Bill Summary for S 491 (2023-2024)

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Summary date: 

Apr 3 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
Senate Bill 491 (Public) Filed Monday, April 3, 2023
Intro. by Moffitt, Krawiec.

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Bill summary

Amends GS Chapter 90 by enacting new Article 44, pertaining to genetic counselor licensure. 

Defines the following terms ABGC (American Board of Genetic Counseling), ACGC (Accreditation Council for Genetic Counseling), ACS (Active Candidate Status conferred by the American Board of Genetic Counseling), Active Candidate Status (a person who has met the requirements established by the ABGC to take the ABGC certification examinations in general genetics and genetic counseling and has been granted this designation by ABGC), board, CEU, department, examination, genetic counseling, genetic counseling intern, genetic counselor, NSGC, qualified supervisor, reciprocity, referral, supervisee, supervision, and temporary license.

Establishes a five-member Genetic Counselors Licensure Board (Board) who serve staggered terms. All members must be State residents. Specifies that two members will be appointed by General Assembly, upon the recommendation of the Speaker of the House and President Pro Tempore of the Senate, respectively and will each serve three-year terms for their initial terms. The remaining three members will be appointed by the Governor, with the initial terms as follows: one to serve a three-year term, one to serve a two-year term and one public member to serve a one-year term. After expiration of the initial term, Board members will be appointed by the specified appointing authority for three-year terms. All except the public member must be licensed genetic counselors who will obtain licensure as soon as the first application period begins. Sets term limits of two consecutive terms. Specifies that a former member is eligible for appointment after a one-year period of not being a member of the Board. Provides for a process for filling vacancies. Bars Board members from participating in matters where they have a pecuniary interest or similar conflict of interest. Requires the Board to meet at least twice a year. Sets forth quorum and rules pertaining to how additional meetings may be called. Requires the Board to annually elect a chair, vice-chair, and secretary.

Bars the Board members from receiving compensation but allows for per diem and necessary travel expenses. Allows them to hire staff and to fix staff compensation. Bars the Board from employing staff to perform inspectional or ministerial tasks for the Board. Emphasizes that the State will not be liable for expenses incurred by the Board in excess of the income derived from Article 44.

Specifies that the Governor may remove a Board member for all of the following: (1) ceases to meet the qualifications specified in the act; (2) fails to attend three successive Board meetings without just cause a determined by the remainder of the Board; (3) is found by the remainder of the Board to be in violation of the provisions of Article 44 or to have engaged in immoral, dishonorable, unprofessional, or unethical conduct, and the conduct is deemed to compromise the integrity of the Board; (4) is found guilty of a felony or an unlawful act involving moral turpitude by a court of competent jurisdiction or is found to have entered a plea of nolo contendere to a felony or an unlawful act involving moral turpitude; (5) is found guilty of malfeasance, misfeasance, or nonfeasance regarding Board duties by a court of competent jurisdiction; and (6) is incapacitated and without reasonable likelihood of resuming Board duties, as determined by the Board.

Specifies the following powers and duties of the Board:

  • Administer, coordinate, and enforce the provisions of Article 44.
  • Adopt, amend, or repeal rules to administer and enforce Article 44.
  • Establish and determine qualification and fitness of applicants for licensure under Article 44.
  • Issue, renew, deny, suspend, revoke, or refuse to issue or renew any license under Article 44.
  • Establish fees for applications, initial and renewal licenses, and other services provided by the Board.
  • Discipline individuals licensed under Article 44.

Specifies that the Board may empower any member to conduct any proceeding or investigation necessary to its purposes and may empower its agent or counsel to conduct any investigation necessary to its purposes, but any final action requires a quorum of the Board. Provides for official seal. Requires the Board to submit an annual report to the Governor of its activities since the preceding July 1, including (1) names of all licensed genetic counselors to whom licenses have been granted; (2) any cases heard or decisions rendered; (3) recommendations of the Board for future actions and policies; and (4) a financial report. Requires all Board members to sign the report and provides for a member to record a dissenting view. 

Enacts GS 90-754, setting forth qualifications for licensure as a genetic counselor and an application process before the Board. Specifies that the applicant must meet the following criteria:

  • Submit an application prescribed by the Board.
  • Pay a fee determined by the Board.
  • Provide satisfactory evidence of having certification as a genetic counselor by the ABGC.
  • Is at least 18 years of age.
  • Is of good moral character and conducts all professional activities in accordance with accepted professional and ethical standards.
  • Has not engaged in any practice at any time that would be a ground for denial, revocation, or suspension of a license.
  • Has submitted the required criminal history record, as required by law.
  • Is qualified for licensure under the requirements of Article 44.

