed.
33     (8) A domestic violence advocate may not, without the consent of
34 the victim, be examined as to any communication between the victim
35 and the domestic violence advocate.
36     (a) For purposes of this section, "domestic violence advocate"
37 means an employee or supervised volunteer from a community-based
38 domestic violence program or human services program that provides
39 information, advocacy, counseling, crisis intervention, emergency
40 shelter, or support to victims of domestic violence and who is not
  p. 23  SB 6232
1 employed by, or under the direct supervision of, a law enforcement
2 agency, a prosecutor's office, or the child protective services
3 section of the department of children, youth, and families as defined
4 in RCW 26.44.020.
5     (b) A domestic violence advocate may disclose a confidential
6 communication without the consent of the victim if failure to
7 disclose is likely to result in a clear, imminent risk of serious
8 physical injury or death of the victim or another person. This
9 section does not relieve a domestic violence advocate from the
10 requirement to report or cause to be reported an incident under RCW
11 26.44.030(1) or to disclose relevant records relating to a child as
12 required by RCW 26.44.030(15). Any domestic violence advocate
13 participating in good faith in the disclosing of communications under
14 this subsection is immune from liability, civil, criminal, or
15 otherwise, that might result from the action. In any proceeding,
16 civil or criminal, arising out of a disclosure under this subsection,
17 the good faith of the domestic violence advocate who disclosed the
18 confidential communication shall be presumed.
19     (9) ((A mental health counselor,)) An independent clinical social
20 worker((,)) or marriage and family therapist licensed under chapter
21 18.225 RCW or a mental health counselor licensed under chapter 18.---
22 RCW (the new chapter created in section 44 of this act) may not
23 disclose, or be compelled to testify about, any information acquired
24 from persons consulting the individual in a professional capacity
25 when the information was necessary to enable the individual to render
26 professional services to those persons except:
27     (a) With the written authorization of that person or, in the case
28 of death or disability, the person's personal representative;
29     (b) If the person waives the privilege by bringing charges
30 against the mental health counselor licensed under chapter ((18.225
31 RCW)) 18.--- RCW (the new chapter created in section 44 of this act);
32     (c) In response to a subpoena from the secretary of health. The
33 secretary may subpoena only records related to a complaint or report
34 under RCW 18.130.050;
35     (d) As required under chapter 26.44 or 74.34 RCW or RCW 71.05.217
36 (6) or (7); or
37     (e) To any individual if the ((mental health counselor,))
38 independent clinical social worker((,)) or marriage and family
39 therapist licensed under chapter 18.225 RCW or a mental health
40 counselor licensed under chapter 18.--- RCW (the new chapter created
  p. 24  SB 6232
1 in section 44 of this act) reasonably believes that disclosure will
2 avoid or minimize an imminent danger to the health or safety of the
3 individual or any other individual; however, there is no obligation
4 on the part of the provider to so disclose.
5     (10) An individual who acts as a sponsor providing guidance,
6 emotional support, and counseling in an individualized manner to a
7 person participating in an alcohol or drug addiction recovery
8 fellowship may not testify in any civil action or proceeding about
9 any communication made by the person participating in the addiction
10 recovery fellowship to the individual who acts as a sponsor except
11 with the written authorization of that person or, in the case of
12 death or disability, the person's personal representative.
13     (11)(a) Neither a union representative nor an employee the union
14 represents or has represented shall be examined as to, or be required
15 to disclose, any communication between an employee and union
16 representative or between union representatives made in the course of
17 union representation except:
18     (i) To the extent such examination or disclosure appears
19 necessary to prevent the commission of a crime that is likely to
20 result in a clear, imminent risk of serious physical injury or death
21 of a person;
22     (ii) In actions, civil or criminal, in which the represented
23 employee is accused of a crime or assault or battery;
24     (iii) In actions, civil or criminal, where a union member is a
25 party to the action, the union member may obtain a copy of any
26 statement previously given by that union member concerning the
27 subject matter of the action and may elicit testimony concerning such
28 statements. The right of the union member to obtain such statements,
29 or the union member's possession of such statements, does not render
30 them discoverable over the objection of the union member;
31     (iv) In actions, regulatory, civil, or criminal, against the
32 union or its affiliated, subordinate, or parent bodies or their
33 agents; or
34     (v) When an admission of, or intent to engage in, criminal
35 conduct is revealed by the represented union member to the union
36 representative.
37     (b) The privilege created in this subsection (11) does not apply
38 to any record of communications that would otherwise be subject to
39 disclosure under chapter 42.56 RCW.
  p. 25  SB 6232
1     (c) The privilege created in this subsection (11) may not
2 interfere with an employee's or union representative's applicable
3 statutory mandatory reporting requirements, including but not limited
4 to duties to report in chapters 26.44, 43.101, and 74.34 RCW.
5     (d) For purposes of this subsection:
6     (i) "Employee" means a person represented by a certified or
7 recognized union regardless of whether the employee is a member of
8 the union.
9     (ii) "Union" means any lawful organization that has as one of its
10 primary purposes the representation of employees in their employment
11 relations   with  employers,   including   without  limitation  labor
12 organizations defined by 29 U.S.C. Sec. 152(5) and 5 U.S.C. Sec.
13 7103(a)(4), representatives defined by 45 U.S.C. Sec. 151, and
14 bargaining representatives defined in RCW 41.56.030, and employee
15 organizations as defined in RCW 28B.52.020, 41.59.020, 41.80.005,
16 41.76.005, 47.64.011, and 53.18.010.
17     (iii) "Union representation" means action by a union on behalf of
18 one or more employees it represents in regard to their employment
19 relations with employers, including personnel matters, grievances,
20 labor disputes, wages, rates of pay, hours of employment, conditions
21 of work, or collective bargaining.
22     (iv) "Union representative" means a person authorized by a union
23 to act for the union in regard to union representation.
24     (v) "Communication" includes any oral, written, or electronic
25 communication or document containing such communication.
26     Sec. 28. RCW 13.40.162 and 2023 c 449 s 17 and 2023 c 150 s 8
27 are each reenacted and amended to read as follows:
28     (1) A juvenile offender is eligible for the special sex offender
29 disposition alternative when:
30     (a) The offender is found to have committed a sex offense, other
31 than a sex offense that is also a serious violent offense as defined
32 by RCW 9.94A.030, and the offender has no history of a prior sex
33 offense; or
34     (b) The offender is found to have committed assault in the fourth
35 degree with sexual motivation, and the offender has no history of a
36 prior sex offense.
37     (2) If the court finds the offender is eligible for this
38 alternative, the court, on its own motion or the motion of the state
  p. 26  SB 6232
1 or the respondent, may order an examination to determine whether the
2 respondent is amenable to treatment.
3     (a) The report of the examination shall include at a minimum the
4 following:
5     (i) The respondent's version of the facts and the official
6 version of the facts;
7     (ii) The respondent's offense history;
8     (iii) An assessment of problems in addition to alleged deviant
9 behaviors;
10     (iv) The respondent's social, educational, and employment
11 situation;
12     (v) Other evaluation measures used.
13     The report shall set forth the sources of the evaluator's
14 information.
15     (b) The examiner shall assess and report regarding the
16 respondent's amenability to treatment and relative risk to the
17 community. A proposed treatment plan shall be provided and shall
18 include, at a minimum:
19      (i) The frequency and type of contact between the offender and
20 therapist;
21     (ii) Specific issues to be addressed in the treatment and
22 description of planned treatment modalities;
23      (iii) Monitoring plans, including any requirements regarding
24 living conditions, lifestyle requirements, and monitoring by family
25 members, legal guardians, or others;
26      (iv) Anticipated length of treatment; and
27      (v) Recommended crime-related prohibitions.
28      (c) For good cause shown, the court on its own motion may order,
29 or on a motion by the state shall order, a second examination
30 regarding the offender's amenability to treatment. The evaluator
31 shall be selected by the party making the motion.
32     (3) After receipt of reports of the examination, the court shall
33 then consider whether the offender and the community will benefit
34 from use of this special sex offender disposition alternative and
35 consider the victim's opinion whether the offender should receive a
36 treatment disposition under this section. If the court determines
37 that    this   special   sex  offender   disposition alternative   is
38 appropriate, then the court shall impose a determinate disposition
39 within the standard range for the offense, or if the court concludes,
40 and enters reasons for its conclusions, that such disposition would
  p. 27  SB 6232
1 cause a manifest injustice, the court shall impose a disposition
2 under option D, and the court may suspend the execution of the
3 disposition and place the offender on community supervision for at
4 least two years.
5     (4) As a condition of the suspended disposition, the court may
6 impose the conditions of community supervision and other conditions,
7 including up to 30 days of confinement and requirements that the
8 offender do any one or more of the following:
9     (a) Devote time to a specific education, employment, or
10 occupation;
11     (b) Undergo available outpatient sex offender treatment for up to
12 two years, or inpatient sex offender treatment not to exceed the
13 standard range of confinement for that offense. A community mental
14 health center may not be used for such treatment unless it has an
15 appropriate program designed for sex offender treatment. The
16 respondent shall not change sex offender treatment providers or
17 treatment conditions without first notifying the prosecutor, the
18 probation counselor, and the court, and shall not change providers
19 without court approval after a hearing if the prosecutor or probation
20 counselor object to the change;
21     (c) Remain within prescribed geographical boundaries and notify
22 the court or the probation counselor prior to any change in the
23 offender's address, educational program, or employment;
24     (d) Report to the prosecutor and the probation counselor prior to
25 any change in a sex offender treatment provider. This change shall
26 have prior approval by the court;
27     (e) Report as directed to the court and a probation counselor;
28     (f) Pay restitution and perform community restitution, or any
29 combination thereof;
30     (g) Make restitution to the victim for the cost of any counseling
31 reasonably related to the offense; or
32     (h) Comply with the conditions of any court-ordered probation
33 bond.
34     (5) If the court orders 24 hour, continuous monitoring of the
35 offender while on probation, the court shall include the basis for
36 this condition in its findings.
37     (6)(a) The court must order the offender not to attend the public
38 or approved private elementary, middle, or high school attended by
39 the victim or the victim's siblings.
  p. 28  SB 6232
1     (b) The parents or legal guardians of the offender are
2 responsible for transportation or other costs associated with the
3 offender's change of school that would otherwise be paid by the
4 school district.
5     (c) The court shall send notice of the disposition and
6 restriction on attending the same school as the victim or victim's
7 siblings to the public or approved private school the juvenile will
8 attend, if known, or if unknown, to the approved private schools and
9 the public school district board of directors of the district in
10 which the juvenile resides or intends to reside. This notice must be
11 sent at the earliest possible date but not later than 10 calendar
12 days after entry of the disposition.
