Minnesota is joining 20 states in deciding to license genetic counselors — professionals who advise people whether to pursue tests that uncover their hereditary risks for cancer and other diseases.

Licensing will separate trained counselors from anyone else claiming expertise in ordering and interpreting genetic tests, said Mary Ahrens, a University of Minnesota counselor.

"There will be a public list of who is qualified to talk to [patients] and has their best interests at heart," she said.

Ahrens said the licensing requirements befit a profession that has emerged over the past decade — guiding patients about risks of cancer or certain metabolic or neurological conditions with genetic traits, and informing women planning families about prenatal or developmental risks if they become pregnant.

Thorny ethical and emotional issues haven't gotten easier with time, as people not only struggle with whether they want to know their genetic risks, but whether their relatives will want to know.

The growing array of often-costly tests also makes counseling important, Ahrens argued. The $100 to $200 cost of a counseling session could avoid incidents of providers ordering the wrong genetic tests, or ordering tests of entire genes when patients only need to know about individual genetic mutations.

"Instead of the $400 test, the provider orders the $4,000 test," she said. In some cases, insurance covers the initial wrong test but reaches a coverage limit and won't pay for the second, correct one.

Licensure requires certification by one of two national genetics organizations, who in turn require counselors to have master's or doctoral degrees — though there are exceptions for veteran counselors with 10 or more years experience. Counselors have until 2018 to obtain licensure from the Minnesota Board of Medical Practice, according to legislation that Gov. Mark Dayton signed this month.

Counselors have pursued state licensure status for seven years with support from organizations such as the March of Dimes and Minnesota Cancer Alliance.

Licensing could be a windfall for counselors if it expands the number of patients willing to consider testing.

It also can't hurt the U, which has the only accredited master's degree program in the state for genetic counseling.

Ahrens said that wasn't the purpose of the licensing push, though. In an era of expanded testing — next generation testing can scour several genes at once for the same price that used to cover only one gene — patients need trustworthy guidance and a measuring stick of counselors' expertise.

The medical board will have authority to discipline genetic counselors who violate standards of patient care.

jeremy.olson@startribune.com

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