Four months after state lawmakers balked at a proposal to do away with the professional term "registered counselor," a new state audit is again urging that the credential – held by roughly 18,000 people in Washington -- be eliminated.

Proponents of the change say that the credentialing requirements are so feeble that they're virtually meaningless. All it takes to become a registered counselor in Washington state is a background check, a fee, and a half-day HIV-safety class. No education, specialized training, exam nor supervised experience is needed.

"The way it's written up, anybody can be a registered counselor," said state Rep. Don Barlow, D-Spokane. "You don't even need a high-school diploma. You just pay the $40, take that class, and you're in."

The recommendation, contained in a broader performance audit of health credentialing released Tuesday by State Auditor Brian Sonntag, echoes calls from Barlow, many licensed mental health professionals, and state health officials for more stringent requirements. (Barlow, who has a master's degree, is a licensed mental-health counselor.)

"The public assumes that there's certainly more oversight than this," said Sonntag. "They're putting their trust, faith and health in the hands of these folks."

Since January, the Washington Professional Counselors' Association has been fighting to preserve the credential. There are a vast range of counseling needs out there, group secretary Kate Abbott said Tuesday, and many registered counselors have years of experience and advanced degrees.

The group supports higher credentialing standards, she said, but not doing away entirely with the category of registered counselor.
"There could be as many as a quarter million clients that could be left high and dry," said Abbott, a registered counselor in Seattle.

Lawmakers and state officials are particularly concerned about the high rate of client complaints about registered counselors compared to other health professions. A state task force convened by Gov. Chris Gregoire last year found that while the number of registered counselors barely increased from 1999 to 2005, complaints about them rose 143 percent. And a recent Seattle Times investigative series found that registered counselors are responsible for a disproportionately high rate of sexual misconduct allegations.

"My whole drive on this is about patient safety," said state Secretary of Health Mary Selecky. "In order to protect patients, we have to beef up or tighten the credentialing process."

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