BILL NUMBER: AB 2552 CHAPTERED 07/27/04 CHAPTER 204 FILED WITH SECRETARY OF STATE JULY 27, 2004 APPROVED BY GOVERNOR JULY 27, 2004 PASSED THE SENATE JULY 12, 2004 PASSED THE ASSEMBLY APRIL 29, 2004 AMENDED IN ASSEMBLY APRIL 26, 2004 INTRODUCED BY Assembly Member Leno FEBRUARY 20, 2004 An act to amend Sections 4980.02, 4980.43, 4980.44, and 4987.7 of, to amend the heading of Chapter 13 (commencing with Section 4980) of Division 2 of, and to amend the heading of Article 6 (commencing with Section 4987.5) of Chapter 13 of Division 2 of, the Business and Professions Code, relating to marriage and family therapy. LEGISLATIVE COUNSEL'S DIGEST AB 2552, Leno. Marriage and family therapy. Under existing law, the Board of Behavioral Sciences is responsible for licensing and regulating the practice of marriage and family therapy. Under existing law, the practice of marriage and family therapy includes the application of certain therapy principles and methods. This bill would include the use, application, and integration of specified coursework and training among those principles and methods. Existing law requires an intern who is employed or volunteering in a private practice to be under the direct supervision of a licensee who is employed and practices at the same site as the intern's employer. This bill would in addition authorize an intern to be supervised by a licensee who is an owner or shareholder of the private practice. The bill would also authorize a supervisor to arrange for alternative supervision during the supervisor's vacation or sick leave, if certain requirements are met. Existing law requires an unlicensed marriage and family therapist intern who performs professional services to inform each client or patient that he or she is unlicensed and under the supervision of specified licensees, including a licensed physician and surgeon who has completed a residency in psychiatry and meets additional requirements. This bill would delete this licensee from the list of authorized supervising licenses. Existing law requires the name of a marriage and family therapy corporation to contain one or more of certain words, including "counseling," "counselor," or "therapist." This bill would in addition authorize the use of the word "therapy" in a marriage and family therapy corporation's name. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The heading of Chapter 13 (commencing with Section 4980) of Division 2 of the Business and Professions Code is amended to read: CHAPTER 13. MARRIAGE AND FAMILY THERAPISTS SEC. 2. Section 4980.02 of the Business and Professions Code is amended to read: 4980.02. For the purposes of this chapter, the practice of marriage and family therapy shall mean that service performed with individuals, couples, or groups wherein interpersonal relationships are examined for the purpose of achieving more adequate, satisfying, and productive marriage and family adjustments. This practice includes relationship and premarriage counseling. The application of marriage and family therapy principles and methods includes, but is not limited to, the use of applied pyschotherapeutic techniques, to enable individuals to mature and grow within marriage and the family, the provision of explanations and interpretations of the psychosexual and psychosocial aspects of relationships, and the use, application, and integration of the coursework and training required by Sections 4980.37, 4980.40, and 4980.41. SEC. 3. Section 4980.43 of the Business and Professions Code is amended to read: 4980.43. (a) For all applicants, a minimum of two calendar years of supervised experience is required, which experience shall consist of 3,000 hours obtained over a period of not less than 104 weeks. Not less than 1,500 hours of experience shall be gained subsequent to the granting of the qualifying master's or doctor's degree. For those applicants who enroll in a qualifying degree program on or after January 1, 1995, not more than 750 hours of counseling and direct supervisor contact may be obtained prior to the granting of the qualifying master's or doctor's degree. However, this limitation shall not be interpreted to include professional enrichment activities. Except for personal psychotherapy hours gained after enrollment and commencement of classes in a qualifying degree program, no hours of experience may be gained prior to becoming a trainee. All experience shall be gained within the six years immediately preceding the date the application for licensure was filed, except that up to 500 hours of clinical experience gained in the supervised practicum required by subdivision (b) of Section 4980.40 shall be exempt from this six-year requirement. (b) All applicants, trainees, and registrants shall be at all times under the supervision of a supervisor who shall be responsible for ensuring that the extent, kind, and quality of counseling performed is consistent with the training and experience of the person being supervised, and who shall be responsible to the board for compliance with all laws, rules, and