2012 -- S 2286 SUBSTITUTE A

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LC01054/SUB A

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

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A N A C T

RELATING TO BUSINESSES AND PROFESSIONS -- LICENSING OF GENETIC

COUNSELORS

     Introduced By: Senators Perry, Nesselbush, Sosnowski, Miller, and Pichardo

     Date Introduced: February 01, 2012

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" is

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hereby amended by adding thereto the following chapter:

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     CHAPTER 86

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GENETIC COUNSELORS

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     5-86-1. Statement of policy. -- The state of Rhode Island has an interest in regulating

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the practice of genetic counseling and in licensing genetic counselors in order to protect the

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public health, safety and welfare.

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     5-86-2. Definitions. -- As used in this chapter, the following words, shall, unless the

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context requires otherwise, have the following meanings:

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     (1) “ABGC” means the American Board of Genetic Counseling, a national agency for

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certification and recertification of genetic counselors or its successor agency.

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     (2) “ABMG” means American Board of Medical Genetics, a national agency for

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certification and recertification of genetic counselors, MD and DO geneticists and PhD

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geneticists or its successor agency.

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     (3) “Department” means the department of health.

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     (4) “Licensed genetic counselor” means a person licensed under this chapter to engage in

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the practice of genetic counseling.

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     (5) “Practice of genetic counseling” means a communication process, conducted by one

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or more appropriately trained individuals that may include:

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     (i) Estimating the likelihood of occurrence or recurrence of a birth defect or of any

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potentially inherited or genetically influenced condition. This assessment may involve:

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     (A) Obtaining and analyzing a complete health history of the person and family;

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     (B) Reviewing pertinent medical records;

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     (C) Evaluating the risks from exposure to possible mutagens or teratogens; and

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     (D) Recommending genetic testing or other evaluations to diagnose a condition or

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determine the carrier status of one or more family members;

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     (ii) Helping the individual, family, health care provider or public to:

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     (A) Appreciate the medical, psychological and social implications of a disorder,

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including its features, variability, usual course and management options;

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     (B) Learn how genetic factors contribute to the disorder and affect the chance for

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recurrence of the condition in other family members;

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     (C) Understand available options for coping with, preventing or reducing the chance of

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occurrence or recurrence of a condition;

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     (D) Select the most appropriate, accurate and cost-effective methods of diagnosis; and

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     (E) Understand genetic or prenatal tests, coordinate testing for inherited disorders, and

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interpret complex genetic test results; and

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     (iii) Facilitating an individual's or family's:

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     (A) Exploration of the perception of risk and challenge associated with the disorder;

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     (B) Decision-making regarding testing or medical interventions consistent with their

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beliefs, goals, needs, resources, culture and ethical or moral views; and

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     (C) Adjustment and adaptation to the condition or their genetic risk by addressing needs

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for psychological, social and medical support.

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     (6) “Provisional licensed genetic counselor” a person with a provisional license issued

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under section 5-86-5.

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     5-86-3. Powers and duties of department regarding licensing of genetic counselors. -

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- For the purposes of conducting its responsibilities under this chapter, the department shall have

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the following powers and duties:

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     (1) To engage persons of established reputation and known ability in genetic counseling

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as consultants to the department; the Rhode Island or New England chapter or affiliate of the

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National Society of Genetic Counselors, if existing, or their successors or equivalent, is

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designated as the appropriate body with which the department shall consult for referral of

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consultants and other assistance to the department.

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     (2) To promulgate regulations and adopt such rules as are necessary to regulate genetic

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     counselors;

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     (3) To receive, review, approve or disapprove applications for licensing, renewal and

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reinstatement and to issue those licenses;

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     (4) To establish administrative procedures for processing applications for licenses and

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license renewals and to hire or appoint such agents as are appropriate for processing applications

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for licenses and license renewals;

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     (5) To retain records of its actions and proceedings in accordance with public records

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laws;

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     (6) To define, by regulation, the appropriate standards for education and experience

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necessary to qualify for licensing, including, but not limited to, continuing professional education

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requirements for licensed genetic counselors and provisional licensed genetic counselors, which

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shall be consistent with those of the American Board of Genetic Counseling, or its successor, and