13     (7)(a) The sex offender treatment provider shall submit quarterly
14 reports on the respondent's progress in treatment to the court and
15 the parties. The reports shall reference the treatment plan and
16 include at a minimum the following: Dates of attendance, respondent's
17 compliance with requirements, treatment activities, the respondent's
18 relative progress in treatment, and any other material specified by
19 the court at the time of the disposition.
20     (b) At the time of the disposition, the court may set treatment
21 review hearings as the court considers appropriate.
22     (c) Except as provided in this subsection, examinations and
23 treatment ordered pursuant to this subsection shall be conducted by
24 qualified professionals as described under (d) of this subsection,
25 certified sex offender treatment providers, or certified affiliate
26 sex offender treatment providers under chapter 18.155 RCW.
27     (d) A sex offender therapist who examines or treats a juvenile
28 sex offender pursuant to this subsection does not have to be
29 certified by the department of health pursuant to chapter 18.155 RCW
30 if the therapist is a professional licensed under chapter 18.225
31 ((or)), 18.83 ((RCW)), or 18.--- RCW (the new chapter created in
32 section 44 of this act) and the treatment employed is evidence-based
33 for sex offender treatment, or if the court finds that: (i) The
34 offender has already moved to another state or plans to move to
35 another state for reasons other than circumventing the certification
36 requirements; (ii) no certified sex offender treatment providers or
37 certified affiliate sex offender treatment providers are available
38 for treatment within a reasonable geographical distance of the
39 offender's home; and (iii) the evaluation and treatment plan comply
  p. 29  SB 6232
1 with this subsection and the rules adopted by the department of
2 health.
3     (8)(a) If the offender violates any condition of the disposition
4 or the court finds that the respondent is failing to make
5 satisfactory progress in treatment, the court may revoke the
6 suspension and order execution of the disposition or the court may
7 impose a penalty of up to 30 days confinement for violating
8 conditions of the disposition.
9     (b) The court may order both execution of the disposition and up
10 to 30 days confinement for the violation of the conditions of the
11 disposition.
12     (c) The court shall give credit for any confinement time
13 previously served if that confinement was for the offense for which
14 the suspension is being revoked.
15     (9) For purposes of this section, "victim" means any person who
16 has sustained emotional, psychological, physical, or financial injury
17 to person or property as a direct result of the crime charged.
18 "Victim" may also include a known parent or guardian of a victim who
19 is a minor child unless the parent or guardian is the perpetrator of
20 the offense.
21     (10) The respondent or the parent, guardian, or other person
22 having custody of the respondent shall not be required to pay the
23 cost of any evaluation or treatment of the respondent ordered under
24 this section.
25     (11) A disposition entered under this section is not appealable
26 under RCW 13.40.230.
27     Sec. 29.   RCW 18.100.050 and 2023 c 60 s 1 are each amended to
28 read as follows:
29     (1) An individual or group of individuals duly licensed or
30 otherwise legally authorized to render the same professional services
31 within this state may organize and become a shareholder or
32 shareholders of a professional corporation for pecuniary profit under
33 the provisions of Title 23B RCW for the purpose of rendering
34 professional service. One or more of the legally authorized
35 individuals   shall  be   the  incorporators   of   the  professional
36 corporation.
37     (2) Notwithstanding any other provision of this chapter,
38 registered architects and registered engineers may own stock in and
  p. 30  SB 6232
1 render   their   individual   professional    services   through   one
2 professional service corporation.
3     (3) Licensed health care professionals, providing services to
4 enrolled participants either directly or through arrangements with a
5 health maintenance organization registered under chapter 48.46 RCW or
6 federally qualified health maintenance organization, may own stock in
7 and render their individual professional services through one
8 professional service corporation.
9     (4) Professionals may organize a nonprofit nonstock corporation
10 under this chapter and chapter 24.03A RCW to provide professional
11 services, and the provisions of this chapter relating to stock and
12 referring to Title 23B RCW shall not apply to any such corporation.
13     (5)(a) Notwithstanding any other provision of this chapter,
14 health care professionals who are licensed or certified pursuant to
15 chapters 18.06, 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A,
16 18.50, 18.53, 18.55, 18.57, 18.59, 18.64, 18.71, 18.71A, 18.74,
17 18.79, 18.83, 18.89, 18.108, ((and)) 18.138 ((RCW)), and 18.--- RCW
18 (the new chapter created in section 44 of this act) may own stock in
19 and render their individual professional services through one
20 professional service corporation and are to be considered, for the
21 purpose of forming a professional service corporation, as rendering
22 the "same specific professional services" or "same professional
23 services" or similar terms.
24     (b) Formation of a professional service corporation under this
25 subsection does not restrict the application of the uniform
26 disciplinary act under chapter 18.130 RCW, or applicable health care
27 professional statutes under ((Title 18 RCW)) this title, including
28 but not limited to restrictions on persons practicing a health
29 profession without being appropriately credentialed and persons
30 practicing beyond the scope of their credential.
31     Sec. 30. RCW 18.120.020 and 2024 c 362 s 9 and 2024 c 217 s 6
32 are each reenacted and amended to read as follows:
33     The definitions in this section apply throughout this chapter
34 unless the context clearly requires otherwise.
35     (1) "Applicant group" includes any health professional group or
36 organization, any individual, or any other interested party which
37 proposes that any health professional group not presently regulated
38 be regulated or which proposes to substantially increase the scope of
39 practice of the profession.
  p. 31  SB 6232
1     (2) "Certificate" and "certification" mean a voluntary process by
2 which a statutory regulatory entity grants recognition to an
3 individual who (a) has met certain prerequisite qualifications
4 specified by that regulatory entity, and (b) may assume or use
5 "certified" in the title or designation to perform prescribed health
6 professional tasks.
7     (3) "Grandfather clause" means a provision in a regulatory
8 statute applicable to practitioners actively engaged in the regulated
9 health profession prior to the effective date of the regulatory
10 statute which exempts the practitioners from meeting the prerequisite
11 qualifications set forth in the regulatory statute to perform
12 prescribed occupational tasks.
13     (4) "Health professions" means and includes the following health
14 and health-related licensed or regulated professions and occupations:
15 Podiatric medicine and surgery under chapter 18.22 RCW; chiropractic
16 under chapter 18.25 RCW; dental hygiene under chapter 18.29 RCW;
17 dentistry under chapter 18.32 RCW; denturism under chapter 18.30 RCW;
18 dental anesthesia assistants under chapter 18.350 RCW; dispensing
19 opticians under chapter 18.34 RCW; hearing instruments under chapter
20 18.35 RCW; naturopaths under chapter 18.36A RCW; embalming and
21 funeral directing under chapter 18.39 RCW; midwifery under chapter
22 18.50 RCW; nursing home administration under chapter 18.52 RCW;
23 optometry under chapters 18.53 and 18.54 RCW; ocularists under
24 chapter 18.55 RCW; osteopathic medicine and surgery under chapter
25 18.57 RCW; pharmacy under chapters 18.64 and 18.64A RCW; medicine
26 under chapters 18.71 and 18.71A RCW; emergency medicine under chapter
27 18.73 RCW; physical therapy under chapter 18.74 RCW; practical nurses
28 under chapter 18.79 RCW; psychologists under chapter 18.83 RCW;
29 registered nurses under chapter 18.79 RCW; occupational therapists
30 licensed under chapter 18.59 RCW; respiratory care practitioners
31 licensed under chapter 18.89 RCW; veterinarians and veterinary
32 technicians under chapter 18.92 RCW; massage therapists under chapter
33 18.108 RCW; acupuncturists or acupuncture and Eastern medicine
34 practitioners licensed under chapter 18.06 RCW; persons registered
35 under chapter 18.19 RCW; persons licensed as ((mental health
36 counselors,)) marriage and family therapists((,)) and social workers
37 under chapter 18.225 RCW; dietitians and nutritionists certified by
38 chapter 18.138 RCW; radiologic technicians under chapter 18.84 RCW;
39 nursing assistants registered or certified under chapter 18.88A RCW;
40 reflexologists   certified   under  chapter   18.108   RCW;   medical
  p. 32  SB 6232
1 assistants-certified,   medical   assistants-hemodialysis    technician,
2 medical   assistants-phlebotomist,   forensic    phlebotomist,   medical
3 assistant-EMT,   and  medical   assistants-registered    certified   and
4 registered under chapter 18.360 RCW; licensed behavior analysts,
5 licensed   assistant   behavior  analysts,    and   certified   behavior
6 technicians under chapter 18.380 RCW; music therapists licensed under
7 chapter 18.233 RCW; dental therapists licensed under chapter 18.265
8 RCW; ((and)) anesthesiologist assistants licensed under chapter
9 18.71D RCW; and persons licensed as mental health counselors under
10 chapter 18.--- RCW (the new chapter created in section 44 of this
11 act).
12     (5) "Inspection" means the periodic examination of practitioners
13 by a state agency in order to ascertain whether the practitioners'
14 occupation is being carried out in a fashion consistent with the
15 public health, safety, and welfare.
16     (6) "Legislative committees of reference" means the standing
17 legislative committees designated by the respective rules committees
18 of the senate and house of representatives to consider proposed
19 legislation to regulate health professions not previously regulated.
20     (7) "License," "licensing," and "licensure" mean permission to
21 engage in a health profession which would otherwise be unlawful in
22 the state in the absence of the permission. A license is granted to
23 those individuals who meet prerequisite qualifications to perform
24 prescribed health professional tasks and for the use of a particular
25 title.
26     (8) "Practitioner" means an individual who (a) has achieved
27 knowledge and skill by practice, and (b) is actively engaged in a
28 specified health profession.
29     (9) "Professional license" means an individual, nontransferable
30 authorization to carry on a health activity based on qualifications
31 which include: (a) Graduation from an accredited or approved program,
32 and (b) acceptable performance on a qualifying examination or series
33 of examinations.
34     (10) "Public member" means an individual who is not, and never
35 was, a member of the health profession being regulated or the spouse
36 of a member, or an individual who does not have and never has had a
37 material financial interest in either the rendering of the health
38 professional service being regulated or an activity directly related
39 to the profession being regulated.
  p. 33  SB 6232
1     (11) "Registration" means the formal notification which, prior to
2 rendering services, a practitioner shall submit to a state agency
3 setting forth the name and address of the practitioner; the location,
4 nature and operation of the health activity to be practiced; and, if
5 required by the regulatory entity, a description of the service to be
6 provided.
7     (12) "Regulatory entity" means any board, commission, agency,
8 division, or other unit or subunit of state government which
9 regulates   one   or  more   professions,   occupations,  industries,
10 businesses, or other endeavors in this state.
11     (13) "State agency" includes every state office, department,
12 board, commission, regulatory entity, and agency of the state, and,
13 where provided by law, programs and activities involving less than
14 the full responsibility of a state agency.
15     Sec. 31. RCW 18.130.040 and 2025 c 360 s 4, 2025 c 66 s 1, and
16 2025 c 5 s 19 are each reenacted and amended to read as follows:
17     (1) This chapter applies only to the secretary and the boards and
18 commissions having jurisdiction in relation to the professions
19 licensed under the chapters specified in this section. This chapter
20 does not apply to any business or profession not licensed under the
21 chapters specified in this section.
22     (2)(a) The secretary has authority under this chapter in relation
23 to the following professions:
24     (i) Dispensing opticians licensed and designated apprentices
25 under chapter 18.34 RCW;
26     (ii) Midwives licensed under chapter 18.50 RCW;
27     (iii) Ocularists licensed under chapter 18.55 RCW;
28     (iv) Massage therapists and businesses licensed under chapter
29 18.108 RCW;
30     (v) Dental hygienists licensed under chapter 18.29 RCW;
31     (vi)   Acupuncturists   or  acupuncture   and   Eastern   medicine
32 practitioners licensed under chapter 18.06 RCW;
33     (vii) Radiologic technologists certified and X-ray technicians
34 registered under chapter 18.84 RCW;
35     (viii) Respiratory care practitioners licensed under chapter
36 18.89 RCW;
37     (ix) Hypnotherapists registered, agency affiliated counselors
38 registered, certified, or licensed, and advisors and counselors
39 certified under chapter 18.19 RCW;
  p. 34  SB 6232
1     (x) Persons licensed as ((mental health counselors, mental health
2 counselor associates,)) marriage and family therapists, marriage and
3  family therapist associates, social workers, social work associates—
4  advanced, and social work associates—independent clinical under
5  chapter 18.225 RCW;
6      (xi) Persons registered as nursing pool operators under chapter
7 18.52C RCW;
8     (xii) Dietitians and nutritionists certified under chapter 18.138
9 RCW;
10     (xiii) Substance use disorder professionals, substance use
11 disorder professional trainees, or co-occurring disorder specialists
12 certified under chapter 18.205 RCW;
13     (xiv) Sex offender treatment providers and certified affiliate
14 sex offender treatment providers certified under chapter 18.155 RCW;
15     (xv) Persons licensed and certified under chapter 18.73 RCW or
16 RCW 18.71.205;
17      (xvi) Orthotists and prosthetists licensed under chapter 18.200
18 RCW;
19     (xvii) Surgical technologists registered under chapter 18.215
20 RCW;
21     (xviii) Recreational therapists under chapter 18.230 RCW;
22     (xix) Animal massage therapists certified under chapter 18.240
23 RCW;
24      (xx) Athletic trainers licensed under chapter 18.250 RCW;
25      (xxi) Home care aides certified under chapter 18.88B RCW;
26      (xxii) Genetic counselors licensed under chapter 18.290 RCW;
27      (xxiii) Reflexologists certified under chapter 18.108 RCW;
28      (xxiv)   Medical    assistants-certified,   medical    assistants-
29 hemodialysis technician, medical assistants-phlebotomist, forensic
30 phlebotomist,   medical   assistant-EMT,   and   medical   assistants-
31 registered certified and registered under chapter 18.360 RCW;
32     (xxv) Behavior analysts, assistant behavior analysts, and
33 behavior technicians under chapter 18.380 RCW;
34     (xxvi) Birth doulas certified under chapter 18.47 RCW;
35     (xxvii) Music therapists licensed under chapter 18.233 RCW;
36     (xxviii) Behavioral health support specialists certified under
37 chapter 18.227 RCW; ((and))
38     (xxix) Certified peer support specialists and certified peer
39 support specialist trainees under chapter 18.420 RCW; and
  p. 35  SB 6232
1     (xxx) Mental health counselors or mental health counselor
2 associates under chapter 18.--- RCW (the new chapter created in
3 section 44 of this act).
4     (b) The boards and commissions having authority under this
5 chapter are as follows:
6     (i) The podiatric medical board as established in chapter 18.22
7 RCW;
8      (ii) The chiropractic quality assurance commission as established
9 in chapter 18.25 RCW;
10     (iii) The dental quality assurance commission as established in
11 chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW,
12 licenses and registrations issued under chapter 18.260 RCW, licenses
13 issued under chapter 18.265 RCW, and certifications issued under
14 chapter 18.350 RCW;
15     (iv) The board of hearing and speech as established in chapter
16 18.35 RCW;
17      (v) The board of examiners for nursing home administrators as
18 established in chapter 18.52 RCW;
19     (vi) The optometry board as established in chapter 18.54 RCW
20 governing licenses issued under chapter 18.53 RCW;
21      (vii) The board of osteopathic medicine and surgery as
22 established in chapter 18.57 RCW governing licenses issued under
23 chapter 18.57 RCW;
24     (viii) The pharmacy quality assurance commission as established
25 in chapter 18.64 RCW governing licenses issued under chapters 18.64
26 and 18.64A RCW;
27     (ix) The Washington medical commission as established in chapter
28 18.71 RCW governing licenses and registrations issued under chapters
29 18.71, 18.71A, 18.71B, 18.71C, and 18.71D RCW;
30     (x) The board of physical therapy as established in chapter 18.74
31 RCW;
32      (xi) The board of occupational therapy practice as established in
33 chapter 18.59 RCW;
34      (xii) The board of nursing as established in chapter 18.79 RCW
35 governing licenses and registrations issued under that chapter and
36 under chapter 18.80 RCW, and nursing assistants registered or
37 certified or medication assistants endorsed under chapter 18.88A RCW;
38     (xiii) The examining board of psychology and its disciplinary
39 committee as established in chapter 18.83 RCW;
  p. 36  SB 6232
1     (xiv) The veterinary board of governors as established in chapter
2 18.92 RCW;
3     (xv) The board of naturopathy established in chapter 18.36A RCW,
4 governing licenses and certifications issued under that chapter;
5 ((and))
6     (xvi) The board of denturists established in chapter 18.30 RCW;
7 and
8     (xvii) The board of licensed mental health counselors established
9 in chapter 18.--- RCW (the new chapter created in section 44 of this
10 act).
11     (3) In addition to the authority to discipline license holders,
12 the disciplining authority has the authority to grant or deny
13 licenses. The disciplining authority may also grant a license subject
14 to conditions, which must be in compliance with chapter 18.415 RCW.
15     (4) All disciplining authorities shall adopt procedures to ensure
16 substantially consistent application of this chapter, the uniform
17 disciplinary act, among the disciplining authorities listed in
18 subsection (2) of this section.
19     Sec. 32. RCW 18.205.090 and 2021 c 165 s 2 are each amended to
20 read as follows:
21     (1) The secretary shall issue a certificate to any applicant who
22 demonstrates to the secretary's satisfaction that the following
23 requirements have been met:
24     (a) Completion of:
25     (i) An educational program approved by the secretary;
26     (ii) An apprenticeship program reviewed by the substance use
27 disorder certification advisory committee, approved by the secretary,
28 and registered and approved under chapter 49.04 RCW; or
29     (iii) Alternate training that meets established criteria;
30     (b) Successful completion of an approved examination, based on
31 core competencies of substance use disorder counseling; and
32     (c) Successful completion of an experience requirement that
33 establishes fewer hours of experience for applicants with higher
34 levels of relevant education. In meeting any experience requirement
35 established under this subsection, the secretary may not require more
36 than one thousand five hundred hours of experience in substance use
37 disorder counseling for applicants who are licensed under chapter
38 18.83 RCW or under chapter 18.79 RCW as advanced practice registered
39 nurse ((practitioners)).
  p. 37  SB 6232
1     (2) The secretary shall establish by rule what constitutes
2 adequate proof of meeting the criteria.
3     (3) Applicants are subject to the grounds for denial of a
4 certificate or issuance of a conditional certificate under chapter
5 18.130 RCW.
6     (4) Certified substance use disorder professionals shall not be
7 required to be registered under chapter 18.19 RCW ((or)), licensed
8 under chapter 18.225 ((RCW)), or chapter 18.--- RCW (the new chapter
9 created in section 44 of this act).
10     (5) As of July 28, 2019, a person certified under this chapter
11 holding the title of chemical dependency professional is considered
12 to hold the title of substance use disorder professional until such
13 time as the person's present certification expires or is renewed.
14     Sec. 33. RCW 18.205.105 and 2023 c 425 s 24 are each amended to
15 read as follows:
16      (1) The department shall develop training standards for the
17 creation of a co-occurring disorder specialist enhancement which may
18 be added to the license or registration held by one of the following:
19     (a) Psychologists licensed under chapter 18.83 RCW;
20     (b) Independent clinical social workers licensed under chapter
21 18.225 RCW;
22     (c) Marriage and family therapists licensed under chapter 18.225
23 RCW;
24      (d) Mental health counselors licensed under chapter ((18.225
25 RCW)) 18.--- RCW (the new chapter created in section 44 of this act);
26 and
27     (e) An agency affiliated counselor licensed under chapter 18.19
28 RCW.
29      (2) To obtain the co-occurring disorder specialist enhancement,
30 the    applicant   must   meet  training   standards  and    experience
31 requirements.    The   training  standards   must  be   designed   with
32 consideration of the practices of the health professions listed in
33 subsection (1) of this section and consisting of sixty hours of
34 instruction consisting of (a) thirty hours in understanding the
35 disease pattern of addiction and the pharmacology of alcohol and
36 other drugs; and (b) thirty hours in understanding addiction
37 placement, continuing care, and discharge criteria, including the
38 American society of addiction medicine criteria; treatment planning
  p. 38  SB 6232
1 specific to substance abuse; relapse prevention; and confidentiality
2 issues specific to substance use disorder treatment.
3     (3) In developing the training standards, the department shall
4 consult with the examining board of psychology established in chapter
5 18.83 RCW, the Washington state ((mental health counselors,))
6 marriage and family therapists((,)) and social workers advisory
7 committee established in chapter 18.225 RCW, the substance use
8 disorder certification advisory committee established in chapter
9 18.205 RCW, and educational institutions in Washington state that
10 train psychologists, marriage and family therapists, mental health
11 counselors, independent clinical social workers, and substance use
12 disorder professionals.
13     (4) The department shall approve educational programs that meet
14 the training standards, and must not limit its approval to
15 university-based courses.
