Education for Licensure and Practice as a Mental Health Counselor

1. 1 Education for Licensure and Practice as a Mental Health Counselor NYMHCA � April 4, 2009 David Hamilton, Ph.D., LMSW Executive Secretary State Board for Mental Health Practitioners New York State Education Department Office of the Professions 

2. 2 Purpose of this Presentation Provide an overview of professional regulation in New York State under the Board of Regents Review the education requirements for licensure as a mental health counselor Review the requirements for licensure as a mental health practitioner Discuss professional responsibility and public protection through Office of Professional Discipline

3. 3 Regulation of Mental Health Practice in New York State Legislation introduced to define practice of psychology and psychotherapy in the 1940s Title protection for �licensed psychologist� in 1957 and for �certified social worker� in 1965 Psychotherapy practiced without restriction in New York State Chapter 676 approved December 2002 creating new professions and restricting psychotherapy Regulations approved January 2005 License required to practice January 1, 2006

4. 4 Education Law defines the practice of the profession Authorize and define the practice of the profession including psychotherapy, assessment and treatment. Restrict use of the title to those licensed Restrict practice of profession to those exempt under law including Other professions and occupations Students completing supervised internship Individuals in specified programs until 6/1/2010 Practitioners held accountable under Law

5. 5 Licensure as a Mental Health Counselor Complete license-qualifying education in a New York State-registered program, or the equivalent as determined by Department File application and fee ($345) At least 21 and of good moral character Pass acceptable licensing examination Complete supervised experience in the profession acceptable to the Department Complete child abuse course or exemption

6. 6 Education for licensure

7. 7 Requirements in law & regulations Master�s or higher degree in counseling with specified course content in mental health counseling Practicum and 600 hour internship in mental health counseling 48 semester hours before 12/31/09 60 semester hours after 1/1/2010

8. 8 License-qualifying program Education Department may register program that meets all requirements All students must complete 48- or 60-semester hour program that includes: specified course work in mental health counseling, including practicum course work in the identification and reporting of suspected child abuse & neglect internship in mental health counseling

9. 9 Supervised internship Registered program is responsible for identification of settings and supervisors Setting must be authorized to provide professional services including mental health counseling and psychotherapy Supervisor must be licensed and registered to practice mental health counseling

10. 10 Student practices only under supervision Supervisor is responsible for assessment, evaluation and treatment of each patient and delegating activities to student Student must be competent by training or education to engage in activities Supervisor retains legal and professional responsibility for patient

11. 11 Verification of education Registrar submits Form 2 to SED indicating date on which: Student approved for graduation from license-qualifying program; OR Student received degree in counseling. Transcript not required for license-qualifying program Submitted by registrar not applicant

12. 12 Specificity set in law Degree in mental health counseling with course work & internship for psychotherapy and practice Not a degree in school counseling, career counseling, geriatric counseling, rehabilitation counseling that lacks content for practice Not a degree in psychology, social work, human services or other field

13. 13 Transcript evaluation of applicant�s education Department must evaluate the transcript and course work of student who did not complete a license-qualifying program: Prior to registration by SED Program outside of New York May require additional course work and/or supervised internship

14. 14 Education deficiencies Determination of deficiency is made by Professional Education, not by applicant, graduate program or other jurisdiction Applicant notified of deficiencies and required course work Department has not registered a �bridge� program or advanced certificate as leading to licensure Internship may only be completed in legal setting as defined in law

15. 15 License-qualifying programs and applicant deficiencies Education program may admit student into license-qualifying program Determination of advanced standing or acceptable credits made by college Student completes internship under the exemption for registered program Receives degree or evidence of completion for individual evaluation

16. 16 Transition from 48 to 60 No authority for awarding 48 semester hour degree after 12/31/2009 License-qualifying program at time of degree award 48 semester hour before 12/31/09 60 semester hour after 1/1/10 Requirements at time of application

17. 17 Requirements for Licensure as a Mental Health Practitioner

18. 18 Applicant must be of good moral character Applicant is required to answer questions about past convictions of state or federal crimes or professional discipline in another profession or jurisdiction The Department reviews this information and investigates as appropriate The process for determining good moral character begins after all other licensure requirements have been met Bias toward rehabilitation but each case is considered on its own merits

19. 19 Submit application prior to graduation from program Application and fee submitted to SED Registrar submits Form 2 to verify education for licensure Applicant eligible for limited permit based on application, fee, approved education and moral character Limited permit authorizes supervised practice while meeting experience and examination requirements for licensure Pass NCMHCE examination Complete supervised experience

20. 20 SED may issue limited permits to practice Department may issue permit Setting acceptable to the Department (authorized to employ licensed professionals and provide services) Supervisor qualified to practice and supervise mental health counseling (licensed and registered to practice in New York) Valid for 2 years; may be renewed for 1 year upon application, fee, and just cause Additional supervisors or settings require additional Form 5 but no additional fee May only practice when limited permit is issued

21. 21 Supervised Experience for Licensure in New York State Mental Health Counseling: 3,000 post-degree hours of mental health counseling experience as defined in law at least one-half of the required 3,000 supervised hours in the practice of mental health counseling should be face-to-face with clients (�direct�) and the remainder may be �indirect�. Indirect activities would include supervision, record-keeping, professional development, research, and case management.

