If you’ve been confused by recent announcements related to California BBS supervision rules, you’re not alone. The Board of Behavioral Sciences (BBS), which governs LMFTs, LPCCs, and LCSWs in the state, has been trying to get word out about three sets of supervision rule changes that are all happening on January 1, 2022. As of that date, remaining waivers expire, new regulations take effect, and new statutes come into effect as well. Here’s what you need to know.
After a surprise last-minute extension, video-based supervision remains allowed for trainees and associates in all work settings through December 31, 2021. On January 1, 2022, the COVID-related waiver allowing this ends, but a different set of rules takes effect from those that were in place pre-pandemic.
The 2022 BBS supervision rules continue to allow video supervision for associates in exempt settings — that was allowed before the pandemic and remains allowed after. The change is that MFT and PCC trainees in exempt settings will also be permanently allowed to receive video supervision, thanks to a change in law from the word “associate” to the broader “supervisee.” (The law is generally silent on such things for CSWs still working on their degrees, leaving such decisions up to the discretion of the graduate program and the work site.)
Making the issue even more complex, this Friday the BBS will be deciding whether to pursue legislation in 2022 that would make video supervision legal across all work settings, not just exempt settings, as of 2023, under specific conditions.
Supervisee limits in private practice
One of the most significant changes is also one of the easiest to explain: As of January 1, 2022, supervisors in private practice are allowed to have up to six supervisees, rather than the current limit of three. It remains the case that supervisors in exempt settings have no limit on the number of supervisees they can supervise at any given time. The limit of six supervisees per supervisor applies in all non-exempt settings.
Under a set of regulations that has been churning through the adoption process for some time now, standards for supervisors of prelicensed MFTs, PCCs, and CSWs, are being largely standardized and made more specific. Among the changes:
New supervisors of all three professions will need to complete 15 hours of initial supervisor training. (I taught a package of on-demand video courses for SimplePractice Learning that meet this requirement.) Supervisors of PCCs and MFTs who are already actively supervising prior to January 1, 2022, are exempt from the new 15-hour requirement.
All supervisors of all three professions, regardless of when they began supervising, will need to take 6 hours of CE in supervision in each license renewal cycle. Prior BBS supervision rules had required supervisors of CSWs to complete 15 hours initially with no requirement thereafter; supervisors of PCCs and MFTs had to complete 6 hours initially and 6 hours in each renewal cycle. Because those requirements were based on the licensure path of the supervisee, rather than the license type of the supervisor, the inconsistency had regularly created confusion and problems.
The supervision agreement
Two documents — the Supervisor Responsibility Statement and the Supervision Plan — are being combined into one and standardized across the professions. The new document is labeled a Supervision Agreement, and it sets forth the responsibilities of both the supervisor and the supervisee. It is required for all supervisees (trainees and associates) across all three professions.
At present, the only way for the BBS to know which licensees are actively supervising (and to address any issues with supervisor qualifications) is to wait until licensure applications come in. At that point, they can disallow hours gained under unqualified supervisors, and where necessary, engage in disciplinary actions against those supervisors. That, however, is a rather late and punitive process for addressing what are sometimes genuine misunderstandings about qualification standards.
As of January 1, 2022, new supervisors will need to complete and submit a supervisor self-assessment within 60 days of starting supervision. Those who have already been actively supervising have until the end of 2022 to submit the self-assessment. (Technically speaking, the document must be received by the BBS by 1/1/2023.) The self-assessment form requires supervisors to review, and attest that they have met, the various requirements to supervise. It must be signed under penalty of perjury.
When a supervisor is not directly employed by the supervisee’s employer (a situation that sometimes happens in nonprofits and county agencies, where there’s no supervision provided so the supervisee hires their own), there must be an oversight agreement in place between the supervisor and the supervisee’s employer. Among other pieces, this agreement authorizes the supervisor to review files and discuss cases that the supervisee is treating. It also includes a statement from the employer that they will not interfere with supervision. New regulations as of January 1, 2022 spell out specific content requirements for that oversight agreement. Where an oversight agreement is necessary, it must be completed prior to supervision commencing.
