Amended in Assembly May 11, 2015

Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 250


Introduced by Assembly Member Obernolte

February 9, 2015


An act to amend Section 4980.43 of the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL’S DIGEST

AB 250, as amended, Obernolte. Telehealth: marriage and family therapist interns and trainees.

Under existing law, “telehealth” is defined as the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site. Existing law requires a health care provider prior to the delivery of health care services via telehealth to inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth. For these purposes, existing law defines a health care provider as a healing arts licensee. Existing law, the Licensed Marriage and Family Therapist Act, provides for the registration of marriage and family therapist interns and regulates marriage and family therapist trainees. Existing law requires applicants for a marriage and family therapist license to complete specified experience subject to certain limitations, including no more than a certain number of hours providing counseling services via telehealth. Existing law requires all marriage and family therapist trainees and registrants to be supervised at all times by a supervisor, as defined, responsible for ensuring that the extent, kind, and quality of counseling performed is consistent with the training and experience of the person being supervised. Existing law requires the supervisor to be responsible to the board for compliance with all laws, rules, and regulations governing the practice of marriage and family therapy.

This billbegin delete wouldend deletebegin insert would, notwithstanding a specified section of law,end insert authorize a marriage and family therapist intern and trainee to provide services via telehealth if he or she is supervised as required by the act, and is acting within the scope authorized by the act and in accordance with any regulations governing the use of telehealth promulgated by the Board of Behavioral Sciences.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 4980.43 of the Business and Professions
2Code
is amended to read:

3

4980.43.  

(a) Prior to applying for licensure examinations, each
4applicant shall complete experience that shall comply with the
5following:

6(1) A minimum of 3,000 hours completed during a period of at
7least 104 weeks.

8(2) Not more than 40 hours in any seven consecutive days.

9(3) Not less than 1,700 hours of supervised experience
10completed subsequent to the granting of the qualifying master’s
11or doctoral degree.

12(4) Not more than 1,300 hours of supervised experience obtained
13prior to completing a master’s or doctoral degree.

14The applicant shall not be credited with more than 750 hours of
15counseling and direct supervisor contact prior to completing the
16master’s or doctoral degree.

17(5) No hours of experience may be gained prior to completing
18either 12 semester units or 18 quarter units of graduate instruction
19and becoming a trainee except for personal psychotherapy.

20(6) No hours of experience may be gained more than six years
21prior to the date the application for examination eligibility was
22filed, except that up to 500 hours of clinical experience gained in
P3    1the supervised practicum required by subdivision (c) of Section
24980.37 and subparagraph (B) of paragraph (1) of subdivision (d)
3of Section 4980.36 shall be exempt from this six-year requirement.

4(7) Not more than a combined total of 1,000 hours of experience
5in the following:

6(A) Direct supervisor contact.

7(B) Professional enrichment activities. For purposes of this
8chapter, “professional enrichment activities” include the following:

9(i) Workshops, seminars, training sessions, or conferences
10directly related to marriage and family therapy attended by the
11applicant that are approved by the applicant’s supervisor. An
12applicant shall have no more than 250 hours of verified attendance
13at these workshops, seminars, training sessions, or conferences.

14(ii) Participation by the applicant in personal psychotherapy,
15which includes group, marital or conjoint, family, or individual
16psychotherapy by an appropriately licensed professional. An
17applicant shall have no more than 100 hours of participation in
18personal psychotherapy. The applicant shall be credited with three
19hours of experience for each hour of personal psychotherapy.

20(8) Not more than 500 hours of experience providing group
21therapy or group counseling.

22(9) For all hours gained on or after January 1, 2012, not more
23than 500 hours of experience in the following:

24(A) Experience administering and evaluating psychological
25tests, writing clinical reports, writing progress notes, or writing
26process notes.

27(B) Client centered advocacy.

28(10) Not less than 500 total hours of experience in diagnosing
29and treating couples, families, and children. For up to 150 hours
30of treating couples and families in conjoint therapy, the applicant
31shall be credited with two hours of experience for each hour of
32therapy provided.

33(11) Not more than 375 hours of experience providing personal
34psychotherapy, crisis counseling, or other counseling services via
35telehealth in accordance with Section 2290.5.

36(12) It is anticipated and encouraged that hours of experience
37will include working with elders and dependent adults who have
38physical or mental limitations that restrict their ability to carry out
39normal activities or protect their rights.

P4    1This subdivision shall only apply to hours gained on and after
2January 1, 2010.

3(b) All applicants, trainees, and registrants shall be at all times
4under the supervision of a supervisor who shall be responsible for
5ensuring that the extent, kind, and quality of counseling performed
6is consistent with the training and experience of the person being
7supervised, and who shall be responsible to the board for
8compliance with all laws, rules, and regulations governing the
9practice of marriage and family therapy. Supervised experience
10shall be gained by interns and trainees only as an employee or as
11a volunteer. The requirements of this chapter regarding gaining
12hours of experience and supervision are applicable equally to
13employees and volunteers. Experience shall not be gained by
14interns or trainees as an independent contractor.

15(1) If employed, an intern shall provide the board with copies
16of the corresponding W-2 tax forms for each year of experience
17claimed upon application for licensure.

18(2) If volunteering, an intern shall provide the board with a letter
19from his or her employer verifying the intern’s employment as a
20volunteer upon application for licensure.

21(c) Except for experience gained pursuant to subparagraph (B)
22of paragraph (7) of subdivision (a), supervision shall include at
23least one hour of direct supervisor contact in each week for which
24experience is credited in each work setting, as specified:

25(1) A trainee shall receive an average of at least one hour of
26direct supervisor contact for every five hours of client contact in
27each setting. No more than six hours of supervision, whether
28individual or group, shall be credited during any single week.

