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Chemical Dependency Professionals Board Rule Changes: Part 2

Client Alert

The below rule changes are effective on April 1, 2024. For questions about these rules, contact BMD attorney Daphne Kackloudis.

Requirements for Certification of Chemical Dependency Counselor Assistants (CDCA) - OAC 4758-5-01

Now, under the amended rule, a certified chemical dependency counselor assistant (CDCA) will be certified for a preliminary, non-renewable thirteen-month period if they meet the requirements under this rule. Specifically, an applicant must (1) be eighteen (18) years old and hold a high school diploma or equivalent and (2) submit a formal application, pay an application fee, and provide a personal attestation statement agreeing to practice by the code of ethical standards adopted by the board. Additionally, the applicant must now complete forty (40) hours of approved substance use disorder specific education in the topics set by the board.

Scope of Practice for Chemical Dependency Counselor Assistants (CDCA) - OAC 4758-6-01

Under the rule, a chemical dependency counselor assistant (CDCA) can provide family counseling within their scope of practice in addition to treatment planning, assessment, crisis intervention, individual counseling, group counseling, case management, and education services. Previously, a CDCA could not provide family counseling to their patients.

Code of Ethics for Chemical Dependency Counselors - OAC 4758-8-01

The amended rule sets forth the minimum standards of practice for certified chemical dependency counselor assistants (CDCA), licensed chemical dependency counselors II (LCDCII), licensed chemical dependency counselors III (LCDCIII), licensed independent chemical dependency counselors (LICDC), licensed independent chemical dependency counselors-clinical supervisors (LICDC-CS), and those licensees who carry the gambling disorder endorsement.

Specifically, licensees or certificate holders should never discriminate against clients on the basis of race, ethnicity, color, sex, gender identity or expression, sexual orientation, religion, age, national ancestry, genetic information, parental status, military status, socioeconomic status, political belief, psychiatric or psychological conditions, and disability, the amount of previous therapeutic or treatment occurrences, or against other persons that could be subject to discrimination but are not expressly protected by state or federal law. The amended rule adds gender identity or expression, genetic information, parental status, and military status as protected categories.

Further, the amended rule adds language imposing an obligation on licensees or certificate holders to protect the clients’ right to confidentiality. The amended rule says that confidential information may only be revealed to others when the clients, or other persons legally authorized to give consent on the behalf of the clients, have given their informed and written consent, unless there is a serious and current or imminent threat of harm to the client of others or as otherwise authorized by law.

The amended rule also states that licensees or certificate holders should maintain objective and non-possessive relationships with clients and not maintain a conflict of interest with any client, former client, family member of a client or a former client, or other person encountered in professional or non-professional settings, which may impair professional judgment, increase the risk of exploitation, or not be in the best interest of a client at any time.

Under the amended rule, a license or certificate holder is prohibited from engaging in any type of sexual conduct or sexual relationship with a current client and should never provide services to anyone in which they have had a prior sexual relationship. Additionally, a licensee or certificate holder is prohibited from having a sexual relationship or any form of sexual conduct with a former client within the two (2) years, at a minimum, following the termination of professional services. However, a licensee or certificate holder should never have a sexual relationship with a former client if such relationship is not in the best interest of the client or increases the risk of exploitation. Sexual conduct is any consensual or non-consensual contact with another person that a reasonable person may consider sexual or sexual in nature, including but not limited to: sexual relationship; sexual advance; sexual solicitation; request for a sexual favor; a text, picture, or video or social media post of a sexual nature; or any other verbal, non-verbal, or physical activity, contact, or conduct that is sexual or sexual in nature.

Further, under the amended rule, a licensee or certificate holder is explicitly prohibited from sexually harassing a client, or they risk the revocation of their license or certificate. Sexual harassment includes any activity, contact, or conduct that a reasonable person may consider offensive or harassing that is sexual or sexual in nature, including but not limited to: sexual advance; sexual solicitation; request for a sexual favor; a text, picture, or video or social media post of a sexual nature; or any other verbal, non-verbal, or physical activity, contact, or conduct that is sexually offensive or harassing.

Importantly, this amended rule now applies to licensees or certificate holders employed to work in any capacity in recovery housing. Residents in recovery housing are considered clients of the licensee or certificate holder.

Code of Ethics for Clinical Supervisors - OAC 4758-8-02

The purpose of this rule is to state the rules of conduct that apply to individuals who hold a valid independent chemical dependency counselor-clinical supervisor license (LICDC-CS), independent chemical dependency counselor license (LICDC) or chemical dependency counselor III license (LCDC III) during the performance of their clinical duties as supervisors.

The amended rule adds the requirement that supervision be maintained through regular face-to-face meetings, which could include video conferencing, with a supervisee or supervisees in group or individual sessions. Sessions should also include documentation of the content of the session, which should be signed by both the supervisor and supervisee if required by certifying or accrediting bodies.

Further, the amended rule adds language that supervision must be provided in a professional and consistent manner to all supervisees regardless of age, race, ethnicity, color, sex, gender identity or expression, national origin, ancestry, religion, genetic information, parental status, military status, physical disability, sexual orientation, political affiliation or belief, marital or social or economic socioeconomic status, psychiatric or psychological conditions, disability, or other identifying traits that could subject an individual to discrimination but are not expressly protected by state or federal law.

Please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com with any questions.


2021 EEOC Charge Statistics: Retaliation & Impact of Remote Work

The U.S. Equal Employment Opportunity Commission (EEOC) released its detailed information on workplace discrimination charges it received in 2021. Unsurprisingly, for the second year in a row, the total number of charges decreased as COVID-19 either shut down workplaces or disconnected employees from each other. In 2021, the agency received a total of approximately 61,000 workplace discrimination charges - the fewest in 25 years by a wide margin. For reference, the agency received over 67,000 charges in 2020, and averaged almost 90,000 charges per year over the previous 10 years.

Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.

No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.