16     (5) The secretary shall issue a co-occurring disorder specialist
17 enhancement to any applicant who demonstrates to the secretary's
18 satisfaction that the following requirements have been met:
19     (a) Completion of the training standards;
20     (b) Successful completion of an approved examination based on
21 core competencies of substance use disorder counseling;
22     (c) Successful completion of an experience requirement of:
23     (i) Eighty hours of supervised experience for an applicant listed
24 under subsection (1) of this section with fewer than five years of
25 experience; or
26     (ii) Forty hours of supervised experience for an applicant listed
27 under subsection (1) of this section with five or more years of
28 experience; and
29     (d) Payment of any fees that may be established by the
30 department.
31     (6) An applicant for the co-occurring disorder specialist
32 enhancement may receive supervised experience from any person who
33 meets or exceeds the requirements of a certified substance use
34 disorder professional in the state of Washington and who would be
35 eligible to take the examination required for substance use disorder
36 professional certification.
37     (7) A person who has obtained a co-occurring disorder specialist
38 enhancement may provide substance use disorder counseling services
39 which are equal in scope with those provided by substance use
  p. 39  SB 6232
1 disorder professionals under this chapter, subject to the following
2 limitations:
3     (a) A co-occurring disorder specialist may only provide substance
4 use disorder counseling services if the co-occurring disorder
5 specialist is employed by:
6     (i) An agency that provides counseling services;
7     (ii) A federally qualified health center; or
8     (iii) A hospital;
9     (b) Following an initial intake or assessment, a co-occurring
10 disorder specialist may provide substance use disorder treatment only
11 to clients diagnosed with a substance use disorder and a mental
12 health disorder;
13     (c) Prior to providing substance use disorder treatment to a
14 client assessed to be in need of 2.1 or higher level of care
15 according to American society of addiction medicine criteria, a co-
16 occurring disorder specialist must make a reasonable effort to refer
17 and connect the client to the appropriate care setting, as indicated
18 by the client's American society of addiction medicine level of care;
19 and
20     (d) A co-occurring disorder specialist must comply with rules
21 promulgated by the department under subsection (11) of this section.
22     (8) The secretary shall establish by rule what constitutes
23 adequate proof of meeting the criteria.
24     (9) Applicants are subject to the grounds for denial of a
25 certificate or issuance of a conditional certificate under chapter
26 18.130 RCW.
27     (10) The department may adopt a fee to defray the cost of
28 regulatory activities related to the issuance of co-occurring
29 disorder specialist enhancements and any related disciplinary
30 activities.
31     (11) The department shall adopt rules regarding the role of co-
32 occurring disorder specialists across the American society of
33 addiction medicine continuum of care.
34     (12) Any increase in fees necessary to cover the cost of
35 regulating   co-occurring   disorder  specialists   who   receive   an
36 enhancement under this section must be borne by persons licensed as
37 psychologists under chapter 18.83 RCW, independent clinical social
38 workers under chapter 18.225 RCW, marriage and family therapists
39 under chapter 18.225 RCW, or mental health counselors under chapter
40 ((18.225 RCW)) 18.--- RCW (the new chapter created in section 44 of
  p. 40  SB 6232
1  this act). The cost of regulating co-occurring disorder specialists
2  who receive an enhancement under this section may not be borne by
3  substance use disorder professionals or substance use disorder
4  professional trainees certified under this chapter and may not be
5  included in the calculation of fees for substance use disorder
6  professionals or substance use disorder professional trainees
7  certified under this chapter.
8     Sec. 34. RCW 19.410.010 and 2025 c 58 s 5085 are each amended to
9 read as follows:
10     (1) Subject to amounts appropriated for this purpose, the
11 psilocybin therapy services pilot program is established within, and
12 administered   by,  the   University  of  Washington  department  of
13 psychiatry and behavioral sciences. No later than January 1, 2025,
14 the University of Washington department of psychiatry and behavioral
15 sciences must implement this section.
16     (2) The pilot program must:
17     (a) Offer psilocybin therapy services through pathways approved
18 by the federal food and drug administration, to populations including
19 first responders and veterans who are:
20     (i) 21 years of age or older; and
21     (ii) Experiencing posttraumatic stress disorder, mood disorders,
22 or substance use disorders;
23     (b) Offer psilocybin therapy services facilitated by:
24     (i) An advanced social worker((,)) or independent clinical social
25 worker((, or mental health counselor)) licensed under chapter 18.225
26 RCW;
27      (ii) A physician licensed under chapter 18.71 RCW; ((or))
28      (iii) A psychiatric advanced practice registered nurse licensed
29 under chapter 18.79 RCW as defined in RCW 71.05.020; or
30     (iv) A mental health counselor licensed under chapter 18.--- RCW
31 (the new chapter created in section 44 of this act);
32     (c) Ensure psilocybin therapy services are safe, accessible, and
33 affordable;
34      (d) Require an initial assessment to understand participant goals
35 and expectations, and assess the participant's history for any
36 concerns that require further intervention or information before
37 receiving psilocybin therapy services, and an integration session
38 after receiving psilocybin therapy services; and
  p. 41  SB 6232
1     (e)   Use   outreach   and  engagement   strategies   to   include
2 participants from communities or demographic groups that are more
3 likely to be historically marginalized and less likely to be included
4 in research and clinical trials represented by race, sex, sexual
5 orientation, socioeconomic status, age, or geographic location.
6     Sec. 35. RCW 25.05.510 and 2001 c 251 s 31 are each amended to
7 read as follows:
8     (1) A person or group of persons licensed or otherwise legally
9 authorized to render professional services, as defined in RCW
10 18.100.030, within this state may organize and become a member or
11 members of a limited liability partnership under the provisions of
12 this chapter for the purposes of rendering professional service.
13 Nothing in this section prohibits a person duly licensed or otherwise
14 legally   authorized  to   render   professional   services  in   any
15 jurisdiction other than this state from becoming a member of a
16 limited liability partnership organized for the purpose of rendering
17 the same professional services. Nothing in this section prohibits a
18 limited liability partnership from rendering professional services
19 outside this state through individuals who are not duly licensed or
20 otherwise legally authorized to render such professional services
21 within this state.
22     (2)(a) Notwithstanding any other provision of this chapter,
23 health care professionals who are licensed or certified pursuant to
24 chapters 18.06, 18.225, 18.22, 18.25, 18.29, 18.34, 18.35, 18.36A,
25 18.50, 18.53, 18.55, 18.64, 18.79, 18.83, 18.89, 18.108, ((and))
26 18.138 ((RCW)), and 18.--- RCW (the new chapter created in section 44
27 of this act) may join and render their individual professional
28 services through one limited liability partnership and are to be
29 considered, for the purpose of forming a limited liability
30 partnership, as rendering the "same specific professional services"
31 or "same professional services" or similar terms.
32     (b) Notwithstanding any other provision of this chapter, health
33 care professionals who are licensed pursuant to chapters 18.57 and
34 18.71 RCW may join and render their individual professional services
35 through one limited liability partnership and are to be considered,
36 for the purpose of forming a limited liability partnership, as
37 rendering the "same specific professional services" or "same
38 professional services" or similar terms.
  p. 42  SB 6232
1      (c) Formation of a limited liability partnership under this
2  subsection does not restrict the application of the uniform
3  disciplinary act under chapter 18.130 RCW, or any applicable health
4  care professional statutes under Title 18 RCW, including but not
5  limited to restrictions on persons practicing a health profession
6  without being appropriately credentialed and persons practicing
7  beyond the scope of their credential.
8     Sec. 36.   RCW 43.70.110 and 2025 c 19 s 1 are each amended to
9 read as follows:
10     (1) The secretary shall charge fees to the licensee for obtaining
11 a license. Physicians regulated pursuant to chapter 18.71 RCW who
12 reside and practice in Washington and obtain or renew a retired
13 active license are exempt from such fees. Municipal corporations
14 providing emergency medical care and transportation services pursuant
15 to chapter 18.73 RCW shall be exempt from such fees, provided that
16 such other emergency services shall only be charged for their pro
17 rata share of the cost of licensure and inspection, if appropriate.
18 The secretary may charge different fees for registered nurses
19 licensed under chapter 18.79 RCW, licensed practical nurses licensed
20 under chapter 18.79 RCW, and nurses who hold a valid multistate
21 license issued by the state of Washington under chapter 18.80 RCW.
22 The secretary may waive the fees when, in the discretion of the
23 secretary, the fees would not be in the best interest of public
24 health and safety, or when the fees would be to the financial
25 disadvantage of the state.
26     (2) Except as provided in subsection (3) of this section, fees
27 charged shall be based on, but shall not exceed, the cost to the
28 department for the licensure of the activity or class of activities
29 and may include costs of necessary inspection.
30     (3) License fees shall include amounts in addition to the cost of
31 licensure activities in the following circumstances:
32     (a) For registered nurses and licensed practical nurses licensed
33 under chapter 18.79 RCW, and for nurses who hold a valid multistate
34 license issued by the state of Washington under chapter 18.80 RCW,
35 support of a central nursing resource center as provided in RCW
36 18.79.202;
37     (b) For all health care providers licensed under RCW 18.130.040,
38 the cost of regulatory activities for retired volunteer medical
39 worker licensees as provided in RCW 18.130.360; and
  p. 43  SB 6232
1     (c) For physicians licensed under chapter 18.71 RCW, physician
2 assistants licensed under chapter 18.71A RCW, osteopathic physicians
3 licensed under chapter 18.57 RCW, naturopaths licensed under chapter
4 18.36A   RCW,   podiatrists  licensed   under   chapter  18.22   RCW,
5 chiropractors licensed under chapter 18.25 RCW, psychologists and
6 psychological associates licensed under chapter 18.83 RCW, registered
7 nurses and licensed practical nurses licensed under chapter 18.79
8 RCW, nurses who hold a valid multistate license issued by the state
9 of Washington under chapter 18.80 RCW, optometrists licensed under
10 chapter 18.53 RCW, mental health counselors and mental health
11 counselor associates licensed under chapter ((18.225 RCW)) 18.--- RCW
12 (the new chapter created in section 44 of this act), massage
13 therapists licensed under chapter 18.108 RCW, advanced social workers
14 licensed under chapter 18.225 RCW, independent clinical social
15 workers and independent clinical social worker associates licensed
16 under chapter 18.225 RCW, midwives licensed under chapter 18.50 RCW,
17 marriage and family therapists and marriage and family therapist
18 associates licensed under chapter 18.225 RCW, occupational therapists
19 and occupational therapy assistants licensed under chapter 18.59 RCW,
20 dietitians and nutritionists certified under chapter 18.138 RCW,
21 speech-language pathologists licensed under chapter 18.35 RCW,
22 acupuncturists or acupuncture and Eastern medicine practitioners
23 licensed under chapter 18.06 RCW, and veterinarians and veterinary
24 technicians licensed under chapter 18.92 RCW, the license fees shall
25 include up to an additional twenty-five dollars to be transferred by
26 the department to the University of Washington for the purposes of
27 RCW 43.70.112.
28     (4) Department of health advisory committees may review fees
29 established by the secretary for licenses and comment upon the
30 appropriateness of the level of such fees.
