NEW YEAR – NEW LAWS for 2022

There are many significant legislative and licensing changes that impact MFTs in 2022.  Below is a quick reference guide that briefly outlines these changes. For a more in-depth look at these changes, you can purchase and watch our recorded workshop on the new laws.

Below you will find information on

• Relevant California Law and Regulation Changes that Impact MFTs
• New Federal Mandate – The No Surprises Act 
• Laws and Regulations that Impact Health Plans

When reading through these overviews below, please be sure to visit the appropriate links through your licensing board, the Board of Behavioral Sciences, for complete information on all of these mandates.

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Effective January 1, 2022, information relevant to an elder or dependent adult financial abuse may be provided to federal law enforcement agency, if the incident may be within the agency’s jurisdiction, for the sole purpose of investigating a financial crime committed against the elder or dependent adult. 

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Since July 1, 2020, AB 630 has required licensed and unlicensed therapists to provide their patients with notice of where they can file complaints related to therapy.

Effective January 1, 2022, AB 690 and SB 801 have amended this requirement in two key ways:

1) Therapists must provide patients with the above notice prior to starting treatment or as soon as practicably possible thereafter.

2) Therapists must document their delivery of these notices in the patients' records.

As of January 1, 2020, SB 425 requires health care facilities and other entities where healing arts licensees (e.g. LMFTs, LCSWs, LPCCs, etc.) practice to report written allegations of sexual abuse or misconduct made by patients or their representatives against healing arts licensees to the licensees’ licensing boards (e.g. the BBS, the Board of Psychology, etc.) within 15 days of receiving such written allegations.

• Applicable written allegations against BBS licensees can be reported online via the Department of Consumer Affairs’ BreEZe page by clicking on the “File a Complaint” option.
• Outside of the above scenario, therapists are only required to report instances of sexual abuse or misconduct by psychotherapists that satisfy their mandated reporting obligations related to child abuse, elder abuse, and dependent adult abuse. • E.g. if a therapist sexually abuses a patient who is under the age of 18.

Pursuant to this legislation, as of January 1, 2022, health care practitioners may not provide documentation in support of their patients’ need for emotional support dogs

(“ESDs”) without satisfying the following criteria:

1. The practitioner must possess a valid active license or associate registration;
   Note: The BBS interprets this provision to allow pre-licensees with valid, active associate registrations to provide ESD documentation so long as their supervisors review and approve the documentation.
2. The practitioner must be licensed or registered to provide therapy services in the jurisdiction in which the documentation is provided (i.e. where the patient is located);
3. The practitioner must:
       a) establish a therapeutic relationship with the patient at least 30 days prior to providing the ESD documentation; AND
       ​b) complete a clinical evaluation regarding the individual’s need for an ESD;
4. The practitioner must notify the patient seeking ED documentation, verbally or in writing, that:
   •“[K]nowingly and fraudulently representing oneself to be the owner or trainer of any canine licensed as, to be qualified as, or identified as, a guide, signal, or service dog is a misdemeanor violation of Section 365.7 of the Penal Code.”
5. The practitioner must include their:

• license/registration number;
• effective date of licensure/registration;
• jurisdiction of licensure/registration (e.g. California); and
• license/registration type in the ESD documentation.
• Note: Associates must also include their supervisors' information.

Click here to access the BBS’s FAQ on this new law.

CAMFT’s article, “Emotional Support Animals, Service Animals, and Reasonable Accommodations” will be published in the Jan/Feb 2022 The Therapist magazine.

Feel Free to Review CAMFT’s Emotional Support Dog Documentation Checklist!

ADDITIONAL REGULATION regarding bringing service animals and emotional support animals on airplanes:

Emotional Support Dogs vs. Service Dogs Service Animals

The Department of Transportation’s Definition of “Service Animal” is a dog, regardless of breed or type that is individually trained to do work or perform tasks for the benefit of a qualified individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Although being in the presence of an emotional support animal may alleviate symptoms of depression, anxiety, or other mental health challenges, emotional support animals do not have special training to perform disability-related jobs and tasks.

What does this means for MFTs?  You will likely receive fewer emotional support animal documentation requests from patients seeking to travel with animals on airplanes.