regulations governing the practice of marriage and family therapy. Experience shall be gained by interns and trainees either as an employee or as a volunteer in any allowable work setting specified in this chapter. The requirements of this chapter regarding gaining hours of experience and supervision are applicable equally to employees and volunteers. Experience shall not be gained by interns or trainees as an independent contractor. (c) Supervision shall include at least one hour of direct supervisor contact for each week of experience claimed. A trainee shall receive an average of at least one hour of direct supervisor contact for every five hours of client contact in each setting. A person gaining postdegree experience shall receive an average of at least one hour of direct supervisor contact for every 10 hours of client contact in each setting in which experience is gained. For purposes of this section, "one hour of direct supervisor contact" means one hour of face-to-face contact on an individual basis or two hours of face-to-face contact in a group of not more than eight persons. The contact may be counted toward the experience requirement for licensure, up to the maximum permitted by subdivision (d). All experience gained by a trainee shall be monitored by the supervisor as specified by regulation. The 5 to 1 and 10 to 1 ratios specified in this subdivision shall be applicable to all hours gained on or after January 1, 1995. (d) (1) The experience required by Section 4980.40 shall include supervised marriage and family therapy, and up to one-third of the hours may include direct supervisor contact and other professional enrichment activities. (2) "Professional enrichment activities," for the purposes of this section, may include group, marital or conjoint, family, or individual psychotherapy received by an applicant. This psychotherapy may include up to 100 hours taken subsequent to enrolling and commencing classes in a qualifying degree program, or as an intern, and each of those hours shall be triple counted toward the professional experience requirement. This psychotherapy shall be performed by a licensed marriage and family therapist, licensed clinical social worker, licensed psychologist, licensed physician and surgeon certified in psychiatry by the American Board of Psychiatry and Neurology, or a licensed physician and surgeon who has completed a residency in psychiatry. (e) (1) A trainee may gain the experience required by subdivision (f) of Section 4980.40 in any setting that meets all of the following: (A) Lawfully and regularly provides mental health counseling or psychotherapy. (B) Provides oversight to ensure that the trainee's work at the setting meets the experience and supervision requirements set forth in this chapter and is within the scope of practice for the profession as defined in Section 4980.02. (C) Is not a private practice owned by a licensed marriage and family therapist, a licensed psychologist, a licensed clinical social worker, a licensed physician and surgeon, or a professional corporation of any of those licensed professions. (2) Experience may be gained by the trainee solely as part of the position for which the trainee volunteers or is employed. (f) (1) An intern may gain the experience required by subdivision (f) of Section 4980.40 in any setting that meets both of the following: (A) Lawfully and regularly provides mental health counseling or psychotherapy. (B) Provides oversight to ensure that the intern's work at the setting meets the experience and supervision requirements set forth in this chapter and is within the scope of practice for the profession as defined in Section 4980.02. (2) An applicant shall not be employed or volunteer in a private practice, as defined in subparagraph (C) of paragraph (1) of subdivision (e), until registered as an intern. (3) While an intern may be either a paid employee or a volunteer, employers are encouraged to provide fair remuneration to interns. (4) Except for periods of time during a supervisor's vacation or sick leave, an intern who is employed or volunteering in private practice shall be under the direct supervision of a licensee enumerated in subdivision (f) of Section 4980.40. The supervising licensee shall either be employed by and practice at the same site as the intern's employer, or shall be an owner or shareholder of the private practice. Alternative supervision may be arranged during a supervisor's vacation or sick leave if the supervision meets the requirements of this section. (5) Experience may be gained by the intern solely as part of the position for which the intern volunteers or is employed. (g) All persons shall register with the board as an intern in order to be credited for postdegree hours of experience gained toward licensure, regardless of the setting where those hours are to be gained. Except as provided in subdivision (h), all postdegree hours shall be gained as a registered intern. (h) Except when employed in a private practice setting, all postdegree hours of experience