Allows for temporary licenses to be issued in certain circumstances and provides for reciprocity with other jurisdictions with substantially the same licensing requirements. Provides for an alternative application for licensure if the individual does not qualify as a genetic counselor under GS 90-754 but who has worked as a genetic counselor for at least 10 years preceding the enactment of Article 44 and provides documentation of all of the following: (1) has a master's or higher degree in genetics or a related field of study; (2) has never passed the ABGC certification examination; (3) submits three letters of recommendation from at least one genetic counselor who qualifies for licensure under this Article and a licensed physician; and (4) can provide documentation of attending NSGC-approved continuing education programs within the last five years. Except for temporary licenses, all licenses must be renewed every two years. Requires genetic counselors whose licenses have been suspended or revoked to return the original license to the Board.

Specifies that the scope of practice of genetic counseling includes all of the following:

  • Obtain and evaluate individual, family, and medical histories to determine genetic risk for genetic or medical conditions and diseases in a patient, the patient's children, and other family members.
  • Discuss the features, natural history, means of diagnosis, genetic and environmental factors, and management of risk for genetic or medical conditions.  
  • Identify, order, and coordinate genetic laboratory tests and other diagnostic studies as appropriate for the genetic assessment.
  • Integrate genetic laboratory test results and other diagnostic studies with personal and family medical history to assess and communicate risk factors for genetic or medical conditions and diseases.  
  • Explain the clinical implications of genetic laboratory tests and other diagnostic studies and their results.
  • Evaluate the client's or family's responses to the condition or risk of recurrence and provide client-centered counseling and anticipatory guidance.
  • Identify and utilize community resources that provide medical, educational, financial, and psychosocial support and advocacy.
  • Provide written documentation of medical, genetic, and counseling information for families and health care professionals.

Sets fee schedule. Sets forth requirements related to criminal history checks for all licensure applicants. Sets forth continuing education requirements.

Bars individuals from holding themselves out as genetic counselors unless licensed under Article 44.

Exempts an individual from the requirements of Article 44 if the following requirements are met: (1) any individual licensed by the State to practice in a profession other than genetic counseling when acting within the scope of the individual's profession  and doing work of a nature consistent with the individual's training (the individual cannot hold themselves out to the public as a genetic counselor); (2) any individual employed as a genetic counselor by the State, as well as the  federal government or an agency thereof, if the individual provides genetic counseling services solely under the direction and control of the organization by which the individual is employed; (3) a student or intern enrolled in an ABGC-accredited genetic counseling educational 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 "genetic counseling intern."

Sets forth a 16-prong code of conduct, a violation of which are grounds for discipline, which may include denying, suspending, or revoking licensure and may place on probation, limit practice, and require examination, remediation, and rehabilitation of any applicant or licensee by the Board. Allows for alternate sanctions in lieu of denial, suspension, or revocation of a license. Allows the Board to enter into consent orders with the licensee or applicant in lieu of or in connection with any disciplinary proceeding or investigation. Permits the Board to seek a court order for a physical or psychological evaluation if the Board is considering whether an applicant or licensee is physically or mentally capable of practicing. Requires disciplinary procedures to conform to the APA, including its hearing provision. Clarifies that no applicant or licensee is entitled to hearing for failure to pass an examination. Specifies that an individual whose license has been denied or revoked may reapply to the Board for licensure after the passage of one calendar year from the date of the denial or revocation. Provides that a licensee may voluntarily relinquish a license at any time with the consent of the Board. Allows the Board to delay or refuse granting consent as necessary in order to investigate any pending complaint, allegation, or issue regarding violation of any provision of Article 44 by the licensee. Notwithstanding any provision to the contrary, clarifies that the Board retains full jurisdiction to investigate alleged violations of Article 44 by any individual whose license is relinquished under this subsection and, upon proof of any violation of Article 44  by any individual, the Board may take disciplinary action.

Effective October 1, 2024.

Requires the Board to adopt temporary rules to implement the act, which remain in effect until permanent rules are adopted and go into effect.

Requires that the initial appointments of the Board must be made on or before October 1, 2023, with the initial terms to commence on January 1, 2024.