by Catherine Atkins, JD
Deputy Executive Director
The Therapist
November/December 2018

In 2014, the Board of Behavioral Sciences (BBS) began a comprehensive review of the supervision of MFT pre-licensees (as well as LCSW/LPCCs) regulated by the BBS. The impetus for the systematic review stemmed from supervisor and supervisee feedback desiring closer supervision, as well as new technology and changing landscapes in the mental health field.

After years of public hearings, stakeholder feedback, and BBS Committee and BBS Board approval, the BBS created a legislative package (AB 93, Medina), encompassing most of the agreed upon changes to LMFT/LCSW/ LPCC supervision requirements.

This article does not list or review all the supervision requirements or qualifications for supervisors, but instead highlights and summarizes the changes in law, through AB 93. Unless noted otherwise, the changes reviewed below go into effect January 1, 2019.

CHANGES IN SUPERVISION THROUGH AB 93
Introduction of Triadic Supervision:

Anytime a pre-licensee needs “one hour of direct supervisor contact,” it can be completed through:

1. “ individual supervision” (one hour with one supervisor and one supervisee),
2. “ triadic supervision” (one hour with one supervisor and two supervisees), or
3. “ group supervision” (two hours of supervision between one supervisor and up to eight supervisees).

Triadic supervision can be utilized in lieu of “individual supervision” at all times, including to satisfy the 52 weeks of individual supervision.

Examination Applicant—Minimum Supervision: Once an associate’s hours are gained, and the BBS has approved the candidate for examination, applicants for licensure shall receive a minimum of one hour of direct supervisor contact per week for each practice setting in which direct clinical counseling is performed. Supervision for nonclinical practice shall be at the supervisor’s discretion.

90-Day Rule and Livescan (**Goes into effect 2020): Historically, postgraduates who wished to count hours between graduation and issuance of the AMFT registration simply needed to apply for registration within 90 days of their graduation postdate (known as the “90-day rule”). The “90-day rule” is a provision that allowed an applicant for registration as an AMFT to count supervised experience hours gained in the time period in between the degree conferral date, and the date the BBS issues the registration.

This change in law, which goes into effect on January 1, 2020, an applicant may gain hours of experience after degree conferral but before the issuance of the AMFT registration only if the BBS recieves their registration within 90 days of degree conferral date and the hours are gained at a work location that requires completed Live Scan fingerprinting. A completed copy of the Live Scan form must be submitted to the BBS with the application for licensure.

Supervision in a Corporation: Removed is the limit that corporations can hire only 15 supervisees. However, supervisors employed by the professional corporation are still limited to supervising up to three supervisees at one time.

Supervisor’s Licensure: To supervise, the supervisor must have been actively licensed in California, or any other state, for at least two years within the five-year period immediately preceding any supervision, and must have either practiced psychotherapy or provided direct clinical supervision in this same time frame.

Expenses Reimbursement: When a prelicensee volunteers (versus W2 employment) at a work setting other than a private practice, they can be reimbursed for expenses (i.e., trainings, mileage). The $500 cap on expense reimbursement was removed, and there is now no limit. Be mindful, however, that this allowed reimbursement is for actual expenses and not a roundabout way for the employer to pay wages to the pre-licensee. The BBS has the ability to audit the pre-licensee and that individual has the burden of showing that the payment was for expenses actually incurred.

Stipend Exceptions to 1099 Rule: A prelicensee who receives a stipend or educational loan repayment from a program intended to encourage demographically underrepresented groups or employment in underserved regions can be paid via W2 or 1099 (in this circumstance only). If issued via a 1099, the pre-licensee must be able to demonstrate the payment was for the stipend or educational loan repayment program, as the BBS has the ability to audit.

Trainees and Telehealth: Clarification that MFT trainees, as well as associates, can gain hours via telehealth.

Consultation and Peer Discussion: Clarification that consultation or peer discussion will not be considered supervision and shall not qualify as supervised experience. 

Six-Year Rule: Hours to be counted towards licensure must have been gained no more than six years prior to the date of licensure application received by BBS (versus postmarked date).

Supervision Requirements: The new law underscores that the supervisor must:

• Ensure that the extent, kind, and quality of counseling is consistent with education, training and experience of person supervised;
• Monitor and evaluate supervisee assessment, diagnosis and treatment decisions;
• Monitor and evaluate the supervisee’s ability to provide services at the site or sites where he or she is practicing and to the particular clientele being served;
• Be aware of and address countertransference-, intrapsychic-, interpersonal-, or trauma-related issues that may affect the supervisory or practitioner-patient relationship;
• Ensure the supervisee’s compliance with laws and regulations governing the practice of marriage and family therapy; • Review progress notes, process notes, and other patient treatment records; and,
• Directly observe or review supervisee’s work through audio/video recordings of the supervisee’s counseling or therapy, as deemed appropriate by the supervisor (only with client’s consent).

Supervisor’s Record Keeping: The BBS can audit records of a supervisor to verify completion of the supervisory qualifications. A supervisor must keep records of completion of the required supervisor qualifications for seven years after termination of the supervision and must make these records available to the BBS if they audit.

LCSW Hour Requirements: To be in line with LPCC and LMFT licensure, LCSW applicants only need to gain 3,000 hours towards licensure.

ASW applicants may also now utilize the “90- day rule” (discussed above), similar to MFTs and PCCs.

COMING DOWN THE ROAD: REGULATION
The BBS has already begun to draft and discuss additional regulations that will help implement the laws addressed above.

Some of the changes currently being reviewed:

• Creating a Supervisory Plan Form (similar to LCSW requirements) that reviews supervision goals and objections, and where the supervisor attests that he/or she understands the responsibilities of a supervisor;
• Supervisor’s responsibility of availability to supervisees;
• An initial supervisory training course of 15 hours for all supervisors regardless of which category of pre-licensee they supervise (MFT, PCC, CSW);
• Continual requirement of six hours of supervision continuing education every renewal period regardless of which category of pre-licensee they supervise;
• Requirement to notify BBS of supervisory status by supervisor;
• Self-Assessment of qualifications by supervisor for BBS and supervisees;
• Alternatives to supervisory continuing education courses, including collaborations, consultation groups, etc.; and,
• Alternatives to continuing education requirements if a CAMFT or AAMFT Certified Supervisor.

The above-mentioned draft regulations are currently being reviewed by the BBS and will go out for public comment in 2019. It is recommended that if a supervisor or supervisee would like to provide comment, they follow the progress on these regulations by visiting bbs.ca.gov for further information, including attending the BBS Policy & Advocacy Committee meetings. CAMFT projects these changes will be finalized in mid- 2019 to mid-2020.

CONCLUSION
There are many changes in supervision that will go into effect, as well as are being considered. CAMFT recommends that schools, employers, supervisees and supervisors review the above listed changes and discuss them to ensure that each party is on the same page and have equal understanding of each nuance of the changes. CAMFT will also be recording a supervision training course on the issues stated above in Winter 2018.

Catherine L. Atkins, JD, is an attorney and the Deputy Executive Director at CAMFT.

This article is not intended to serve as legal advice and is offered for educational purposes only. The information provided should not be used as a substitute for independent legal advice and it is not intended to address every situation that could potentially arise. Please be aware that laws, regulations and technical standards change over time. As a result, it is important to verify and update any reference or information that is provided in this article.