THIRD READING  

Bill No: AB 1540

Author: Holden (D)

Amended: 4/25/19 in Assembly

Vote: 21

SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/24/19

AYES: Glazer, Chang, Archuleta, Dodd, Galgiani, Hill, Leyva, Pan, Wilk

ASSEMBLY FLOOR: 75-0, 5/2/19 - See last page for vote

SUBJECT: Music therapy

SOURCE: Certification Board for Music Therapists

DIGEST:

This bill establishes the Music Therapy Act and prohibits an individual from using the title “Board Certified Music Therapist” without meeting specified qualifications.

ANALYSIS:

Existing law:

1. Establishes a voluntary program for the certification and registration of massage therapists and interior designers. (BPC § 4600 et seq. and 5800 et seq.)
2. Specifies that provisions relating to the licensure and regulations of healing art practitioners do not apply to art therapists, dance therapists, music therapists, and recreation therapists, who are personnel of health facilities. (BPC § 4507)
   

This bill:

1. Establishes the Music Therapy Act, and prohibits an individual who provides music therapy from referring to oneself as a “Board Certified Music Therapist” (BCMT) unless the individual has completed the following:
2. A bachelor’s degree or its equivalent or higher from a music therapy degree program approved by the American Music Therapy Association (AMTA) using current standards, beginning with those adopted on April 1, 2015;
3. A minimum of 1,200 hours of supervised clinical work through pre-internship training at an approved degree program and internship training through an approved national roster or university affiliated internship program, or the equivalent; and,
4. The current certification requirements, beginning with those adopted on April 1, 2015, established by the Certification Board for Music Therapists for the Music Therapist-Board certified credential.
   
5. Clarifies that the provisions of this bill do not authorize a person engaged in music therapy to state or imply that they provide licensed mental health counseling, psychotherapy, or occupational therapy.
   
6. Clarifies that the use of music is not restricted to any profession; however, the use of music does not imply or suggest that that the person is a BCMT, if they do not meet the required specifications.
   
7. Defines “music therapy” as the clinical and evidence-based use of music therapy interventions in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational settings to address physical, emotional, cognitive, and social needs or individuals within a therapeutic relationship.
   
8. Includes in the definition of “music therapy” the following: the development of music therapy treatment plans specific to the needs and strengths of the client who may be seen individually or in groups; and, music therapy plans must establish goals, objectives, and potential strategies of the music therapy services appropriate for the client and setting.
   
9. States that “music therapy interventions” include, but are not limited to, music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music.
   
10. States that it is an unfair business practice, as specified, for a person to use the title “BCMT” if they do not meet the requirements for certification.
    
11. States that the provisions of this bill do not require a music therapist, currently employed by the State of California, to obtain certification as a BCMT.
    
12. Makes findings and declarations relating to the educational and training standards for music therapists and the Certification Board of Music Therapists; and states legislative intent to provide a statutory definition for music therapy and enable consumers and state and local agencies to more easily identify qualified.

Background

Music Therapy. According to the AMTA, Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music therapists may work in a variety of settings including psychiatric hospitals, rehabilitative facilities, medical hospitals, outpatient clinics, day care treatment centers, agencies serving persons with developmental disabilities, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice. There is no current licensure requirement for music therapists to practice in California.

Certification Board for Music Therapists (CBMT). The CBMT is responsible for the voluntary certification and recertification of music therapists. In order to obtain certification, an individual must have completed a bachelor's degree or higher in music therapy from an AMTA-approved college or university program. Upon completion of the appropriate program, an individual must take and pass an examination administered by the CBMT. There are currently two schools in California that provide an approved degree program in music therapy for purposes of certification: California State University, Northridge and the University of the Pacific. As currently drafted, this bill does not require a registration or a license in order to practice music therapy in California, but instead would specify that in order to use the title “Board Certified Music Therapist” an individual must be certified by the CBMT. Additionally, this bill clarifies that persons certified by the CBMT are not authorized to provide mental health counseling which requires a license.

Music Therapy in California. According to information from the sponsor, inconsistencies in current state regulations (California Code of Regulations (CCR), Titles 9, 17, and 22) include references to obsolete credentialing agencies that no longer exist which have created confusion regarding the practice of music therapy in California.