31     Sec. 37. RCW 43.70.442 and 2025 c 58 s 5094 are each amended to
32 read as follows:
33     (1)(a) Each of the following professionals certified or licensed
34 under Title 18 RCW shall, at least once every six years, complete
35 training in suicide assessment, treatment, and management that is
36 approved, in rule, by the relevant disciplining authority:
37     (i) An adviser or counselor certified under chapter 18.19 RCW;
38     (ii) A substance use disorder professional licensed under chapter
39 18.205 RCW;
  p. 44  SB 6232
1      (iii) A marriage and family therapist licensed under chapter
2  18.225 RCW;
3      (iv) A mental health counselor licensed under chapter ((18.225
4  RCW)) 18.--- RCW (the new chapter created in section 44 of this act);
5      (v) An occupational therapy practitioner licensed under chapter
6  18.59 RCW;
7      (vi) A psychologist licensed under chapter 18.83 RCW;
8      (vii) An advanced social worker or independent clinical social
9  worker licensed under chapter 18.225 RCW; and
10    (viii)   A   social   worker   associate—advanced   or   social   worker
11 associate—independent clinical licensed under chapter 18.225 RCW.
12     (b) The requirements in (a) of this subsection apply to a person
13 holding a retired active license for one of the professions in (a) of
14 this subsection.
15     (c) The training required by this subsection must be at least six
16 hours in length, unless a disciplining authority has determined,
17 under subsection (10)(b) of this section, that training that includes
18 only screening and referral elements is appropriate for the
19 profession in question, in which case the training must be at least
20 three hours in length.
21     (d) Beginning July 1, 2017, the training required by this
22 subsection must be on the model list developed under subsection (6)
23 of this section. Nothing in this subsection (1)(d) affects the
24 validity of training completed prior to July 1, 2017.
25     (2)(a) Except as provided in (b) of this subsection:
26     (i) A professional listed in subsection (1)(a) of this section
27 must complete the first training required by this section by the end
28 of the first full continuing education reporting period after January
29 1, 2014, or during the first full continuing education reporting
30 period after initial licensure or certification, whichever occurs
31 later.
32     (ii) Beginning July 1, 2021, the second training for a
33 psychologist, a marriage and family therapist, a mental health
34 counselor, an advanced social worker, an independent clinical social
35 worker, a social worker associate-advanced, or a social worker
36 associate-independent clinical must be either: (A) An advanced
37 training focused on suicide management, suicide care protocols, or
38 effective treatments; or (B) a training in a treatment modality shown
39 to be effective in working with people who are suicidal, including
40 dialectical behavior therapy, collaborative assessment and management
  p. 45  SB 6232
1 of suicide risk, or cognitive behavior therapy-suicide prevention. If
2 a professional subject to the requirements of this subsection has
3 already completed the professional's second training prior to July 1,
4 2021, the professional's next training must comply with this
5 subsection. This subsection (2)(a)(ii) does not apply if the licensee
6 demonstrates that the training required by this subsection (2)(a)(ii)
7 is not reasonably available.
8     (b)(i) A professional listed in subsection (1)(a) of this section
9 applying for initial licensure may delay completion of the first
10 training required by this section for six years after initial
11 licensure if he or she can demonstrate successful completion of the
12 training required in subsection (1) of this section no more than six
13 years prior to the application for initial licensure.
14     (ii) Beginning July 1, 2021, a psychologist, a marriage and
15 family therapist, a mental health counselor, an advanced social
16 worker, an independent clinical social worker, a social worker
17 associate-advanced, or a social worker associate-independent clinical
18 exempt from his or her first training under (b)(i) of this subsection
19 must comply with the requirements of (a)(ii) of this subsection for
20 his or her first training after initial licensure. If a professional
21 subject to the requirements of this subsection has already completed
22 the professional's first training after initial licensure, the
23 professional's next training must comply with this subsection
24 (2)(b)(ii). This subsection (2)(b)(ii) does not apply if the licensee
25 demonstrates that the training required by this subsection (2)(b)(ii)
26 is not reasonably available.
27     (3) The hours spent completing training in suicide assessment,
28 treatment, and management under this section count toward meeting any
29 applicable continuing education or continuing competency requirements
30 for each profession.
31     (4)(a) A disciplining authority may, by rule, specify minimum
32 training and experience that is sufficient to exempt an individual
33 professional from the training requirements in subsections (1) and
34 (5) of this section. Nothing in this subsection (4)(a) allows a
35 disciplining authority to provide blanket exemptions to broad
36 categories or specialties within a profession.
37     (b) A disciplining authority may exempt a professional from the
38 training requirements of subsections (1) and (5) of this section if
39 the professional has only brief or limited patient contact.
  p. 46  SB 6232
1     (5)(a) Each of the following professionals credentialed under
2 Title 18 RCW shall complete a one-time training in suicide
3 assessment, treatment, and management that is approved by the
4 relevant disciplining authority:
5     (i) A chiropractor licensed under chapter 18.25 RCW;
6     (ii) A naturopath licensed under chapter 18.36A RCW;
7     (iii) A licensed practical nurse, registered nurse, or advanced
8 practice registered nurse, other than a certified registered nurse
9 anesthetist, licensed under chapter 18.79 RCW;
10     (iv) An osteopathic physician and surgeon licensed under chapter
11 18.57 RCW, other than a holder of a postgraduate osteopathic medicine
12 and surgery license issued under RCW 18.57.035;
13     (v) A physical therapist or physical therapist assistant licensed
14 under chapter 18.74 RCW;
15     (vi) A physician licensed under chapter 18.71 RCW, other than a
16 resident holding a limited license issued under RCW 18.71.095(3);
17     (vii) A physician assistant licensed under chapter 18.71A RCW;
18     (viii) A pharmacist licensed under chapter 18.64 RCW;
19     (ix) A dentist licensed under chapter 18.32 RCW;
20     (x) A dental hygienist licensed under chapter 18.29 RCW;
21     (xi) An athletic trainer licensed under chapter 18.250 RCW;
22     (xii) An optometrist licensed under chapter 18.53 RCW;
23     (xiii) An acupuncture and Eastern medicine practitioner licensed
24 under chapter 18.06 RCW;
25     (xiv) A dental therapist licensed under chapter 18.265 RCW; and
26     (xv) A person holding a retired active license for one of the
27 professions listed in (a)(i) through (xiv) of this subsection.
28     (b)(i) A professional listed in (a)(i) through (vii) of this
29 subsection or a person holding a retired active license for one of
30 the professions listed in (a)(i) through (vii) of this subsection
31 must complete the one-time training by the end of the first full
32 continuing education reporting period after January 1, 2016, or
33 during the first full continuing education reporting period after
34 initial licensure, whichever is later. Training completed between
35 June 12, 2014, and January 1, 2016, that meets the requirements of
36 this section, other than the timing requirements of this subsection
37 (5)(b), must be accepted by the disciplining authority as meeting the
38 one-time training requirement of this subsection (5).
39     (ii) A licensed pharmacist or a person holding a retired active
40 pharmacist license must complete the one-time training by the end of
  p. 47  SB 6232
1 the first full continuing education reporting period after January 1,
2 2017, or during the first full continuing education reporting period
3 after initial licensure, whichever is later.
4     (iii) A licensed dentist, a licensed dental hygienist, or a
5 person holding a retired active license as a dentist shall complete
6 the one-time training by the end of the full continuing education
7 reporting period after August 1, 2020, or during the first full
8 continuing education reporting period after initial licensure,
9 whichever is later. Training completed between July 23, 2017, and
10 August 1, 2020, that meets the requirements of this section, other
11 than the timing requirements of this subsection (5)(b)(iii), must be
12 accepted by the disciplining authority as meeting the one-time
13 training requirement of this subsection (5).
14     (iv) A licensed optometrist or a licensed acupuncture and Eastern
15 medicine practitioner, or a person holding a retired active license
16 as   an  optometrist   or   an   acupuncture  and   Eastern  medicine
17 practitioner, shall complete the one-time training by the end of the
18 full continuing education reporting period after August 1, 2021, or
19 during the first full continuing education reporting period after
20 initial licensure, whichever is later. Training completed between
21 August 1, 2020, and August 1, 2021, that meets the requirements of
22 this section, other than the timing requirements of this subsection
23 (5)(b)(iv), must be accepted by the disciplining authority as meeting
24 the one-time training requirement of this subsection (5).
25     (c) The training required by this subsection must be at least six
26 hours in length, unless a disciplining authority has determined,
27 under subsection (10)(b) of this section, that training that includes
28 only screening and referral elements is appropriate for the
29 profession in question, in which case the training must be at least
30 three hours in length.
31     (d) Beginning July 1, 2017, the training required by this
32 subsection must be on the model list developed under subsection (6)
33 of this section. Nothing in this subsection (5)(d) affects the
34 validity of training completed prior to July 1, 2017.
35     (6)(a) The secretary and the disciplining authorities shall work
36 collaboratively to develop a model list of training programs in
37 suicide assessment, treatment, and management. Beginning July 1,
38 2021, for purposes of subsection (2)(a)(ii) of this section, the
39 model list must include advanced training and training in treatment
  p. 48  SB 6232
1 modalities shown to be effective in working with people who are
2 suicidal.
3     (b) The secretary and the disciplining authorities shall update
4 the list at least once every two years.
5     (c) By June 30, 2016, the department shall adopt rules
6 establishing minimum standards for the training programs included on
7 the model list. The minimum standards must require that six-hour
8 trainings include content specific to veterans and the assessment of
9 issues related to imminent harm via lethal means or self-injurious
10 behaviors and that three-hour trainings for pharmacists or dentists
11 include content related to the assessment of issues related to
12 imminent harm via lethal means. By July 1, 2024, the minimum
13 standards must be updated to require that both the six-hour and
14 three-hour trainings include content specific to the availability of
15 and the services offered by the 988 crisis hotline and the behavioral
16 health crisis response and suicide prevention system and best
17 practices for assisting persons with accessing the 988 crisis hotline
18 and the system. Beginning September 1, 2024, trainings submitted to
19 the department for review and approval must include the updated
20 information in the minimum standards for the model list as well as
21 all subsequent submissions. When adopting the rules required under
22 this subsection (6)(c), the department shall:
23     (i) Consult with the affected disciplining authorities, public
24 and private institutions of higher education, educators, experts in
25 suicide assessment, treatment, and management, the Washington
26 department   of   veterans   affairs,    and   affected  professional
27 associations; and
28     (ii) Consider standards related to the best practices registry of
29 the American foundation for suicide prevention and the suicide
30 prevention resource center.
