By David G. Jensen, JD
former Staff Attorney
The Therapist
May/June 2017

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Did you notice the spin on the word “All” in the title? Much like the spin a pitcher puts on a baseball to make it curve, the word “All” is italicized to call attention to a certain type of trouble the BBS enforces: Not completing all of your continuing education requirements. You likely won’t lose your license over this kind of trouble. But, you might have to pay an administrative fine, with such fines typically ranging from $300 to $1,200, depending on the severity of the case. A case of one missing unit will be treated differently by the BBS than a case of thirty missing units. You would also have to make up any deficiencies in continuing education requirements as part of your penance.

This sort of trouble commences with the issuance of a “Citation Order” by the BBS, and such orders are used to enforce less severe violations of the unprofessional conduct laws. Although relatively minor when compared with losing one’s license or being placed on probation, a Citation Order is still trouble nonetheless. Being issued a Citation Order can lead to severe angst by LMFTs because such orders are accessible by others at the BBS’s website for a period of five years. So, although you don’t have to wear the “Scarlet Letter A” anymore on your outer attire, it is available online for others to read.

Moreover, Citation Orders can be especially disturbing for licensees because, in these types of cases, such orders also contain allegations of fraud, misrepresentation, and conspiracy. Remember, and this is critical, when you signed the license renewal form, you promised, under penalty of perjury, that you had completed all of your continuing education requirements before you submitted the renewal form to the BBS. A failed audit indicates that you really had not completed all the requirements after you promised under penalty of perjury that you had done so. Hence, the fraud, misrepresentation, and conspiracy allegations. These are difficult words to have your professional reputation associated with indeed!

Since MFTs should guard their professional reputations the way dogs guard their bones, it behooves them to understand a common reason for the issuance of Citation Orders, which is failing to complete all of one’s continuing education requirements.

The Spike 
Failing to complete all of your continuing education requirements is a gamble or oversight that is now more risky than ever. Cue the ominous music!

Why? Because in January, 2016, after a long hiatus, the BBS resumed it’s auditing of licensees to detect those out of compliance. In fact, according to Kim Madsen of the BBS, it now has a staff person dedicated to that activity. So, according to Ms. Madsen, every month, 1% of licensees will be queried about their compliance with continuing education requirements. Auditing is back with a vengeance. Consider the following:    

• In March, 2016, the BBS issued ten Citation Orders and none of them had anything to do with continuing education requirements.¹
• In April, 2016, the BBS issued no Citation Orders.
• In May, 2016, the BBS issued four Citation Orders and none of them had anything to do with continuing education requirements.²
• In June, 2016, the BBS issued thirteen Citation Orders and none of them had anything to do with continuing education requirements.³
• In July, 2016, the BBS issued six Citation Orders, and two of them were for not doing the requisite number of continuing education units.⁴
• In August, 2016, the BBS did not issue any Citation Orders.
• In September, 2016, the BBS issued fourteen Citation Orders and all fourteen had to do with failing to complete required coursework.
• In October, 2016, the BBS issued four Citation Orders and all four had to do with failing to complete required coursework.
• In November, 2016, the BBS issued eleven Citation Orders and all eleven had to do with failing to complete required coursework.
• In December, 2016, the BBS issued eighteen Citation Orders and sixteen of them had to do with failing to complete required coursework.⁵  

So, prior to September, 2016, the “landscape” had been sea-level flat for Citation Orders for violations of the continuing education requirements. But, in September, 2016, there was an Everest-like spike in that landscape. Such spike indicates that the BBS’s auditing efforts are paying off handsomely in detecting those out of compliance with continuing education requirements.

According to Ms. Madsen, LMFTs fail the audit at a rate of 21%! This high number is certainly motivation for the BBS to continue auditing LMFTs! And, based on the number of Citation Orders issued since September, 2016, continuing education auditing might just be the likeliest way for LMFTs to get into trouble with the BBS, which is tragicallyironic because this sort of trouble is eminently avoidable: Simply complete all of your continuing education units before renewing your license.

Auditing is simple and effective for the BBS. To initiate an audit, it notifies you in writing that you have been selected, and that you have to produce evidence of your completed units. Don’t panic; but make sure you have completed all of your continuing education requirements before renewing your license. Towards that end, consider the following:

Number of Hours 
If you are renewing your license for the first time, you must do a minimum of eighteen continuing education units. If you are on your second renewal, and for subsequent renewals thereafter, you must do a minimum of thirty-six continuing education units.

First Time Requirements 
If you are renewing your license for the first time, you must determine whether, as part of your graduate program or otherwise, you completed at least seven hours in the subject of HIV/AIDS, at least seven hours in the subject of Child Abuse Assessment and Reporting, and/or at least three hours of instruction in the subject of aging and long-term care. If you did not meet each of these requirements previously, you would have to cure any deficiencies during your first renewal cycle.

