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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.


Ohio Supreme Court Clarifies Medical Statute of Limitations

The Ohio Supreme Court issued a decision in late December that clarifies and finalizes the Ohio law regarding the period of time in which patients can assert claims for medical malpractice. The Court was examining the interplay between three different statutes being the statute of limitations, the statute of repose, and the savings statute.

Ohio Hospitals and Healthcare Clinics: It’s Time to Revisit Your Billing and Collection Practices

According to a recent Cuyahoga County case, certain healthcare entities may not be protected from liability when engaging in unfair or deceptive billing acts. This decision is consistent with the growing trend across the country to encourage price transparency and eliminate unfair surprise billing practices by health care organizations. Now is the time for hospitals and other health care organizations to revisit their billing and collection policies and procedures to confirm that they are legally defensible and consistent with best practices.

HIPAA Business Associate Agreements: Why These Contracts Matter

No one loves drafting, reading or negotiating HIPAA Business Associate Agreements (BAAs). Yet many of us need to do so, and some of us do so daily. They are often boring, dense and technical, but BAAs are important from both a legal and a business perspective, and they deserve our attention. Failure to enter a BAA when one is required can constitute a HIPAA violation that results in substantial liability, as demonstrated by certain recent Department of Health & Human Services (HHS) settlements.1 A business associate who makes a disclosure that is not authorized by the applicable BAA or required by law can be subject to civil and, in some cases, criminal penalties. Further, parties are often presented with BAAs that contain onerous one-sided indemnification and other provisions that can be devasting to an organization in the event of a HIPAA breach. The significance of a BAA is often not fully understood by the parties until something goes wrong (e.g., a HIPAA security incident or breach, an Office of Civil Rights (OCR) audit or a fracture in the relationship between the parties) and, at that point, there is limited opportunity to mitigate legal and business risk. Ideally, attention should be given at the commencement of the business associate relationship, when the parties are able, to thoughtfully addressing regulatory requirements, planning and preparing for potential adverse events and appropriately allocating risk among the parties. As with most healthcare regulatory compliance initiatives, a proactive approach with respect to BAAs is preferable. This article provides a broad overview of certain BAA requirements and some practical negotiating tips for the parties involved.

“I’m Out Of Here!” Now What?

We all know that the healthcare industry is experiencing a wave of integration. This trend has been evident for many years. Fewer physicians are willing to assume the legal, financial and other business risks associated with owning their own practices. More and more physicians, including anesthesiologists, are becoming employed by large physician groups, health systems and national providers. This shift necessarily involves not only entry into new employment arrangements but also the termination of existing relationships. And those terminations are often governed by written employment agreements, state and federal healthcare laws and employer benefit plans and other policies and procedures. Before pursuing their next opportunity, physicians should pause for a moment and first attend to the arrangement that they are leaving. Departing physicians need to understand their legal rights and obligations when leaving their current employment relationships in order to avoid unintended consequences and detrimental missteps along the way. Here are a few words of practical advice for physicians contemplating an exit from their current employment arrangements.

Investment Training for the Second and Third Generations

Consider this scenario. Mom and Dad started the business from the ground up. Over the decades it has expanded into a money-making machine. They are able to sell the business and it results in a multimillion-dollar payday for their labors. The excess money has allowed Mom and Dad to invest with various financial advising firms, several fund management groups, and directly with new startups and joint ventures. Their experience has made them savvy investors, with a detailed understanding of how much to invest, when, and where. They cannot justify formation of a full family office with dedicated investors to manage the funds, but Mom and Dad have set up a trust fund for the children to allow these investments to continue to grow over the years. Eventually, Mom and Dad pass. Their children enjoy the fruits of their labors, and, by the time the grandchildren are adults, Mom and Dad's savvy investments are gone.