Title Act vs. Practice Act. There is an important distinction between regulations which require licensure and those which protect a professional title. Statutes regulating professions in California generally fall into two categories: a "practice act" or a "title act." A “practice act" regulates the duties, responsibilities and scope of practice that a licensee can perform upon meeting specific educational, experiential or training requirements. A “title act" simply regulates the use of the title an individual may use in practice. In order to be permitted to use a title, a state may require proof that an individual has a certain level of experience or education relevant to the particular title being regulated. Title protection is generally intended to be a means of market differentiation whereas a "practice act" would literally prohibit individuals from engaging in the practice regardless of how it is described. As currently written, this bill allows individuals to continue to practice music therapy in California but they would be prohibited from using the title "Board Certified Music Therapist" unless they meet certain criteria.

FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No

SUPPORT: (Verified 6/25/19)

Certification Board for Music Therapists (source)

American Federation of State, County and Municipal Employees

California Park and Recreation Society

OPPOSITION: (Verified 6/25/19)

None received

ARGUMENTS IN SUPPORT: The Certification Board for Music Therapists writes in support, “Music therapy is a unique marriage of music and science—particularly neuroscience. Practitioners works with people of all ages in providing services and treatment in the areas of medical illness, traumatic brain injury, autism, developmental disability, memory impairment, oncology support, special education, neonatal intensive care, stroke, Parkinson’s Disease, trauma, post-traumatic stress disorders, early interventions (birth-3 years) and the terminally ill to name a few.”

The American Federation of State, County and Municipal Employees and the California Park and Recreation Society write in support and note that this bill would bring clarity to the music therapy profession by establishing a standard definition for music therapy.

ASSEMBLY FLOOR: 75-0, 5/2/19

AYES: Aguiar-Curry, Bauer-Kahan, Berman, Bigelow, Bloom, Boerner Horvath, Bonta, Brough, Burke, Calderon, Carrillo, Cervantes, Chau, Chen, Chiu, Choi, Chu, Cooley, Cooper, Cunningham, Dahle, Daly, Diep, Eggman, Fong, Frazier, Friedman, Gabriel, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Muratsuchi, Nazarian, Obernolte, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Voepel, Waldron, Weber, Wicks, Wood, Rendon

NO VOTE RECORDED: Arambula, Flora, Mullin, Patterson, Quirk

Prepared by: Elissa Silva / B., P. & E.D. / 916-651-4104

6/26/19 15:57:43

**** END ****

SENATE COMMITTEE ON

BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT

Senator Steven Glazer, Chair

2019 - 2020 Regular

Bill No: Hearing Date: June 24, 2019

Subject:

SUMMARY:

Establishes the Music Therapy Act and prohibits an individual from using the title “Board Certified Music Therapist” without meeting specified qualifications.

Existing law:

1. Provides for the licensure and regulation of various healing arts professions and vocations under the Business and Professions Code (BPC). (BPC §§ 500-4999.129)
   
2. Establishes a voluntary program for the certification and registration of massage therapists and interior designers. (BPC § 4600 et seq. and 5800 et seq.)
3. Specifies that provisions relating to the licensure and regulations of healing art practitioners do not apply to art therapists, dance therapists, music therapists, and recreation therapists, who are personnel of health facilities. (BPC § 4507)
   

This bill:

1. Establishes the Music Therapy Act.
   
2. Prohibits an individual who provides music therapy from referring to oneself as a “Board Certified Music Therapist” (BCMT) unless the individual has completed the following:
3. A bachelor’s degree or its equivalent or higher from a music therapy degree program approved by the American Music Therapy Association (AMTA) using current standards, beginning with those adopted on April 1, 2015;
4. A minimum of 1,200 hours of supervised clinical work through pre-internship training at an approved degree program and internship training through an approved national roster or university affiliated internship program, or the equivalent; and,
5. The current certification requirements, beginning with those adopted on April 1, 2015, established by the Certification Board for Music Therapists for the Music Therapist-Board certified credential.
   
6. Clarifies that the provisions of this bill do not authorize a person engaged in music therapy to state or imply that they provide licensed mental health counseling, psychotherapy, or occupational therapy.
   
7. Clarifies that the use of music is not restricted to any profession; however, the use of music does not imply or suggest that that the person is a BCMT, if they do not meet the required specifications.
   
8. Defines “music therapy” as the clinical and evidence-based use of music therapy interventions in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational settings to address physical, emotional, cognitive, and social needs or individuals within a therapeutic relationship.
   