Additionally, you are also required to take six hours of continuing education in law and ethics, even if you already took the law and ethics course in graduate school.

Law & Ethics 
All licensees must do six continuing education units in the subject of law and ethics each and every license renewal period. This requirement, however, can also be fulfilled by participating in at least six hours of the following activities:

1. BBS enforcement case review training,
2. BBS subject matter expert for enforcement case review,
3. BBS examination development workshops, or
4. A professional organization’s law and ethics committee.

The Time Frame 
Continuing education units may only be earned during a license renewal period. You must be aware of your license’s issuance and expiration dates. All of your continuing education units must be done within such license renewal period, not before and not after.

Who is Your Provider? 
For continuing education units to count towards your eighteen-hour or thirty-six hour requirement, as the case may be, effective July 1, 2015, such units must have been earned from one of the following four (4) sources:

1. A BBS-recognized approval agency, such as CAMFT.
2. A provider who has been approved or registered by a BBS-recognized approval agency. For example, providers who have been approved by CAMFT’s Continuing Education Provider Approval (CEPA) Program. The list of such providers can be found at CAMFT’s website.
3. A regionally accredited or state-approved postsecondary institution. The list of acceptable postsecondary institutions can be found at the BBS’s website.
4. A provider with a BBS-issued continuing education provider number that is current and valid. However, the BBS has discontinued its approval and renewal of continuing education providers. Providers with a valid BBS-issued number may offer CE courses only until the provider number expires. By June 30, 2017 there will no longer be any BBS-approved providers except for CAMFT, AAMFT, and NASW.

Some Citation Orders have been issued because the licensee produced certificates of completion or attendance for courses taken from providers who were not approved by one of the entities listed above. Guess what? Those hours did not count, which dropped the licensee’s total below the 18-hour or 36-hour threshold, resulting in the issuance of Citation

Orders. The legitimacy of the provider is an issue the BBS seems to be examining closely.

Before you enroll in a class you must determine who the provider is and whether that provider has been approved by one of the entities listed above. Failure to do so may result in the disqualification of some of your continuing education units, which could drop your total below the 18/36 thresholds.

Supervisors Beware! 
If you supervise trainees or interns, you must do six hours of continuing education in the subject of supervision. The BBS recently announced that a six hour course in law and ethics and supervision could only be used to fulfill either supervision continuing education or law and ethics continuing education requirements, but not both requirements with the same class.

Where are Your Certificates? 
When renewing, you do not need to submit your continuing education certificates or course transcripts to the BBS. You only need to produce them if you are being audited, and you will know if you have been selected for auditing! Therefore, please store your certificates or transcripts in a readily-accessible file folder so that you will have them, should the need arise, which it just might.

Additionally, the BBS will only look back one continuing education cycle for auditing purposes so keeping them for at least two years from the expiration of that licensure renewal period would suffice.

Teaching and Earning CEUs 
Not all continuing education units have to be earned as an attendee. You can also earn continuing education units by teaching a class yourself!

If you teach a six-hour course on treating depression, for instance, you could also get six hours of continuing education credit for doing so. Basically, such coursework must comply with the BBS’s requirements for continuing education courses. If that is met, you get the same credit, in terms of hours, that attendees would get for attending. Unfortunately, continuing education credit is not available for preparation time. There is a limitation, however. You can only claim credit for teaching a course once during a particular renewal period.

If you teach a university-level class, you can earn fifteen continuing education units for each semester unit of the class. So, if you teach a two-unit class on treating depression, you could get thirty hours of continuing education for do so. For those colleges and universities on the quarter system, you can earn ten continuing education units per each quarter hour of the class.

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David Jensen, JD, is a staff attorney at CAMFT. He is available to answer members’ questions regarding legal, ethical, and licensure issues.

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Endnotes
¹ Mistakes cited included supervising without a valid license, not complying with the BBS’s fingerprinting requirement, and allowing interns to work in private practices when the interns were on their second intern registrations, and allowing interns to work as independent contractors. 
²Mistakes cited included failing to meet the BBS’s fingerprinting requirements; supervising an intern with a lapsed registration; and, practicing and advertising without a valid intern registration. 
³ Mistakes cited included minor situations involving the use of alcohol; petty theft; supervising an “intern” who was not registered with the BBS; allowing a trainee to gain hours of experience in a private practice; practicing without valid licenses; gaining hours of experience without supervision; and, breaching confidentiality. 
⁴ Other mistakes cited included practicing without a license, reckless driving, and minor abuses of alcohol. 
⁵Other mistakes cited included shoplifting.

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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.