MENTAL HEALTH COUNSELORS OF CENTRAL FLORIDA - ALICIA M. HOMRICH, PHD LICENSED PSYCHOLOGIST - MENTAL HEALTH COUNSELORS OF ...
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Mental Health Counselors
of Central Florida
Alicia M. Homrich, PhD
Licensed Psychologist
Licensed Marriage and Family Therapist
National Certified Counselor
Professor, Rollins College
Objectives
Participants will be able to:
• Understand the mission of regulatory
law.
• Locate Florida’s Laws and Rules that
govern their license.
• Apply licensure laws and rules to
their personal practice.
• Learn about strategies for legal
practice of therapy in the state of
Florida.
Don’t Confuse Us!
Not a Not an
Therapist! Attorney!
Attorney Therapist
Just as lawyers are not trained to provide therapy,
I am not trained to interpret or advise about the law!
If the wording of legislation or board rule is unclear
Consult the board staff or an attorney for clarification.
Just like the speed limit… you are responsible for knowing the rules and laws that govern your license • Ignorance of the law is no excuse. • It is important to stay current. • You are charged to practice legally and ethically and must know how this standard is determined.
Legal? Ethical? What is the difference?
Ethical Guidelines
Established by Professional Associations
Voluntary and apply only to members
Aspirational Codes of Conduct
Reflect Standards of Best Practice
< Most Intent: 1. Promote Profession
Practitioners 2. Protect Clients
Legal Mandates (Laws & Rules)
Established by Governing Bodies
Apply to all licensed individuals AND
to any person practicing described activities
Minimal Mandates or Standards
Intent: 1. Protect Clients/Consumers
An ethical violation may or may not be illegal. A legal violation is almost always unethical.
Primary Governance Florida Department of Health (DOH) Division of Medical Quality Assurance (MQA) Chapter 491 Florida Statutes (the Law) Clinical Counseling and Psychotherapy Services Rule Chapter 64B4 Florida Administrative Code (the Rules) Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling
The Structure of Our Mandates
Florida Statues (LAW)
Made by Legislators,
signed by Governor
Administrative Code
(RULES)
Legislation gives
authority to a Board
to make Rules = LAW
9
0
FS 12
The Structure of Our Mandates FS 4
56
FS. 93
Florida Statues (LAW)
Made by Legislators,
signed by Governor 3 94
FS
FS 415
Additional
Florida Statues
Administrative that govern
Code (RULES) 0 your license:
9
Legislation gives FS
authority to a Board
FS
39
to make Rules = LAW 7456.003 Legislative intent • persons desiring to engage in any lawful profession regulated by the department shall be entitled to do so as a matter of right if otherwise qualified. • professions shall be regulated only for the preservation of the health, safety, and welfare of the public under the police powers of the state. • unregulated practice can harm or endanger the health, safety, and welfare of the public, • the department nor any board may create a regulation that has an unreasonable effect on job creation or job retention
Florida Statute Florida Administrative
491 Code 64B4Example: • 491.0143 - Practice of Sex Therapy • 64B4-7.004 - Use of the title “Sex Therapist.”
Researching the Laws and Rules
To access the licensing board websites:
http://floridasmentalhealthprofessions.gov
https://floridaspsychology.gov/Want to find information about
proposed changes
or issues of concerns?
Read the Board Meeting Minutes!SIGN UP FOR UPDATES!
• http://floridasmentalhealthprofessions.gov/resources/
»Subscribe to receive an email
when new posts are added to the
Board website.Continuing Education Review • CEU records will tracked electronically at the time of renewal. • You will not be able to renew your license electronically without having a completed record of CEU requirements.
Florida 491 CEU Requirements:
Required Subject Area # Hours Important Information
General Hours 25
Medical Errors 2 Must be taken from Board
approved ME provider
Ethics and Boundaries 3
Laws and Rules 3 Required every 3rd Biennium.
Included in the 25 general hours.
Domestic Violence 2 Required every 3rd Biennium.
Included in the 25 general hours.
Qualified Supervisory 4 Required every 3rd Biennium.
Training Included in the 25 general hours.Chapter 491, F.S. 491.003 Definitions – “Scope of Practice.” § 491.003(7) Practice of Clinical Social Work § 491.003(8) Practice of Marriage and Family Therapy § 491.003(9) Practice of Mental Health Counseling
Chapter 491, F.S. • 491.012 – Protected Titles for 491 Licenses and Penalties for Violations. • 491.014 – Exemptions from Licensure. – (3) Clergy – (4) Specified facilities
Chapter 491, F.S. • To report unlicensed practice: – 1-877-HALT ULA (1-877-425-8852) • Email: HALTULA@doh.state.fl.us
Registered Interns and Qualified Supervisors
Definition of Supervision
F.A.C. 64B4-2.002
(1) An Intern shall be credited for the time of supervision
required by Section 491.005 FS, if the intern:
(a) Received at least 100 hours of supervision in no
less than 100 weeks; and,
(b) Provided at least 1500 hours of face-to-face
psychotherapy with clients; and,
(b) Received at least 1 hour of supervision every two
weeks;
(2) Focus on the raw data (written clinical materials, direct
observation and video and audio recordings);Definition of Supervision
F.A.C. 64B4-2.002
(3) May utilize face-to-face electronic methods (not
telephone only) for no more than 50% of supervision;
responsible for maintaining confidentiality;
(4) Group supervision may alternate with each hour of
individual supervision.