9. Includes in the definition of “music therapy” the following:
10. The development of music therapy treatment plans specific to the needs and strengths of the client who may be seen individually or in groups.
11. Music therapy plans must establish goals, objectives, and potential strategies of the music therapy services appropriate for the client and setting.
    
12. States that “music therapy interventions” include, but are not limited to, music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music.
    
13. States that it is an unfair business practice, as specified, for a person to use the title “BCMT” if they do not meet the requirements for certification.
    
14. States that the provisions of this bill do not require a music therapist, currently employed by the State of California, to obtain certification as a BCMT.
    
15. Makes findings and declarations relating to the educational and training standards for music therapists and the Certification Board of Music Therapists.
    
16. States legislative intent to provide a statutory definition for music therapy and enable consumers and state and local agencies to more easily identify qualified music therapists.

FISCAL EFFECT:

None. This bill is not keyed fiscal by Legislative Counsel.

COMMENTS:

1. Purpose. This bill will establish a title protection for persons practicing music therapy and who are certified by the BCMT. This is bill is sponsored by the Certification Board for Music Therapists. According to the author, “National accrediting organizations, such as the Joint Commission and the Commission for Accreditation of Rehabilitation Facilities (CARF), outline within their standards the qualifications and professional requirements of staff that are permitted to practice within accredited healthcare facilities. These standards often reiterate that professionals hold the credential that is required or recognized by the state.

“Official state recognition of music therapists will help healthcare facilities that rely upon state regulations to address the confusion regarding the difference between music therapists, music practitioners, music thanatologists, and other non-music therapy musicians in healthcare. Official state recognition of music therapists will help make a distinction between music therapy and other creative arts therapies and related professions (e.g., counseling).”

1. Background.
   

Music Therapy. According to the AMTA, Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music therapists assess emotional well-being, physical health, social functioning, communication abilities, and cognitive skills through musical responses; design music sessions for individuals and groups based on client needs using music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, music performance, and learning through music; participate in interdisciplinary treatment planning, ongoing evaluation, and follow up. Music therapists may work in a variety of settings including psychiatric hospitals, rehabilitative facilities, medical hospitals, outpatient clinics, day care treatment centers, agencies serving persons with developmental disabilities, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice. There is no current licensure requirement for music therapists to practice in California.

Certification Board for Music Therapists (CBMT). The CBMT is responsible for the voluntary certification and recertification of music therapists. In order to obtain certification, an individual must have completed a bachelor's degree or higher in music therapy from an AMTA-approved college or university program. Upon completion of the appropriate program, an individual must take and pass an examination administered by the CBMT. The certification is good for five years. In order to get recertified, an individual must take 100 credit hours of continuing education. There are currently two schools in California that provide an approved degree program in music therapy for purposes of certification: California State University, Northridge and the University of the Pacific.

According to the CBMT, there are approximately 8,200 music therapists maintaining the MT-BC credential. As currently drafted, this bill does not require a registration or a license in order to practice music therapy in California, but instead would specify that in order to use the title “Board Certified Music Therapist” an individual must be certified by the CBMT. Additionally, this bill clarifies that persons certified by the CBMT are not authorized to provide mental health counseling which requires a license.

Music Therapy in California. According to information from the sponsor, inconsistencies in current state regulations (California Code of Regulations (CCR), Titles 9, 17, and 22) include references to obsolete credentialing agencies that no longer exist which have created confusion regarding the practice of music therapy in California.

For example, under current regulations for mental health rehabilitation centers, skilled nursing facilities, intermediate care facilities, intermediate care facilities for the developmentally disabled, and adult day health centers, the definition of "music therapist" is a person who has a bachelor's degree in music therapy and who is registered or eligible for registration as a music therapist by the National Association for Music Therapy, (9 CCR § 782.36, 17 CCR § 54342, 22 CCR § 72069, 22 CCR § 73065, 22 CCR § 76105, 22 CCR § 78065). The National Association for Music Therapy no longer registers music therapists, as it is now handled by the CBMT. However, the current Department of Education Regulations for purposes of special education, have already revised those regulations to update the certifying entity and specify that music therapy may be provided only by personnel who hold a certifying credential from the CBMT on the completion of all academic and clinical training requirements (5 CCR Section 3051.21). Because there may be a number of individuals who may be music therapists currently employed by the state of California who do not have a certification from the CBMT, and this bill specifies that those currently employed would not need to obtain a certification.