• However, the new regulations still give airlines discretion to allow emotional support animals, so you may continue to receive some requests.
• Additionally, the US Department of Transportation’s regulations may not apply to international flights.
• You may begin receiving requests from patients supporting their need for service dogs.

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AB 690:  New Opportunities for Supervisors in Private Practices and Professional Corporations

Hiring Supervisors in a Private Practice or Professional Corporation

Changes were made to the law regarding where the supervisor of an associate working in a private practice or professional corporation must be employed and practice.  The supervisor must be employed by or contracted by the associate’s employer, or be an owner. The supervisor must also provide  psychotherapeutic services to clients for the associate’s employer; or have a written contract in place that provides the supervisor access to the associate’s clinical records and the associate’s clients must also authorize the release of their clinical records to the supervisor

Increase in Number of Supervisees in Nonexempt Settings

Supervisors of supervisees in any nonexempt setting are limited to six supervisees per supervisor. (Please note that this limit applies to all nonexempt settings, not just private practices and professional corporations.) Click here to review the BBS’s AB 690 FAQ on Practice Settings Definitions and Supervision Law Changes.

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ADDITIONAL SUPERVISION REGULATIONS CHANGES

Changes to Supervision Requirements

Effective January 1, 2022, the BBS’s new supervision regulations do all of the following:

• Create consistency in supervisor requirements and responsibilities between the LMFT, LCSW and LPCC professions.
• Implement several new supervisor responsibilities.
• Require all supervisors to submit a Self-Assessment Report in order to inform the Board that they are supervising, and to self-certify that they meet all qualifications to supervise.
• Require supervisors and supervisees to complete and sign a Supervision Agreement (replaces the Supervisor Responsibility Statement and Supervisory Plan for NEW supervisory relationships).
• Update the contents of the written oversight agreement (for NEW supervisory relationships)
• Set standards in regards to temporary substitute supervisors.
• Set standards for documentation when a supervisor is deceased or becomes incapacitated prior to signing off on an applicant’s supervised experience.
• Set standards in regards to supervisees who have been placed in an agency by a temporary staffing agency.
• Modify supervisor training requirements, including the following:
  • Requires new supervisors to take 15 hours of supervision training that contains specified content within 60 days of commencing supervision.
  • Requires existing supervisors to take 6 hours of continuing professional development every two years, which may include continuing education courses or other specified professional development activities.

Be on the lookout for CAMFT’s 2-part webinar series discussing these new supervision laws and regulations to be held on Friday, January 14^th!

Click here to review the BBS’s FAQ on Supervision Regulation Changes.

The full text of the Supervision-Related Regulations can be found at https://bbs.ca.gov/pdf/regulation/2020/sup_related_ooa.pdf

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SB 801: Registering Email Addresses with the BBS

Any applicant, registrant, or licensee who has an electronic mail (email) address shall provide the BBS with that address no later than July 1, 2022. The email address provided will be considered confidential and not subject to public disclosure. If changes are made to your email address, you must provide the change to the BBS no later than 30 calendar days after the changes have occurred. To access your BBS record and ensure your email address is provided, use the BBB’s BreEZe system.

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SB 801: The Updated MFT Scope of Practice

Exciting news! MFT Scope of Practice has been modernized! SB 801 does not change the MFT scope of practice; it modernizes the language to better articulate what modern MFTs do on a daily basis and the various therapeutic services MFTs provide.

Effective January 1, 2022 the new MFT Scope of Practice will be:

For the purposes of this chapter, the practice of marriage and family therapy shall mean the application of psychotherapeutic and family systems theories, principles, and methods in the delivery of services to individuals, couples, or groups in order to assess, evaluate, and treat relational issues, emotional disorders, behavioral problems, mental illness, alcohol and substance use, and to modify intrapersonal and interpersonal behaviors.

(b) The application of marriage and family therapy principles and methods includes, but is not limited to, all of the following:

(1) Assessment, evaluation, and prognosis.

(2) Treatment, planning, and evaluation.

(3) Individual, relationship, family, or group therapeutic interventions.

(4) Relational therapy.

(5) Psychotherapy.

(6) Client education.

