Source: http://www.sos.state.tx.us/texreg/archive/December152017/Adopted%20Rules/22.EXAMINING%20BOARDS.html
Timestamp: 2018-02-20 13:14:41
Document Index: 468951883

Matched Legal Cases: ['§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§465', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§501', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§465', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§465', '§465', '§501', '§463', '§ 463', '§465', '§501', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§465', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§463', '§501', '§463', '§463', '§463', '§463', '§463', '§463', '§501', '§463', '§501', '§465', '§465', '§463', '§465', '§463', '§465', '§465', '§463', '§463', '§465', '§463', '§469', '§473', '§473', '§473']

22 TAC §463.1
The Texas State Board of Examiners of Psychologists adopts amendment §463.1, Types of Licensure, with changes to the proposed text published in the October 6, 2017, issue of the Texas Register (42 TexReg 5343), and will be republished.
BACKGROUND AND JUSTIFICATION. The amendment is necessary to ensure conformity in the Board’s rules, namely with new §463.8, regarding Licensed Psychological Associate (LPA), which is also published elsewhere and adopted in this issue of the Texas Register. The amendment to §463.1 deletes any reference to the supervision of LPAs to conform with the changes in new §463.8.
Currently, LPAs must be under the supervision of a Licensed Psychologist and may not engage in independent practice. The new §463.8 will allow qualified LPAs to practice independently. The new rule addresses the licensed mental health provider shortage in Texas by fully utilizing LPAs in the workforce today. The new rule will be a benefit to consumers because it will increase access, affordability, and capacity of licensed mental health providers. The new rule is also directly responsive to stakeholder requests to allow independent practice by psychological associates, as well as requests from legislators who have expressed an interest in this issue.
The new §463.8 will continue to require an LPA to hold a graduate degree in psychology from an accredited university or college, but will require the degree to consist of a minimum of 60 semester credit hours, rather than the 42 semester hours previously required. In conjunction with the amendment to §463.14, regarding written examinations, which is also published elsewhere and adopted in this issue of the Texas Register, LPAs will be required to achieve a minimum score on all licensure examinations equal to other licensees that can practice independently. The new §463.8 will also require an LPA to obtain at least 3,000 hours of supervised practice from a licensed psychologist after receiving their degree to be eligible to practice independently. The increased credit hours, examination standards, and supervised practice requirements are all necessary to protect the public and help ensure future licensees have the requisite knowledge, are appropriately trained, and have the minimum level of skills to be qualified for independent practice. The Board’s competency rule, §465.9, would still apply to LPAs; therefore an LPA would be required to practice only within their areas of competency.
The new §463.8 will also require LPAs practicing independently to inform all patients and clients, as part of the informed consent process, what type of degree the LPA holds and the LPA will also be required to provide or post conspicuously a copy of a Board approved notice or brochure that describes the differences between the levels of training and education one receives in a master’s, specialist, or doctoral degree program. The importance of this Board approved notice or brochure is to inform and protect the public so they may be aware of the licensee’s education, training, and skills in order to make an informed decision about engaging the licensee’s services. The Board reviewed draft language of a notice or brochure at the quarterly meeting on November 9, 2017, and approved the language to be published on the Board’s website.
The new §463.8 is also necessary to give full effect to the Sunset Advisory Commission's management action from its review of this agency in the 85th Legislature which states: "[t]he board should repeal any rule that, after its evaluation, it deems susceptible to legal challenge based on precedent in the Supreme Court ruling" in North Carolina State Board of Dental Examiners v. Federal Trade Commission.
The Board did not receive any written comments strictly related to §463.1 during the 30-day comment period, which ended November 6, 2017, regarding this proposed amendment to §463.1, but the Board did receive comments regarding the new §463.8. Since the new §463.8 relates to the changes made in the amendments to §463.1 the comments received for new §463.8 are included below.
The Board received both verbal and written comments prior to and during the quarterly meeting held on November 9, 2017, and those comments were considered when deciding to adopt the new rule. During the 30-day comment period, which ended November 6, 2017, the Board received comments in support of the new rule from the following interested groups or associations: the Texas Association of Psychological Associates together with approximately 21 individuals.
A summary of the comments in support of the new rule are:
The comments received reflect general agreement with the proposed changes, and further reinforce the benefits such a change would bring about. More particularly, the comments are supportive of an increase in the number of mental health providers anticipated following this change, greater fairness in marketplace competition, and increased licensing standards. The comments also raised the point of a lack of empirical support for the lifetime supervision requirement.
During the comment period, the Board received comments in opposition of the new rule from the following interested groups or associations: the Texas Psychological Association, the Capital Areas Psychological Association, and the American Psychological Association together with approximately 240 individuals.
A summary of comments in opposition of the new rule are:
The comments received reflect fervent disagreement with the proposed change allowing LPAs to practice independently, and reiterate the need to continue imposing perpetual supervision for practicing LPAs. In general, the comments reflect a belief that master’s level training programs do not constitute sufficient training and education for LPAs to practice safely independent of supervision from a licensed psychologist. The comments also suggest that the proposed change will not increase the number of mental health providers, but rather cause a decrease in numbers; that LPAs will practice beyond the scope of their training and education at the expense of public safety; that greater competition will result from LPA independent practice thereby driving down the cost of services, and necessarily psychologists’ income; will result in a loss of distinction between doctoral and master’s degrees; and finally, will result in confusion if LPAs are permitted to use the title of "psychologist."
The Board’s responses to these comments are:
The proposed amendment is necessary to give full effect to the Sunset Advisory Commission’s management action requiring the agency to conduct a rule review to identify all rules susceptible to legal challenge under the Sherman and Clayton Acts, and then either modify or repeal those rules. The proposed amendment is also directly responsive to stakeholder requests for changes allowing for independent practice by psychological associates, as well as requests from legislators who have expressed interest in the same issue.
With regard to the comments in opposition, the Board will first address the concern about confusion over the use of titles. The proposed change is extremely clear about the correct title for LPAs to use, whether practicing independently or under supervision. The Board is unpersuaded that the use of the title "Licensed Psychological Associate" or "Psychological Associate" will cause confusion with members of the public. To suggest that the use of the word "psychological" within the permissible title somehow equates to the title of "psychologist" strains credibility past its breaking point. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Second, the Board disagrees that the proposed change will not result in an increase in the number of mental health providers. Based upon comments received in the past and other anecdotal observations, the Board believes more individuals will apply for licensure as an LPA if a reasonable pathway to independent practice is created. Moreover, the Board does not believe the proposed change will lead to an exodus of psychologists from the profession because, contrary to the alarmist positions reflected in many of the comments received, such an exodus did not occur when other masters level mental health care providers gained licensure and independent practice authority in the past. In fact, the number of psychologists being licensed by this agency continues to grow despite competition from other masters level providers such as Licensed Specialists in School Psychology (LSSPs), Licensed Professional Counselors (LPCs), Licensed Marriage and Family Therapists (LMFTs), and Social Workers. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Third, the Board disagrees with the suggestion that LPAs will practice beyond the scope of their training and education at the expense of public safety. The Board is not aware of any evidence to support this allegation nor was any such evidence provided in the comments. Thus, the Board declines to impute such a wholesale disregard of Board rule 465.9 to an entire class of licensees. It was also suggested within several of the comments that LPAs may inadvertently practice beyond the scope of their training and education because "they don’t know what they don’t know." If true, such an argument would apply equally to doctoral level providers. However, the Board is unaware of any prior threats to public health, safety, or welfare arising out of a licensee’s practice beyond his or her competency where the Board’s existing rules proved inadequate. The Board is also unpersuaded that any of its licensee populations would be more likely than another to practice beyond the scope of their competency. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Fourth, the Board disagrees with how many of those submitting comments framed the issue as being a question of whether LPAs receive sufficient training and education within their master’s degree programs to practice safely independent of supervision from a licensed psychologist. The question is not whether LPAs have sufficient training and education to practice independently upon graduation from a master’s degree program, but rather, whether that training and education, when coupled with the additional requirements for independent practice set out in the rule provide adequate assurances of public protection. Additionally, while virtually every individual who commented in opposition to the proposed change alleged that LPAs lack sufficient training and education upon graduation from a master’s degree program, none provided competent evidentiary support for their claims. Absent some evidentiary support for such claims, the Board is of the opinion that the proposed change reflects a reasonable approach that balances licensure eligibility and scope of practice with public safety. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Fifth, the Board disagrees that the proposed change will result in a loss of distinction between doctoral and master’s degrees. The Board does not believe the public’s perception, much less the perception of the profession itself, will be affected by the proposed change. The proposed change does nothing to take away from the significant training and education that goes into earning a doctoral degree, nor does it prevent psychologists from advertising these differences in the marketplace. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Sixth, the Board agrees with those comments suggesting that the proposed change will result in greater competition- that is one of the underlying reasons behind the proposed change. A careful review of the Board’s Sunset hearing and report, together with a thorough review of the Sherman and Clayton Acts and related secondary materials, reveals that restraint-of-trade and market competition are two important factors that necessitate the proposed change. As several of the individuals submitting comments suggested, with independent practice, LPAs will provide greater competition to other mental health care providers. And while some providers may suffer a decline in income as a result of greater market competition, it equally stands to reason that LPA practitioners may see an increase in their income. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Lastly, the Board declines to adopt the following proposals made by individuals submitting comments in opposition to the proposed rule:
Complete 3,000 hours of post-graduate supervised experience in not more than 36 months;.
Require at least two hours of individual supervision and two hours of additional training or supervision each week during the post-graduate supervised experience.
Receive verification from at least two psychologists that the LPA is competent to practice independently.
Pass a proficiency exam or other certification process approved by the Board in desired areas of practice.
Requiring an individual to demonstrate at least 1,000 hours of supervised practice in each of the years required for "grandfathering" under subsection (h).
With regard to the first proposal, the Board fails to see any substantial difference between the stakeholder proposal and the Board proposed change. The Board has proposed requiring 3,000 hours of post-graduate supervised experience be completed within two to four years. With regard to the second proposal, Board rule 465.2(c)(4) would require LPAs for whom supervision is required, to receive at least one hour of individual supervision per week. This requirement was adopted following extensive stakeholder input during the recent revision of the Board’s rules governing supervision. Since then, the Board has not been presented with any information necessitating an increase like that suggested here.
With regard to the third proposal, the Board has serious reservations about granting one category of licensees authority to determine "readiness to practice" over another, when the underlying concern behind the rule change is restraint of trade between the groups. Additionally, the Board does not believe it proper to delegate its decision making authority in such a manner. With regard to the fourth proposal, the Board would remind its licensees that it issues a generic license, rather than a specialty license. Thus, the Board does not have authority to license LPAs in specialty areas only. Lastly, with regard to the "grandfathering" proposal, the Board declines to impose the suggested requirement based upon the improbable and theoretical scenarios described by the individual submitting the proposal.
STATUTORY AUTHORITY. The amended rule is adopted under Texas Occupations Code, Title 3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners of Psychologists with the authority to make all rules, not inconsistent with the Constitution and Laws of this State, which are reasonably necessary for the proper performance of its duties and regulations of proceedings before it.
Additionally, the Board adopts this amended rule pursuant to the authority found in §501.259 of the Texas Occupations Code which vests the Board with the authority to set standards for the issuance of licenses to psychological personnel who hold a master’s degree.
§463.1.Types of Licensure.
TRD-201704823
22 TAC §463.8
The Texas State Board of Examiners of Psychologists adopts the repeal of rule §463.8, Licensed Psychological Associate, without changes to the proposed text published in the October 6, 2017, issue of the Texas Register (42 TexReg 5346), will not be republished.
BACKGROUND AND JUSTIFICATION. The purpose of this adopted repeal is to delete the current version of §463.8 and replace it with a new §463.8, which is also published elsewhere and adopted in this issue of the Texas Register.
The new §463.8 will continue to require an LPA to hold a graduate degree in psychology from an accredited university or college, but will require the degree to consist of a minimum of 60 semester credit hours, rather than the 42 semester hours previously required. In conjunction with the amendment to §463.14, regarding written examinations, which is also published elsewhere and adopted in this issue of the Texas Register, LPAs will be required to achieve a minimum score on all licensure examinations equal to other licensees that can practice independently. The new §463.8 will also require an LPA to obtain at least 3,000 hours of supervised practice from a licensed psychologist after receiving their degree to be eligible to practice independently. The increased credit hours, examination standards, and supervised practice requirements are all necessary to protect the public and help ensure future licensees have the requisite knowledge, are appropriately trained, and have the minimum level of skills to be qualified for independent practice. The Board's competency rule, §465.9, would still apply to LPAs; therefore an LPA would be required to practice only within their areas of competency.
The new §463.8 will also require LPAs practicing independently to inform all patients and clients, as part of the informed consent process, what type of degree the LPA holds and the LPA will also be required to provide or post conspicuously a copy of a Board approved notice or brochure that describes the differences between the levels of training and education one receives in a master's, specialist, or doctoral degree program. The importance of this Board approved notice or brochure is to inform and protect the public so they may be aware of the licensee's education, training, and skills in order to make an informed decision about engaging the licensee's services. The Board reviewed draft language of a notice or brochure at the quarterly meeting on November 9, 2017, and approved the language to be published on the Board's website.
The Board did not receive any written comments strictly related to the repeal of §463.8 during the 30-day comment period, which ended November 6, 2017, regarding this proposed repeal of §463.8, but the Board did receive comments regarding the new §463.8. Since the new §463.8 relates to the repeal of the current version of §463.8 the comments received for new §463.8 are included below.
The comments received reflect fervent disagreement with the proposed change allowing LPAs to practice independently, and reiterate the need to continue imposing perpetual supervision for practicing LPAs. In general, the comments reflect a belief that master's level training programs do not constitute sufficient training and education for LPAs to practice safely independent of supervision from a licensed psychologist. The comments also suggest that the proposed change will not increase the number of mental health providers, but rather cause a decrease in numbers; that LPAs will practice beyond the scope of their training and education at the expense of public safety; that greater competition will result from LPA independent practice thereby driving down the cost of services, and necessarily psychologists' income; will result in a loss of distinction between doctoral and master's degrees; and finally, will result in confusion if LPAs are permitted to use the title of "psychologist."
The Board's responses to these comments are:
The proposed amendment is necessary to give full effect to the Sunset Advisory Commission's management action requiring the agency to conduct a rule review to identify all rules susceptible to legal challenge under the Sherman and Clayton Acts, and then either modify or repeal those rules. The proposed amendment is also directly responsive to stakeholder requests for changes allowing for independent practice by psychological associates, as well as requests from legislators who have expressed interest in the same issue.
Third, the Board disagrees with the suggestion that LPAs will practice beyond the scope of their training and education at the expense of public safety. The Board is not aware of any evidence to support this allegation nor was any such evidence provided in the comments. Thus, the Board declines to impute such a wholesale disregard of Board rule §465.9 to an entire class of licensees. It was also suggested within several of the comments that LPAs may inadvertently practice beyond the scope of their training and education because "they don't know what they don't know." If true, such an argument would apply equally to doctoral level providers. However, the Board is unaware of any prior threats to public health, safety, or welfare arising out of a licensee's practice beyond his or her competency where the Board's existing rules proved inadequate. The Board is also unpersuaded that any of its licensee populations would be more likely than another to practice beyond the scope of their competency. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Fourth, the Board disagrees with how many of those submitting comments framed the issue as being a question of whether LPAs receive sufficient training and education within their master's degree programs to practice safely independent of supervision from a licensed psychologist. The question is not whether LPAs have sufficient training and education to practice independently upon graduation from a master's degree program, but rather, whether that training and education, when coupled with the additional requirements for independent practice set out in the rule provide adequate assurances of public protection. Additionally, while virtually every individual who commented in opposition to the proposed change alleged that LPAs lack sufficient training and education upon graduation from a master's degree program, none provided competent evidentiary support for their claims. Absent some evidentiary support for such claims, the Board is of the opinion that the proposed change reflects a reasonable approach that balances licensure eligibility and scope of practice with public safety. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Fifth, the Board disagrees that the proposed change will result in a loss of distinction between doctoral and master's degrees. The Board does not believe the public's perception, much less the perception of the profession itself, will be affected by the proposed change. The proposed change does nothing to take away from the significant training and education that goes into earning a doctoral degree, nor does it prevent psychologists from advertising these differences in the marketplace. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Sixth, the Board agrees with those comments suggesting that the proposed change will result in greater competition - that is one of the underlying reasons behind the proposed change. A careful review of the Board's Sunset hearing and report, together with a thorough review of the Sherman and Clayton Acts and related secondary materials, reveals that restraint-of-trade and market competition are two important factors that necessitate the proposed change. As several of the individuals submitting comments suggested, with independent practice, LPAs will provide greater competition to other mental health care providers. And while some providers may suffer a decline in income as a result of greater market competition, it equally stands to reason that LPA practitioners may see an increase in their income. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Lastly, the Board declines to adopt the following proposals made by individuals submitting comments in opposition to the proposed rule.
Complete 3,000 hours of post-graduate supervised experience in not more than 36 months.
With regard to the first proposal, the Board fails to see any substantial difference between the stakeholder proposal and the Board proposed change. The Board has proposed requiring 3,000 hours of post-graduate supervised experience be completed within two to four years. With regard to the second proposal, Board rule §465.2(c)(4) would require LPAs for whom supervision is required, to receive at least one hour of individual supervision per week. This requirement was adopted following extensive stakeholder input during the recent revision of the Board's rules governing supervision. Since then, the Board has not been presented with any information necessitating an increase like that suggested here.
STATUTORY AUTHORITY. The repeal is adopted under Texas Occupations Code, Title 3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners of Psychologists with the authority to make all rules, not inconsistent with the Constitution and Laws of this State, which are reasonably necessary for the proper performance of its duties and regulations of proceedings before it.
Additionally, the Board adopts this repeal pursuant to the authority found in §501.259 of the Texas Occupations Code which vests the Board with the authority to set standards for the issuance of licenses to psychological personnel who hold a master's degree.
TRD-201704824
The Texas State Board of Examiners of Psychologists adopts new rule §463.8, Licensed Psychological Associate, with changes to the proposed text published in the October 6, 2017, issue of the Texas Register (42 TexReg 5349), and will be republished.
BACKGROUND AND JUSTIFICATION. Currently, LPAs must be under the supervision of a Licensed Psychologist and may not engage in independent practice. The adopted new rule will allow experienced LPAs to practice independently. The adopted new rule addresses the licensed mental health provider shortage in Texas by fully utilizing LPAs in the workforce today. The adopted new rule will be a benefit to consumers because it will increase access, affordability, and capacity of licensed mental health providers. The adopted new rule is also directly responsive to stakeholder requests to allow independent practice by psychological associates, as well as requests from legislators who have expressed an interest in this issue.
The adopted new rule will continue to require an LPA to hold a graduate degree in psychology from an accredited university or college, but will require the degree to consist of a minimum of 60 semester credit hours, rather than the 42 semester hours previously required. In conjunction with the amended Board rule regarding written examinations, 22 Texas Administrative Code § 463.14, which is also adopted in this issue of the Texas Register, LPAs will be required to achieve a minimum score on all licensure examinations equal to other licensees that can practice independently. The adopted new rule will also require an LPA to obtain at least 3,000 hours of supervised practice from a licensed psychologist after receiving their degree to be eligible to practice independently. The increased credit hours, examination standards, and supervised practice requirements are all necessary to protect the public and help ensure future licensees have the requisite knowledge, are appropriately trained, and have the minimum level of skills to be qualified for independent practice. The Board's competency rule, 22 Texas Administrative Code §465.9, would still apply to LPAs; therefore an LPA would be required to practice only within their areas of competency.
The adopted new rule will also require LPAs practicing independently to inform all patients and clients, as part of the informed consent process, what type of degree the LPA holds and the LPA will also be required to provide or post conspicuously a copy of a Board approved notice or brochure that describes the differences between the levels of training and education one receives in a master's, specialist, or doctoral degree program. The importance of this Board approved notice or brochure is to inform and protect the public so they may be aware of the licensee's education, training, and skills in order to make an informed decision about engaging the licensee's services. The Board reviewed draft language of a notice or brochure at the quarterly meeting on November 9, 2017, and approved the language to be published on the Board's website.
The adopted new rule is also necessary to give full effect to the Sunset Advisory Commission's management action from its review of this agency in the 85th Legislature which states: "[t]he board should repeal any rule that, after its evaluation, it deems susceptible to legal challenge based on precedent in the Supreme Court ruling" in North Carolina State Board of Dental Examiners v. Federal Trade Commission.
The Board received both verbal and written comments prior to and during the quarterly meeting held on November 9, 2017, and those comments were considered when deciding to adopt this new rule. During the 30-day comment period, which ended November 6, 2017, the Board received comments in support of the proposed rule from the following interested groups or associations: the Texas Association of Psychological Associates together with approximately 21 individuals.
A summary of the comments in support of the rule are:
During the comment period, the Board received comments in opposition of the proposed rule from the following interested groups or associations: the Texas Psychological Association, the Capital Areas Psychological Association, and the American Psychological Association together with approximately 240 individuals.
A summary of comments in opposition of the rule are:
The comments received reflect fervent disagreement with the proposed change allowing LPAs to practice independently, and reiterate the need to continue imposing perpetual supervision for practicing LPAs. In general, the comments reflect a belief that masters level training programs do not constitute sufficient training and education for LPAs to practice safely independent of supervision from a licensed psychologist. The comments also suggest that the proposed change will not increase the number of mental health providers, but rather cause a decrease in numbers; that LPAs will practice beyond the scope of their training and education at the expense of public safety; that greater competition will result from LPA independent practice thereby driving down the cost of services, and necessarily psychologists' income; will result in a loss of distinction between doctoral and master's degrees; and finally, will result in confusion if LPAs are permitted to use the title of "psychologist."
