RULE REVISION LISTENING SESSION

The following topics were brought up by LMFT stakeholders at the rule revision listening session held on September 27, 2019.  The notes below represent a summary of comments made by the participants as part of a brainstorming session.  The Board has not made any determinations about rule revisions and will take these comments under consideration as part of the rule review process.  

1. Cultural competency as part of CEUs –MAMFT proposal

    Separate requirement from Ethics CEs.

Why:  Culture and mental health studies that show not living up to cultural norms creates anxiety. 

          Constantly changing cultural trends and relationship to mental health. 

          Can be a barrier to underserved communities receiving/needing help.

          Religious aspects of culture should be addressed as a part of cultural competency.  

There were several members who spoke to this.  This requirement is being added by other boards around the country.

Cultural competency incorporated into MAMFT Board Ethics statement

Increase participation in profession – send the right message on MN’s focus on issue. 

Keep outstate communities in the discussion. 

Programs shouldn’t be partisan

2. Telemental health practices and guidelines.

Training or guidance on how to do telemental health competently is lacking.  

What to require? Additional testing? Training? 

AMFTRB guidelines a good reference point. State of Texas also taking a leading role.  

3. License Portability.
Issues goes hand-in-hand with telemental health. Current 5-year rule was “new” standard 3-5 years ago. Now a lesser standard being promoted by AMFTRB (initial licensure + one complete renewal cycle). Decreasing awareness/concern with jurisdictional limits of a health license when population more mobile.  

4. Guest licensure / temporary licensure considerations. 

In MN, case law establishes the location of the patient as determining where the health care services are provided. May vary state to state. Issue when treating “snowbirds,” college students, etc. New license (guest/temporary) likely requires statutory change (not rule change). 

--Consider whether to allow non-LMFT do some of the required, postgraduate supervision.

Need to aid those practicing in non-metro areas and/or training in specific type of therapy.

--Rule 5300.0150/.0155, have guidelines/requirements for those mental health professionals allowed to provide this non-LMFT supervision.

--Concern, MFT systemic approach needs to be addressed (or, possibly, required) as a part of supervision. 

--Concern if clinic has too many supervisees, lose quality of supervisors.

--Other professions—have a primary supervisor and a delegated supervisor. Require that MFT supervisor is the primary therapist. Perhaps require that supervisors must confer when concurrent supervision occurring. 

-Consider limiting # of supervisors a supervisee can have. Too many supervisees indication of issues. (Board unaware of a correlation between # of supervisors & documented issues in providing MFT.)

--Consider limiting # of supervisees a supervisor can have. 

--Eliminating 90-day grace period concerning; no context; fear it may lead to loss of license for extended period.

--Concern clerical error could cause loss of license

--Discussion of history of CE attestation / extension process. Automatic extension not contained in board rules. Variance/waiver still may be requested, but licensee must show hardship. Discussion of other behavioral health board processes. Board of Psychology grants extension but requires licensee to contemporaneously file plan stating how CEs will be completed (program name, etc.). 

7. Diagnosis and treatment required 5300.0350, subd.6 L (2).
Concern that rule requires a DSM diagnosis—and not all cases fit within a DSM diagnosis.  Other mental health rules do not require a diagnosis. Consider elimination of language from recordkeeping rule.  

Discussion of evidence that relationship skills training beneficial to clients. Most MFTs have not been trained specifically to provide relationship skills training to clients. Require CEUs to train MFTs to teach relationship education/skills to their patients.

Violates MN prohibition on corporate practice of medicine (Minn. Stat. 319B). Unlicensed private practice of MFT. Enforcement lacking/awareness of prohibition lacking. 

Consider prohibition on any applicant for licensure engaged in unlicensed solo/private practice.

Require a minimum period of licensure before a licensee can go into private practice. 

Consider potential impact on services in outstate Minnesota and services to underserved populations.