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for the conduct and ethics which shall govern the practice of genetic counseling;

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     (7) To establish standards of supervision for students or persons in training to become

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qualified to obtain a license in the occupation or profession it represents;

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     (8) To conduct hearings upon charges calling for the discipline of a licensed genetic

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counselor or for revocation of a license pursuant to section 5-86-7. The department has the power

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to issue subpoenas and compel the attendance of witnesses and administer oaths to persons giving

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testimony at hearings. The department shall cause the prosecution of all persons violating this

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chapter and has the power to incur the necessary expenses for the prosecution;

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     (9) To summarily suspend the license of a licensee who poses an imminent danger to the

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public, but a hearing shall be afforded to the licensee within seven (7) days of an action by the

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department to determine whether such summary action is warranted; and

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     (10) To perform such other functions and duties as may be required to carry out this

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chapter.

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     5-86-4. Genetic counselors; license applications; fee; proof of age; and educational

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and professional requirements. -- An application for an original license or license renewal shall

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be made on forms approved by the department. The initial fee for application for licensure is one

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hundred and seventy dollars ($170). Licenses shall be renewed every twenty-four (24) months

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after initial licensure upon payment of a fee of one hundred and seventy dollars ($170) and in

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compliance with any additional requirements that the department promulgates. An applicant for

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an original license shall furnish satisfactory evidence to the department that:

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     (1) He or she is at least eighteen (18) years old;

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     (2) Meets educational experience qualifications as follows:

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     (i) Successfully completed a genetic counseling education program approved by the

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department; provided, however, that the program shall meet the educational standards established

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by the ABGC or its successor; and provided, further, that the genetic counselor remains certified

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in accordance with the ABGC or ABMG, or their successors;

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     (ii) Earned a master’s degree from a genetic counseling training program that is

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accredited by the ABGC or an equivalent as determined by the ABGC, or a doctoral degree from

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a medical genetics training program that is accredited by the ABMG or an equivalent as

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determined by the ABMG;

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     (iii) Completed such experience as may be required by the department;

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     (3) Passed the examination for certification as:

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     (i) A genetic counselor by the American Board of Genetic Counseling or the American

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Board of Medical Genetics, or successor or equivalent; or

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     (ii) A medical geneticist by the American Board of Medical Genetics, or successor or

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equivalent.

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        5-86-5. Practice as provisional licensed genetic counselor; expiration; extension;

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supervision by professional licensed genetic counselor. -- A person who meets the

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qualifications for licensure except for the requirement in subdivision 5-86-4(3) may practice as a

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provisional licensed genetic counselor upon filing an approved application with the department

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and payment of a fee of eighty-five dollars ($85.00). Such license shall be valid for one year from

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the date of its issue and may be renewed for an additional one year if an applicant fails the ABGC

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or ABMG certification exam. Such provisional license shall expire automatically upon the

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earliest of the following:

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     (1) Issuance of a full license;

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     (2) Thirty (30) days after the applicant fails to pass the complete examination on the last

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permitted attempt as provided by the ABGC or ABMG, or their successors; or

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     (3) The date printed on the temporary license. An application for extension shall be

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signed by a supervising licensed genetic counselor. A provisional licensed genetic counselor shall

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be under the general supervision of a licensed genetic counselor or a licensed physician at all

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times during which the provisional licensed genetic counselor performs clinical genetic

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counseling. The department shall adopt rules governing such supervision and direction which

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may not require the immediate physical presence of the supervising licensed genetic counselor.

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      5-86-6. Practice of genetic counseling by unlicensed persons; exceptions. -- No

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person shall hold oneself out as a genetic counselor unless he or she is licensed in accordance

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with this chapter. No person who is not so licensed may use in connection with his or her name or

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place of business, the title “genetic counselor”, “licensed genetic counselor”, “gene counselor”,

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“genetic consultant”, “genetic associate” or any words, letters, abbreviations or insignia

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indicating or implying a person holds a genetic counseling license. Nothing in this section shall

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be construed to prevent or restrict the practice, service or activities of:

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     (1) Any person licensed, certified, or registered in the state, by any other statute other

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than as a genetic counselor from engaging in activities within the scope of practice of the