The author notes that official state recognition of music therapists will help healthcare facilities that rely upon state regulations to address the confusion regarding the difference between music therapists, music practitioners, music thanatologists, and other non-music therapy musicians in healthcare.

Title Act vs. Practice Act. There is an important distinction between regulations which require licensure and those which protect a professional title. Statutes regulating professions in California generally fall into two categories: a "practice act" or a "title act." A “practice act" regulates the duties, responsibilities and scope of practice that a licensee can perform upon meeting specific educational, experiential or training requirements. A “title act" simply regulates the use of the title an individual may use in practice. In order to be permitted to use a title, a state may require proof that an individual has a certain level of experience or education relevant to the particular title being regulated. Title protection is generally intended to be a means of market differentiation whereas a "practice act" would literally prohibit individuals from engaging in the practice regardless of how it is described. As currently written, this bill would allow individuals to continue to practice music therapy in California but they would be prohibited from using the title "Board Certified Music Therapist" unless they meet certain criteria.

1. Prior Related Legislation. AB 1279 (Holden of 2015) would have established the Music Therapy Act and provided that only a qualified individual, as specified, may call himself or herself a "Board Certified Music Therapist." (Status: This bill was vetoed by the Governor. “Generally, I have been very reluctant to add licensing or title statutes to the laws of California. This bill appears to be unnecessary as the Certification Board for Music Therapists, a private sector group, already has defined standards for board certification.”)

AB 161 (Chau) of 2015 would have established certification and training requirements for athletic trainers and prohibit individuals from calling themselves athletic trainers unless they meet those requirements. (Status: The bill was vetoed by Governor Brown who wrote in his veto message that the conditions set forth in the bill “impose unnecessary burdens on athletic trainers without sufficient evidence that they are really needed.”)

1. Arguments in Support. The Certification Board of Music Therapists writes in support, “Music therapy is a unique marriage of music and science—particularly neuroscience. Practitioners works with people of all ages in providing services and treatment in the areas of medical illness, traumatic brain injury, autism, developmental disability, memory impairment, oncology support, special education, neonatal intensive care, stroke, Parkinson’s Disease, trauma, post-traumatic stress disorders, early interventions (birth-3 years) and the terminally ill to name a few.”

The American Federation of State, County and Municipal Employees writes in support, “[This bill] would bring clarity to the music therapy profession regulations by establishing a standard definition of music therapy and ensure continuity and uniformity of service for all who practice and receive music therapy.”

SUPPORT AND OPPOSITION:

Support:

Certification Board for Music Therapists (Sponsor)

American Federation of State, County and Municipal Employees

Opposition:

None on file as of June 18, 2019

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 1540

Author:(Holden)

As Amended Ver:April 25, 2019

Majority vote

SUMMARY:

Establishes the Music Therapy Act and prohibits an individual from using the title "Board Certified Music Therapist" unless the individual meets specified educational requirements and is certified by the Certification Board for Music Therapists.

Major Provisions

1. Defines "music therapy" to mean the clinical and evidence-based use of music therapy interventions in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational settings to address physical, emotional, cognitive, and social needs of individuals within a therapeutic relationship.
2. Specifies that music therapy includes the following:
   1. The development of music therapy treatment plans specific to the needs and strengths of the client who may be seen individually or in groups.
   2. The creation of music therapy plans that establish goals, objectives, and potential strategies of the music therapy services appropriate for the client and setting.
3. Defines "music therapy interventions" as including music, improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music.
4. Prohibits individuals who provide music therapy from referring to themselves using the title "Board Certified Music Therapist" unless they have completed specified education and training requirements, including a minimum of 1,200 hours of supervised clinical work through preinternship training at an approved degree program and internship training through an approved national roster or university affiliated internship program, or the equivalent.
5. Clarifies that a music therapist currently employed by the State of California is not required to obtain certification as a Board Certified Music Therapist.
6. Makes technical clarifications.

COMMENTS:

According to the American Music Therapy Association, music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It also states that music therapists work in a variety of settings including psychiatric treatment centers, outpatient clinics, community mental health centers, substance abuse programs, group homes, rehabilitation facilities, medical hospitals, senior centers, schools, hospice and other facilities.

