Proposal Summary/ Overview
Name: Briana Colton, Nikki Kutil, Emily Taylor
Organization: Minnesota Art Therapy Licensure Coalition
Phone: (612) 849-6865 (Briana Colton - mobile)
Email Address:
bcolton.mcat14@gmail.com (Briana Colton, Licensure Chair)
Is this proposal regarding:
New or increased regulation of an existing profession/occupation? If so, complete this form, Questionnaire A.
Increased scope of practice or decreased regulation of an existing profession? If so, complete Questionnaire B.
Any other change to regulation or scope of practice? If so, please contact the Committee Administrator to discuss how to proceed.
1) State the profession/occupation that is the subject of the proposal.
Clinical Art Therapy
2) Briefly describe the proposed change.
Creation of a license to ensure that only qualified practitioners are able to bill themselves as art therapists, claim to provide art therapy services, or use any titles or letters that would suggest that they do either of the above
3) If the proposal has been introduced, provide the bill number and names of House and Senate sponsors. If the proposal has not been introduced, indicate whether legislative sponsors have been identified. If the bill has been proposed in previous sessions, please list previous bill numbers and years of introduction.
Rep. Esther Agbaje is the primary bill author for this legislation in the House -- HF2743. Reps. Jerry Newton and Matt Norris are co-authors. The authors in the Senate are Sen. John Hoffman, Sen. Matt Klein, and Sen. Liz Bolden. The Senate bill does not have a number yet.
4) Given the press of business in the 2023 legislative session it is unlikely that health licensing and scope of practice bills will be taken up this year. If there is an urgent need that this bill be heard this year, please explain the urgency.
National changes to the landscape of mental health professions are coming together to create a major problem for art therapists, especially in the next 1-2 years and beyond.
Historically, CAHEP accredited art therapy educational programs have been considered substantially similar to CAACREP accredited counseling programs inasmuch as they cover the vast majority, if not all, of the basic curriculum of counseling programs with the addition of art therapy specific coursework.
As the counseling profession, nationally, moves toward advancing the counseling interstate compact (anticipated to be in place in 2023 or 2024), they are as a result, tightening regulations around licensure to exclude a host of other master’s level mental health professions who have historically utilized the titles under which they are licensed.
As such, art therapy, which has, as a profession, relied on licensure under counseling titles for several decades, is in a position which represents an existential threat to the profession at large if nothing is done. In Minnesota in particular, this impacts recent art therapy graduates who would, under current regulations, be eligible for licensure as clinical counselors in the next few years but would not be eligible with the tighter regulations under the interstate compact. An independent clinical art therapy license provides an avenue for them to achieve licensure regardless of what happens with the interstate compact.
Questionnaire A: New or increased regulation (adapted from Mn Stat 214.002 subd 2 and MDH Scope of Practice Tools)
This questionnaire is intended to help legislative committees decide which proposals for new or increased regulation of health professions should receive a hearing and advance through the legislative process. It is also intended to alert the public to these proposals and to narrow the issues for hearing.
This form must be completed by the sponsor of the legislative proposal. The completed form will be posted on the committee’s public web page. At any time before the bill is heard in committee, opponents may respond in writing with concerns, questions, or opposition to the information stated and these documents will also be posted. The Chair may request that the sponsor respond in writing to any concerns raised before a hearing will be scheduled.
A response is not required for questions which do not pertain to the profession/occupation (indicate “not applicable”). Please be concise. Refer to supporting evidence and provide citation to the source of the information where appropriate.
New or increased regulation of health professions is governed by Mn State 214. Please read and be familiar with those provisions before submitting this form.
While it is often impossible to reach complete agreement with all interested parties, sponsors are advised to try to understand and to address the concerns of any opponents before submitting the form.
Who does the proposal impact?
Define the occupations, practices, or practitioners who are the subject of this proposal.
Art therapy, the practice of art therapy, and art therapists. Art therapy is defined in the legislation as follows:
"Art therapy" means the integrative application of psychotherapeutic principles and methods with specialized training in art media, the neurobiological implications of art-making, and art-based assessment models to assist an individual, family, or group to improve cognitive and sensory-motor functions, increase self-awareness and self-esteem, cope with grief and traumatic experience, resolve conflicts and distress, and enhance social functioning.
