S.F. 2023 Section 1. Section 135.24, subsection 7, paragraph d, Code 1 2018, is amended to read as follows: 2 d. “Health care provider” means a physician licensed under 3 chapter 148 , a chiropractor licensed under chapter 151 , a 4 physical therapist licensed pursuant to chapter 148A , an 5 occupational therapist licensed pursuant to chapter 148B , 6 a podiatrist licensed pursuant to chapter 149 , a physician 7 assistant licensed and practicing under a supervising physician 8 pursuant to chapter 148C , a licensed practical nurse, a 9 registered nurse, or an advanced registered nurse practitioner 10 licensed pursuant to chapter 152 or 152E , a respiratory 11 therapist licensed pursuant to chapter 152B , a dentist, dental 12 hygienist, or dental assistant registered or licensed to 13 practice under chapter 153 , an optometrist licensed pursuant to 14 chapter 154 , a psychologist licensed pursuant to chapter 154B , 15 a social worker licensed pursuant to chapter 154C , a mental 16 health counselor , a clinical art therapist, or a marital and 17 family therapist licensed pursuant to chapter 154D , a speech 18 pathologist or audiologist licensed pursuant to chapter 154F , a 19 pharmacist licensed pursuant to chapter 155A , or an emergency 20 medical care provider certified pursuant to chapter 147A . 21 Sec. 2. Section 147.1, subsections 3 and 6, Code 2018, are 22 amended to read as follows: 23 3. “Licensed” or “certified” , when applied to a physician 24 and surgeon, podiatric physician, osteopathic physician and 25 surgeon, physician assistant, psychologist, chiropractor, 26 nurse, dentist, dental hygienist, dental assistant, 27 optometrist, speech pathologist, audiologist, pharmacist, 28 physical therapist, physical therapist assistant, occupational 29 therapist, occupational therapy assistant, orthotist, 30 prosthetist, pedorthist, respiratory care practitioner, 31 practitioner of cosmetology arts and sciences, practitioner 32 of barbering, funeral director, dietitian, marital and 33 family therapist, clinical art therapist, mental health 34 counselor, respiratory care and polysomnography practitioner, 35 -1- LSB 5442XS (4) 87 ss/rh 1/ 11

S.F. 2023 polysomnographic technologist, social worker, massage 1 therapist, athletic trainer, acupuncturist, nursing home 2 administrator, hearing aid specialist, or sign language 3 interpreter or transliterator means a person licensed under 4 this subtitle . 5 6. “Profession” means medicine and surgery, podiatry, 6 osteopathic medicine and surgery, practice as a physician 7 assistant, psychology, chiropractic, nursing, dentistry, 8 dental hygiene, dental assisting, optometry, speech 9 pathology, audiology, pharmacy, physical therapy, physical 10 therapist assisting, occupational therapy, occupational 11 therapy assisting, respiratory care, cosmetology arts and 12 sciences, barbering, mortuary science, marital and family 13 therapy, clinical art therapy, mental health counseling, 14 polysomnography, social work, dietetics, massage therapy, 15 athletic training, acupuncture, nursing home administration, 16 practice as a hearing aid specialist, sign language 17 interpreting or transliterating, orthotics, prosthetics, or 18 pedorthics. 19 Sec. 3. Section 147.2, subsection 1, Code 2018, is amended 20 to read as follows: 21 1. A person shall not engage in the practice of medicine 22 and surgery, podiatry, osteopathic medicine and surgery, 23 psychology, chiropractic, physical therapy, physical 24 therapist assisting, nursing, dentistry, dental hygiene, 25 dental assisting, optometry, speech pathology, audiology, 26 occupational therapy, occupational therapy assisting, 27 orthotics, prosthetics, pedorthics, respiratory care, 28 pharmacy, cosmetology arts and sciences, barbering, social 29 work, dietetics, marital and family therapy , clinical art 30 therapy, or mental health counseling, massage therapy, mortuary 31 science, polysomnography, athletic training, acupuncture, 32 nursing home administration, or sign language interpreting or 33 transliterating, or shall not practice as a physician assistant 34 or a hearing aid specialist, unless the person has obtained a 35 -2- LSB 5442XS (4) 87 ss/rh 2/ 11