According to the Author:

"[This bill] creates a uniform definition for music therapy services and clearly defines what education and clinical training requirements must be completed in order to practice as a music therapist in California. Music therapists use music interventions to accomplish non-musical goals for people of all ages and ability levels within a therapeutic relationship. This bill would protect consumers from potential harm or misrepresentation from unqualified individuals that are not practicing under the Certification Board for Music Therapists (CBMT) Code of Professional Practice."

Arguments in Support:

According to the Certification Board for Music Therapists, "In State government alone, there are inconsistent definitions and references to registration and credentialing organizations that are obsolete that have not been updated since 1979. These inconsistencies and outdated references… have created confusion regarding the practice of music therapy, not only in the public, but within state service in the various departments that use music therapists. Seeing the need for clarity regarding the music therapy profession, the California Department of Education adopted the national Certification Board for Music Therapists' definition for music therapy in 2014. [This bill] not only incorporates those definitions and standards but also provides the template and statutory authority for other state departments to follow suit. Music therapists typically work on interdisciplinary teams, often in close collaboration with neuroscience. It is essential that music therapy be delivered by those who are not only trained in music, but also the neurological processes of the brain, which is clearly articulated in the education and training programs for certified music therapists."

Arguments in Opposition:

None on file.

FISCAL COMMENTS:

Unknown. This bill is keyed non-fiscal by the Legislative Counsel.

VOTES:

ASM BUSINESS AND PROFESSIONS: 20-0-0

YES: Low, Brough, Bloom, Chen, Chiu, Cunningham, Dahle, Eggman, Fong, Gipson, Gloria, Grayson, Holden, Irwin, McCarty, Medina, Mullin, Obernolte, Ting, Wood

UPDATED:

VERSION: April 25, 2019

CONSULTANT: Vincent Chee / B. & P. / (916) 319-3301 FN: 0000253

ASSEMBLY THIRD READING

ATR Bill Id:AB 1540

Author:(Holden)

As Introduced Ver:February 22, 2019

Majority vote

SUMMARY:

Establishes the Music Therapy Act and prohibits an individual from using the title "Board Certified Music Therapist" unless the individual meets specified educational requirements and is certified by the Certification Board for Music Therapists.

Major Provisions

1. Defines "music therapy" to mean the clinical and evidence-based use of music therapy interventions in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational settings to address physical, emotional, cognitive, and social needs of individuals within a therapeutic relationship.
2. Specifies that music therapy includes the following:
   1. The development of music therapy treatment plans specific to the needs and strengths of the client who may be seen individually or in groups.
   2. The creation of music therapy plans that establish goals, objectives, and potential strategies of the music therapy services appropriate for the client and setting.
3. Defines "music therapy interventions" as including music, improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music.
4. Prohibits individuals who provide music therapy from referring to themselves using the title "Board Certified Music Therapist" unless they have completed specified education and training requirements, including a minimum of 1,200 hours of supervised clinical work through preinternship training at an approved degree program and internship training through an approved national roster or university affiliated internship program, or the equivalent.
5. Makes technical clarifications.

COMMENTS:

According to the American Music Therapy Association, music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It also states that music therapists work in a variety of settings including psychiatric treatment centers, outpatient clinics, community mental health centers, substance abuse programs, group homes, rehabilitation facilities, medical hospitals, senior centers, schools, hospice and other facilities.

According to the Author:

"[This bill] creates a uniform definition for music therapy services and clearly defines what education and clinical training requirements must be completed in order to practice as a music therapist in California. Music therapists use music interventions to accomplish non-musical goals for people of all ages and ability levels within a therapeutic relationship. This bill would protect consumers from potential harm or misrepresentation from unqualified individuals that are not practicing under the Certification Board for Music Therapists (CBMT) Code of Professional Practice."

Arguments in Support:

According to the Certification Board for Music Therapists, "In State government alone, there are inconsistent definitions and references to registration and credentialing organizations that are obsolete that have not been updated since 1979. These inconsistencies and outdated references… have created confusion regarding the practice of music therapy, not only in the public, but within state service in the various departments that use music therapists. Seeing the need for clarity regarding the music therapy profession, the California Department of Education adopted the national Certification Board for Music Therapists' definition for music therapy in 2014. [This bill] not only incorporates those definitions and standards but also provides the template and statutory authority for other state departments to follow suit. Music therapists typically work on interdisciplinary teams, often in close collaboration with neuroscience. It is essential that music therapy be delivered by those who are not only trained in music, but also the neurological processes of the brain, which is clearly articulated in the education and training programs for certified music therapists.

