No. 37948 (Amendment): Rule R156-60. Mental Health Professional Practice Act Rule

(Amendment)

DAR File No.: 37948
Filed: 08/29/2013 04:17:07 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

During the 2013 General Legislative Session, H.B. 56 was passed which amended provisions of Title 58, Chapter 60, the Mental Health Professional Practice Act. As a result, the Division and the various mental health therapy licensing boards are proposing amendments to this rule to comply with the provisions of H.B. 56 (2013). Additional amendments are also necessary due to the publishing of new versions of materials used by mental health professionals to diagnose mental illness.

Summary of the rule or change:

In Subsection R156-60-102(1), the proposed amendment expands the definition of "approved diagnostic and statistical manual for mental disorders" to include the DSM (Diagnostic and Statistical Manual of Mental Disorders)-5. The inclusion is necessary because the American Psychiatric Association released DSM-5 in May 2013 and it is already in use. The rule should still reference DSM-IV because it continues to be used by many practitioners. A reference to ICD-9 is added because many practitioners continue to use it. In Subsection R156-60-102(3), the definition of "direct supervision" is added as a result of H.B. 56 (2013). Under the proposed language, direct supervision may include when a supervisee meets with a supervisor remotely via real-time electronic methods. Section R156-60-502 is added because the licensing boards felt it was necessary in light of the new reference to the practice of mental health therapy remotely adopted in H.B. 56 (2013).

State statutory or constitutional authorization for this rule:

• Subsection 58-1-106(1)(a)
• Subsection 58-1-202(1)(a)
• Section 58-60-101

Anticipated cost or savings to:

the state budget:

The Division will incur minimal costs due to the need for the Division and various licensing boards to review and approve written supervisory agreements from licensees seeking approval to complete some or all 100 hours of direct supervision via real-time electronic methods under Subsection R156-60-102(3). At this time, it is anticipated that only a few supervisees will seek this approval, resulting in minimal impact to the Division and its budget.

local governments:

The proposed amendments only apply to mental health therapists. As a result, the proposed amendment does not apply to local governments.

small businesses:

The proposed amendment to Subsection R156-60-102(3) expands the definition of direct supervision to include when a supervisee meets with a supervisor remotely via real-time electronic methods. Small businesses may experience a cost savings as a result of this proposed amendment because it may save a supervisor and supervisee the cost of traveling to physically meet with one another. This anticipated cost savings cannot be quantified by the Division due to a wide range of circumstances.

persons other than small businesses, businesses, or local governmental entities:

The proposed amendment to R156-60-102(3) expands the definition of direct supervision to include when a supervisee meets with a supervisor remotely via real-time electronic methods. In some cases, this proposed amendment may translate into a cost savings for individual supervisors and supervisees because they will save the cost of traveling to physically meet with one another. This anticipated cost savings cannot be quantified by the Division due to a wide range of circumstances.

Compliance costs for affected persons:

The proposed amendment to Subsection R156-60-102(3) expands the definition of direct supervision to include when a supervisee meets with a supervisor remotely via real-time electronic methods. In some cases, this proposed amendment may translate into a cost savings for individual supervisors and supervisees because they will save the cost of traveling to physically meet with one another. This anticipated cost savings cannot be quantified by the Division due to a wide range of circumstances.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule filing updates an existing definition to reflect industry developments and creates, in response to H.B. 56 (2013), provisions to ensure that a supervisor who is not physically proximate to a supervisee fulfills the supervisory duties through real-time electronic methods and according to a written plan. Any fiscal impact to businesses was considered by the Legislature in determining to allow remote supervision. No additional fiscal impact is anticipated from these proposed amendments.

Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY, UT 84111-2316

Direct questions regarding this rule to:

• Rich Oborn at the above address, by phone at 801-530-6767, by FAX at 801-530-6511, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

10/15/2013

Interested persons may attend a public hearing regarding this rule:

• 10/03/2013 09:00 AM, Heber Wells Bldg, 160 E 300 S, Conference Room 475, Salt Lake City, UT

This rule may become effective on:

10/22/2013

Authorized by:

Mark Steinagel, Director

RULE TEXT

R156. Commerce, Occupational and Professional Licensing.

R156-60. Mental Health Professional Practice Act Rule.

R156-60-102. Definitions.

In addition to the definitions in Title 58, Chapters 1 and 60, as used in Title 58, Chapters 1 and 60, or this rule:

(1) "Approved diagnostic and statistical manual for mental disorders" means the following:[current edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, or the ICD-10-CM published by Medicode, the American Psychiatric Association, or Practice Management Information Corporation in conjunction with the World Health Organization.]

(a) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5 or Fourth Edition: DSM-IV published by the American Psychiatric Association;

(b) 2013 ICD-9-CM for Physicians, Volumes 1 and 2 Professional Edition published by the American Medical Association; or

(c) ICD-10-CM 2013: The Complete Official Draft Code Set published by the American Medical Association.

(2) "Client or patient" means an individual who, when competent requests, or when not competent to request is lawfully provided professional services by a mental health therapist when the mental health therapist agrees verbally or in writing to provide professional services to that individual, or without an overt agreement does in fact provide professional services to that individual.

(3) "Direct supervision" of a supervisee in training, as used in Subsection 58-60-205(1)(f), 58-60-305(1)(f), and 58-60-405(1)(f), means:

(a) a supervisor meeting with the supervisee when both are physically present in the same room at the same time; or

(b) a supervisor meeting with the supervisee remotely via real-time electronic methods that allow for visual and audio interaction between the supervisor and supervisee under the following conditions:

(i) the supervisor and supervisee shall enter into a written supervisory agreement which, at a minimum, establishes the following:

(A) frequency, duration, reason for, and objectives of electronic meetings between the supervisor and supervisee;

(B) a plan to ensure accessibility of the supervisor to the supervisee despite the physical distance between their offices;

(C) a plan to address potential conflicts between clinical recommendations of the supervisor and the representatives of the agency employing the supervisee;

(D) a plan to inform a supervisee's client or patient and employer regarding the supervisee's use of remote supervision;

(E) a plan to comply with the supervisor's duties and responsibilities as established in rule; and

(F) a plan to physically visit the location where the supervisee practices on at least a quarterly basis during the period of supervision or at a lesser frequency as approved by the Division in collaboration with the Board;

(ii) the supervisee submits the supervisory agreement to the Division and obtains approval before counting direct supervision completed via live real-time methods toward the 100 hour direct supervision requirement; and

(iii) in evaluating a supervisory agreement, the Division shall consider whether it adequately protects the health, safety, and welfare of the public.

([3]4) "Employee" means an individual who is or should be treated as a W-2 employee by the Internal Revenue Service.

([4]5) "General supervision" means that the supervisor is available for consultation with the supervisee by personal face to face contact, or direct voice contact by telephone, radio, or some other means within a reasonable time consistent with the acts and practices in which the supervisee is engaged.

 

R156-60-502. Unprofessional Conduct.

"Unprofessional conduct" includes when providing services remotely:

(1) failing to practice according to professional standards of care in the delivery of services remotely;

(2) failing to protect the security of electronic, confidential data and information; or

(3) failing to appropriately store and dispose of electronic, confidential data and information.

 

KEY: licensing, mental health, therapists

Date of Enactment or Last Substantive Amendment: [November 13, 2012]2013

Notice of Continuation: July 27, 2009

Authorizing, and Implemented or Interpreted Law: 58-1-106(1)(a); 58-1-202(1)(a); 58-60-101

 

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