With regard to the comments in opposition, the Board will first address the concern about confusion over the use of titles. The proposed change is extremely clear about the correct title for LPAs to use, whether practicing independently or under supervision. The Board is unpersuaded that the use of the title "Licensed Psychological Associate" or "Psychological Associate" will cause confusion with members of the public. To suggest that the use of the word "sychological" within the permissible title somehow equates to the title of "psychologist" strains credibility past its breaking point. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Third, the Board disagrees with the suggestion that LPAs will practice beyond the scope of their training and education at the expense of public safety. The Board is not aware of any evidence to support this allegation nor was any such evidence provided in the comments. Thus, the Board declines to impute such a wholesale disregard of Board rule 465.9 to an entire class of licensees. It was also suggested within several of the comments that LPAs may inadvertently practice beyond the scope of their training and education because "they don't know what they don't know." If true, such an argument would apply equally to doctoral level providers. However, the Board is unaware of any prior threats to public health, safety, or welfare arising out of a licensee's practice beyond his or her competency where the Board's existing rules proved inadequate. The Board is also unpersuaded that any of its licensee populations would be more likely than another to practice beyond the scope of their competency. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
STATUTORY AUTHORITY. The new rule is adopted under Texas Occupations Code, Title 3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners of Psychologists with the authority to make all rules, not inconsistent with the Constitution and Laws of this State, which are reasonably necessary for the proper performance of its duties and regulations of proceedings before it.
Additionally, the Board adopts this new rule pursuant to the authority found in §501.259 of the Texas Occupations Code which vests the Board with the authority to set standards for the issuance of licenses to psychological personnel who hold a master's degree.
§463.8.Licensed Psychological Associate.
TRD-201704825
The Texas State Board of Examiners of Psychologists adopts amendment §463.11, Licensed Psychologists, without changes to the proposed text as published in the September 29, 2017, issue of the Texas Register (42 TexReg 5214), and will not be republished.
The amendment as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist. The change is also necessary to ensure that those applicants whose post-doctoral supervised experience occurred both prior to and after September 1, 2016, are able to utilize the experience acquired prior to September 1, 2016, to satisfy the requirements for full licensure.
TRD-201704826
22 TAC §463.13
The Texas State Board of Examiners of Psychologists adopts amendment §463.13, concerning Requirements for Licensed Out-of-State Applicants, without changes to the proposed text as published in the September 29, 2017, issue of the Texas Register (42 TexReg 5219). The amended text will not be republished.
The amendment as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist. The adopted change also serves to clarify some language in the rule.
TRD-201704827
22 TAC §463.14
The Texas State Board of Examiners of Psychologists adopts amendment to §463.14, Written Examinations, without changes to the proposed text published in the October 6, 2017, issue of the Texas Register (42 TexReg 5353), and will not be republished.
BACKGROUND AND JUSTIFICATION. This amendment is necessary to ensure conformity in the Board's rules, namely with new §463.8, regarding Licensed Psychological Associate (LPA), which is also published elsewhere and adopted in this issue of the Texas Register. The amendment to §463.14 will increase the required minimum score that LPAs must achieve on all licensure examinations to be equal to other licensees that can practice independently.
The new §463.8 will continue to require an LPA to hold a graduate degree in psychology from an accredited university or college but will require the degree to consist of a minimum of 60 semester credit hours, rather than the 42 semester hours previously required. In conjunction with the amendment to §463.14, LPAs will be required to achieve a minimum score on all licensure examinations equal to other licensees that can practice independently. The new §463.8 will also require an LPA to obtain at least 3,000 hours of supervised practice from a licensed psychologist after receiving their degree to be eligible to practice independently. The increased credit hours, examination standards, and supervised practice requirements are all necessary to protect the public and help ensure future licensees have the requisite knowledge, are appropriately trained, and have the minimum level of skills to be qualified for independent practice. The Board's competency rule, §465.9, would still apply to LPAs; therefore, an LPA would be required to practice only within their areas of competency.
The new §463.8 will also require LPAs practicing independently to inform all patients and clients, as part of the informed consent process, what type of degree the LPA holds and the LPA will also be required to provide or post conspicuously a copy of a Board approved notice or brochure that describes the differences between the levels of training and education one receives in a master's, specialist, or doctoral degree program. The importance of this Board approved notice or brochure is to inform and protect the public so they may be aware of the licensee's education, training, and skills in order to make an informed decision about engaging the licensee's services. The Board reviewed draft language of a notice or brochure at the quarterly meeting on November 9, 2017, and approved the language to be published on the Board's website. The new §463.8 is also necessary to give full effect to the Sunset Advisory Commission's management action from its review of this agency in the 85th Legislature which states: "{t}he board should repeal any rule that, after its evaluation, it deems susceptible to legal challenge based on precedent in the Supreme Court ruling" in North Carolina State Board of Dental Examiners v. Federal Trade Commission.
The Board did not receive any written comments strictly related to §463.14 during the 30-day comment period, which ended November 6, 2017, regarding this proposed amendment to §463.14, but the Board did receive comments regarding the new §463.8. Since the new §463.8 relates to the changes made in the amendments to §463.14 the comments received for new §463.8 are included below.