As of January 1, 2022, supervisors must “establish written procedures for supervisees to contact the supervisor or, in the supervisor’s absence, procedures for contacting an alternative on-call supervisor to assist supervisees in handling crises and emergencies.” This is a more detailed version of a previous regulation that simply required supervisors to establish emergency protocols. Under the new rule, supervisors must provide these procedures to supervisees prior to beginning supervision.
Evaluation of supervisees
Both the BBS supervision rules and professional ethical standards have been moving in the direction of requiring more formal and routine evaluations of supervisees. As of January 1, 2022, supervisors must engage in formal evaluations of all supervisees at least once per year and again at the termination of supervision. The evaluation should include the supervisee’s strengths and limitations. Supervisees must receive a copy of each evaluation. This was already a requirement for supervisors of social work associates. The new regulations expand this requirement to cover all MFT, PCC, and CSW supervisees, including trainees.
New regulations set forth a standard process for substitute supervision. This process allows a supervisee to continue to gain hours of experience under a temporary replacement supervisor when their regular supervisor is on vacation or otherwise unavailable.
The substitute supervisor must meet all the usual qualifications to supervise, and must complete a Supervision Agreement with each supervisee. Where an oversight agreement is needed (see above), the substitute supervisor must sign one of those as well. If the substitute supervisor is supervising for 30 consecutive calendar days or less, no new Supervision Plan is needed, and the hours gained during this time can be verified by the regular supervisor. If the substitute supervisor is supervising for more than 30 days, a new Supervision Plan is required, and the substitute supervisor is responsible for verifying the experience.
When a supervisor has died or is incapacitated
Under new regulations, the BBS is establishing a protocol for awarding hours of experience gained under a supervisor who has died or become incapacitated. Previously, without the supervisor signing a Verification of Experience at the end of supervision, it was extremely difficult to get the board to approve hours, even with proof that the supervisor had died.
As of January 1, 2022, if a supervisor has died or become incapacitated, the supervisee may still be able to get hours counted. They will need to submit to the BBS 1) evidence of the supervisor’s death or incapacitation; 2) all documentation that had been signed by the supervisor; and 3) documentation of the supervisor’s relationship to the employer. Typically that means either proof of employment or a signed oversight agreement.
Odds and ends
There are some other new rules as well, such as provisions related to the hiring of prelicensed therapists through temporary staffing agencies.
Some existing rules see new specifics added or changed. For example, the definitions of a “private practice” and an “exempt setting” are changed on January 1, as a result of the passage of Assembly Bill 690. That same bill allows MFT and PCC trainees, CSW interns, and applicants for associate registration from all three professions to gain hours in those few non-exempt settings that aren’t private practices or professional corporations. It will be interesting to see that rule get tested when a trainee inevitably attempts to gain hours working for an app-based therapy company.
And as of January 1, the PCC licensure requirement for 150 hours of experience in a hospital or community-based setting is removed. The specific requirements for assessing or treating couples or families are also deleted for PCCs.
Staying compliant with BBS supervision rules
There’s a lot here, to be sure. And I didn’t even cover some of the more minor or obscure provisions. Thankfully, the BBS will be putting out new forms and new guidance for supervisors to help with compliance. Of course, you can always review the rule changes yourself, in the adopted BBS supervision regulations and Assembly Bill 690, which is where most of these changes are located. One of the most important things to hold in mind is the date requirement associated with several of these rules:
- Oversight agreement, where required: Prior to commencement of supervision.
- Emergency provisions: Prior to commencement of supervision.
- Supervision agreement: Within 60 days of commencement of supervision.
- Supervisor self-assessment: Within 60 days of commencement of supervision for those starting to supervise after 1/1/2022; received by BBS by 1/1/2023 for those actively supervising as of 1/1/2022.
- Supervisee evaluation: At least once per year and again at the conclusion or termination of supervision.