This regulation will not impact individuals who fall under the following exemptions:
(l) a person employed as a clinical art therapist by the federal government or any federal
agency if the person is providing services under the direction and control of the employer;
(2) a student enrolled in an art therapy academic program with an accredited educational
institution while practicing clinical art therapy under supervision if such practice constitutes
4.3 part of the student's approved course of study and the student is designated by a title such
4.4 as "student," "trainee," or any other title that clearly indicates training status;
4.5 (3) a nonresident who is licensed as a clinical art therapist or its equivalent under the
4.6 law of their state of residence who is practicing clinical art therapy in the state for up to 30
4.7 days during any calendar year;
4.8 (4) a person licensed or regulated under the laws of this state in another profession or
4.9 occupation, if the person is performing art therapy incidental to the person's professional
4.10 scope of practice, if the person does not represent their practice as clinical art therapy, use
4.11 any of the protected titles under subdivision 2, or otherwise hold themselves out to the public
4.12 by any title or description stating or implying that they are licensed to engage in the practice
4.13 of clinical art therapy, unless they are licensed under sections 148B.73 to 148B.89;
4.14 (5) a rabbi, priest, minister, or clergyperson of any religious denomination or sect,
4.15 provided the activities and services are within the scope of the performance of regular or
4.16 specialized ministerial duties; or
4.17 (6) an unlicensed complementary and alternative health care practitioner performing a
4.18 complementary and alternative health care practice as defined under chapter 146A, if the
4.19 person does not represent their practice as clinical art therapy or art therapy, use any of the
4.20 protected titles under subdivision 2, or otherwise hold themselves out to the public by any
4.21 title or description stating or implying that they are licensed to engage in the practice of
4.22 clinical art therapy, unless they are licensed under sections 148B.73 to 148B.89.
List any associations or other groups representing the occupation seeking regulation and the approximate number of members of each in Minnesota
As of December 2023, the number of Minnesota Art Therapists listed as members of the American Art Therapy Association is 123.
Describe the work settings, and conditions for practitioners of the occupation, including any special geographic areas or populations frequently served.
Art therapy is practiced in clinical one on one or group settings serving a wide range of populations including but not limited to the elderly, those with learning disabilities, individuals from backgrounds in which traditional talk therapy is heavily stigmatized, veterans suffering from post traumatic stress disorder, and children struggling to express trauma.
Describe the work duties or functions typically performed by members of this occupational group and whether they are the same or similar to those performed by any other occupational groups.
Art therapists provide mental health services to a number of distinct client groups utilizing many similar tools and modalities to those utilized by professional counselors and marriage and family therapists with the addition of art therapy specific interventions which require additional specific training gained during art therapy masters degree studies.
Specialized training, education, or experience (“preparation”) required to engage in the occupation
What preparation is required to engage in the occupation? How have current practitioners acquired that preparation?
Art therapy is a master’s level mental health care profession requiring completion of all ACATE degree requirements, supervised practice hours, in addition to the requirements for whichever license the practitioner has pursued to gain licensure as a mental health practitioner within the state. At present art therapists, in general, complete educational and supervised practice requirements before attaining licensure under a related title.
Would the proposed regulation change the way practitioners become prepared? If so, why and how? Include any change in the cost of entry to the occupation. Who would bear these costs?
The proposed legislation would allow art therapists to be licensed more easily rather than relying on special exemptions predicated on language allowing for ‘substantially similar’ educational backgrounds and require special examination by the licensing board or staff. Ultimately, this would not change, substantially, the requirements for licensure, and reduce licensing board time required per new granted license by creating a more tailored streamline process for licensure of art therapists
Is there an existing model of this change being implemented in another state? Please list state, originating bill and year of passage?
There are art therapy licenses in 12 states and the District of Columbia, the most recent similar model passing in Tennessee in 2021 with SB0101 and HB0183.
If current practitioners in Minnesota lack any training, education, experience, or credential that would be required under the new regulation, how does the proposal address that lack?
At present, any mental health practitioner, or anyone at all, can present themselves as art therapists. In the case of other licensed mental health practitioners, there is nothing preventing an unqualified practitioner from attempting to utilize art therapy methods and billing themselves as art therapists, and in the case of unlicensed individuals, so long as they are able to avoid protected scope of practice of other mental health professions, there is, similarly, nothing preventing such misleading claims.
Would new entrants into the occupation be required to provide evidence of preparation or be required to pass an examination? If not, please explain why not. Would current practitioners be required to provide such evidence? If not, why not?
Minimum requirements for entry into the profession are generally set at completion of a masters degree, completion of supervised hours requirements, and receipt of a passing score on the Art Therapy Credentials Board’s board certification exam. Current practitioners would need to provide evidence of passage of the examination, though many already hold the board certified credential which would achieve that end.
Supervision of practitioners
How are practitioners of the occupation currently supervised, including any supervision within regulated institution or by a regulated health professional? How would the proposal change the provision of supervision?
Supervision is able to be provided by Board Certified art therapists or (in part) other licensed mental health practitioners.
Does a regulatory entity currently exist or does the proposal create a regulatory entity? What is the proposed scope of authority of the entity? (For example, will it have authority to develop rules, determine standards for education and training, assess practitioners’ competence levels?) Has the proposed change been discussed with the current regulatory authority? If so, please list participants and date.
This legislation seeks to create an advisory council under the board of marriage and family therapists which would expand the scope of its authority to include art therapists as well as marriage and family therapists. We met with the board members on 1/20/23 to discuss adoption of this model.
Do provisions exist to ensure that practitioners maintain competency? Describe any proposed change.
Practitioners are required to demonstrate maintenance of competency through a continuing education quota.