31     (d) Beginning January 1, 2017:
32     (i) The model list must include only trainings that meet the
33 minimum standards established in the rules adopted under (c) of this
34 subsection and any three-hour trainings that met the requirements of
35 this section on or before July 24, 2015;
36     (ii) The model list must include six-hour trainings in suicide
37 assessment, treatment, and management, and three-hour trainings that
38 include only screening and referral elements; and
39     (iii) A person or entity providing the training required in this
40 section may petition the department for inclusion on the model list.
  p. 49  SB 6232
1 The department shall add the training to the list only if the
2 department determines that the training meets the minimum standards
3 established in the rules adopted under (c) of this subsection.
4     (e) By January 1, 2021, the department shall adopt minimum
5 standards for advanced training and training in treatment modalities
6 shown to be effective in working with people who are suicidal.
7 Beginning July 1, 2021, all such training on the model list must meet
8 the minimum standards. When adopting the minimum standards, the
9 department must consult with the affected disciplining authorities,
10 public and private institutions of higher education, educators,
11 experts in suicide assessment, treatment, and management, the
12 Washington department of veterans affairs, and affected professional
13 associations.
14     (7) The department shall provide the health profession training
15 standards created in this section to the professional educator
16 standards board as a model in meeting the requirements of RCW
17 28A.410.226 and provide technical assistance, as requested, in the
18 review and evaluation of educator training programs. The educator
19 training programs approved by the professional educator standards
20 board may be included in the department's model list.
21     (8) Nothing in this section may be interpreted to expand or limit
22 the scope of practice of any profession regulated under chapter
23 18.130 RCW.
24     (9) The secretary and the disciplining authorities affected by
25 this section shall adopt any rules necessary to implement this
26 section.
27     (10) For purposes of this section:
28     (a) "Disciplining authority" has the same meaning as in RCW
29 18.130.020.
30     (b) "Training in suicide assessment, treatment, and management"
31 means empirically supported training approved by the appropriate
32 disciplining authority that contains the following elements: Suicide
33 assessment, including screening and referral, suicide treatment, and
34 suicide management. However, the disciplining authority may approve
35 training that includes only screening and referral elements if
36 appropriate for the profession in question based on the profession's
37 scope of practice. The board of occupational therapy may also approve
38 training that includes only screening and referral elements if
39 appropriate for occupational therapy practitioners based on practice
40 setting.
  p. 50  SB 6232
1     (11) A state or local government employee is exempt from the
2 requirements of this section if he or she receives a total of at
3 least six hours of training in suicide assessment, treatment, and
4 management from his or her employer every six years. For purposes of
5 this subsection, the training may be provided in one six-hour block
6 or may be spread among shorter training sessions at the employer's
7 discretion.
8     (12) An employee of a community mental health agency licensed
9 under chapter 71.24 RCW or a chemical dependency program certified
10 under chapter 71.24 RCW is exempt from the requirements of this
11 section if he or she receives a total of at least six hours of
12 training in suicide assessment, treatment, and management from his or
13 her employer every six years. For purposes of this subsection, the
14 training may be provided in one six-hour block or may be spread among
15 shorter training sessions at the employer's discretion.
16     Sec. 38.    RCW 43.70.903 and 2023 c 425 s 5 are each amended to
17 read as follows:
18     (1) The department, in consultation with the workforce training
19 and education coordinating board and the examining board of
20 psychology, shall examine licensure requirements for the following
21 professions to identify changes to statutes and rules that would
22 remove barriers to entering and remaining in the health care
23 workforce and to streamline and shorten the credentialing process:
24     (a) Advanced social workers and independent clinical social
25 workers licensed under chapter 18.225 RCW;
26     (b) Marriage and family therapists licensed under chapter 18.225
27 RCW;
28      (c) Mental health counselors licensed under chapter ((18.225
29 RCW)) 18.--- RCW (the new chapter created in section 44 of this act);
30     (d) Substance use disorder professionals certified under chapter
31 18.205 RCW; and
32     (e) Psychologists licensed under chapter 18.83 RCW.
33     (2) The licensure requirements to be examined by the department
34 shall   include   examinations,  continuing  education   requirements,
35 administrative requirements for license application and renewal,
36 English language proficiency requirements, and supervised experience
37 requirements, including supervisor requirements and costs associated
38 with completing supervised experience requirements.
  p. 51  SB 6232
1     (3) When conducting the review required in subsection (1) of this
2 section, the department shall at a minimum consider the following:
3     (a) The availability of peer-reviewed research and other
4 evidence, including requirements in other states, indicating the
5 necessity of specific licensure requirements for ensuring that
6 behavioral health professionals are prepared to practice with
7 reasonable skill and safety;
8     (b) Changes that would facilitate licensure of qualified, out-of-
9 state and international applicants to promote reciprocity, including
10 the adoption of applicable interstate compacts;
11     (c) Changes that would promote greater consistency across
12 licensure requirements for professions licensed under chapters 18.225
13 ((RCW)) and 18.--- RCW (the new chapter created in section 44 of this
14 act) and allow for applicants' prior professional experience within
15 relevant   fields  to   be   counted  towards   supervised  experience
16 requirements established under chapters 18.225 ((RCW)) and 18.--- RCW
17 (the new chapter created in section 44 of this act), including the
18 extent to which an applicant may use prior professional experience
19 gained before graduation from a master's or doctoral level
20 educational program to satisfy the applicant's supervised experience
21 requirement;
22     (d) Technical assistance programs, such as navigators or
23 dedicated customer service lines, to facilitate the completion of
24 licensing applications;
25     (e) In consultation with the examining board of psychology and a
26 statewide organization representing licensed psychologists, the
27 creation of an associate-level license for psychologists;
28     (f) Whether agency affiliated counselors should be allowed to
29 practice in federally qualified health centers; and
30     (g) Any rules that pose excessive administrative requirements for
31 application or renewal or that place a disproportionate burden on
32 applicants from disadvantaged communities.
33     (4) By November 1, 2023, the department shall provide a progress
34 report and initial findings to the appropriate committees of the
35 legislature on actions and recommendations to remove licensing
36 barriers and improve credentialing time frames.
37     (5) By November 1, 2024, the department shall provide a final
38 report to the appropriate committees of the legislature on actions
39 and recommendations to remove licensing barriers and improve
40 credentialing time frames.
  p. 52  SB 6232
1     Sec. 39. RCW 48.43.087 and 2025 c 58 s 5050 are each amended to
2 read as follows:
3     (1) For purposes of this section:
4     (a) "Health carrier" includes disability insurers regulated under
5 chapter 48.20 or 48.21 RCW, health care services contractors
6 regulated under chapter 48.44 RCW, plans operating under the health
7 care authority under chapter 41.05 RCW, the basic health plan
8 operating under chapter 70.47 RCW, the state health insurance pool
9 operating under chapter 48.41 RCW, insuring entities regulated under
10 this chapter, and health maintenance organizations regulated under
11 chapter 48.46 RCW.
12     (b) "Intermediary" means a person duly authorized to negotiate
13 and execute provider contracts with health carriers on behalf of
14 mental health care practitioners.
15     (c) Consistent with their lawful scopes of practice, "mental
16 health care practitioners" includes only the following: Any generally
17 recognized medical specialty of practitioners licensed under chapter
18 18.57 or 18.71 RCW who provide mental health services, advanced
19 practice psychiatric nurses as authorized by the state board of
20 nursing under chapter 18.79 RCW, psychologists licensed under chapter
21 18.83 RCW, ((and mental health counselors,)) marriage and family
22 therapists((,)) and social workers licensed under chapter 18.225 RCW,
23 and mental health counselors licensed under chapter 18.--- RCW (the
24 new chapter created in section 44 of this act).
25     (d) "Mental health services" means outpatient services.
26     (2) Consistent with federal and state law and rule, no contract
27 between a mental health care practitioner and an intermediary or
28 between a mental health care practitioner and a health carrier that
29 is written, amended, or renewed after June 6, 1996, may contain a
30 provision prohibiting a practitioner and an enrollee from agreeing to
31 contract for services solely at the expense of the enrollee as
32 follows:
33     (a) On the exhaustion of the enrollee's mental health care
34 coverage;
35     (b) During an appeal or an adverse certification process;
36     (c) When an enrollee's condition is excluded from coverage; or
37     (d) For any other clinically appropriate reason at any time.
38     (3) If a mental health care practitioner provides services to an
39 enrollee during an appeal or adverse certification process, the
40 practitioner must provide to the enrollee written notification that
  p. 53  SB 6232
1  the enrollee is responsible for payment of these services, unless the
2  health carrier elects to pay for services provided.
3      (4) This section does not apply to a mental health care
4  practitioner who is employed full time on the staff of a health
5  carrier.
6     Sec. 40.   RCW 49.44.220 and 2022 c 11 s 1 are each amended to
7 read as follows:
8     (1)(a) It is unlawful for an employer to obtain individually
9 identifiable information regarding an employee's participation in an
10 employee assistance program. Individually identifiable information
11 gathered in the process of conducting an employee assistance program
12 must be kept confidential.
13     (b) Subsection (1)(a) of this section does not apply to:
14     (i) Authorized disclosures under RCW 41.04.730;
15     (ii)   Disclosures  to   an  employer   regarding  an   employee's
16 attendance in an employee assistance program, which the employee was
17 required to attend as a condition of continued employment; and
18     (((ii) [(iii)])) (iii) Disclosures that are:
19     (A) Made to prevent or lessen a perceived threat to the health or
20 safety of an individual or the public; or
21     (B) Permitted or required under RCW 18.225.105, 70.02.050, ((or))
22 71.05.120, or section 9 of this act.
23     (2) An employee's participation or nonparticipation in an
24 employee assistance program must not be a factor in a decision
25 affecting an employee's job security, promotional opportunities,
26 corrective or disciplinary action, or other employment rights.
27     Sec. 41. RCW 70.02.180 and 2001 c 251 s 34 are each amended to
28 read as follows:
29     ((Mental health counselors, marriage)) Marriage and family
30 therapists((,)) and social workers licensed under chapter 18.225 RCW
31 and mental health counselors licensed under chapter 18.--- RCW (the
32 new chapter created in section 44 of this act) are subject to this
33 chapter.