29(2) An individual supervised after being granted a qualifying
30degree shall receive at least one additional hour of direct supervisor
31contact for every week in which more than 10 hours of client
32contact is gained in each setting. No more than six hours of
33supervision, whether individual or group, shall be credited during
34 any single week.

35(3) For purposes of this section, “one hour of direct supervisor
36contact” means one hour per week of face-to-face contact on an
37individual basis or two hours per week of face-to-face contact in
38a group.

39(4) Direct supervisor contact shall occur within the same week
40as the hours claimed.

P5    1(5) Direct supervisor contact provided in a group shall be
2provided in a group of not more than eight supervisees and in
3segments lasting no less than one continuous hour.

4(6) Notwithstanding paragraph (3), an intern working in a
5governmental entity, a school, a college, or a university, or an
6institution that is both nonprofit and charitable may obtain the
7required weekly direct supervisor contact via two-way, real-time
8videoconferencing. The supervisor shall be responsible for ensuring
9that client confidentiality is upheld.

10(7) All experience gained by a trainee shall be monitored by the
11supervisor as specified by regulation.

12(8) The six hours of supervision that may be credited during
13any single week pursuant to paragraphs (1) and (2) shall apply to
14supervision hours gained on or after January 1, 2009.

15(d) (1) A trainee may be credited with supervised experience
16completed in any setting that meets all of the following:

17(A) Lawfully and regularly provides mental health counseling
18or psychotherapy.

19(B) Provides oversight to ensure that the trainee’s work at the
20setting meets the experience and supervision requirements set forth
21in this chapter and is within the scope of practice for the profession
22as defined in Section 4980.02.

23(C) Is not a private practice owned by a licensed marriage and
24family therapist, a licensed professional clinical counselor, a
25licensed psychologist, a licensed clinical social worker, a licensed
26physician and surgeon, or a professional corporation of any of
27those licensed professions.

28(2) Experience may be gained by the trainee solely as part of
29the position for which the trainee volunteers or is employed.

30(e) (1) An intern may be credited with supervised experience
31completed in any setting that meets both of the following:

32(A) Lawfully and regularly provides mental health counseling
33or psychotherapy.

34(B) Provides oversight to ensure that the intern’s work at the
35setting meets the experience and supervision requirements set forth
36in this chapter and is within the scope of practice for the profession
37as defined in Section 4980.02.

38(2) An applicant shall not be employed or volunteer in a private
39practice, as defined in subparagraph (C) of paragraph (1) of
40subdivision (d), until registered as an intern.

P6    1(3) While an intern may be either a paid employee or a
2volunteer, employers are encouraged to provide fair remuneration
3to interns.

4(4) Except for periods of time during a supervisor’s vacation or
5sick leave, an intern who is employed or volunteering in private
6practice shall be under the direct supervision of a licensee that has
7satisfied the requirements of subdivision (g) of Section 4980.03.
8The supervising licensee shall either be employed by and practice
9at the same site as the intern’s employer, or shall be an owner or
10shareholder of the private practice. Alternative supervision may
11be arranged during a supervisor’s vacation or sick leave if the
12supervision meets the requirements of this section.

13(5) Experience may be gained by the intern solely as part of the
14position for which the intern volunteers or is employed.

15(f) Except as provided in subdivision (g), all persons shall
16register with the board as an intern in order to be credited for
17postdegree hours of supervised experience gained toward licensure.

18(g) Except when employed in a private practice setting, all
19postdegree hours of experience shall be credited toward licensure
20so long as the applicant applies for the intern registration within
2190 days of the granting of the qualifying master’s or doctoral
22degree and is thereafter granted the intern registration by the board.

23(h) Trainees, interns, and applicants shall not receive any
24remuneration from patients or clients, and shall only be paid by
25their employers.

26(i) Trainees, interns, and applicants shall only perform services
27at the place where their employers regularly conduct business,
28which may include performing services at other locations, so long
29as the services are performed under the direction and control of
30their employer and supervisor, and in compliance with the laws
31and regulations pertaining to supervision.begin delete For purposes of sectionend delete
32begin insert Notwithstanding Sectionend insert 2290.5, interns and trainees working
33under licensed supervision, consistent with subdivision (b), may
34provide services via telehealth within the scope authorized by this
35chapter and in accordance with any regulations governing the use
36of telehealth promulgated by the board. Trainees and interns shall
37have no proprietary interest in their employers’ businesses and
38shall not lease or rent space, pay for furnishings, equipment, or
39supplies, or in any other way pay for the obligations of their
40employers.

P7    1(j) Trainees, interns, or applicants who provide volunteered
2services or other services, and who receive no more than a total,
3from all work settings, of five hundred dollars ($500) per month
4as reimbursement for expenses actually incurred by those trainees,
5interns, or applicants for services rendered in any lawful work
6setting other than a private practice shall be considered an
7 employee and not an independent contractor. The board may audit
8applicants who receive reimbursement for expenses, and the
9applicants shall have the burden of demonstrating that the payments
10received were for reimbursement of expenses actually incurred.

11(k) Each educational institution preparing applicants for
12licensure pursuant to this chapter shall consider requiring, and
13shall encourage, its students to undergo individual, marital or
14conjoint, family, or group counseling or psychotherapy, as
15appropriate. Each supervisor shall consider, advise, and encourage
16his or her interns and trainees regarding the advisability of
17undertaking individual, marital or conjoint, family, or group
18counseling or psychotherapy, as appropriate. Insofar as it is deemed
19appropriate and is desired by the applicant, the educational
20institution and supervisors are encouraged to assist the applicant
21in locating that counseling or psychotherapy at a reasonable cost.



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