The comments received reflect fervent disagreement with the proposed change allowing LPAs to practice independently and reiterate the need to continue imposing perpetual supervision for practicing LPAs. In general, the comments reflect a belief that master's level training programs do not constitute sufficient training and education for LPAs to practice safely independent of supervision from a licensed psychologist. The comments also suggest that the proposed change will not increase the number of mental health providers but rather, cause a decrease in numbers; that LPAs will practice beyond the scope of their training and education at the expense of public safety; that greater competition will result from LPA independent practice, thereby driving down the cost of services and necessarily psychologists' income; will result in a loss of distinction between doctoral and master's degrees; and finally, will result in confusion if LPAs are permitted to use the title of "psychologist."
Second, the Board disagrees that the proposed change will not result in an increase in the number of mental health providers. Based upon comments received in the past and other anecdotal observations, the Board believes more individuals will apply for licensure as an LPA if a reasonable pathway to independent practice is created. Moreover, the Board does not believe the proposed change will lead to an exodus of psychologists from the profession because, contrary to the alarmist positions reflected in many of the comments received, such an exodus did not occur when other masters level mental health care providers gained licensure and independent practice authority in the past. In fact, the number of psychologists being licensed by this agency continues to grow, despite competition from other masters level providers such as Licensed Specialists in School Psychology (LSSPs), Licensed Professional Counselors (LPCs), Licensed Marriage and Family Therapists (LMFTs), and Social Workers. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
Fourth, the Board disagrees with how many of those submitting comments framed the issue as being a question of whether LPAs receive sufficient training and education within their master's degree programs to practice safely independent of supervision from a licensed psychologist. The question is not whether LPAs have sufficient training and education to practice independently upon graduation from a master's degree program, but rather, whether that training and education, when coupled with the additional requirements for independent practice set out in the rule, provide adequate assurances of public protection. Additionally, while virtually every individual who commented in opposition to the proposed change alleged that LPAs lack sufficient training and education upon graduation from a master's degree program, none provided competent evidentiary support for their claims. Absent some evidentiary support for such claims, the Board is of the opinion that the proposed change reflects a reasonable approach that balances licensure eligibility and scope of practice with public safety. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
With regard to the first proposal, the Board fails to see any substantial difference between the stakeholder proposal and the Board proposed change. The Board has proposed requiring 3,000 hours of post-graduate supervised experience be completed within two to four years. With regard to the second proposal, Board rule 465.2(c)(4) would require LPAs for whom supervision is required to receive at least one hour of individual supervision per week. This requirement was adopted following extensive stakeholder input during the recent revision of the Board's rules governing supervision. Since then, the Board has not been presented with any information necessitating an increase like that suggested here.
With regard to the third proposal, the Board has serious reservations about granting one category of licensees authority to determine "readiness to practice" over another when the underlying concern behind the rule change is restraint of trade between the groups. Additionally, the Board does not believe it proper to delegate its decision making authority in such a manner. With regard to the fourth proposal, the Board would remind its licensees that it issues a generic license rather than a specialty license. Thus, the Board does not have authority to license LPAs in specialty areas only. Lastly, with regard to the "grandfathering" proposal, the Board declines to impose the suggested requirement based upon the improbable and theoretical scenarios described by the individual submitting the proposal.
Additionally, the Board adopts this amended rule pursuant to the authority found in §501.259 of the Texas Occupations Code which vests the Board with the authority to set standards for the issuance of licenses to psychological personnel who hold a master's degree.
TRD-201704828
22 TAC §463.15
The Texas State Board of Examiners of Psychologists adopts the repeal of §463.15, Oral Examination, without changes to the proposed text published in the September 29, 2017, issue of the Texas Register (42 TexReg 5221) and will not be republished.
The repeal is being adopted to ensure the protection and safety of the public.
The repeal as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist.
A general comment was received regarding the adoption of the repeal.
The Board received comments that reflects disagreement with the proposed elimination of the oral examination. In general, the comments reflect a belief that the oral examination serves the important function of ensuring that individuals licensed as psychologists possess the requisite entry level competency necessary for independent practice as a psychologist.
The proposed repeal is necessary because the agency no longer has the resources needed to administer the oral examination. By way of example, the agency repeatedly struggles with recruiting and securing enough examiners to cover the content areas selected by candidates and has lost the use of the facilities located on the U.T. Austin campus. The loss of the agency's testing facilities, together with its inability to secure comparable facilities given the agency's limited appropriations, leaves the agency with little choice but to eliminate the oral examination. Without the repeal of this requirement, doctoral level applicants otherwise qualified for independent practice would be unable to achieve licensure as a psychologist.
Two individuals submitted comments in support of this rule change.