shall be credited toward licensure so long as the applicant applies for the intern registration within 90 days of the granting of the qualifying master's or doctor's degree and is thereafter granted the intern registration by the board. (i) Trainees, interns, and applicants shall not receive any remuneration from patients or clients, and shall only be paid by their employers. (j) Trainees, interns, and applicants shall only perform services at the place where their employers regularly conduct business, which may include performing services at other locations, so long as the services are performed under the direction and control of their employer and supervisor, and in compliance with the laws and regulations pertaining to supervision. Trainees and interns shall have no proprietary interest in the employer's business. (k) Trainees, interns, or applicants who provide volunteered services or other services, and who receive no more than a total, from all work settings, of five hundred dollars ($500) per month as reimbursement for expenses actually incurred by those trainees, interns, or applicants for services rendered in any lawful work setting other than a private practice shall be considered an employee and not an independent contractor. The board may audit applicants who receive reimbursement for expenses, and the applicants shall have the burden of demonstrating that the payments received were for reimbursement of expenses actually incurred. (l) Each educational institution preparing applicants for licensure pursuant to this chapter shall consider requiring, and shall encourage, its students to undergo individual, marital or conjoint, family, or group counseling or psychotherapy, as appropriate. Each supervisor shall consider, advise, and encourage his or her interns and trainees regarding the advisability of undertaking individual, marital or conjoint, family, or group counseling or psychotherapy, as appropriate. Insofar as it is deemed appropriate and is desired by the applicant, the educational institution and supervisors are encouraged to assist the applicant in locating that counseling or psychotherapy at a reasonable cost. SEC. 4. Section 4980.44 of the Business and Professions Code is amended to read: 4980.44. (a) An unlicensed marriage and family therapist intern employed under this chapter shall: (1) Have earned at least a master's degree as specified in Section 4980.40. (2) Be registered with the board prior to the intern performing any duties, except as otherwise provided in subdivision (e) of Section 4980.43. (3) File for renewal of registration annually for a maximum of five years after initial registration with the board. Renewal of registration shall include filing an application for renewal, paying a renewal fee of seventy-five dollars ($75), and notifying the board whether he or she has been convicted, as defined in Section 490, of a misdemeanor or felony, or whether any disciplinary action has been taken by any regulatory or licensing board in this or any other state, subsequent to the issuance of the initial registration or the registrant's last renewal. (4) Inform each client or patient prior to performing any professional services that he or she is unlicensed and under the supervision of a licensed marriage and family therapist, licensed clinical social worker, licensed psychologist, or a licensed physician and surgeon certified in psychiatry by the American Board of Psychiatry and Neurology. (5) Continued employment as an unlicensed marriage and family therapist intern shall cease after six years unless the requirements of subdivision (b) are met. No registration shall be renewed or reinstated beyond the six years from initial issuance regardless of whether it has been revoked. (b) When no further renewals are possible, an applicant may apply for and obtain new intern registration status if the applicant meets the educational requirements for registration in effect at the time of the application for a new intern registration. An applicant who is issued a subsequent intern registration pursuant to this subdivision may be employed or volunteer in any allowable work setting except private practice. SEC. 5. The heading of Article 6 (commencing with Section 4987.5) of Chapter 13 of Division 2 of the Business and Professions Code is amended to read: Article 6. Marriage and Family Therapy Corporations SEC. 6. Section 4987.7 of the Business and Professions Code is amended to read: 4987.7. The name of a marriage and family therapy corporation shall contain one or more of the words "marriage," "family," or "child" together with one or more of the words "counseling," "counselor," "therapy," or "therapist," and wording or abbreviations denoting corporate existence. A marriage and family therapy corporation that conducts business under a fictitious business name shall not use any name that is false, misleading or deceptive, and shall inform the patient, prior to the commencement of treatment, that the business is conducted by a marriage and family therapy corporation.