S.F. 2023 license for that purpose from the board for the profession. 1 Sec. 4. Section 147.13, subsection 16, Code 2018, is amended 2 to read as follows: 3 16. For marital and family therapy , clinical art therapy, 4 and mental health counseling, the board of behavioral science. 5 Sec. 5. Section 147.14, subsection 1, paragraph m, Code 6 2018, is amended to read as follows: 7 m. For behavioral science, three members licensed to 8 practice marital and family therapy, all of whom shall be 9 practicing marital and family therapists; three members 10 licensed to practice mental health counseling, one of whom 11 shall be employed in graduate teaching, training, or research 12 in mental health counseling and two of whom shall be practicing 13 mental health counselors; one member licensed to practice 14 clinical art therapy; and three two members who are not 15 licensed to practice marital and family therapy , clinical art 16 therapy, or mental health counseling and who shall represent 17 the general public. 18 Sec. 6. Section 147.74, Code 2018, is amended by adding the 19 following new subsection: 20 NEW SUBSECTION . 14A. A clinical art therapist licensed 21 under chapter 154D and this chapter may use the words “licensed 22 clinical art therapist” after the person’s name or signify the 23 same by the use of the letters “L.C.A.T.” after the person’s 24 name. A clinical art therapist licensed under chapter 154D and 25 this chapter who possesses a doctoral degree may use the prefix 26 “Doctor” or “Dr.” in conjunction with the person’s name, but 27 shall add after the person’s name the words “licensed clinical 28 art therapist” or letters “L.C.A.T.”. 29 Sec. 7. Section 154D.1, Code 2018, is amended by adding the 30 following new subsections: 31 NEW SUBSECTION . 01. “Art therapy” means the integrative 32 use of psychotherapeutic principles and methods by persons 33 with specialized training in art media, the neurobiological 34 implications of art-making, and art-based assessment models to 35 -3- LSB 5442XS (4) 87 ss/rh 3/ 11

S.F. 2023 assist individuals, families, or groups to improve cognitive 1 and sensorimotor functions, increase self-awareness and 2 self-esteem, cope with grief and traumatic experience, resolve 3 conflicts and distress, and enhance social functioning. “Art 4 therapy” includes therapeutic interventions that facilitate 5 alternative modes of receptive and expressive communication and 6 evaluation and assessments that define and implement art-based 7 treatment plans that address developmental, behavioral, mental, 8 and emotional needs. 9 NEW SUBSECTION . 1A. “Clinical art therapy” means the 10 application of art therapy principles and methods in the 11 diagnosis, prevention, treatment, and amelioration of 12 psychological problems and emotional or mental conditions. 13 NEW SUBSECTION . 1B. “Licensed clinical art therapist” 14 means a person licensed to practice clinical art therapy under 15 chapter 147 and this chapter. 16 NEW SUBSECTION . 7A. “Temporary licensed clinical art 17 therapist” means a person licensed to practice clinical art 18 therapy under supervision in accordance with section 154D.7. 19 Sec. 8. Section 154D.1, subsections 4 and 7, Code 2018, are 20 amended to read as follows: 21 4. “Licensee” includes a licensed marital and family 22 therapist , a licensed clinical art therapist, and a licensed 23 mental health counselor. 24 7. “Temporary license” means a license to practice marital 25 and family therapy , clinical art therapy, or mental health 26 counseling under direct supervision of a qualified supervisor 27 as determined by the board by rule to fulfill the postgraduate 28 supervised clinical experience requirement in accordance with 29 this chapter . 30 Sec. 9. Section 154D.4, Code 2018, is amended to read as 31 follows: 32 154D.4 Exemptions. 33 1. This chapter and chapter 147 do not prevent qualified 34 members of other professions, including but not limited to 35 -4- LSB 5442XS (4) 87 ss/rh 4/ 11

S.F. 2023 nurses, psychologists, social workers, physicians, physician 1 assistants, attorneys at law, or members of the clergy, 2 from providing or advertising that they provide services 3 of a marital and family therapy , clinical art therapy, or 4 mental health counseling nature consistent with the accepted 5 standards of their respective professions, but these persons 6 shall not use a title or description denoting that they are 7 licensed marital and family therapists , licensed clinical art 8 therapists, or licensed mental health counselors. 9 2. The licensure requirements of this chapter and chapter 10 147 do not apply to the following: 11 a. Students whose activities are conducted within a course 12 of professional education in marital and family therapy , 13 clinical art therapy, or mental health counseling. 14 b. A person who practices marital and family therapy , 15 clinical art therapy, or mental health counseling under the 16 supervision of a person licensed under this chapter as part 17 of a clinical experience as described in section 154D.2, 18 subsection 2 , or section 154D.8, subsection 1, paragraph “b” . 19 c. The provision of children, family, or mental health 20 services through the department of human services or juvenile 21 court, or agencies contracting with the department of human 22 services or juvenile court, by persons who do not represent 23 themselves to be either a marital and family therapist , a 24 clinical art therapist, or a mental health counselor. 25 Sec. 10. Section 154D.5, Code 2018, is amended to read as 26 follows: 27 154D.5 Sexual conduct with client. 28 The license of a marital and family therapist , a clinical art 29 therapist, or a mental health counselor shall be revoked if the 30 board finds that the licensee engaged in sexual activity with a 31 client as determined by board rule. The revocation shall be in 32 addition to any other penalties provided by law. 33 Sec. 11. Section 154D.7, Code 2018, is amended to read as 34 follows: 35 -5- LSB 5442XS (4) 87 ss/rh 5/ 11

