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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
genetic counselors; licensure
Purpose
Establishes licensure requirements, regulations and standards for genetic counselors. Requires, beginning January 1, 2025, a person to obtain a license to practice genetic counseling in Arizona.
Background
The Department
of Health Services (DHS) provides and coordinates public health services and
programs in Arizona by licensing and regulating various health care providers
and health care institutions (A.R.S.
§ 36-132). A health professional group seeking regulation or increase in
scope of practice must submit a written report (sunrise application) by
November 1 to the President of the Senate and the Speaker of the House of
Representatives that addresses: 1) why regulation is necessary; 2) the efforts
made to address the problem; 3) the alternatives considered; 4) the benefit to
the public if regulation is granted; 5) the extent to which regulation might
harm the public;
6) the maintenance of standards; 7) a description of the health professional
group proposed for regulation; and 8) the expected costs of regulation (A.R.S.
§ 32-3105).
On October 18, 2023, a sunrise application was submitted for the licensure of genetic counselors. Genetic counselors provide information about how a genetic condition could affect an individual or family and interpret genetic tests designed to help estimate the risk of a disease, as well as convey information to address the concerns of the individual or family, help them make an informed decision about their medical situation and provide psychological counseling to help them adapt to their condition or risk (National Human Genome Research Institute). Genetic counselors have specialized graduate training in medical genetics and counseling through programs that are accredited by the Accreditation Council for Genetic Counseling (ACGC). Currently, there are 31 ACGC-certified or ACGC-eligible genetic counselors in Arizona (Sunrise Application).
If there is a cost associated with establishing licensure requirements, regulations and standards for genetic counselors, then there may be an impact to the state General Fund (GF) associated with this legislation.
Provisions
License Application Requirements
1. Requires, beginning January 1, 2025, a person to obtain a license to practice genetic counseling in Arizona.
2. Requires, by April 1, 2025, a person who practices genetic counseling before or on the general effective date of this legislation to apply to DHS for licensure.
3. Requires an applicant for genetic counseling licensure to submit to DHS an application, required fees and satisfactory evidence of current certification.
4. Requires DHS to grant a genetic counseling license to a person who meets the prescribed qualifications and DHS Rules.
5. Permits DHS to grant licensure to applicants who provide adequate documentation of licensure or registration as a genetic counselor under another state, territory or U.S. jurisdiction with similar licensure requirements to Arizona, subject to the opinion of DHS.
6. Allows an individual who has been practicing genetic counseling and working as a genetic counselor in Arizona at least eight years before the general effective date of this legislation that does not qualify for licensure to apply to DHS for licensure by submitting:
a) documentation of a master's or higher degree in medical genetics, genetic counseling or a related field of genetic study from an ACGC-accredited program;
b) three letters of recommendation from physicians or genetic counselors who have worked with the applicant in an employment setting within the last 10 years and are able to attest to the applicant's competency in providing genetic counseling services, with at least one letter from a license-eligible genetic counselor and an American Board of Medical Genetics and Genomics-certified clinical or medical geneticist; and
c) documentation of having completed two and one-half continuing education units (CEUs) in the 12 months prior to the application date.
7. Issues all genetic counseling licenses, except for provisional licenses, for a two-year period on payment of the prescribed fees.
8. Authorizes renewal of a genetic counseling license upon the filing of a renewal application with documentation of CEU completion, prorated for the length of the license.
9. Requires a person to file a renewal application at least 30 days and no more than 60 days before the expiration date of the individual's current genetic counseling license.
Provisional License Requirements
10. Allows DHS to grant a provisional genetic counseling license to a person with active candidate status who files an application and pays the provisional license fee.
11. Validates a provisional genetic counseling license for one year after the date of issuance and allows the provisional license to be extended for one year if the applicant fails to obtain certification.
12. Expires a provisional genetic counseling license automatically on the earliest of the following:
a) issuance of a license;
b) 30 days after the applicant fails to take or pass the next available complete certification examination; or
c) the date printed on the provisional license.
13. Requires an extension application for a provisional genetic counseling license to be signed by the provisional licensee's qualified supervisor.
14. Requires a provisional licensee to work under the supervision of a qualified supervisor while practicing genetic counseling.
15. Directs the qualified supervisor and the provisional licensee to complete and maintain a supervision agreement, signed by and on file with both parties.
DHS Rules
16. Allows the Director of DHS (Director) to adopt rules to properly administer and enforce genetic counseling licensure requirements.
