New Washington Administrative Code regulations governing licensed mental health counselors, licensed marriage and family therapists and independent clinical social workers in the State of Washington effective 5/13/06

April 2006: Clarification of rules governing licensed counselor record keeping  and mandatory reporting of misconduct.

  Purpose of rule changes: The rules adopt without material change, sections from the Registered Counselor Washington Administrative Code (WAC) chapter 246-810 WAC and are placed in chapter 246-809 WAC for licensed counselors. This rule adoption will result in greater consistency across all counseling professions. This adoption will also establish consistent standards and definitions for licensed counselors for recordkeeping and retention, reporting of abuse, sexual misconduct and mandatory reporting.

Note to the reader:  References below to the RCW refer to the Revised Code of Washington, the law as passed by the Washington State Legislature.  References to the WAC refer to the Washington Administrative Code, the official administrative interpretation of the law by the agencies responsible for enforcing the RCWs.

INDEX TO NEW WAC SECTIONS (5/13/06):

Definitions of licensed counselor,
Recordkeeping and retention,
Reporting of suspected abuse or neglect,
Sexual misconduct,
Mandatory reporting,
Reporting by Health care institutions,
Reporting by Licensed counselor associations,
Health care service contractors and disability insurance carriers,
Reporting by Professional liability carriers,
Reporting by Courts,
Reporting by State and federal agencies.
 

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NEW SECTION

WAC 246-809-010 Definitions. The following terms are defined within the meaning of this chapter.

"Licensed counselor" means a licensed marriage and family therapist, licensed mental health counselor, licensed advanced social worker or licensed independent clinical social worker regulated under chapter 18.225 RCW.

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[NEW SECTION]

WAC 246-809-035 Record Keeping and Retention.

     (1) The licensed counselor providing professional services to a client or providing services billed to a third-party payor, shall document services, except as provided in subsection (2) of this section. The documentation shall include:
     (a) Client name;
     (b) The fee arrangement and record of payments;
     (c) Dates counseling was received;
     (d) Disclosure form, signed by licensed counselor and client;
     (e) The presenting problem(s), purpose or diagnosis;
     (f) Notation and results of formal consults, including information obtained from other persons or agencies through a release of information;
     (g) Progress notes sufficient to support responsible clinical practice for the type of theoretical orientation/therapy the licensed counselor uses.
     (2) If a client requests that no treatment records be kept, and the licensed counselor agrees to the request, the request must be in writing and only the following must be retained:
     (a) Client name;
     (b) Fee arrangement and record of payments;
     (c) Dates counseling was received;
     (d) Disclosure form, signed by licensed counselor and client;
     (e) Written request that no records be kept.
     (3) The licensed counselor must not agree to the request if maintaining records is required by other state or federal law.
     (4) The licensed counselor must keep all records must be kept for a period of five years following the last visit. Within this five-year period, all records must be maintained safely, with properly limited access.
     (5) The licensed counselor must make provisions for retaining or transferring records in the event of going out of business, death or incapacitation.  These provisions may be made in the practitioner's will, an office policy, or by ensuring another licensed counselor is available to review records with a client and recommend a course of action; or other appropriate means as determined by the licensed counselor.

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[NEW SECTION]

     WAC 246-809-040 Reporting of suspected abuse or neglect of a child, dependent adult, or a developmentally disabled person.

     As required by chapter 26.44 and 74.34 RCW, all licensed counselors must report abuse or neglect of a child, dependent adult, dependent adult, or developmentally disabled person if the counselor has reasonable cause to believe that such an incident has occurred.
     The report shall be made to the local law enforcement agency or to the department of social and health services at the first opportunity, but no longer than forty-eight hours after there is reasonable cause to believe that the child or adult has suffered abuse or neglect.

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[NEW SECTION]

     WAC 246-809-049 Sexual misconduct.

     (1) A licensed counselor shall not engage in sexual contact or sexual activity with current clients.
     (2) Licensed counselors shall not accept as patients or clients individuals with whom they have engaged in sexual contact or activity.
     (3) A licensed counselor shall not engage in sexually harassing or demeaning behavior with clients.
     (4) Sexual contact or activity with a client, or an individual who has been a client within the past two years, constitutes unprofessional conduct.
     (5) Licensed counselors shall never engage in sexual contact or activity with former clients, if such contact or activity involves the abuse of the licensed counselor-client relationship.
     (a) The department may consider the following factors in evaluating if the counselor-client relationship has been abusive:
     (i) The amount of time that has passed where there is no contact of any kind between licensed counselor and client;
     ( ii) The nature and duration of the therapy;
     (iii) The circumstances of cessation or termination of therapy;
     (iv) The client's personal history;
     (v) The client's current mental status, emotional dependence and vulnerability;
     (vi) The likelihood of adverse impact on the client and others; and
     (vii) Any statements or actions made by the licensed counselor during the course of therapy suggesting or inviting the possibility of a post termination sexual or romantic relationship with the client.
     (b) If a licensed counselor engages in sexual contact or activity with a client more than two years after the last therapeutic session, the licensed counselor has had no contact with the client during the two-year period, and the sexual activity is not abusive of the licensed counselor-client relationship the department will not consider the relationship to be unprofessional conduct.