22. 22 Guidelines for completion of supervised experience Experience must be completed in a setting where profession may be practiced legally under supervision of a qualified professional Applicant may not operate a private practice Supervisor is licensed to practice the profession and has at least three years of experience prior to supervising Permit provides pre-approval of setting and supervisor for experience

23. 23 Supervision increases skill in practice of profession Average of one hour per week in-person contact between the applicant and supervisor during which: the applicant apprises the supervisor of the assessment and treatment of each client; cases are discussed with the supervisor; the supervisor provides oversight and guidance in developing skills as a mental health practitioner; and may be individual or group supervision.

24. 24 Supervisor is responsible for patients of permit holder Supervisor must evaluate the patient and delegate activities Supervision is NOT consultation Patient must be notified and consent Third-party supervision may only occur when supervisor is employed by facility, not permit holder

25. 25 Examination for Licensure National Clinical Mental Health Counselor Examination (NCMHCE) Computer administered examination Test sites across the U.S. One-week window each month Register with and pay fee to NBCC for examination appointment 10 scenarios for information gather and decision making skills

26. 26 Ensuring Public Protection

27. 27 Practice Under New York State Law & Regulations Title VIII of Education Law defines qualifications for licensure and practice of mental health professions (Article 163) Commissioner�s Regulations clarify the law and requirements for licensure Regents Rules define unprofessional conduct Public Health Law establishes requirements for record keeping and access to records by patients Business Corporations Law defines professional corporate entities

28. 28 Public Protection Through Enforcement Professional discipline process to investigate and address conduct Verify license and discipline on-line (www.op.nysed.gov) Professional Assistance Program for impaired practitioners Illegal practice authority (OAG & SED)

29. 29 Education Law Defines Professional Misconduct Obtaining license fraudulently Practicing fraudulently, beyond authorized scope, with gross incompetence, with gross negligence Practice while ability is impaired by alcohol, drugs, physical or mental disability Convicted of crime or misconduct in New York State, another jurisdiction or federal law.

30. 30 Education Law Defines Professional Misconduct Permitting, aiding or abetting an unlicensed person to provide professional services Practicing the profession while license is suspended, or willfully failing to register or notify department of any change in name or mailing address Committing unprofessional conduct as defined in Regents Rules or Regulations

31. 31 Regents Rules Define Unprofessional Conduct Exercising undue influence on the patient, including sale of appliances, goods or drugs to exploit the client for financial gain Directly or indirectly offering, giving, soliciting, or receiving any fee for the referral of a patient Fee splitting for professional service, rent, etc. Moral unfitness to practice the profession Revealing identifiable information Practicing beyond the scope or without supervision when required

32. 32 Regents Rules Define Unprofessional Conduct Delegating professional responsibility to person not competent to practice Advertising that is not in public interest: False, fraudulent, deceptive, misleading Guarantees any service or outcome Claims professional service that cannot be substantiated Claims professional superiority Offers bonus or inducement other than discount in established fee

33. 33 Unprofessional conduct in health profession Part 29.2 Willfully harassing, abusing or intimidating a patient Failing to maintain patient record & provide access per Public Health Law Using �doctor� without the degree Failing to provide appropriate supervision Guaranteeing satisfaction or cure Claiming special or secret treatment Failure to wear name badge with professional title in a clinic or public setting

34. 34 Law and Regents Rules prohibit certain activities Mental health counselors are prohibited from: prescribing or administering drugs as defined in this chapter as a treatment, therapy, or professional service in the practice of his or her profession; or using invasive procedures as a treatment, therapy, or professional service in the practice of his or her profession. For purposes of this subdivision, "invasive procedure" means any procedure in which human tissue is cut, altered, or otherwise infiltrated by mechanical or other means. Invasive procedure includes surgery, lasers, ionizing radiation, therapeutic ultrasound, or electroconvulsive therapy.

35. 35 Law and Rules require consultation with physician It shall be deemed practicing outside the boundaries of his or her professional competence for a person licensed pursuant to this article, in the case of treatment of any serious mental illness, to provide any mental health service for such illness on a continuous and sustained basis without a medical evaluation of the illness by, and consultation with, a physician regarding such illness. Such medical evaluation and consultation shall be to determine and advise whether any medical care is indicated for such illness. For purposes of this section, "serious mental illness" means schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention-deficit hyperactivity disorder and autism.

36. 36 Licensure affects business entities and corporations Professions are practiced by licensed individuals not by corporations Professional entities include P.C., PLLC, PLLP, but not �Inc.� Entities may only provide services in profession in which member(s) licensed All members of entity must be licensed PLLP and PLLC owners restricted to same licensed profession

37. 37 How do I get more information? NYS Education Department State Board for Mental Health Practitioners 89 Washington Ave, 2nd Floor, Albany, New York 12234 www.op.nysed.gov/mhp.htm 518-474-3817 ext. 450 MHPBD@mail.nysed.gov