S.F. 2023 154D.7 Temporary license —— marital and family therapy —— 1 mental health counseling —— fees. 2 Any person who has fulfilled all of the requirements for 3 licensure under this chapter , except for having completed 4 the postgraduate supervised clinical experience requirement 5 as determined by the board by rule, may apply to the board 6 for a temporary license. The license shall be designated 7 “temporary license in marital and family therapy” , “temporary 8 license in clinical art therapy”, or “temporary license in 9 mental health counseling” and shall authorize the licensee to 10 practice marital and family therapy , clinical art therapy, or 11 mental health counseling under the supervision of a qualified 12 supervisor as determined by the board by rule. The license 13 shall be valid for three years and may be renewed at the 14 discretion of the board. The fee for a temporary license 15 shall be set by the board to cover the administrative costs of 16 issuing the license, and if renewed, a renewal fee as set by 17 the board shall be required. 18 Sec. 12. NEW SECTION . 154D.8 Licensure —— clinical art 19 therapy. 20 1. An applicant for a license to practice clinical art 21 therapy shall be granted a license by the board when the 22 applicant satisfies all of the following requirements: 23 a. Possesses a master’s or doctoral degree from a nationally 24 accredited institution consisting of at least sixty semester 25 hours, or its equivalent, in one of the following art therapy 26 programs: 27 (1) A program approved by the American art therapy 28 association or its successor. 29 (2) A program accredited by the commission on accreditation 30 of allied health education programs at the time the degree was 31 conferred. 32 (3) A substantially equivalent program as approved by the 33 board. 34 b. Has at least two years of supervised experience or its 35 -6- LSB 5442XS (4) 87 ss/rh 6/ 11

S.F. 2023 equivalent as approved by the board that satisfies all of the 1 following requirements: 2 (1) Successful completion of at least three thousand 3 hours of clinical art therapy that shall include at least one 4 thousand five hundred hours of direct client contact and two 5 hundred hours of clinical supervision. 6 (2) Includes experience in clinical settings that provide 7 opportunities to diagnose, treat, appraise and assess 8 mental, emotional, behavioral and addiction disorders in both 9 individual and group settings, as determined by the board by 10 rule. 11 (3) Provides for supervision by an art therapy certified 12 supervisor, licensed clinical art therapist, board certified 13 art therapist, or other qualified licensed mental health 14 professional approved by the board. Applicants beginning 15 supervised experience on or after January 1, 2019, shall 16 complete at least five hundred hours of direct client contact 17 under supervision by an art therapy certified supervisor or 18 board certified art therapist. 19 c. Passes the national board examination of the art therapy 20 credentials board or its successor. 21 2. The board may make a determination that a program is 22 substantially equivalent to a master’s degree program in art 23 therapy approved by the American art therapy association or its 24 successor if the program includes graduate-level courses and 25 training in the following areas: 26 a. The art therapy profession. 27 b. Theory and practice of art therapy. 28 c. Human growth and developmental dynamics in art. 29 d. Application of art therapy with people in different 30 treatment settings. 31 e. Art therapy assessment. 32 f. Ethical and legal issues of art therapy practice. 33 g. Matters of cultural and social diversity bearing on the 34 practice of art therapy. 35 -7- LSB 5442XS (4) 87 ss/rh 7/ 11

S.F. 2023 h. Standards of good art therapy practice. 1 i. Group art therapy. 2 j. Diagnosis, assessment, and treatment procedures. 3 k. An art therapy internship of not less than six hundred 4 hours that is performed under supervision and is part of an 5 approved course of study. 6 3. This section shall not be construed to prevent members of 7 other professions licensed or certified under this chapter from 8 engaging in any act or practice, including the use of art or 9 art materials, in a manner consistent with their training and 10 the accepted standards of their respective professions without 11 a license to practice clinical art therapy, but such persons 12 shall not represent such acts or practices as art therapy, or 13 use any title or description denoting they are a clinical art 14 therapist or licensed to practice clinical art therapy under 15 this chapter. 16 Sec. 13. TRANSITION PROVISIONS. 17 1. Notwithstanding sections 147.14, as amended in this 18 Act, and 147.16, the governor may appoint, as the initial 19 member licensed to practice clinical art therapy to the board 20 of behavioral science pursuant to section 147.14, subsection 21 1, paragraph “m”, as amended in this Act, an individual who 22 is credentialed as a board-certified art therapist by the 23 art therapy credentials board with experience and expertise 24 substantially equivalent to the requirements for licensure as a 25 clinical art therapist under section 154D.8, as enacted in this 26 Act. 27 2. Notwithstanding section 154D.8, subsection 1, as 28 enacted in this Act, during the period of one year from the 29 effective date of rules implementing this Act, the board 30 may grant a license to practice clinical art therapy for an 31 applicant who provides documentation satisfactory to the board 32 that the applicant holds a credential in good standing as a 33 board-certified art therapist with the art therapy credentials 34 board and has been engaged in the practice of clinical art 35 -8- LSB 5442XS (4) 87 ss/rh 8/ 11

S.F. 2023 therapy for not less than five years at the time of the 1 effective date of rules adopted by the board to implement this 2 Act, which shall include experience in a clinical setting 3 that provides substantial opportunities to diagnose, treat, 4 appraise, and assess mental, emotional, behavioral, and 5 addiction disorders in both individual and group settings, as 6 determined by the board by rule. 7 3. Notwithstanding section 154D.8, subsection 1, paragraph 8 “b”, as enacted in this Act, during the period of three years 9 from the effective date of rules implementing this Act, the 10 board shall accept for purposes of qualifying an applicant for 11 a temporary license to practice clinical art therapy under 12 supervision in accordance with section 154D.7, as amended 13 in this Act, a plan for supervision that includes direct 14 clinical supervision by an individual who is credentialed as a 15 registered art therapist by the art therapy credentials board 16 who has been engaged in the practice of clinical art therapy 17 for not less than five years, as determined by the board by 18 rule. 19 Sec. 14. EFFECTIVE DATE AND IMPLEMENTATION. This Act 20 shall take effect January 1, 2019, except that the board of 21 behavioral science may begin implementation prior to that date, 22 to the extent necessary to fully implement the provisions 23 providing for the licensure of clinical art therapists by 24 January 1, 2019. 25 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanation’s substance by the members of the general assembly. 28 This bill provides for the licensure of clinical art 29 therapists. Under the bill, the board of behavioral science 30 shall administer the licensure of clinical art therapists and 31 shall adopt rules relating to the practice of clinical art 32 therapy. The bill modifies the membership of the board of 33 behavioral science to add one clinical art therapist and remove 34 one public member. The bill provides that persons not licensed 35 -9- LSB 5442XS (4) 87 ss/rh 9/ 11

S.F. 2023 under the bill but referring to themselves as clinical art 1 therapists or using other similar terms or abbreviations shall 2 be guilty of a simple misdemeanor. A simple misdemeanor is 3 punishable by confinement for no more than 30 days or a fine of 4 at least $65 but not more than $625 or by both. 5 The bill defines several terms including “art therapy” 6 and “clinical art therapy”. The bill provides for temporary 7 licensure of clinical art therapists. The bill requires that 8 to acquire a license to practice art therapy, an applicant 9 must have a master’s or doctoral degree in art therapy from 10 a program approved by the American art therapy association, 11 accredited by the commission on accreditation of allied health 12 education programs at the time the degree was conferred, or 13 another program approved by the board of behavioral science, 14 pass a national board examination, and complete at least 15 two years of supervised experience. The bill allows other 16 licensees under Code chapter 154D to use art or art materials 17 as part of their practice without an art therapy license if 18 they do not represent that they practice art therapy. 19 The bill includes licensed certified art therapists as 20 “health care providers” eligible to provide services through 21 the volunteer health care provider program created in Code 22 section 135.24. The bill provides that the board of behavioral 23 science may waive the licensing requirements established by 24 the bill for persons with certain qualifications in the first 25 year after rules implementing the licensure of clinical art 26 therapists are adopted. The bill also directs the board to 27 grant temporary licenses to applicants seeking to practice 28 clinical art therapy under supervision whose supervision plan 29 includes supervision by a registered art therapist who has been 30 practicing for at least five years. This directive applies for 31 the first three years following the effective date of rules 32 implementing the bill. The bill includes an effective date of 33 January 1, 2019, except that the board of behavioral science 34 may begin implementation prior to that date, to the extent 35 -10- LSB 5442XS (4) 87 ss/rh 10/ 11