Arguments in Opposition:

According to the American Federation of State, County and Municipal Employees, "Currently, the state hires non-certified music therapists in the California Department of State Hospitals, the CalVet Veteran Services, and the California Department of Developmental Services…. Music therapists working for the state departments have already demonstrated competency. They have received bachelor's degrees in music therapy from a recognized school and have completed internships or worked full-time as paid staff in a clinical setting. Requiring music therapy workers to become certified would cause a lot of non-certified music therapists to lose their employment in these state agencies. Although these employees are non-certified, they have worked in these positions for many years and are just as experienced as certified music therapists when providing therapy to patients. Without these employees providing music therapy, a lot of patients will also lose access to this much needed rehabilitative health service."

FISCAL COMMENTS:

Unknown. This bill is keyed non-fiscal by the Legislative Counsel.

VOTES:

ASM BUSINESS AND PROFESSIONS: 20-0-0

YES: Low, Brough, Bloom, Chen, Chiu, Cunningham, Dahle, Eggman, Fong, Gipson, Gloria, Grayson, Holden, Irwin, McCarty, Medina, Mullin, Obernolte, Ting, Wood

UPDATED:

VERSION: February 22, 2019

CONSULTANT: Vincent Chee / B. & P. / (916) 319-3301 FN: 0000222

Date of Hearing: April 9, 2019

ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS

Evan Low, Chair

ABPCA Bill Id:AB 1540

Author:(Holden) – As Introduced Ver:February 22, 2019

SUBJECT: Music therapy.

SUMMARY: Establishes the Music Therapy Act and prohibits an individual from using the title "Board Certified Music Therapist” unless the individual meets specified educational requirements and is certified by the Certification Board for Music Therapists.

EXISTING LAW:

1. Provides for the licensure and regulation of various healing arts professions and vocations under the Business and Professions Code (BPC). (BPC §§ 500-4999.129)
2. Defines “unfair competition” to mean and include any unlawful, unfair, or fraudulent business act or practice and unfair, deceptive, untrue, or misleading advertising. (BPC § 17200)
3. Prohibits unfair competition and makes a person who engages in unfair competition liable for a civil penalty not to exceed $2,500 for each violation. (BPC § 17206)

THIS BILL:

1. Establishes the Music Therapy Act.
2. States legislative findings, declarations, and intent.
3. Defines "music therapy" to mean the clinical and evidence-based use of music therapy interventions in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational settings to address physical, emotional, cognitive, and social needs of individuals within a therapeutic relationship.
4. Specifies that music therapy includes the following:
   1. The development of music therapy treatment plans specific to the needs and strengths of the client who may be seen individually or in groups.
   2. The creation of music therapy plans that establish goals, objectives, and potential strategies of the music therapy services appropriate for the client and setting.
5. Defines "music therapy interventions" as including music, improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music.
6. Prohibits individuals who provide music therapy from referring to themselves using the title “Board Certified Music Therapist” unless they have completed all of the following:
   1. A bachelors degree or its equivalent, or higher, from a music therapy degree program approved by the American Music Therapy Association using current standards, beginning with those adopted on April 1, 2015.
   2. A minimum of 1,200 hours of supervised clinical work through preinternship training at an approved degree program and internship training through an approved national roster or university affiliated internship program, or the equivalent.
   3. The current requirements for certification, beginning with those adopted on April 1, 2015, established by the Certification Board for Music Therapists for the Music Therapist-Board Certified credential.
7. Clarifies that the provisions under this bill do not authorize a person engaged in music therapy to state or imply that they provide mental health counseling, psychotherapy, or occupational therapy for which a license is required.
8. Clarifies that, while the use of music is not restricted to any profession, the use of music does not imply or suggest that the person is a Board Certified Music Therapist, if they do not meet the criteria under this bill.
9. Clarifies that it is an unfair business practice to use the title “Board Certified Music Therapist” without meeting the requirements under this bill.

FISCAL EFFECT: Unknown. This bill is keyed non-fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This bill is sponsored by the California Board of Music Therapy. According to the author, this bill “creates a uniform definition for music therapy services and clearly defines what education and clinical training requirements must be completed in order to practice as a music therapist in California. Music therapists use music interventions to accomplish non-musical goals for people of all ages and ability levels within a therapeutic relationship. This bill would protect consumers from potential harm or misrepresentation from unqualified individuals that are not practicing under the Certification Board for Music Therapists (CBMT) Code of Professional Practice.”