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[NEW SECTION]

WAC 246-809-060 Mandatory reporting.

     (1) All reports required by this chapter shall be submitted to the department as soon as possible, but no later than twenty days after a determination is made.
     (2) Reports made in accordance with WAC 246-809-061, 246-809-062, 246-809-063, and 246-809-064 should contain the following information if known:
     (a) The name, address, and telephone number of the person making the report.
     (b) The name, address and telephone number of the licensed counselor being reported.
     (c) The case number of any client or patient whose treatment is a subject of the report.
     (d) A brief description or summary of the facts which gave rise to the issuance of the report, including dates of occurrences.
     (e) If court action is involved, the name of the court in which the action is filed along with the date of filing and docket number.
     (f) Any further information which would aid in the evaluation of the report.
     (3) Mandatory reports are exempt from public inspection and copying to the extent permitted under chapter 42.17 RCW.
     (4) A person is immune from civil liability, whether direct or derivative, for providing information to the department pursuant to RCW 18.130.070.

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[NEW SECTION]

     WAC 246-809-061 Health care institutions.

     (1) The chief administrator or executive officer or their designee of any hospital, nursing home, chemical dependency treatment programs as defined in chapter 70.96A RCW, drug treatment agency as defined in chapter 69.54 RCW, and public and private mental health treatment agencies as defined in RCW 71.05.020, and 71.24.025, shall report to the department when:
     (a) any licensed counselor's services are terminated or are restricted based upon a determination that the counselor has committed an act which may constitute unprofessional conduct or
     (b) that the licensed counselor may be unable to practice with reasonable skill or safety to clients by reason of a mental or physical condition.
     (2) Reports are to be made in accordance with WAC 246-809-060.

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[NEW SECTION]

     WAC 246-809-062 Licensed counselor associations or societies.

     The president or chief executive officer of any licensed counselor association or society within this state shall report to the department when the association or society determines:
     (a) A licensed counselor has committed unprofessional conduct; or
     (b) A licensed counselor may not be able to practice counseling with reasonable skill and safety to clients as the result of any mental or physical condition.
     (2) The report required by this section shall be made without regard to whether the licensed counselor appeals, accepts, or acts upon the determination made by the association or society.  Notification of appeal shall be included.
     (3) Reports must be made in accordance with WAC 246-809-060.

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[NEW SECTION]

WAC 246-809-063 Health care service contractors and disability insurance carriers.

     (1) The executive officer of every health care service contractor and disability insurer, licensed under chapters 48.20, 48.21, 48.21A, and 48.44 RCW, operating in the state of Washington shall report to the department all final determinations that a licensed counselor has engaged in fraud in billing for services. Reports are to be made in accordance with WAC 246-809-060.

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[NEW SECTION]

WAC 246-809-064 Professional liability carriers.

   (1) Every institution or organization providing professional liability insurance directly or indirectly to licensed counselors shall send a complete report to the department of any malpractice settlement, award, or payment in excess of twenty thousand dollars as a result of a claim or action for damages alleged to have been caused by an insured licensed counselor's incompetency or negligence in the practice of counseling.
     (2) The institution or organization shall also report the award, settlement, or payment of three or more claims during a twelve-month period as a result of the licensed counselor's alleged incompetence or negligence in the practice of counseling.
     (3) Reports are to be made in accordance with WAC 246-809-060.

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[NEW SECTION]

     WAC 246-809-065 Courts.

     The department requests the assistance of the clerk of trial courts within the state to report to the department all professional malpractice judgments and all convictions of licensed counselors, other than minor traffic violations.

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[NEW SECTION]

     WAC 246-809-066 State and federal agencies.

     The department requests the assistance of executive officers of any state or federal program operating in the state of Washington, under which a licensed counselor is employed to provide client care services, to report to the department when:
     (a) A licensed counselor has been judged to have demonstrated his/her incompetency or negligence in the practice of counseling; or
     (b) Has otherwise committed unprofessional conduct; or
     (c) May not be able to practice with reasonable skill and safety by reason of any mental or physical condition.
     (2) These requirements do not supersede any federal or state law.

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Webmasters Note:  All these mandatory reporting regulations all ready applied to registered counselors in WAC 246-810.  Now the same standards are clearly being applied to licensed counselor of all kinds in WAC 246-809.