Level of regulation (See Mn Stat 214.001, subd. 2, declaring that “no regulations shall be imposed upon any occupation unless required for the safety and well-being of the citizens of the state.” The harm must be “recognizable, and not remote.” Ibid.)
Describe the harm to the public posed by the unregulated practice of the occupation or by the continued practice at its current degree of regulation.
The public is at risk of financial harm and of harm to their health or mental wellbeing. Financially, the degree of confusion present in the marketplace is such that individuals seeking art therapy services are not reasonably able to delineate between qualified art therapy providers and individuals providing ‘art for mental health’ services under the guise of art therapy or individuals attempting to practice art therapy without adequate training. In either event, untrained individuals are unable to provide the service that the consumer reasonably expects and should be entitled to when contracting art therapy services, leading, minimally, to a financial loss. In the most severe cases, this loss can encompass far more than the inability to make fully informed decisions about retaining services. Untrained individuals attempting to render art therapy services has resulted in disaster on a number of occasions resulting in worsening of the symptoms being experienced by the client, refusal on the part of the client to seek mental healthcare, generally, for extended periods of time, and general failure to address the complaint of the client.
Explain why existing civil or criminal laws or procedures are inadequate to prevent or remedy any harm to the public.
At present, there are no civil or criminal law procedures to remedy this harm to the public. Without the title and practice protection granted by licensure, there is no legal remedy for those harmed by an individual calling themselves an art therapist beyond civil lawsuits. There is no systematic way for individuals in the public to reliably distinguish between qualified an unqualified providers in the way that an individual can distinguish between licensed and unlicensed providers.
Explain why the proposed level of regulation has been selected and why a lower level of regulation was not selected.
Licensure is the only level of regulation which disallows individuals not meeting the minimum criteria for practice from utilizing the title “art therapist” or “licensed art therapist”. In a marketplace already confused by a proliferation of “art for mental health”, “art for wellbeing”, and “healing art” among other things, the ability of potential clients to distinguish between an individual providing art therapy services and art for mental health services is already fraught with potentially misleading claims and advertising, to expect potential clients to also delve into the academic credentials of each potential provider is simply to expect too much.
Implications for Health Care Access, Cost, Quality, and Transformation
Describe how the proposal will affect the availability, accessibility, cost, delivery, and quality of health care, including the impact on unmet health care needs and underserved populations. How does the proposal contribute to meeting these needs?
The proposed legislation will increase availability of art therapy services throughout the state, open the door to more insurance reimbursement options for clients, ensure that all providers are adequately qualified to render art therapy services, and generally make Minnesota a more appealing place to stay for art therapy graduates from the state’s programs. In general, we see a substantial increase in the number of art therapists within a state once licensing legislation is passed and, with them, better access to mental healthcare, generally, as art therapists proliferate and serve traditionally underserved communities.
Describe the expected impact of the proposal on the supply of practitioners and on the cost of services or goods provided by the occupation. If possible, include the geographic availability of proposed providers/services. Cite any sources used.
The proposed legislation is likely to have the effect of substantially increasing the supply of art therapists in the state. In other states where art therapy has been licensed, we have experienced an increase in retention of graduates from art therapy programs and an influx of new art therapists into the state, especially in cases where the new license is the first in a region.
Does the proposal change how and by whom the services are compensated? What costs and what savings would accrue to patients, insurers, providers, and employers?
The proposed legislation does not directly impact how or by whom services are compensated but licensure has in some cases led to wider insurance coverage leading to greater affordability for clients
Describe any impact of the proposal on an evolving health care delivery and payment system (e.g., collaborative practice, innovations in technology, ensuring cultural competency, value-based payments)?
State recognition of art therapy on a par with the rest of the allied mental health professions will help to allow art therapy to serve successfully as part of holistic care plans, will increase awareness of art therapy, spurring innovation, and require the cultural competency of practitioners in the state through tailored continuing education requirements.
What is the expected regulatory cost to state government? Is there an up-to-date fiscal note for the proposal? How are the costs covered under the proposal?
In all comparable cases, art therapy licenses have operated at a budgetary surplus.
Evaluation/Reports
Describe any plans to evaluate and report on the impact of the proposal if it becomes law, including focus and timeline. List the evaluating agency and frequency of reviews.
N/A
Support for and opposition to the proposal
What organizations are sponsoring the proposal? How many members do these organizations represent in Minnesota?
American Art Therapy Association: 123
List organizations, including professional, regulatory boards, consumer advocacy groups, and others, who support the proposal.
MN Board of Marriage and Family Therapy
MN Board of Behavioral Health and Therapy
MN Board of Social Work
Individual employers of current art therapists
List any organizations, including professional, regulatory boards, consumer advocacy groups, and others, who have indicated concerns/opposition to the proposal or who are likely to have concerns/opposition. Explain the concerns/opposition of each, as the sponsor understands it.
N/A
What actions has the sponsor taken to minimize or resolve disagreement with those opposing or likely to oppose the proposal?
N/A
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