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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.


Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.

Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.

Ohio Department of Health Releases Updated Charge Limits for Medical Records

Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.