Amendment #1141 to H4400

Licensing of Genetic Counselors

Mr. Chan of Quincy moves to amend the bill by adding the following 2 sections:

"SECTION XXXX. Chapter 112 of the General Laws is hereby further amended by striking out sections 252, 254, 255, 256, and 257, as appearing in the 2016 Official Edition, and inserting in place thereof the following sections:-

Section 252. As used in sections 252 to 258, inclusive, the following words, shall unless the context requires otherwise, have the following meanings:-

“ABGC”, the American Board of Genetic Counseling, a national agency for certification and recertification of genetic counselors or its successor agency.

“ABMGG”, American Board of Medical Genetics and Genomics, a national agency for certification and recertification of genetic counselors, MD geneticists and PhD geneticists or its successor agency.

“ACGC”, Accreditation Council for Genetic Counseling, a national agency for accreditation of genetic counselor training programs or its successor agency.

“Board”, the board of registration of genetic counselors.

“General supervision”, a supervisor, whether a licensed genetic counselor or MD, who has the overall responsibility to assess the work of the supervisee, whether a provisional or fully-licensed genetic counselor, including regular meetings and chart review; provided, however, that an annual supervision contract signed by the supervisor and supervisee shall be on file with both parties.

“Licensed genetic counselor”, a person licensed under section 105 of chapter 13 to engage in the practice of genetic counseling.

“Practice of genetic counseling”, a communication process, conducted by 1 or more appropriately trained individuals that may include:

(a) obtain and evaluate individual, family, and medical histories to determine genetic risk for genetic/medical conditions and diseases in a patient, his/her offspring, and other family members;

(b) discuss the features, natural history, means of diagnosis, genetic and environmental factors, and management of risk for genetic/medical conditions and diseases;

(c) identify, order, and coordinate genetic laboratory tests and other diagnostic studies as appropriate for the genetic assessment;

(d) integrate genetic laboratory test results and other diagnostic studies with personal and family medical history to assess and communicate risk factors for genetic/medical conditions and diseases;

(e) explain the clinical implications of genetic laboratory tests and other diagnostic studies and their results;

(f) evaluate the client's or family's responses to the condition or risk of recurrence and provide client-centered counseling and anticipatory guidance;

(g) identify and utilize community resources that provide medical, educational, financial, and psychosocial support and advocacy;

(h) provide written documentation of medical, genetic, and counseling information for families and health care professionals; or

(i) any other criteria the board deems appropriate and consistent with provisions above.

"Provisional licensed genetic counselor", a person with a provisional license issued under section 230.

Section 254. An applicant for registration as a genetic counselor shall have:

(a) successfully completed a genetic counseling education program approved by the board; provided, however, that the program shall meet the educational standards established by the ACGC or its successor; and provided further that the board shall require continuing education as a condition for license renewals;

(b) earned a master’s degree from a genetic counseling training program that is accredited by the ACGC or an equivalent as determined by the ACGC, or a doctoral degree from a medical genetics training program that is accredited by the ABMGG or an equivalent as determined by the ABMGG; and

(c) completed such experience as may be required by the board.

Section 255. A person who meets the qualifications to be admitted to the examination for licensure as a genetic counselor may,  apply to practice as a provisional licensed genetic counselor by filing an approved application with the board and payment of a fee to be determined by the secretary of administration and finance. The board may grant a provisional license to a person who successfully completes a genetic counseling education program approved by the board and is qualified to be admitted to the examination. Such license shall be valid for 1 year from the date of its issue and may be renewed for an additional 1 year if an applicant fails the first sitting of the ABGC or ABMGG certification exam. Such provisional license shall expire automatically upon the earliest of the following:

(a) issuance of a full license;

(b) 30 days after the applicant fails to pass the complete examination; or

(c) the date printed on the temporary license.

An application shall be signed by a supervising licensed genetic counselor. A provisional licensed genetic counselor shall be under the general supervision of a licensed genetic counselor or a licensed physician with current ABMGG certification in clinical genetics at all times during which the provisional licensed genetic counselor performs clinical genetic counseling. The board shall adopt rules governing such supervision and direction which may not require the immediate physical presence of the supervising licensed genetic counselor.

Section 256. (a) The board shall examine applicants for certification as genetic counselors at such times and places as it may determine. The examination shall meet the standards established by the ACGC. The examination shall test an applicant's knowledge of basic and clinical sciences as they relate to genetic counseling theory and practice and other subjects as the board may deem useful to determine the applicant's fitness to act as a genetic counselor. The board may utilize a national examination that meets the requirements of this section.

(b) The board shall examine applicants for certification as Ph.D. medical geneticists at such times and places as it may determine. The examination shall meet the standards established by the ABMGG. The examination shall test an applicant's knowledge of basic and clinical sciences as they relate to genetic counseling theory and practice and other subjects as the board may deem useful to determine the applicant's fitness to act as a genetic counselor. The board may utilize a national examination that meets the requirements of this section.

Section 257. No person shall hold himself out as a genetic counselor unless he is licensed in accordance with section 255 or section 105 of chapter 13. No person who is not so licensed may use in connection with his name or place of business, the title “genetic counselor”, “licensed genetic counselor”, “gene counselor”, “genetic consultant”, “genetic associate” or any words, letters, abbreviations or insignia indicating or implying a person holds a genetic counseling license.

Nothing in this section shall be construed to prevent or restrict the practice, service or activities of:

(a) any person licensed, certified, or registered in the commonwealth, by any other statute other than as a genetic counselor from engaging in activities within the scope of practice of the profession or occupation for which he is licensed provided that he does not represent to the public, directly or indirectly, that he is licensed under section 255 or section 105 of chapter 13, and that he does not use any name, title or designation indicating that the person is licensed under those sections;

(b) any person employed as a genetic counselor by the federal government or an agency thereof if such person provides genetic counseling services solely under the direction and control of the organization by which he is employed;

(c) a student or intern enrolled in an approved genetic counseling education program if genetic counseling services performed by the student are an integral part of the student's course of study and are performed under the direct supervision of a licensed genetic counselor assigned to supervise the student and who is on duty and available in the assigned patient care area and if the person is designated by a title which clearly indicates his status as a student or intern;

(d) an individual trained as a Ph.D. medical geneticist who is reapplying for the ABMGG certification examination and is gathering logbook cases under a supervisor identified in the training program’s ABMGG accreditation documents as a member of the training faculty; and

(e) visiting ABGC or ABMGG-certified genetic counselors from outside the commonwealth operating as consultants or the use of occasional services of organizations from outside the commonwealth employing ABGC or ABMGG-certified genetic counselors.

SECTION XXXX. Chapter 112 of the General Laws is hereby amended by inserting after section 258 the following sections:-

Section 258A. Notwithstanding sections 252 to 258, inclusive, of chapter 112 of the General Laws, the initial appointment of genetic counselors to the board of registration of genetic counselors, in accordance with section 105 of chapter 13 of the General Laws, shall consist of persons eligible for licensing as genetic counselors who shall apply for and receive such licenses as genetic counselors within 90 days after the board has issued its first license. The initial appointments to the board shall be for terms of 3 years.

Section 258B. Notwithstanding sections 252 to 258, inclusive, of chapter 112 of the General Laws, a person shall be eligible until 1 year from the effective date of this act to make application to the board and to receive a license if the person is actively engaged in the practice of genetic counseling consistent with said sections 252 to 258, inclusive, of said chapter 112.".

Additional co-sponsor(s) added to Amendment #1141 to H4400

Licensing of Genetic Counselors