BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 250| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- CONSENT Bill No: AB 250 Author: Obernolte (R) Amended: 6/16/15 in Senate Vote: 21 SENATE BUS, PROF. & ECON. DEV. COMMITTEE: 9-0, 6/15/15 AYES: Hill, Bates, Berryhill, Block, Galgiani, Hernandez, Jackson, Mendoza, Wieckowski ASSEMBLY FLOOR: 78-0, 5/14/15 (Consent) - See last page for vote SUBJECT: Telehealth: marriage and family therapist interns and trainees SOURCE: California Association of Marriage and Family Therapists DIGEST: This bill authorizes marriage and family therapist (MFT) interns and trainees working under licensed supervision to provide services via telehealth. ANALYSIS: Existing law: 1)Authorizes the Board of Behavioral Sciences (Board) to license and regulate the practice of marriage and family therapy and licensed professional clinical counseling. (Business and AB 250 Page 2 Professions Code (BPC) §§ 4980.34, 4999.14) 2)Defines "telehealth" to mean 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 service while the patient is at the originating site and the health care provider is at a distant site; telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers. (BPC § 2290.5(a)(6)) 3)Requires a licensed health care practitioner providing services via telehealth to be subject to the requirements and definitions set forth in existing law, as specified, to the practice act relating to his or her licensed profession, and to the regulations adopted by a board pursuant to that practice act. (BPC § 686) 4)Defines "health care provider" for purposes of telehealth to mean a person who is licensed under BPC. (BPC § 2290.5 (a)(3)) 5)States that, unless otherwise expressly provided, "license" means license, certificate, registration, or other means to engage in a business or profession, as specified. (BPC § 23.7) 6)Defines a MFT "intern" to mean an unlicensed person who has earned his or her master's or doctor's degree qualifying him or her for licensure and is registered with the Board. (BPC § 4980.03(b)). 7)Defines an MFT "trainee" to mean an unlicensed person who is currently enrolled in a master's or doctor's degree program, as specified, that is designed to qualify him or her for licensure, and who has completed no less than 12 semester units or 18 quarter units of coursework in any qualifying degree program. (BPC § 4980.03(c)) 8)Requires a MFT applicant for licensure to complete no more than 375 hours of experience providing personal psychotherapy, crisis counseling, or other counseling services via AB 250 Page 3 telehealth, as specified. (BPC § 4980.43 (a)(11)) 9)Requires an applicant for a professional clinical counselor license to complete a minimum of 3,000 postdegree hours of supervised clinical mental health experience related to the practice of professional clinical counseling, which may include not more than 375 hours of experience providing personal psychotherapy, crisis counseling, or other counseling services via telehealth. (BPC § 4999.46) This bill: 1)Expands the definition of a health care provider to include a MFT intern or trainee for purposes of providing telehealth services. 2)Authorizes MFT interns and trainees working under licensed supervision to provide services via telehealth within the scope authorized by the Marriage and Family Therapist Act (Act) and in accordance with any regulations governing the use of telehealth promulgated by the Board. Background Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, and public health. Technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications. The law establishing parameters for providing telehealth services authorizes only licensed healthcare providers to provide remote healthcare. However, the Act authorizes unlicensed MFT interns and trainees to obtain experience towards their license via telehealth. This presents a disconnect in code. This bill specifically authorizes an MFT intern or trainee to practice via telehealth in both sections of code in accordance with the Act. FISCAL EFFECT: Appropriation: No Fiscal Com.:NoLocal: No AB 250 Page 4 SUPPORT: (Verified6/17/15) California Association of Marriage and Family Therapists (source) American Association for Marriage and Family Therapy, California Division Association of California Healthcare Districts Board of Behavioral Sciences California Council of Community Mental Health Agencies California Primary Care Association SUPPORT AND OPPOSITION: OPPOSITION: (Verified6/17/15) None received ARGUMENTS IN SUPPORT: The sponsor of this bill, the California Association of Marriage and Family Therapists, writes, "Telehealth affords both the patient and the health care provider increased access, flexibility, and cost-efficiencies. BPC § 2290.5 defines 'telehealth,' as well as states that telehealth can be administered by a 'health care provider' licensed under BPC § 2290.5, which includes a MFT. Moreover, BPC § 4980.43 allows MFT trainees to obtain the necessary hours toward their licensure by conducting therapy through telehealth services. However, BPC § 2290.5 fails to authorize the very same trainees to conduct telehealth services. This lack of conformity raises concerns about trainees, and their supervisors, being liable for performing telehealth services without this proposed change." ASSEMBLY FLOOR: 78-0, 5/14/15 AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina AB 250 Page 5 Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins NO VOTE RECORDED: Linder, Medina Prepared by:Sarah Huchel / B., P. & E.D. / (916) 651-4104 6/17/15 15:22:49 **** END ****