34     Sec. 42. RCW 71.24.025 and 2025 c 360 s 17 and 2025 c 346 s 2
35 are each reenacted and amended to read as follows:
36     Unless the context clearly requires otherwise, the definitions in
37 this section apply throughout this chapter.
  p. 54  SB 6232
1     (1) "23-hour crisis relief center" means a community-based
2 facility or portion of a facility which is licensed or certified by
3 the department of health and open 24 hours a day, seven days a week,
4 offering access to mental health and substance use care for no more
5 than 23 hours and 59 minutes at a time per patient, and which accepts
6 all   behavioral  health   crisis   walk-ins  drop-offs  from   first
7 responders,   and  individuals   referred  through  the   988  system
8 regardless of behavioral health acuity, and meets the requirements
9 under RCW 71.24.916.
10     (2) "988 crisis hotline" means the universal telephone number
11 within the United States designated for the purpose of the national
12 suicide prevention and mental health crisis hotline system operating
13 through the national suicide prevention lifeline.
14     (3) "Acutely mentally ill" means a condition which is limited to
15 a short-term severe crisis episode of:
16     (a) A mental disorder as defined in RCW 71.05.020 or, in the case
17 of a child, as defined in RCW 71.34.020;
18     (b) Being gravely disabled as defined in RCW 71.05.020 or, in the
19 case of a child, a gravely disabled minor as defined in RCW
20 71.34.020; or
21     (c) Presenting a likelihood of serious harm as defined in RCW
22 71.05.020 or, in the case of a child, as defined in RCW 71.34.020.
23     (4) "Alcoholism" means a disease, characterized by a dependency
24 on alcoholic beverages, loss of control over the amount and
25 circumstances of use, symptoms of tolerance, physiological or
26 psychological withdrawal, or both, if use is reduced or discontinued,
27 and impairment of health or disruption of social or economic
28 functioning.
29     (5) "Approved substance use disorder treatment program" means a
30 program for persons with a substance use disorder provided by a
31 treatment program licensed or certified by the department as meeting
32 standards adopted under this chapter.
33     (6) "Authority" means the Washington state health care authority.
34     (7) "Available resources" means funds appropriated for the
35 purpose of providing community behavioral health programs, federal
36 funds, except those provided according to Title XIX of the Social
37 Security Act, and state funds appropriated under this chapter or
38 chapter 71.05 RCW by the legislature during any biennium for the
39 purpose of providing residential services, resource management
40 services, community support services, and other behavioral health
  p. 55  SB 6232
1 services. This does not include funds appropriated for the purpose of
2 operating and administering the state psychiatric hospitals.
3     (8) "Behavioral health administrative services organization"
4 means an entity contracted with the authority to administer
5 behavioral health services and programs under RCW 71.24.381,
6 including crisis services and administration of chapter 71.05 RCW,
7 the involuntary treatment act, for all individuals in a defined
8 regional service area.
9     (9) "Behavioral health aide" means a counselor, health educator,
10 and advocate who helps address individual and community-based
11 behavioral health needs, including those related to alcohol, drug,
12 and tobacco abuse as well as mental health problems such as grief,
13 depression, suicide, and related issues and is certified by a
14 community health aide program of the Indian health service or one or
15 more tribes or tribal organizations consistent with the provisions of
16 25 U.S.C. Sec. 1616l and RCW 43.71B.010 (7) and (8).
17     (10) "Behavioral health provider" means a person licensed under
18 chapter 18.57, 18.71, 18.71A, 18.83, 18.205, 18.225, ((or)) 18.79
19 ((RCW)), or 18.--- RCW (the new chapter created in section 44 of this
20 act), as it applies to registered nurses and advanced practice
21 registered nurses.
22     (11) "Behavioral health services" means mental health services,
23 substance use disorder treatment services, and co-occurring disorder
24 treatment services as described in this chapter and chapter 71.36 RCW
25 that, depending on the type of service, are provided by licensed or
26 certified behavioral health agencies, behavioral health providers, or
27 integrated into other health care providers.
28     (12) "Child" means a person under the age of 18 years.
29     (13) "Chronically mentally ill adult" or "adult who is
30 chronically mentally ill" means an adult who has a mental disorder
31 and meets at least one of the following criteria:
32     (a) Has undergone two or more episodes of hospital care for a
33 mental disorder within the preceding two years; or
34     (b)    Has   experienced    a    continuous    behavioral  health
35 hospitalization or residential treatment exceeding six months'
36 duration within the preceding year; or
37     (c) Has been unable to engage in any substantial gainful activity
38 by reason of any mental disorder which has lasted for a continuous
39 period of not less than 12 months. "Substantial gainful activity"
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1 shall be defined by the authority by rule consistent with Public Law
2 92-603, as amended.
3     (14) "Clubhouse" means a community-based program that provides
4 rehabilitation services and is licensed or certified by the
5 department.
6     (15) "Co-response" means a multidisciplinary partnership between
7 first responders and human services professionals that responds to
8 emergency situations involving behavioral health crises and people
9 experiencing complex medical needs. Participants in co-response
10 respond to in-progress 911 calls, 988 calls, and requests for service
11 from dispatch and other first responders and include first responders
12 such as public safety telecommunicators, law enforcement officers,
13 firefighters, emergency medical technicians, and paramedics, and
14 human services professionals such as social workers, behavioral
15 health clinicians, advanced practice registered nurses, registered
16 nurses, community health workers, and peer support specialists.
17     (16)    "Community   behavioral    health   program"    means   all
18 expenditures, services, activities, or programs, including reasonable
19 administration and overhead, designed and conducted to prevent or
20 treat substance use disorder, mental illness, or both in the
21 community behavioral health system.
22     (17) "Community behavioral health service delivery system" means
23 public,   private,   or   tribal   agencies   that   provide   services
24 specifically to persons with mental disorders, substance use
25 disorders, or both, as defined under RCW 71.05.020 and receive
26 funding from public sources.
27     (18) "Community support services" means services authorized,
28 planned, and coordinated through resource management services
29 including, at a minimum, assessment, diagnosis, emergency crisis
30 intervention available 24 hours, seven days a week, prescreening
31 determinations for persons who are mentally ill being considered for
32 placement in nursing homes as required by federal law, screening for
33 patients being considered for admission to residential services,
34 diagnosis and treatment for children who are acutely mentally ill or
35 severely emotionally or behaviorally disturbed discovered under
36 screening through the federal Title XIX early and periodic screening,
37 diagnosis, and treatment program, investigation, legal, and other
38 nonresidential services under chapter 71.05 RCW, case management
39 services, psychiatric treatment including medication supervision,
40 counseling, psychotherapy, assuring transfer of relevant patient
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1 information between service providers, recovery services, and other
2 services determined by behavioral health administrative services
3 organizations.
4     (19) "Community-based crisis team" means a team that is part of
5 an emergency medical services agency, a fire service agency, a public
6 health agency, a medical facility, a nonprofit crisis response
7 provider, or a city or county government entity, other than a law
8 enforcement agency, that provides the on-site community-based
9 interventions of a mobile rapid response crisis team for individuals
10 who are experiencing a behavioral health crisis.
11     (20) "Consensus-based" means a program or practice that has
12 general support among treatment providers and experts, based on
13 experience or professional literature, and may have anecdotal or case
14 study support, or that is agreed but not possible to perform studies
15 with random assignment and controlled groups.
16     (21) "Coordinated regional behavioral health crisis response
17 system" means the coordinated operation of 988 call centers, regional
18 crisis lines, certified public safety telecommunicators, and other
19 behavioral health crisis system partners within each regional service
20 area.
21     (22) "County authority" means the board of county commissioners,
22 county council, or county executive having authority to establish a
23 behavioral health administrative services organization, or two or
24 more of the county authorities specified in this subsection which
25 have entered into an agreement to establish a behavioral health
26 administrative services organization.
27     (23) "Crisis stabilization services" means services such as 23-
28 hour crisis relief centers, crisis stabilization units, short-term
29 respite facilities, peer-run respite services, and same-day walk-in
30 behavioral health services, including within the overall crisis
31 system components that operate like hospital emergency departments
32 that accept all walk-ins, and ambulance, fire, and police drop-offs,
33 or determine the need for involuntary hospitalization of an
34 individual.
35     (24) "Crisis stabilization unit" has the same meaning as under
36 RCW 71.05.020.
37     (25) "Department" means the department of health.
38     (26) "Designated 988 contact hub" or "988 contact hub" means a
39 state-designated    contact   center    that   streamlines   clinical
40 interventions and access to resources for people experiencing a
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1 behavioral health crisis and participates in the national suicide
2 prevention lifeline network to respond to statewide or regional 988
3 contacts that meets the requirements of RCW 71.24.890.
4     (27) "Designated crisis responder" has the same meaning as in RCW
5 71.05.020.
6     (28) "Director" means the director of the authority.
7     (29) "Drug addiction" means a disease characterized by a
8 dependency on psychoactive chemicals, loss of control over the amount
9 and circumstances of use, symptoms of tolerance, physiological or
10 psychological withdrawal, or both, if use is reduced or discontinued,
11 and impairment of health or disruption of social or economic
12 functioning.
13     (30) "Early adopter" means a regional service area for which all
14 of the county authorities have requested that the authority purchase
15 medical and behavioral health services through a managed care health
16 system as defined under RCW 71.24.380(7).
17     (31) "Emerging best practice" or "promising practice" means a
18 program or practice that, based on statistical analyses or a well
19 established theory of change, shows potential for meeting the
20 evidence-based or research-based criteria, which may include the use
21 of a program that is evidence-based for outcomes other than those
22 listed in subsection (32) of this section.
23     (32) "Evidence-based" means a program or practice that has been
24 tested in heterogeneous or intended populations with multiple
25 randomized, or statistically controlled evaluations, or both; or one
26 large   multiple   site  randomized,   or   statistically  controlled
27 evaluation, or both, where the weight of the evidence from a systemic
28 review demonstrates sustained improvements in at least one outcome.
29 "Evidence-based" also means a program or practice that can be
30 implemented with a set of procedures to allow successful replication
31 in Washington and, when possible, is determined to be cost-
32 beneficial.
33     (33) "First responders" includes ambulance, fire, mobile rapid
34 response crisis team, co-responder team, designated crisis responder,
35 fire department mobile integrated health team, community assistance
36 referral and education services program under RCW 35.21.930, and law
37 enforcement personnel.
38     (34) "Immediate jeopardy" means a situation in which the licensed
39 or certified behavioral health agency's noncompliance with one or
40 more statutory or regulatory requirements has placed the health and
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1 safety of patients in its care at risk for serious injury, serious
2 harm, serious impairment, or death.
3     (35) "Indian health care provider" means a health care program
4 operated by the Indian health service or by a tribe, tribal
5 organization, or urban Indian organization as those terms are defined
6 in the Indian health care improvement act (25 U.S.C. Sec. 1603).