Individual supervision =
1 supervisor + 1 or 2 interns
Group supervision =
1 supervisor + up to 6 internsQualified Supervisors: 64B4-3.0085 (2) 1. Send in your letter agreeing to supervise! 2. Make sure the Board receives and acknowledges your Intent to Supervise letter. 3. Obtain a copy of your registered intern’s letter acknowledging approving you as supervisor. 4. Notify the Board yourself if you are no longer supervising a registered intern.
Qualified Supervisors: 1. New Verification Form: 64B4-3.0015 2. http://www.flrules.org/Gateway/reference.asp? No=Ref-07835,
27
Make sure your registered
interns identify themselves
accurately! FS 491.0149
They must use their full professional
title on ALL promotional material
Including all Social Media
I am a Registered
Marriage & Family Therapist
InternChapter 456, F.S.
Regulation of Professions &Occupations
• Omnibus chapter that regulates the
MQA professions under the DOH.
• Takes precedent over other
regulations and the laws of individual
Chapters cannot conflict with it.Florida Mental Health Act:
Chapter 394, F.S. The Baker Act
394.463- Involuntary examinations
• Mental Health Counselors privileged by
Legislative Action in 2005
• Marriage and Family Therapists in 2006
• Preparation Courses are essential
• http://bakeract.fmhi.usf.edu
• Forms available at:
http://www.dcf.state.fl.us/programs/samh/M
entalHealth/laws/index.shtmlSubstance Abuse Services:
Chapter 397, F.S. – The Marchman Act
Special importance To 491 Licensees:
• 397.311(23), (25)
– Defined as providers under this Chapter
• 397.416 - Certified Addictions Professional
(CAP) credential
– This is not a license to do psychotherapySubstance Abuse Services:
Chapter 397, F.S. – The Marchman Act
• 397.501(7)(e) - Minors may seek
treatment without parental consent
• Involuntary admissions:
• 397.675 Criteria for involuntary
admissions
• 397.6791 Initiation of emergency
admission
• Who can institute involuntary
admissions?Proceedings Related to Children
CHAPTER 39, F.S.
Special Importance to 491 Licensees:
Mandatory reporting of known
or suspected child abuse
39.201(1)(a) & (1)(b)2. - 491 Licensees
included as Reporters
39.203 – Protection for ReportingMandatory Reporting of Abuse
Toll free number for reporting in
Florida:
1-800-962-2873
Website: http://www.dcf.state.fl.us/abuse/64B4-7.006 Evaluation of Minors
• To perform evaluations of
minors for the purpose of
making a recommendation
regarding custody, residence or
visitation, the licensee shall
have…64B4-7.006 Requirements for Evaluations of Minors for the Purpose of Addressing Custody, Residence or Visitation Disputes. (1) To perform evaluations of minors for the purpose of making a recommendation regarding custody, residence or visitation, the licensee shall have: – (a) Competence in performing assessments of a psychological nature on children and families; – (b) Education and training in the areas of child and family development, child and family psychopathology, and the impact of divorce on children and families; and – (c) Knowledge of the legal standards and procedures governing divorce and child custody.
• 64B4-7.006 Requirements for Evaluations of Minors for the Purpose of Addressing Custody, Residence or Visitation Disputes. (2) When providing such evaluation of a minor, the licensee shall: – (a) Be impartial, act in the best interest of the child, avoid conflicts of interest, and not have been the treating psychotherapist nor had a prior relationship with any of the parties to the evaluation; and – (b) Use multiple avenues of data gathering, including testing and interviewing methods, and shall involve all persons central to the child in question, including, at a minimum, communication with the child, the parties seeking custody or visitation, any treating mental health professional, family physician, and relatives of the immediate families.
ADULT PROTECTIVE SERVICES
Chapter 415, F.S.
Special Importance to 491 Licensees:
• 415.1034- Mandatory Reporting of
Elder or Disabled Abuse
• 415.1036- Immunity For Reporting
Toll free number for reporting in Florida
1-800-962-2873AVAILABLE FROM:
www.
counseling.org
/publications
/bookstore
OR amazon.comGATEKEEPING IN THE MENTAL HEALTH PROFESSIONS
1. Introduction to Gatekeeping
2. Critical Terminology in Gatekeeping
3. Challenges and Strategies in Addressing
Problematic Trainees
4. Trainee Development and Factors Affecting Behavior
5. Faculty and Supervisor Roles in Gatekeeping
6. Collaboration During Gatekeeping
7. Informing Trainees about Gatekeeping Policies
8. Standards for Personal Behavior and
Professional Conduct
9. Evaluating Trainee Professional Performance
10. Designing Remediation Plans and Interventions
11. Documentation in Gatekeeping
42
12. Preventing Problematic Behavior in TraineesAVAILABLE FROM:
www.
counseling.org
/publications
/bookstore
OR amazon.com• 491.0141 – Practice of Hypnosis • 64B4-7.002 – Qualifications necessary for CSWs, MFTs and MHCs to practice hypnosis.
