BILL NUMBER: AB 250 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 11, 2015
AMENDED IN ASSEMBLY MARCH 26, 2015
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 bill would would, notwithstanding a
specified section of law, 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:
SECTION 1. Section 4980.43 of the Business and Professions Code is
amended to read:
4980.43. (a) Prior to applying for licensure examinations, each
applicant shall complete experience that shall comply with the
following:
(1) A minimum of 3,000 hours completed during a period of at least
104 weeks.
(2) Not more than 40 hours in any seven consecutive days.
(3) Not less than 1,700 hours of supervised experience completed
subsequent to the granting of the qualifying master's or doctoral
degree.
(4) Not more than 1,300 hours of supervised experience obtained
prior to completing a master's or doctoral degree.
The applicant shall not be credited with more than 750 hours of
counseling and direct supervisor contact prior to completing the
master's or doctoral degree.
(5) No hours of experience may be gained prior to completing
either 12 semester units or 18 quarter units of graduate instruction
and becoming a trainee except for personal psychotherapy.
(6) No hours of experience may be gained more than six years prior
to the date the application for examination eligibility was filed,
except that up to 500 hours of clinical experience gained in the
supervised practicum required by subdivision (c) of Section 4980.37
and subparagraph (B) of paragraph (1) of subdivision (d) of Section
4980.36 shall be exempt from this six-year requirement.
(7) Not more than a combined total of 1,000 hours of experience in
the following:
(A) Direct supervisor contact.
(B) Professional enrichment activities. For purposes of this
chapter, "professional enrichment activities" include the following:
(i) Workshops, seminars, training sessions, or conferences
directly related to marriage and family therapy attended by the
applicant that are approved by the applicant's supervisor. An
applicant shall have no more than 250 hours of verified attendance at
these workshops, seminars, training sessions, or conferences.
(ii) Participation by the applicant in personal psychotherapy,
which includes group, marital or conjoint, family, or individual
psychotherapy by an appropriately licensed professional. An applicant
shall have no more than 100 hours of participation in personal
psychotherapy. The applicant shall be credited with three hours of
experience for each hour of personal psychotherapy.
(8) Not more than 500 hours of experience providing group therapy
or group counseling.
(9) For all hours gained on or after January 1, 2012, not more
than 500 hours of experience in the following:
(A) Experience administering and evaluating psychological tests,
writing clinical reports, writing progress notes, or writing process
notes.
(B) Client centered advocacy.
(10) Not less than 500 total hours of experience in diagnosing and
treating couples, families, and children. For up to 150 hours of
treating couples and families in conjoint therapy, the applicant
shall be credited with two hours of experience for each hour of
therapy provided.
(11) Not more than 375 hours of experience providing personal
psychotherapy, crisis counseling, or other counseling services via
telehealth in accordance with Section 2290.5.
(12) It is anticipated and encouraged that hours of experience
will include working with elders and dependent adults who have
physical or mental limitations that restrict their ability to carry
out normal activities or protect their rights.
This subdivision shall only apply to hours gained on and after
January 1, 2010.
(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. Supervised experience shall
be gained by interns and trainees only as an employee or as a
volunteer. 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.
(1) If employed, an intern shall provide the board with copies of
the corresponding W-2 tax forms for each year of experience claimed
upon application for licensure.
(2) If volunteering, an intern shall provide the board with a
letter from his or her employer verifying the intern's employment as
a volunteer upon application for licensure.
(c) Except for experience gained pursuant to subparagraph (B) of
paragraph (7) of subdivision (a), supervision shall include at least
one hour of direct supervisor contact in each week for which
experience is credited in each work setting, as specified:
(1) 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. No more than six hours of supervision, whether
individual or group, shall be credited during any single week.
(2) An individual supervised after being granted a qualifying
degree shall receive at least one additional hour of direct
supervisor contact for every week in which more than 10 hours of
client contact is gained in each setting. No more than six hours of
supervision, whether individual or group, shall be credited during
any single week.
(3) For purposes of this section, "one hour of direct supervisor
contact" means one hour per week of face-to-face contact on an
individual basis or two hours per week of face-to-face contact in a
group.
(4) Direct supervisor contact shall occur within the same week as
the hours claimed.
(5) Direct supervisor contact provided in a group shall be
provided in a group of not more than eight supervisees and in
segments lasting no less than one continuous hour.
(6) Notwithstanding paragraph (3), an intern working in a
governmental entity, a school, a college, or a university, or an
institution that is both nonprofit and charitable may obtain the
required weekly direct supervisor contact via two-way, real-time
videoconferencing. The supervisor shall be responsible for ensuring
that client confidentiality is upheld.
(7) All experience gained by a trainee shall be monitored by the
supervisor as specified by regulation.
(8) The six hours of supervision that may be credited during any
single week pursuant to paragraphs (1) and (2) shall apply to
supervision hours gained on or after January 1, 2009.
(d) (1) A trainee may be credited with supervised experience
completed 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 professional clinical counselor, 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.
(e) (1) An intern may be credited with supervised experience
completed 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 (d), 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 that has
satisfied the requirements of subdivision (g) of Section 4980.03.
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.
(f) Except as provided in subdivision (g), all persons shall
register with the board as an intern in order to be credited for
postdegree hours of supervised experience gained toward licensure.
(g) 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 doctoral degree
and is thereafter granted the intern registration by the board.
(h) Trainees, interns, and applicants shall not receive any
remuneration from patients or clients, and shall only be paid by
their employers.
(i) 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. For purposes of
section Notwithstanding Section 2290.5, interns
and trainees working under licensed supervision, consistent with
subdivision (b), may provide services via telehealth within the scope
authorized by this chapter and in accordance with any regulations
governing the use of telehealth promulgated by the board. Trainees
and interns shall have no proprietary interest in their employers'
businesses and shall not lease or rent space, pay for furnishings,
equipment, or supplies, or in any other way pay for the obligations
of their employers.
(j) 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.
(k) 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.