7     (36) "Intensive behavioral health treatment facility" means a
8 community-based   specialized  residential   treatment  facility  for
9 individuals with behavioral health conditions, including individuals
10 discharging from or being diverted from state and local hospitals,
11 whose impairment or behaviors do not meet, or no longer meet,
12 criteria for involuntary inpatient commitment under chapter 71.05
13 RCW, but whose care needs cannot be met in other community-based
14 placement settings.
15     (37) "Licensed or certified behavioral health agency" means:
16     (a) An entity licensed or certified according to this chapter or
17 chapter 71.05 RCW;
18     (b) An entity deemed to meet state minimum standards as a result
19 of accreditation by a recognized behavioral health accrediting body
20 recognized and having a current agreement with the department; or
21     (c) An entity with a tribal attestation that it meets state
22 minimum standards for a licensed or certified behavioral health
23 agency.
24     (38) "Licensed physician" means a person licensed to practice
25 medicine or osteopathic medicine and surgery in the state of
26 Washington.
27     (39) "Long-term inpatient care" means inpatient services for
28 persons committed for, or voluntarily receiving intensive treatment
29 for, periods of 90 days or greater under chapter 71.05 RCW. "Long-
30 term inpatient care" as used in this chapter does not include: (a)
31 Services for individuals committed under chapter 71.05 RCW who are
32 receiving services pursuant to a conditional release or a court-
33 ordered less restrictive alternative to detention; or (b) services
34 for individuals voluntarily receiving less restrictive alternative
35 treatment on the grounds of the state hospital.
36     (40) "Managed care organization" means an organization, having a
37 certificate of authority or certificate of registration from the
38 office of the insurance commissioner, that contracts with the
39 authority under a comprehensive risk contract to provide prepaid
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1 health care services to enrollees under the authority's managed care
2 programs under chapter 74.09 RCW.
3     (41) "Mental health peer-run respite center" means a peer-run
4 program to serve individuals in need of voluntary, short-term,
5 noncrisis services that focus on recovery and wellness.
6     (42) Mental health "treatment records" include registration and
7 all other records concerning persons who are receiving or who at any
8 time have received services for mental illness, which are maintained
9 by the department of social and health services or the authority, by
10 behavioral health administrative services organizations and their
11 staffs, by managed care organizations and their staffs, or by
12 treatment facilities. "Treatment records" do not include notes or
13 records maintained for personal use by a person providing treatment
14 services for the entities listed in this subsection, or a treatment
15 facility if the notes or records are not available to others.
16     (43) "Mentally ill persons," "persons who are mentally ill," and
17 "the mentally ill" mean persons and conditions defined in subsections
18 (3), (13), (52), and (53) of this section.
19     (44) "Mobile rapid response crisis team" means a team that
20 provides professional on-site community-based intervention such as
21 outreach, de-escalation, stabilization, resource connection, and
22 follow-up support for individuals who are experiencing a behavioral
23 health crisis, that shall include certified peer counselors or
24 certified peer support specialists as a best practice to the extent
25 practicable based on workforce availability, and that meets standards
26 for response times established by the authority.
27     (45) "Recovery" means a process of change through which
28 individuals improve their health and wellness, live a self-directed
29 life, and strive to reach their full potential.
30     (46) "Regional crisis line" means the behavioral health crisis
31 hotline in each regional service area which provides crisis response
32 services 24 hours a day, seven days a week, 365 days a year including
33 but not limited to dispatch of mobile rapid response crisis teams,
34 community-based crisis teams, and designated crisis responders. A
35 regional crisis line may not dispatch law enforcement.
36     (47) "Research-based" means a program or practice that has been
37 tested with a single randomized, or statistically controlled
38 evaluation, or both, demonstrating sustained desirable outcomes; or
39 where the weight of the evidence from a systemic review supports
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1 sustained outcomes as described in subsection (32) of this section
2 but does not meet the full criteria for evidence-based.
3     (48) "Residential services" means a complete range of residences
4 and supports authorized by resource management services and which may
5 involve a facility, a distinct part thereof, or services which
6 support community living, for persons who are acutely mentally ill,
7 adults who are chronically mentally ill, children who are severely
8 emotionally disturbed, or adults who are seriously disturbed and
9 determined   by   the  behavioral   health   administrative   services
10 organization or managed care organization to be at risk of becoming
11 acutely or chronically mentally ill. The services shall include at
12 least evaluation and treatment services as defined in chapter 71.05
13 RCW, acute crisis respite care, long-term adaptive and rehabilitative
14 care, and supervised and supported living services, and shall also
15 include any residential services developed to service persons who are
16 mentally ill in nursing homes, residential treatment facilities,
17 assisted living facilities, and adult family homes, and may include
18 outpatient services provided as an element in a package of services
19 in a supported housing model. Residential services for children in
20 out-of-home placements related to their mental disorder shall not
21 include the costs of food and shelter, except for children's long-
22 term residential facilities existing prior to January 1, 1991.
23     (49) "Resilience" means the personal and community qualities that
24 enable individuals to rebound from adversity, trauma, tragedy,
25 threats, or other stresses, and to live productive lives.
26     (50)   "Resource   management   services"   mean   the  planning,
27 coordination, and authorization of residential services and community
28 support services administered pursuant to an individual service plan
29 for: (a) Adults and children who are acutely mentally ill; (b) adults
30 who are chronically mentally ill; (c) children who are severely
31 emotionally disturbed; or (d) adults who are seriously disturbed and
32 determined   by   a   behavioral    health   administrative  services
33 organization or managed care organization to be at risk of becoming
34 acutely or chronically mentally ill. Such planning, coordination, and
35 authorization shall include mental health screening for children
36 eligible under the federal Title XIX early and periodic screening,
37 diagnosis, and treatment program. Resource management services
38 include seven day a week, 24 hour a day availability of information
39 regarding enrollment of adults and children who are mentally ill in
40 services and their individual service plan to designated crisis
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1 responders, evaluation and treatment facilities, and others as
2 determined   by   the  behavioral   health   administrative   services
3 organization or managed care organization, as applicable.
4     (51) "Secretary" means the secretary of the department of health.
5     (52) "Seriously disturbed person" means a person who:
6     (a) Is gravely disabled or presents a likelihood of serious harm
7 to himself or herself or others, or to the property of others, as a
8 result of a mental disorder as defined in chapter 71.05 RCW;
9     (b) Has been on conditional release status, or under a less
10 restrictive alternative order, at some time during the preceding two
11 years from an evaluation and treatment facility or a state mental
12 health hospital;
13     (c) Has a mental disorder which causes major impairment in
14 several areas of daily living;
15     (d) Exhibits suicidal preoccupation or attempts; or
16     (e) Is a child diagnosed by a mental health professional, as
17 defined in chapter 71.34 RCW, as experiencing a mental disorder which
18 is clearly interfering with the child's functioning in family or
19 school or with peers or is clearly interfering with the child's
20 personality development and learning.
21     (53) "Severely emotionally disturbed child" or "child who is
22 severely emotionally disturbed" means a child who has been determined
23 by the behavioral health administrative services organization or
24 managed care organization, if applicable, to be experiencing a mental
25 disorder as defined in chapter 71.34 RCW, including those mental
26 disorders that result in a behavioral or conduct disorder, that is
27 clearly interfering with the child's functioning in family or school
28 or with peers and who meets at least one of the following criteria:
29     (a) Has undergone inpatient treatment or placement outside of the
30 home related to a mental disorder within the last two years;
31     (b) Has undergone involuntary treatment under chapter 71.34 RCW
32 within the last two years;
33     (c) Is currently served by at least one of the following child-
34 serving systems: Juvenile justice, child-protection/welfare, special
35 education, or developmental disabilities;
36     (d) Is at risk of escalating maladjustment due to:
37     (i) Chronic family dysfunction involving a caretaker who is
38 mentally ill or inadequate;
39     (ii) Changes in custodial adult;
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1     (iii) Going to, residing in, or returning from any placement
2 outside of the home, for example, behavioral health hospital, short-
3 term inpatient, residential treatment, group or foster home, or a
4 correctional facility;
5     (iv) Subject to repeated physical abuse or neglect;
6     (v) Drug or alcohol abuse; or
7     (vi) Homelessness.
8     (54) "State minimum standards" means minimum requirements
9 established by rules adopted and necessary to implement this chapter
10 by:
11     (a) The authority for:
12     (i) Delivery of mental health and substance use disorder
13 services; and
14     (ii) Community support services and resource management services;
15     (b) The department of health for:
16     (i) Licensed or certified behavioral health agencies for the
17 purpose of providing mental health or substance use disorder programs
18 and services, or both;
19     (ii) Licensed behavioral health providers for the provision of
20 mental health or substance use disorder services, or both; and
21     (iii) Residential services.
22     (55) "Substance use disorder" means a cluster of cognitive,
23 behavioral, and physiological symptoms indicating that an individual
24 continues using the substance despite significant substance-related
25 problems. The diagnosis of a substance use disorder is based on a
26 pathological pattern of behaviors related to the use of the
27 substances.
28     (56) "Tribe," for the purposes of this section, means a federally
29 recognized Indian tribe.
30     Sec. 43.   RCW 74.09.748 and 2018 c 175 s 8 are each amended to
31 read as follows:
32     Upon adoption of a fully integrated managed health care system
33 pursuant to chapter 71.24 RCW, regional service areas:
34     (1) Must allow reimbursement for time spent supervising persons
35 working toward satisfying supervision requirements established for
36 the relevant practice areas pursuant to RCW 18.225.090 and chapter
37 18.--- RCW (the new chapter created in section 44 of this act); and
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1     (2) May allow reimbursement for services delivered through a
2 partial hospitalization or intensive outpatient program as described
3 in RCW 71.24.385.
4      NEW SECTION.    Sec. 44.    Sections 1   through   16   of   this   act
5  constitute a new chapter in Title 18 RCW.
6     NEW SECTION.   Sec. 45.   Sections 1 through 16 of this act take
7 effect July 1, 2026.
8     NEW SECTION. Sec. 46. Sections 17 through 43 of this act take
9 effect June 30, 2027, or later, contingent upon the Washington state
10 board of licensed mental health counselors adopting rules and
11 assuming full regulatory authority from the secretary. The department
12 of health must provide written notice of the effective date of these
13 sections to affected parties, the chief clerk of the house of
14 representatives, the secretary of the senate, the office of the code
15 reviser, and others as deemed appropriate by the department.
16     NEW SECTION.    Sec. 47.   If any provision of this act or its
17 application to any person or circumstance is held invalid, the
18 remainder of the act or the application of the provision to other
19 persons or circumstances is not affected.
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