Background. According to the American Music Therapy Association, music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It also states that music therapists work in a variety of settings including psychiatric treatment centers, outpatient clinics, community mental health centers, substance abuse programs, group homes, rehabilitation facilities, medical hospitals, senior centers, schools, hospice and other facilities.

Certifying Board. The California Board of Music Therapy is a private sector entity that issues voluntary certificates for music therapists. According to its candidate handbook, it “was incorporated in 1983 to advance the profession of music therapy and assist the public in identifying qualified professionals by developing board certification and recertification programs for music therapists.”

The board is accredited by the National Commission for Certifying Agencies (NCCA), a national accreditor for certifying bodies. The purpose of NCCA accreditation is to ensure that the standards and competencies tested by the certifying body are psychometrically valid, meaning the certification demonstrations competency in the standards.

The board’s standards are based on the educational requirements established by the American Music Therapy Association, a professional association of music therapists that approves music therapy programs. According to the association, there are two schools in California that provide an approved degree in music therapy which are approved for certification: California State University, Northridge and the University of the Pacific.

Certified individuals are required to obtain recertification every five years. The board is currently the only entity that certifies music therapists. Prior to the current board certification process, music therapists were registered with the National Association of Music Therapy, which no longer certifies music therapists.

Title Protection. A title protection statute prohibits a person from using a specified title unless the person meets the requirements under the title protection provisions. Title protection is generally intended to be a means of market differentiation for purposes of consumer protection. Title protection is typically used when the risk of harm from the misrepresentation of a title high but the practice relevant to the title is not so demonstrably harmful that it should be limited to those who can demonstrate minimum competence. To that end, this bill would prohibit people from using the title "Board Certified Music Therapist" but would continue to allow individuals to continue to practice music therapy without meeting the requirements so long as they do not use the title.

Defining Music Therapy. According to the author and sponsor, one of the purposes of this bill is to help make a distinction between music therapy and other creative arts therapies and related professions. According to the author, inconsistencies in current state regulations include references to obsolete credentialing agencies that no longer exist and can create confusion regarding the practice of music therapy in California. By adding a standardized definition for the term “music therapy,” the author and sponsor believe that it will help ensure continuity and uniformity of service for those who practice and receive music therapy.

Reimbursement. According to the author and sponsor, professional qualifications have slowly shifted away from state regulation to federal regulation. One of the goals of this bill is to outline qualifications for music therapist employment and inclusion in funding sources.

Coverage and Access. According to the author and sponsor, state programs such as special education, Medicaid funding, and private insurance regulations often require state recognition of the profession and its credential. This may create coverage problems for consumers attempting to access music therapy services.

Health Facility Credentialing. According to the author and sponsor, national accrediting organizations, such as the Joint Commission and the Commission for Accreditation of Rehabilitation Facilities, outline within their standards the qualifications and professional requirements of staff that are permitted to practice within accredited facilities. The standards often reiterate that professionals hold the credential that is required or recognized by the state.

One of the goals of this bill is to provide state recognition of music therapists to help healthcare facilities that rely upon state regulations to address the confusion regarding the difference between music therapists, music practitioners, music thanatologists, and other non-music therapy musicians in healthcare. It also seeks to help music therapists meet the credentialing requirements of a health facility and obtain privileges to practice at the facility.

Prior Related Legislation. AB 1279 (Holden) of 2015, vetoed by Governor Brown, was substantially similar to this bill. According to the Governor’s veto message, AB 1279 was vetoed because it was duplicative of the current unfair practice prohibitions.

POLICY ISSUES:

Necessity. Currently, the misrepresentation of a title is prohibited. While this bill would additionally define a “Board Certified Music Therapist,” it is already unlawful to do so with the intent of deceiving a consumer. In addition, outdated regulations can be fixed at the agency level. However, there may be some benefit to recognize and define at the state level music therapy if misrepresentation is common and uncontrolled, there are unnecessary workforce barriers, or there is a need for greater access to music therapy services.

REGISTERED SUPPORT:

Certification Board for Music Therapists (sponsor)

REGISTERED OPPOSITION:

None on file

Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301