The comments received reflect general agreement with the proposed change. Furthermore, many of the individuals submitting comments stated that they believed the regulatory burden imposed by the examination outweighed its benefit in terms of public protection.
TRD-201704829
22 TAC §463.27
The Texas State Board of Examiners of Psychologists adopts amendments to §463.27, concerning Temporary License for Persons Licensed In Other States, without changes to the proposed text as published in the September 29, 2017, issue of the Texas Register (42 TexReg 5221). The amended rule will not be republished.
The amendment as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist.
TRD-201704831
22 TAC §463.29
The Texas State Board of Examiners of Psychologists adopts the repeal of §463.29, Reciprocity Agreements with Other Jurisdictions, without changes to the proposed text as published in the September 29, 2017, issue of the Texas Register (42 TexReg 5223), and will not be republished.
The repeal as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist. The adopted repeal is also necessary to reflect the fact that §501.262 of the Psychologists Licensing Act does not limit the Board's authority to enter into reciprocity agreements for psychologists licensure only.
TRD-201704832
The Texas State Board of Examiners of Psychologists adopts new rule §463.29, Reciprocity Agreements with Other Jurisdictions without changes to the proposed text published in the September 29, 2017, issue of the Texas Register (42 TexReg 5223) and will not be republished.
The new rule is being adopted to ensure the protection and safety of the public.
The new rule as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applications otherwise qualified for independent practice would be unable to achieve licensure as a psychologist. The adopted new rule is also necessary to reflect the fact that §501.262 of the Psychologists Licensing Act does not limit the Board's authority to enter into reciprocity agreements for psychologists licensure only.
TRD-201704833
22 TAC §465.2
The Texas State Board of Examiners of Psychologists adopts amendment to §465.2, Supervision, without changes to the proposed text published in the October 6, 2017, issue of the Texas Register (42 TexReg 5356), and will not be republished.
BACKGROUND AND JUSTIFICATION. This amendment is necessary to ensure conformity in the Board's rules, namely with new §463.8, regarding Licensed Psychological Associate (LPA), which is also published elsewhere and adopted in this issue of the Texas Register. The amendment to §465.2 deletes certain references to the supervision of LPAs to conform with the changes in new §463.8.
The Board did not receive any written comments strictly related to §465.2 during the 30-day comment period, which ended November 6, 2017, regarding this proposed amendment to §465.2, but the Board did receive comments regarding the new §463.8. Since the new §463.8 relates to the changes made in the amendments to §465.2, the comments received for new §463.8 are included below.
Sixth, the Board agrees with those comments suggesting that the proposed change will result in greater competition--that is one of the underlying reasons behind the proposed change. A careful review of the Board's Sunset hearing and report, together with a thorough review of the Sherman and Clayton Acts and related secondary materials, reveals that restraint-of-trade and market competition are two important factors that necessitate the proposed change. As several of the individuals submitting comments suggested, with independent practice, LPAs will provide greater competition to other mental health care providers. And while some providers may suffer a decline in income as a result of greater market competition, it equally stands to reason that LPA practitioners may see an increase in their income. Thus, the Board declines to withdraw or modify the proposed change based upon these comments.
TRD-201704834
The Texas State Board of Examiners of Psychologists adopts amendments to §469.7, Persons with Criminal Backgrounds, without changes to the proposed text published in the September 29, 2017, issue of the Texas Register (42 TexReg 5224) and will not be republished.
The amendments are being adopted to ensure the protection and safety of the public.
The amendments as adopted are necessary due to state and federal laws prohibiting agency access to the criminal history information of individuals not presently licensed or with a pending application before the agency.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title 3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners of Psychologists with the authority to make all rules, not inconsistent with the Constitution and Laws of this State, which are reasonably necessary for the proper performance of its duties and regulations of proceedings before it.
TRD-201704835
The Texas State Board of Examiners of Psychologists adopts amendment to §473.2, Examination Fees (Non-Refundable) without changes to the proposed text published in the September 29, 2017 issue of the Texas Register (42 TexReg 5226) and will not be republished.
The amendment as adopted is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applicants otherwise qualified for independent practice would be unable to achieve licensure as a psychologist.
TRD-201704836
22 TAC §473.7
The Texas State Board of Examiners of Psychologists adopts the repeal of §473.7, concerning Penalties, without changes to the proposed text as published in the September 29, 2017, issue of the Texas Register (42 TexReg 5226). The repealed text will not be republished.
The repeal as adopted is necessary following recent changes in how the Board handles complaints involving professional development hours. Additionally, the repeal also serves to eliminate redundant language in the agency's regulations.
TRD-201704837