17. Requires the Director, by rule, to:
a) define and describe the duties and limits of the practice of genetic counseling;
b) adopt standards with respect to the practice of genetic counseling designed to safeguard patient health and safety; and
c) establish criteria for granting, denying, suspending and revoking a genetic counseling license to protect patient health and safety.
18. Directs the Director to establish a five-member Genetic Counselors Advisory Committee (Advisory Committee) that is composed of four genetic counselors and one physician.
19. Requires the Advisory Committee to assist DHS with:
a) developing, revising and adopting rules and suggesting statutory changes that are necessary to regulate genetic counselors in Arizona; and
b) any investigations and administrative proceedings concerning competency, unlawful practice or unprofessional conduct complaints of licensed genetic counselors.
20. Entitles Advisory Committee members to reimbursement of expenses.
Enforcement and Violations
21. Prohibits an individual from acting as a licensed genetic counselor as prescribed, with certain exceptions and if specified criteria are met.
22. Authorizes the Director to deny, suspend or revoke a person's genetic counseling license, if the person:
a) violates any law or rule adopted related to genetic counseling;
b) is convicted of a felony or a misdemeanor involving moral turpitude; or
c) indulges in conduct or a practice detrimental to a patient's health or safety.
23. Authorizes DHS to deny licensure to a person without holding a hearing and allows the person to appeal a licensure denial decision.
24. Requires DHS to conduct a hearing to suspend or revoke a genetic counseling license in accordance with prescribed administrative hearing procedures.
25. Allows, upon the Director's determination that grounds exist to suspend or revoke a genetic counseling license at a hearing, the Director to suspend or revoke a person's license under any conditions the Director deems appropriate, and allows the person to appeal the final decision.
26. Allows the Director, in addition to any other disciplinary action, to assess a civil penalty of no more than $100 per violation as determined by a hearing and specifies that each day a violation continues constitutes a separate offense.
27. Authorizes the Attorney General (AG) or a county attorney to bring an action in the name of Arizona to enforce a civil penalty and requires that such action be filed in superior court or justice court in the county where the violation occurred.
28. Allows the Director, in addition to other available remedies, to apply to a superior court for an injunction to restrain a person from violating genetic counseling licensing requirements and:
a) requires the court to grant a temporary restraining order, a preliminary injunction or a permanent injunction without bond;
b) allows the defendant to be served in any Arizona county; and
c) requires the action to be brought on behalf of the Director by the AG or a county attorney of the county where the violation occurs.
29. Requires a provisional genetic counseling licensee who loses active candidate status to immediately surrender the license to DHS.
30. Requires a person whose genetic counseling license is suspended, revoked or surrendered to promptly deliver the license to DHS.
31. Authorizes the Director to investigate information indicating a potential violation of genetic counseling licensure requirements.
32. Allows DHS, in an investigation, to examine and copy documents and other physical evidence that relates to the conduct or competency of a genetic counselor, subject to genetic counseling licensing requirements.
33. Allows the Director in an investigation or an administrative proceeding to:
a) issue subpoenas to compel witness testimony or demand production of relevant documents and other physical evidence; and
b) obtain a compliance order issued by a superior court if a person refuses to comply with a subpoena.
34. Deems, as not public record or subject to publication, any patient record, findings and genetic counseling information kept by the Director for an investigation or an administrative proceeding.
35. Requires the Director to keep the names of patients and families whose records are reviewed during an investigation or administrative hearing confidential.
36. Classifies, as a class 6 felony:
a) obtaining genetic counseling licensure by fraud, intentional misrepresentation or deceit;
b) practicing genetic counseling without a license; and
c) practicing genetic counseling after a person's license has been denied, suspended or revoked.
37. Declares it a violation of genetic counseling licensure laws for a person who is not a licensed genetic counselor to use the title licensed genetic counselor, the abbreviation L.G.C. or any other indication that the person is licensed.
Licensing Fees
38. Requires the Director to prescribe in DHS rule and collect fees for each of the following:
a) an initial genetic counseling license application;
b) a one-year provisional genetic counseling license and, if granted, $100 for a one-year provisional license extension;
c) a two-year genetic counseling license;
d) a two-year renewal of a genetic counseling license; and
e) an application for reinstatement of an expired genetic counseling license.
39. Allocates the collection of licensing and renewal fees as follows:
a) 90 percent of fees in the DHS Health Services Licensing Fund; and
b) 10 percent of the fees in the state GF.
Miscellaneous
40. Defines relevant terms.
41. Makes conforming changes.
42. Becomes effective on the general effective date.
Prepared by Senate Research
January 12, 2024
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