BILL ANALYSIS Ó ----------------------------------------------------------------------- |Hearing Date:June 6, 2011 |Bill No:AB | | |956 | ----------------------------------------------------------------------- SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Curren D. Price, Jr., Chair Bill No: AB 956Author:R. Hernandez As Amended:May 27, 2011 Fiscal: Yes SUBJECT: Marriage and family therapy: interns and trainees: advertisements. SUMMARY: Requires a marriage and family therapist intern and a marriage and family therapist trainee, prior to performing professional services, to provide each client or patient with the name of his or her employer and indicate that he or she is under the supervision of a licensed person, as specified, and requires any advertisement by or on behalf of an intern or trainee to include specified information; requires an intern's registration number to be disclosed to clients and patients and in advertisements. Existing law: 1) Licenses and regulates the practice of marriage and family therapists (MFTs), and provides for the registration and regulation of MFT interns, and MFT trainees by the Board of Behavioral Sciences (BBS) within the Department of Consumer Affairs. 2) Authorizes MFT interns and trainees to perform counseling activities and services in certain work settings; and requires that a trainee or intern shall at all times be under the supervision of a supervisor. a) Requires the supervisor to be responsible for ensuring that the counseling performed is consistent with the training and experience of the person being supervised, requires the supervisor to be responsible to the BBS for compliance with all laws, rules, and regulations governing the practice of marriage and family therapy. (Business and Professions (BPC) § 4980.43) AB 956 Page 2 b) Defines "supervisor" to include an MFT, licensed clinical social worker (LCSW), licensed psychologist, or licensed physician certified in psychiatry. (BPC § 4980.03) 3)Requires MFT interns and trainees to 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 (MFT), licensed clinical social worker (LCSW), licensed psychologist, or a licensed physician and surgeon certified in psychiatry. (BPC §§ 4980.44, 4980.48) 4)Requires any advertisement for services performed by a trainee to include the trainee's name, the supervisor's license designation or abbreviation, and the supervisor's license number. (BPC § 4980.48) This bill: 1)Requires an MFT intern to additionally inform clients or patients prior to performing professional services that he or she is an unlicensed MFT intern, provide his or her registration number and the name of his or her employer. 2)Requires any advertisement by or on behalf of a MFT intern to include at a minimum the following information: a) That he or she is a registered intern. b) The intern's registration number. c) The name of the intern's employer. d) That the intern is supervised by a licensed person. 1) For MFT interns, prohibits the use of the abbreviation "MFTI" in an advertisement unless the title "marriage and family therapist registered intern" appears in the advertisement. 2) Requires an MFT trainee to additionally inform clients or patients prior to performing professional services that he or she is an unlicensed MFT trainee, and the name of his or her employer. 3)Requires any advertisement by or on behalf of a MFT trainee to include at a minimum the following information: a) That he or she is an MFT trainee. AB 956 Page 3 b) The name of the trainee's employer. c) That the trainee is supervised by a licensed person. FISCAL EFFECT: The Assembly Appropriations Committee analysis, dated May 4, 2011, indicates a negligible state fiscal impact. COMMENTS: 1. Purpose. This bill is sponsored by California Association of Marriage and Family Therapists (Sponsor). According to the Author, misleading and deceptive online advertisements offering mental health services are becoming an emerging trend, and more advertisements offering marriage and family counseling are created by unqualified individuals. The Author states that an increasing number of such advertisements are published by MFT interns, who by law, may only provide services to the public as an employee or a volunteer for a licensed person or other lawful entity, and can only do so under appropriate supervision. Certain advertisements appear to offer services performed by licensed professionals, but are instead carried out by interns, and the Author indicates, the advertisements can mislead consumers to believe interns are medical professionals by using the acronym MFTI, instead of explicitly stating the full title of the intern. "Unfortunately, this type of misleading advertising is increasing. If left unaddressed, those seeking mental health services from a licensed professional may unknowingly receive inferior care from an unlicensed individual." The Author further indicates that this ambiguity is found not only in online advertisements, but within some medical clinics as well. Currently, MFT interns must disclose their intern status before treating patients; however other critical information, such as the disclosure of whether the MFT intern is under the supervision of a licensed professional, may be omitted. This bill will encourage truthfulness in advertising and will allow consumers to make informed choices when choosing a mental health provider, according to the Author. 2. Background. Only licensed mental health professionals may supervise MFT interns and trainees. Licensed mental health professionals include MFTs, LCSWs, licensed psychologists, and licensed physicians certified in psychiatry by the American Board of Psychiatry and Neurology. Additionally, the supervisor must AB 956 Page 4 maintain a current valid California license for at least two years. The Board requires supervisors of registered interns and trainees to complete a minimum of six hours of supervision training or coursework within two years immediately preceding supervision (or within 60 days of commencement of supervision) and every renewal period thereafter. Psychologists and physicians certified in psychiatry are exempt from supervision training. 3. Related Legislation. SB 363 (Emmerson), allows MFT trainees to continue counseling clients while not enrolled in a practicum if the lapse in enrollment is less than 45 days; limits the number of client-centered advocacy hours for a marriage and family therapist intern to 500 hours; and allows LPCCs to supervise MFT interns if they meet additional training and education requirements to treat couples and families. That bill passed this Committee on April 11, 2011 on a 7-0 vote, and has been referred to the Assembly Business, Professions and Consumer Protection Committee. SB 146 (Wyland) revises various provisions relating to the practice of mental health professionals to also include the practice of licensed professional clinical counselors, clinical counselor trainees, and clinical counselor interns; makes technical updating and conforming changes. That bill passed this Committee on April 11, 2011 on a 9-0 vote, and has been referred to the Assembly Business, Professions and Consumer Protection Committee. SB 704 (Negrete McLeod) revises and recasts examination requirements for marriage and family therapists and interns and for licensed clinical social workers and associate social workers; makes technical cleanup and conforming changes. That bill was approved on Consent by this Committee on April 4, 2011, and is currently awaiting hearing in the Assembly Business, Professions and Consumer Protection Committee. AB 583 (Hayashi, Chapter 436, Statutes of 2010) mandates similar disclosures for physicians and other health care professionals. 4. Arguments in Support. In Sponsoring the bill, California Association of Marriage and Family Therapists writes, "Current law governing advertising by or on behalf of a marriage and family therapist registered intern or trainee?does not adequately inform members the public who the employer of the intern or trainee is, who the supervisor of the intern or trainee is, and what the supervisor's licensure status is. Additionally, the use of 'MFTI' by marriage and family therapist registered interns is confusing and misleading. The Sponsor argues that is important for interns AB 956 Page 5 and trainees to identify who their employers are and that they are under the supervision of an appropriately licensed professional. "These changes in the law will assure that there is no ambiguity with respect to how marriage and family therapist registered interns or trainees advertise or identify themselves. These changes also insure that the public will know the unlicensed status of the individual prior to engaging in professional services with any marriage and family therapist registered intern or trainee." The California Psychiatric Association believes the bill will provide transparency to the consumer related to the qualifications of their therapist by requiring interns to disclose their status as interns when they treat those consumers. The Board of Behavioral Sciences (Board) supports the bill, stating that bill clarifies inconsistencies in the law relating to advertising. The recent amendments for requiring the registration number to be included in MFT intern advertising and to be given to clients were made at the Board's request, and will provide greater consistency and clarity according to the Board. SUPPORT AND OPPOSITION: Support: California Association of Marriage and Family Therapists (Sponsor) Board of Behavioral Sciences California Psychiatric Association Opposition: None on file as of May 31, 2011 Consultant:G. V. Ayers