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profession or occupation for which he or she is licensed provided that he or she does not represent

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to the public, directly or indirectly, that he or she is licensed under this chapter, and that he or she

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does not use any name, title or designation indicating that the person is licensed under this

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chapter;

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     (2) Any person employed as a genetic counselor by the federal government or an agency

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thereof if such person provides genetic counseling services solely under the direction and control

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of the organization by which such person is employed;

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     (3) A student or intern enrolled in an approved genetic counseling education program if

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genetic counseling services performed by the student are an integral part of the student's course of

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study and are performed under the direct supervision of a licensed genetic counselor assigned to

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supervise the student and who is on duty and available in the assigned patient care area and if the

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person is designated by a title which clearly indicates his or her status as a student or intern;

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     (4) An individual trained as a Ph.D. or medical geneticist who is reapplying for the

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ABMG certification examination and is gathering logbook cases under a supervisor identified in

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the training program’s ABMG accreditation documents as a member of the training faculty; and

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     (5) An out-of-state genetic counselor from working as a consultant, or out-of-state

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employer or other organization from employing genetic counselors providing occasional services,

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who are not licensed pursuant to this act, from engaging in the practice of genetic counseling,

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subject to the stated circumstances and limitations as defined by the department, by regulation, so

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long as the genetic counselor holds a license, if available, in the genetic counselor’s state of

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employment. If licensure is not available in the genetic counselor’s state of employment, the

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genetic counselor shall be certified by the American Board of Genetic Counseling or the

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American Board of Medical Genetics, or their successors, in order to practice genetic counseling

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without a state license in accordance with this subsection.

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     5-86-7. Grounds for denial; refusal to renew; revocation; suspension or cancellation

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of genetic counselor license. -- The department may deny or refuse to renew a license or, after a

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hearing, revoke, suspend or cancel the license or place on probation, reprimand, censure or

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otherwise discipline a licensee upon proof satisfactory to the department that the person has:

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     (1) Obtained or attempted to obtain a license by fraud or deception;

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     (2) Been convicted of one or more of the offenses set forth in section 23-17-37;

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     (3) Been adjudged mentally ill or incompetent by a court of competent jurisdiction;

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     (4) Used illicit drugs or intoxicating liquors to the extent which adversely affects his or

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her practice;

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     (5) Engaged in unethical or unprofessional conduct including, but not limited to, willful

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acts, negligence or incompetence in the course of professional practice;

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     (6) Violated any lawful order, rule or regulation rendered or adopted by the department;

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or

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     (7) Been refused issuance or been disciplined in connection with a license issued by any

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other state or country.

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     5-86-8. Counseling concerning abortion. – Nothing in this chapter may be construed to

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require any genetic counselor to participate in counseling with respect to abortion, nor shall

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licensing of any genetic counselor be contingent upon participation in such counseling with

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respect to abortion, and the refusal of the genetic counselor to participate in such counseling with

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respect to abortion shall not form the basis for any claim of damages on account of the refusal or

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for any disciplinary or recriminatory action against the genetic counselor, provided that the

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genetic counselor clearly informs the patient, in a manner consistent with ethical standards and

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subdivision 5-86-7(5), that he or she will not participate in counseling with respect to abortion

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and offers to give the patient a list of the licensed genetic counselors in the state. The genetic

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counselor’s disclosure of non-participation and offer of a list of other licensed genetic counselors

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shall be made at the start of the counseling relationship and at other appropriate times, if any,

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based on the genetic counselor’s professional judgment.

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     5-86-9. Privileged communications. -- The provisions of section 9-17-24 shall apply to

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persons licensed pursuant to this chapter.    

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     SECTION 2. This act shall take effect upon passage.

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LC01054/SUB A

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO BUSINESSES AND PROFESSIONS -- LICENSING OF GENETIC

COUNSELORS

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     This act would provide a statutory framework for the licensing and regulations of genetic

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counselors. Also, there is nothing in the act that would be construed to require any genetic

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counselor to participate in counseling with respect to abortion, nor would any licensing of any

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genetic counselor be contingent on participation of counseling with respect to abortion.

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     This act would take effect upon passage.

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LC01054/SUB A

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