• 491.0143 - Practice of Sex Therapy • 64B4-7.004 - Use of the title “Sex Therapist.” • 491.0144 - The Practice of Juvenile Sex Offender Therapy • 64B4-7.007 - Use of the title Juvenile Sex Offender Therapy
o 491.0111; 64B4-10.001; 64B4-10.002
o Sexual Misconduct by a Psychotherapist
o 491.0112
o Sexual Misconduct by a Psychotherapist;
Felony Penalties
o 64b4-10.003
o Psychotherapist-Client Relationship
o 64b4-10.004
o Sexual Misconduct not involving a Client§ 456.072 (1)(i) – “Snitch” Law
§ 491.009 – Discipline Section
§ 64B4-5.001 – Disciplinary Guidelines
§ Defines penalties for violations
identified in 491.009
§ EXAMPLE:
§ 491.009 (f)
§ 64B4-5.001(f)
§Statute 491 and Code 64B4
go Hand-in-Hand
when it comes to defining
specific penalties
and qualifications.Other Disciplinary Issues
§ 491.009 – Discipline Section
§ (c) – Found guilty of a crime
§ (f) – Association with those in violation of
laws
§ (i ) – False Documentation
§ (j) – Kickbacks/Fee splitting
§ (q) – Experimental Treatment
§ (r) – Prevailing Standards Treatment
§ (s) – Peer performance
§ (u) – ConfidentialityIf you are ever disciplined…
§ 120 F.S. – Administrative
Procedures Act
§ 120.57 – Hearing Rights
Procedures
§ Your rights in the event you must
go through a disciplinary
hearing.
§ Addresses details of evidence,
procedures, and processes.DOCUMENTATION
• 491.0148 Records
• 64B4-9 Client Records
– 9.001 Requirements for Client
Records.
– 9.002 Definitions and Content of
Records.Chapter 456, F.S.
Special importance to 491 licensees:
§ 456.057 –
Ownership /Control of Records
Of specific concern: (6)
§ 456.058 -- Disposition of Records
Implemented in 64B4-9.001(4) read
previously456.057 Ownership and control of patient records;
report or copies of records to be furnished;
disclosure of information.—
• (6) Any health care practitioner licensed by the department… who
makes a physical or mental examination of, or administers treatment or
dispenses legend drugs to, any person shall, upon request of such
person or the person’s legal representative, furnish, in a timely manner,
without delays for legal review, copies of all reports and records relating
to such examination or treatment….
• However, when a patient’s psychiatric, chapter 490
psychological, or chapter 491 psychotherapeutic records are
requested by the patient or the patient’s legal representative,
the health care practitioner may provide a report of
examination and treatment in lieu of copies of records.
• Upon a patient’s written request, complete copies of the
patient’s psychiatric records shall be provided directly to a
subsequent treating psychiatrist. The furnishing of such report
or copies shall not be conditioned upon payment of a fee for
services rendered.Confidentiality
Privilege
Privacy
Frequent licensure board
complaints involve a breach of
confidentiality and/or a violation
of client/patient privacy.Confidentiality
The legal and ethical duty of the mental health
professional to protect private client
communication.
Privilege
Protection in a judicial or administrative proceeding,
of confidential communication.
Privilege belongs to the client.
Privilege is established/defined by state statute.
(Florida Statutes 90.505 Psychotherapist-patient privilege and 491.0147 Confidentiality
and privileged communication)Privacy Federal statute (HIPAA) designed to establish minimum standards for the protection of private health care information – specifically as it relates to electronic transmission but also has implications for how, to whom, and with what required authorization of protected health information may be communicated.
Evidence Code Chapter 90, F.S. Special importance to 491 licensees: 90.503- Psychotherapist-Patient Privilege (1)(a)3. & (2) & (4) Ò Makes therapeutic records more difficult to access in court without client permission. Ò Distinction between Privilege and Confidentiality.
Confidentiality and
Privileged Communications
• 456.059 - “Duty (?) to Warn”
• 491.0147 – Confidentiality
and Privileged CommunicationHow to Stay Current: • Resources in course booklet. • Books, Articles, Electronic Sources. • Continuing education training. • Consulting with colleagues. • “Interested Parties” e-mail list of the 491 Board • Professional association meetings (FAMFT, FMHCA, NASW, etc.)
Beware of “DRIFT” • Faulty thinking • Faulty information • Faulty advice
Thanks for your attention. ahomrich@rollins.edu
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