(7) Clinical case management.

(8) Consultation.

(9) Supervision.

(10) Use, application, and integration of the coursework and training required by Sections 4980.36, 4980.37, and 4980.41, as applicable.

Beginning January 1, 2022, the No Surprises Act (H.R. 133) will go into effect. The law includes new requirements for health care providers, facilities, health plans and insurers which are intended to prevent consumers (a.k.a. patients) from receiving unanticipated medical bills. Part 1 of the subsequent regulations protects consumers with health plan coverage from surprise bills from out-of-network MFT providers under limited circumstances related to emergency and non-emergency services at in-network facilities. Part 2 of the regulations published in October of 2021, requires all health care providers and health care facilities licensed, certified or approved by the state to provide good faith estimates of expected charges for services offered to uninsured and self-pay patients. This means as of January 1, 2022, MFTs must provide a good faith estimate of expected charges for services and items within specific timeframes to uninsured or private pay current and future patients. These new regulations set forth specific requirements for what these good faith estimates must contain and add to MFT providers’ recordkeeping responsibilities. For a more in-depth reading of the Act and requirements pertaining to MFTs, click here.

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LAWS and LEGISLATION regarding HEALTH PLANS

AB 1184: Starting July 1, 2022, health plans will have to take additional steps to protect the confidentiality of medical information related to “sensitive services” provided to subscribers and enrollees who qualify as “protected individuals.”  This law impacts health plans directly, but therapists can educate their patients about these new mandates, and encourage patients to work with their health plans regarding their communications of their health records.

Civil Code 56.107(a)

1) A health care service plan shall not require a protected individual to obtain the policyholder, primary subscriber, or other enrollee's authorization to:

• Receive sensitive services; or
• Submit a claim for sensitive services if the protected individual has the right to consent to care.

Civil Code 56.107(a)(3)

A health care service plan shall direct all communications regarding a protected individual’s receipt of sensitive services to an alternative:

• mailing address;
• email address; and/or
• phone number should the protect individual designate such alternative contact information.

Communications that health plans may direct to alternative mailing addresses, email addresses, and phone numbers include:

•  Bills and attempts to collect payment;
• A notice of adverse benefits determinations;
• An explanation of benefits notice;
• A health care service plan’s request for additional information regarding a claim;
  • A notice of a contested claim;
• The name and address of a provider, description of services provided, and other information related to a visit;
• Any written, oral, or electronic communication from a health care service plan that contains protected health information.

Common Treatment Scenarios in Which Patients May Benefit from This Information

• Minor’s consent-based treatment;
• Treatment involving young adults who are on their parents’ health plans;
• Treatment involving domestic violence and/or other forms of abuse;
• Treatment for substance use disorders;
• Treatment involving sexual and reproductive health;
• Treatment involving patients questioning or exploring their sexual and/or gender identities.

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SB 855:  Mental Health Parity

• Effective January 1, 2021, this bill clarifies in state statute that health plans are required to cover treatment for all behavioral conditions contained in the Diagnostic and Statistical Manual of Mental Disorders.
• CAMFT advocated for the inclusion of not only licensed MFTs, but also associate marriage and family therapists and marriage and family therapist trainees.

Pursuant to this law, health plans are permitted (and in some cases may be required) to reimburse for services rendered by:

• MFT associates and trainees;
• ACSWs; and
• APCCs and PCC trainees depending on whether their supervisors have individual or group contracts with the health plans.

Note: The BBS does not permit Prelicensees to receive direct compensation from patients or health plans. Make sure that the plan will be reimbursing the supervisor / the agency or group practice for the pre-licensee’s services.

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Commencing July 1, 2022, [health plans must ensure their enrollees receive] non-urgent follow up appointments with…non-physician mental health care or substance use disorder provider[s] within 10 business days of the prior appointment[s] for those undergoing…course[s] of treatment for…ongoing mental health or substance use disorder condition[s].

Having Trouble with Noncompliant Plans?

Contact the California Department of Managed Health Care’s Help Center

Contact Information for Patients

Phone: 1-888-466-2219

Online Complaint: Click Here

Contact Information for Providers

Phone: 1-888-466-2219

Online Complaint: Click Here