Progress and Obstacles in the Pursuit of Genetic Counselor Licensure — TSGC

By Ashley Svenson, Jamie Fong, and Rebecca Okashah Littlejohn

This year’s journey towards licensure for genetic counselors in Texas was marked by both progress and obstacles. Unfortunately, we were not successful in passing licensure legislation during the 88th Texas legislative cycle, however, we gained important insights that can be applied for our next attempt. Here we summarize the key events, highlight on the ground we gained, and consider challenges to inform future strategies.

Early Support and Sponsorship

Prior to the start of the legislative session, Representative. Stephanie Klick (R), Chair of the Public Health Committee in the House, and Senator Nathan Johnson (D) from the Senate Business and Commerce Committee were identified as bill sponsors. With their support, bills were filed in November 2022, providing an early start compared to previous sessions.

House Passage

The genetic counselor licensure bill, House Bill 173 (HB173), was prioritized and placed on the agenda for the first meeting of the Public House Committee. Rep. Klick stated that she is not typically in favor of new regulation but licensure of genetic counselors is an important exception. Carla McGruder, a TSGC member from the Dallas-area, provided testimony and clarified questions regarding scope of practice and how genetic counseling is related to genetic testing but is a distinct service. HB173 was voted out of the committee unanimously.

There was an unexpected delay for HB173 to get voted out of the House Calendars committee so that it could receive a full vote. Eventually, with the support of Rep. Klick, the bill garnered sufficient backing and passed the House with a substantial majority (116-26) on April 27, 2023.

So Close in the Senate

Dr. John Odom, Ashley Svenson, and Heather Vasek of Delisi Communications at the Capitol for HB173 Bill Hearing

Even though an identical “companion” bill had been filed in the Senate, Senate Bill 484 (SB484), the Senate chose to receive HB173, which had already passed the House. In general, there is antiregulatory sentiment in the Texas legislature. With the help of Heather Vasek from Delisi Communications, the lobbyist hired by TSGC, we were able to get a hearing with the Business and Commerce Committee on May 19, 2023, one of the very last days possible. Ashley Svenson, TSGC Licensure Co-Chair, and Dr. John Odom, a medical geneticist from San Antonio, provided testimony and the bill received a favorable committee vote (8-2) two days later. Unfortunately, HB173 was not able to get a full Senate vote before the end of the legislative session.

Reflections and Looking Ahead

Dan Riconda, Jackie Harkenrider, Rebecca Littlejohn, Ashley Svenson, and Jamie Fong at the March of Dimes Lobby Day

There were many factors that worked in our favor this session and allowed the licensure efforts to get further than ever before. First and foremost, having a bill that was ready to go and could be filed early allowed us more time to garner support and deal with unanticipated setbacks and delays. Rep. Klick’s passion for the issue and her authority to expedite the bill through the Public Health Committee was a valuable asset. Several genetic counselors and genetic counseling students accompanied the Texas Chapter of March of Dimes (MoD) to the Capitol for Lobby Day in April 2023. Advocating not only MoD’s legislative agenda, but also promoting the importance of HB173, genetic counselors at the Capitol had the opportunity to speak in person with legislators and their staff. This proved invaluable, as it allowed for another touch point during the session with lawmakers. Engagement and support from several organizations is acknowledged and appreciated. Last but certainly not least, the well-timed calls from TSGC volunteers were extremely impactful.

Looking forward, it is important to be aware of the challenges with scope of practice issues in Texas and nationally. We will continue to need improved messaging and on-going advocacy from within and outside of TSGC. We understand that achieving passage of HB173 during this session may have been particularly challenging, given the deeply partisan divisions within the Texas legislature and given lawmakers’ attention towards other issues, like the impeachment of the Attorney General, and the need for a special legislative session.

In summary, by building off the learnings from this session and continuing to cultivate strategic partners outside of our profession, the goal of licensure for genetic counselors in Texas remains within reach.