STATE LEGISLATION
Note: If you are not already familiar with the process of how bills become laws in Florida, it may be helpful to review one or more of these articles prior to reading the legislative update:
How a Florida bill becomes a law (Tampa Bay Times)
FAQ: How a Bill Becomes a Law in Florida (Spectrum News 13)
Flowchart: How a Bill Becomes a Law (Florida Senate)
There are two branches of Florida's Legislative Branch--the Senate and the House of Representatives. To become a law, a bill written in one branch must pass various committees and then be voted on by legislators. Additionally, a "companion bill" in the other branch of the legislature must successfully navigate the same process.
Licensure Portability
SB 358, which we discussed in the November 2021 Legislative Update, is the Counseling Compact bill that, if passed, would enable Florida to join the new interstate counseling compact, permitting counselors in Florida to obtain an "interstate license" permitting them to practice in other states that join the compact, whether in-person or via telehealth.
It's companion bill is HB1521.
FMHCA is hoping to have both bills amended to also rename "registered mental health counselor interns" as "licensed associate mental health counselors" to be consistent with other states and to reduce confusion among legislators and the public who falsely believe that "registered mental health counselor interns" are college students. In order for these bills to pass, SB 590 and HB 1523 will also need to pass. These two bills would exempt the activities of the interstate compact board from Florida's Sunshine Laws. This is needed because there is no guarantee that the other states that join the compact, some of which would not have laws similar to Florida's Sunshine Laws, would want to make all of their activities accessible to the public.
Progress:
- SB 358 was filed on 9/27/21, passed the Senate's Health Policy Committee unanimously on 11/3/21, and is now in the Appropriations Subcommittee on Health and Human Services.
- HB 1521 was filed on 1/10/22 and is currently in the Professions & Public Health Subcommittee.
- SB 590 was filed on 10/20/21, approved by the Health Policy Committee on 12/2/21, and approved by the Governmental Oversight and Accountability on 1/13/22. It is now in the Rules Committee.
- HB 1523 was filed on 1/10/22 and referred to the Professions & Public Health Subcommittee.
- FMHCA is very active in the promotion of these bills.
Licensure Requirements
If passed, SB 566 would postpone the requirement for LMFT applicants to have a master's degree accredited by COAMFTE or CACREP to 9/1/27, giving graduate programs more time to achieve accreditation. Additionally, the bill would revise the requirement (effective 7/1/25) that all LMHC applicants have a CACREP-accredited degree to permit (1) degrees accredited by CACREP; (2) degrees accredited by the the Masters in Psychology and Counseling Accreditation Council; or (3) "an equivalent accrediting body."
Its companion bill is HB 343.
Progress:
- SB 566 was filed on 10/20/21, passed the Health Policy Committee and the Children on 12/2/21, passed the Children, Families, and Elder Affairs Committee, on 12/2/21, and is currently in the Health Policy Committee.
- HB 343 was filed on 10/19/21 and is currently in the Professions & Public Health Subcommittee.
- FMHCA has not taken an official position on this bill as of this writing.
Registered Interns, Telehealth, and Private Practice
F.S. 491.005(1)(c) currently requires registered interns working in private practice settings to have a licensed mental health professional "on the premises" when conducting clinical services. This statute is problematic for a couple reasons, the most notable of which involves telehealth. Many interns in private practice would like to provide telehealth from home offices, where they would not have a licensed mental health professional on the premises. If passed, SB 768 will add the following line to the statute: "When a registered intern provides clinical services through telehealth, a licensed mental health professional must be accessible by telephone or electronic means," effectively making it easier for interns in private practice to conduct telehealth.
Its companion bill is HB 693.
Progress:
- SB 768 was filed on 11/2/21 and is currently in the Appropriations Subcommittee on Health and Human Services.
- HB 693 was filed on 11/22/21 and is currently in the Professions & Public Health Subcommittee.
- Though FMHCA prefers to have this line of Florida law completely removed, this bill is viewed as an improvement over the current law.
"Audio-Only" Telehealth Appointments
If passed, SB 312 will expand the definition of "telehealth" to include "audio-only" sessions, whereas the current definition requires both video and audio. It is my understanding that such a revision in the law would enable counselors to bill Medicaid for audio-only telehealth appointments.
Its companion bill is HB 17.
Progress:
- SB 312 was filed on 9/22/21, approved by the Health Policy Committee on 11/3/21, Banking and Insurance Committee on 12/1/21, and the Rules Committee on 1/13/22, and it has been placed on the calendar for a 2nd reading.
- HB 17 was filed on 8/2/21 and is currently in the Health & Human Services Committee.
- FMHCA has not taken an official position on this bill as of this writing.
FEDERAL LEGISLATION
Note: If you are not already familiar with the process of how bills become federal laws, it may be helpful to review the process at https://www.usa.gov/how-laws-are-made.
Medicare for Counselors and Marriage and Family Therapists
As noted in previous legislative updates, the Mental Health Access Improvement Act (S.828 and companion bill HR.432), if passed, will enable counselors and MFTs to bill Medicare. We consider this bill crucial given that (a) Medicare recipients are struggling to access psychotherapy, and counselors are the single largest group of licensed therapists in the country; and (b) as long as counselors cannot bill Medicare, counselors will never truly be treated equally as our colleagues in psychology and social work, thus perpetuating the myth that counselors are somehow "less than" other professions that can bill Medicare. Click here to learn more from our national parent chapter, the American Mental Health Counselors Association (AMHCA), about how you can support this legislation.
"No Surprises Act" (45 CFR, Part 149) Implementation
The No Surprises Act act was passed in December 2020 and became effective on 1/1/22. However, the interim rule with the greatest application to counselors was not written until 9/30/21, requiring all healthcare professionals (including counselors) to "to give uninsured and self-pay patients a good faith estimate of costs for services that they offer, when scheduling care or when the patient requests an estimate." Among other requirements, counselors are required to specifically ask all new clients whether they have insurance and whether they intend to use it, provide a "good faith estimate" detailing specific information such as diagnoses, anticipated costs of services, frequency/quantity of sessions, legal disclaimers, etc. to all private pay, uninsured, or out-of-network clients. The standard consent forms that counselors have used in the past are highly unlikely to meet the requirements under the new law.
FMHCA broadcasted a complimentary webinar on how to implement the new law on 1/7/22. This 1-hour webinar can be viewed by clicking here, and handouts and templates can be downloaded here.
Additional resources on implementing this law are listed below: