Title of Regulation: 18VAC115-30. Regulations Governing the Certification of Substance Abuse Counselors and Substance Abuse Counseling Assistants (amending 18VAC115-30-10 through 18VAC115-30-62, 18VAC115-30-110 through 18VAC115-30-150; adding 18VAC115-30-15, 18VAC115-30-63, 18VAC115-30-111; repealing 18VAC115-30-90).

Statutory Authority: §§ 54.1-2400 and 54.1-3505 of the Code of Virginia.

Public Hearing Information:

November 1, 2018 - 10:05 a.m. - Department of Health Professions, 9960 Mayland Drive, 2nd Floor, Richmond, VA 23233

Public Comment Deadline: December 28, 2018.

Agency Contact: Jaime Hoyle, Executive Director, Board of Counseling, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4406, FAX (804) 527-4435, or email jaime.hoyle@dhp.virginia.gov.

Basis: Regulations of the Board of Counseling are promulgated under the general authority of § 54.1-2400 of the Code of Virginia. The scope of practice for professions regulated by the board is found in §§ 54.1-3507.1 and 54.1-3507.2 of the Code of Virginia.

Purpose: The board has added more specificity to the supervised experience requirements and limits the amount of time a person may take to obtain experience and certification. By doing so, clients receiving substance abuse counseling services are more assured of the oversight for those working under supervision and of the competency of their counselors once certified. Additional standards of conduct and causes for disciplinary action will provide further guidance to counselors and assistants on the expectations for ethical practice and give the board more explicit grounds on which to discipline practitioners for the purpose of protecting the health, safety, and welfare of the public they serve.

Substance: The proposed amendments (i) update several definitions and fee requirements and add a section for rules on maintaining current name and address with the board; (ii) clarify prerequisites for certification, including changing "documentation" or "affidavit" to "verification" or "attestation" to accommodate online applications; (iii) change requirements for endorsement to include verification of a passing score on a board-approved examination; (iv) update course content listed in 18VAC115-30-50 and move hours of experience in performing certain therapies from 18VAC115-30-50 to18VAC115-30-60; (v) require completion of half of one's education and for registration of supervision approved by the board prior to the start of supervised practice; (vi) set a time limit on the acquisition of hours of supervision with an allowance for an appeal to the board for an extension; (vii) clarify the minimum hours of supervision by the supervisor; (viii) require some professional training in supervision for supervisors; (ix) specify how supervisees are to identify themselves to clients and how long documentation of supervision must be maintained; (x) clarify requirements for substance abuse counseling assistants; (xi) give a candidate approved to sit for an examination two years to take the exam and pass it, but after the applicant has applied twice and not passed the examination, the applicant would be required to complete an additional six months of supervision; (xii) add requirements for continuing education and more specific requirements for persons who are seeking reinstatement, including demonstration of continued competence and submission of a report from the National Practitioner Data Bank; (xiii) include standards from other behavioral sciences professions that are currently missing in the certified substance abuse counselor regulations, such as maintenance of client records, informed consent, and confidentiality provisions; and (xiv) revise grounds for disciplinary action for more specificity and to include such things as performance of an act likely to deceive, defraud, or harm the public.

Issues: The primary advantage of the proposed amendments for the public is more assurance of competency for certified substance abuse counselors who are increasingly important practitioners in working with persons who have substance abuse issues. There are no disadvantages for the public. There are no advantages or disadvantages to the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Counseling (Board) proposes several amendments concerning the certification of substance abuse counselors and substance abuse counseling assistants. The proposed changes are about: 1) new continuing education requirements, 2) a time limit to pass the certification exam, 3) didactic¹ training, 4) supervised experience, 5) attestation of having read and understood laws and regulations, 6) fees, 7) reports from the U.S. Department of Health and Human Services (USDHHS) National Practitioner Data Bank, and 8) standards of practice, 9) grounds for discipline, and 10) clarifying amendments.

Result of Analysis. The benefits likely exceed the costs for the majority of proposed changes. For other proposed amendments it is uncertain.

Estimated Economic Impact:

Continuing Education. Continuing education (CE) is not currently required for certification renewal. The Board proposes to require certified substance abuse counselors (CSAC) to have completed a minimum of 10 contact hours of CE in substance abuse and certified substance abuse counseling assistants (CSAC-A) to have completed a minimum of 5 contact hours of CE in substance abuse prior to renewal each year.

The median hourly wage for substance abuse counselors in the Commonwealth is $19.83 per hour.² If we assess the value of their time as their median wage, then the time cost for the proposed required 10 contact hours of continuing education for CSACs would be about $200 annually. Data is not available for the median hourly wage for substance abuse counseling assistants. Since their wage is presumably lower, the time cost for the proposed required 5 contact hours of continuing education for CSAC-As would be less than $100 annually.

Members of NAADAC,³ the Association for Addiction Professionals (annual membership cost of $139 for national and state affiliate in Virginia⁴) can take all of the required CE through webinars at no costs.⁵ Many employers of CSACs, such as community services boards, offer continuing education through in-service programs at no costs.⁶ Thus for some CSACs and CSAC-As CE can be obtained for few if any fees, while others may need to spend up to $139 annually.

CE can potentially be valuable for maintaining or increasing competency of professionals. Individuals who actively seek continuing education on their own are likely to benefit in that they will likely be active learners. When there are no examinations or other concrete indications of learning taking place, the value of requiring CE for those who would otherwise not have participated is uncertain; they may not pay attention and gather or reinforce knowledge. Thus we cannot say whether the benefits of the proposed CE requirements exceed the costs.

Certification Exam Time Limit. The Board proposes to require that the certification exam be passed within 2 years of board approval to sit for the exam for both CSAC and CSAC-A applicants. The applicant can take the exam every 90 days within the two-year period or potentially 8 times in 2 years. If he does not pass within the two years, the applicant must reapply in accordance with regulations in effect at that time. If the applicant has applied twice and has still not passed, he will not be approved to sit for the examination again unless he can provide evidence of extenuating circumstances for failure to pass within a four-year period. The Board is concerned about applicants who attempt passage multiple times over a period of years.⁷ If they do finally pass, there may be a large gap between their education and supervised experience and exam passage, which raises questions about competency to practice.

Didactic Training. Applicants for certification as a substance abuse counselor by examination must, among other requirements, have completed didactic training in substance abuse education. The Board proposes to increase the required total number of clock hours of substance abuse didactic training from 220 to 240. This would not add to the net required time required as the Board is also proposing to reduce required supervised experience training by 20 clock hours. Within the 240 hours, the required topics and number of hours per topic in didactic training are proposed to change as well. Further, the Board proposes to add governmental agencies, public school systems and licensed health facilities to the list of approved providers of didactic training. This would be beneficial for applicants as it provides greater flexibility in obtaining qualified education.

Supervised Experience. Applicants for certification as a substance abuse counselor by examination must also obtain supervised experience training to perform specified tasks with substance abuse clients. As alluded to above, the Board proposes to reduce the required total number of clock hours from 180 to 160. Additionally, the Board proposes to require that supervisors have professional training in supervision. Training for supervisors is required for other professions under the Board. The Board believes it is necessary since it is aware of situations in which the supervisor did not understand his role and responsibility and did not appropriately provide training and oversight for a supervisee. Clinical supervisors can obtain professional training in supervision consisting of three credit hours or four quarter hours in graduate-level coursework in supervision. Alternatively, the supervisor could satisfy this requirement with at least two hours of CE in supervision offered by a board-approved provider.

Understanding Laws and Regulations. The current regulation requires that applicants for certification by endorsement submit an affidavit of having read and understood the regulations and laws governing the practice of substance abuse counseling in Virginia. An affidavit requires a notary public signature. Under the proposed regulation the applicant only must attest to having read and understood the regulations and laws governing the practice of substance abuse counseling in Virginia. This change would be beneficial in that it would save time for the applicant without introducing any risk to the public. The Board also proposes to require that applicants for certification by examination attest to having read and understood the regulations and laws governing the practice of substance abuse counseling in Virginia.

Fees. The Board proposes to introduce a $25 fee for verification of an individual's certification to another state or entity. Such verification can be obtained at no cost online through License Lookup at the Department of Health Professions' (DHP) website. Some states will not accept an online verification from DHP's website and require an official paper verification of licensure/certification form completed by the Board. That requires staff time to complete the form and costs for mailing. These costs are currently paid for through other fees not directly linked to this service. Charging this proposed fee directly linked to the service provided is beneficial.

National Practitioner Data Bank. The current regulation requires that applicants for certification as a substance abuse counselor by examination and applicants for certification as a substance abuse counselor by endorsement submit a current report from the USDHHS National Practitioner Data Bank. The Board proposes to also require that applicants for certification by examination for substance abuse counseling assistant applicants for reinstatement submit the report. The report costs only $4 and provides information that may indicate that some applicants have acted previously in a manner that are grounds for denial of certification. Given the low cost and potential to prevent unsafe future situations, these proposed amendments likely produce a net benefit.

Businesses and Entities Affected. The proposed amendments affect the 1,784 certified substance abuse counselors and 218 certified substance abuse counseling assistants in the Commonwealth, as well as potential applicants.

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments are unlikely to significantly affect total employment.

Effects on the Use and Value of Private Property. The proposed amendment do not significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendments do not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed CE requirements require CSACs and CSAC-As to spend time and perhaps fees on completing the requirement. This may produce a small cost for small businesses that employ them in terms of time away from work and potentially in some cases reimbursed fees.

Alternative Method that Minimizes Adverse Impact. Encouraging but not requiring CE would potentially reduce the small potential adverse impact for small businesses.

Adverse Impacts:

Businesses. The proposed CE requirements require CSACs and CSAC-As to spend time and perhaps fees on completing the requirement. This may produce a small cost for businesses that employ them in terms of time away from work and potentially in some cases reimbursed fees.

Localities. The proposed amendments do not adversely affect localities.

Other Entities. The proposed CE requirements increase costs for CSACs and CSAC-As who otherwise would not have taken the required hours of CE.

_______________________________

¹"Didactic" means teaching-learning methods that impart facts and information, usually in the form of one-way communication (includes directed readings and lectures).

²Source: U.S. Bureau of Labor Statistics May 2016 State Occupational Employment and Wage Estimates: https://www.bls.gov/oes/2016/may/oes_va.htm

³National Association for Alcoholism and Drug Abuse Counselors

⁴Source: Department of Health Professions

⁵Ibid

⁶Ibid

⁷Source: Department of Health Professions

Agency's Response to Economic Impact Analysis: The Board of Counseling concurs with the economic impact analysis (EIA) of the Department of Planning and Budget with the exception of the statement in the EIA that the time cost for the proposed required 10 contact hours of continuing education for certified substance abuse counselors (CSACs) would be about $200. The EIA notes that "many employers of CSACs, such as community services boards, offer continuing education through in-service programs at no costs." A CSAC who completes in-service programs or continuing education offered by or required by an employer would not lose pay for the time spent in such a course. Therefore, the agency does not concur that there would be a loss of income of $200 as asserted by the EIA.

Summary:

The proposed amendments include (i) clarifying and specifying requirements for supervised practice, (ii) adding time limits for completion of experience, (iii) adding requirements for continuing education for renewal, and (iv) adding standards of practice.

Part I
General Provisions

18VAC115-30-10. Definitions.

A. The following words and terms when used in this chapter shall have the meaning ascribed to them in § 54.1-3500 of the Code of Virginia:

"Board"

"Certified substance abuse counselor"

"Certified substance abuse counseling assistant"

"Licensed substance abuse treatment practitioner"

"Practice of substance abuse treatment"

"Substance abuse" and "substance dependence"

"Substance abuse treatment"

B. The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Applicant" means an individual who has submitted a completed application with documentation and the appropriate fees to be examined for certification as a substance abuse counselor or substance abuse counseling assistant.

"Candidate" means a person who has been approved to take the examinations for certification as a substance abuse counselor or substance abuse counseling assistant.

"Clinical supervision" means the ongoing process performed by a clinical supervisor who monitors the performance of the person supervised and provides regular, documented face-to-face consultation, guidance and education with respect to the clinical skills and competencies of the person supervised.

"Clinical supervisor" means one who provides case-related supervision, consultation, education and guidance for the applicant. The supervisor must be credentialed as defined in 18VAC115-30-60 C.

"Competency area" means an area in which a person possesses knowledge and skill and the ability to apply them in the clinical setting.

"Contact hour" means the amount of credit awarded for 60 minutes of participation in and successful completion of a continuing education program.

"Didactic" means teaching-learning methods that impart facts and information, usually in the form of one-way communication (includes directed readings and lectures).

"Endorsement" means the waiver of the examination requirement for certification as a substance abuse counselor for persons currently certified or licensed in another jurisdiction.

"Group supervision" means the process of clinical supervision of no less than two nor more than six persons in a group setting provided by a qualified clinical supervisor.

"NAADAC" means the National Association of Alcoholism and Drug Abuse Counselors
Association of Addiction Professionals.

"NCC AP" means the National Certification Commission for Addiction Professionals, an affiliate of NAADAC.

"Regionally accredited" means accredited by one of the regional accreditation agencies recognized by the U.S. Department of Education as responsible for accrediting senior postsecondary institutions.

"Substance abuse counseling" means applying a counseling process, treatment strategies and rehabilitative services to help an individual to:

1. Understand his substance use, abuse or dependency; and

2. Change his drug-taking behavior so that it does not interfere with effective physical, psychological, social or vocational functioning.

18VAC115-30-15. Maintenance of current name and address.

A. Certified substance abuse counselors or counseling assistants shall notify the board of any change of name, email address, or address of record within 60 days.

B. Failure to receive a renewal notice and application forms shall not excuse the certified substance abuse counselor or counseling assistant from the renewal requirement.

18VAC115-30-30. Fees required by the board.

A. The board has established the following fees applicable to the certification of substance abuse counselors and substance abuse counseling assistants:

Substance abuse counselor annual certification renewal	$65
Substance abuse counseling assistant annual certification renewal	$50
Substance abuse counselor initial certification by examination: Application processing and initial certification	$115
Substance abuse counseling assistant initial certification by examination: Application processing and initial certification	$115
Initial certification by endorsement of substance abuse counselors: Application processing and initial certification	$115
Registration of supervision	$65
Add or change supervisor to supervision	$30
Duplicate certificate Certificate verification	$10 $25
Late renewal	$25
Reinstatement of a lapsed certificate	$125
Replacement of or additional wall certificate	$25
Returned check	$35
Reinstatement following revocation or suspension	$600

B. All fees are nonrefundable.

C. Examination fees shall be paid directly to the examination services according to its requirements.

Part II
Requirements for Certification

18VAC115-30-40. Prerequisites for certification by examination for substance abuse counselors.

A. A candidate Every applicant for certification as a substance abuse counselor shall meet all the requirements of this section and by examination shall pass the a written examination prescribed in 18VAC115-30-90 approved by the board. The board shall determine the passing score on the examination.

1. If an applicant fails to achieve a passing score within two years of board approval to sit for the examination, the applicant shall reapply according to regulations in effect at that time.

2. An applicant who has applied twice and has not passed the examination shall not be approved to retake the examination, unless the applicant can provide evidence of extenuating circumstances for failure to pass the examination within the four-year period.

B. Every applicant for examination for certification by the board shall:

1. Meet the educational and experience requirements prescribed in 18VAC115-30-50 and 18VAC115-30-60;

2. Submit the following to the board:

a. A completed application form;

b. Official transcript documenting coursework and attainment of a bachelor's or post-baccalaureate degree;

c. Official transcripts or certificates verifying completion of the didactic training requirement set forth in subsection B of 18VAC115-30-50;

d. Verification Attestation of supervisor's education and experience as required under 18VAC115-30-60 if supervised experience was not previously approved by the board;

e. Verification of supervision forms documenting fulfillment of the experience requirements of 18VAC115-30-60;

f. Documentation Verification of any other health or mental health license or certificate ever held in Virginia or in another jurisdiction. In order to qualify for certification by examination, the applicant shall have no unresolved action against a license or certificate. The board will consider history of disciplinary action on a case-by-case basis;

g. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB); and

h. The application processing and initial certification fee; and

i. Attestation of having read and understood the laws and regulations governing the practice of substance abuse counseling in Virginia.

18VAC115-30-45. Prerequisites for certification by endorsement for substance abuse counselors.

Every applicant for certification by endorsement shall submit:

1. A completed application;

2. The application processing and initial certification fee;

3. Verification of all health or mental health licenses or certificates ever held in Virginia or in any other jurisdiction. In order to qualify for endorsement, the applicant shall have no unresolved action against a license or certificate. The board will consider history of disciplinary action on a case-by-case basis. The board will also determine whether any or all other professional licenses or certificates held in another jurisdiction are substantially equivalent to those sought in Virginia;

4. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB);

5. Affidavit Attestation of having read and understood the regulations and laws governing the practice of substance abuse counseling in Virginia; and

6. Further documentation of one of the following:

a. Licensure Active, unrestricted licensure or certification as a substance abuse counselor in another jurisdiction in good standing obtained by standards substantially equivalent to the education and experience requirements set forth in this chapter as verified by a certified copy of the original application submitted directly from the out-of-state licensing agency, or a copy of the regulations in effect at the time of initial licensure or certification and verification of a passing score on a licensure examination in the jurisdiction in which licensure or certification was obtained, and that is deemed substantially equivalent by the board; or

b. Verification of a current certification in good standing issued by NAADAC NCC AP or other board-recognized national certification in substance abuse counseling obtained by educational and experience standards substantially equivalent to those set forth in this chapter; and

7. Verification of a passing score on an examination in the jurisdiction in which licensure or certification was obtained or on a board-approved national examination at the level for which the applicant is seeking certification in Virginia.

18VAC115-30-50. Educational requirements for substance abuse counselors.

A. An applicant for examination for certification as a substance abuse counselor shall:

1. Have a bachelor's or post-baccalaureate degree; and

2. Have completed 400 240 clock hours of didactic training in substance abuse education from one of the following programs:

a. An A regionally accredited university or college; or

b. Seminars and workshops that meet the requirements of subsection B of this section and are offered or approved by one of the following:

(1) The American Association of Marriage and Family Counselors and its state affiliates Federal, state, or local governmental agencies; public school systems; or licensed health facilities.

(2) The American Association of Marriage and Family Therapists and its state affiliates.

(3) The American Association of State Counseling Boards.

(4) The American Counseling Association and its state and local affiliates.

(5) The American Psychological Association and its state affiliates.

(6) The Commission on Rehabilitation Counselor Certification.

(7) NAADAC, The Association for Addiction Professionals and its state and local affiliates.

(8) National Association of Social Workers.

(9) National Board for Certified Counselors.

(10) A national behavioral health organization or certification body recognized by the board.

(11) Individuals or organizations that have been approved as continuing competency sponsors by the American Association of State Counseling Boards or a counseling board in another state.

B. Substance abuse education.

1. The education will include 220 Of the 240 hours spent in receiving of didactic training in substance abuse counseling, a minimum of 120 hours shall be completed prior to registration of supervision.

2. Each applicant shall have received a minimum of 10 16 clock hours in each of the following eight 13 areas:

a. Understanding the dynamics Dynamics of human behavior;

b. Signs and symptoms of substance abuse;

c. Treatment approaches Counseling theories and techniques;

d. Continuum of care and case management skills;

e. Recovery process and relapse prevention methods;

f. Ethics Professional orientation and ethics;

g. Professional identity in the provision of substance abuse services Pharmacology of abused substances; and

h. Crisis Trauma and crisis intervention.;

i. Co-occurring disorders;  

j. Cultural competency;

In addition, each applicant shall have at least 20 hours in each of the following two areas:

(i) k. Substance abuse counseling approaches and treatment planning and substance abuse research; and

(ii) l. Group counseling; and

m. Prevention, screening, and assessment of substance use and abuse.

2. The education shall also consist of 180 hours of experience performing the following tasks with substance abuse clients:

a. Screening clients to determine eligibility and appropriateness for admission to a particular program;

b. Intake of clients by performing the administrative and initial assessment tasks necessary for admission to a program;

c. Orientation of new clients to program's rules, goals, procedures, services, costs and the rights of the client;

d. Assessment of client's strengths, weaknesses, problems, and needs for the development of a treatment plan;

e. Treatment planning with the client to identify and rank problems to be addressed, establish goals, and agree on treatment processes;

f. Counseling the client utilizing specialized skills in both individual and group approaches to achieve treatment goals and objectives;

g. Case management activities that bring services, agencies, people and resources together in a planned framework of action to achieve established goals;

h. Crisis intervention responses to clients' needs during acute mental, emotional or physical distress;

i. Education of clients by providing information about drug abuse and available services and resources;

j. Referral of clients in order to meet identified needs unable to be met by the counselor and assisting the client in effectively utilizing those resources;

k. Reporting and charting information about client's assessment, treatment plan, progress, discharge summaries and other client-related data; and

l. Consultation with other professionals to assure comprehensive quality care for the client.

Each of these tasks shall be performed for at least eight hours under supervision and shall be verified as a part of the application by the supervisor.

C. Groups and classes attended as a part of a therapy or treatment program will not be accepted as any part of the educational experience.

18VAC115-30-60. Experience requirements for substance abuse counselors.

A. Registration. Supervision in Virginia shall be registered and approved by the board prior to the beginning of supervised experience in order to be counted toward certification. Supervision obtained without prior board approval will not be accepted if it does not meet the requirements set forth in subsections B and C of this section. To register supervision for board approval prior to obtaining the supervised experience, an applicant shall submit in one package:

1. A supervisory contract;

2. Verification Attestation of the supervisor's education and experience as required under subsection subsections C and D of this section; and

3. The registration fee;

4. An official transcript documenting attainment of a bachelor's or post-baccalaureate degree; and

5. Evidence of completion of at least 120 hours of didactic education as required by 18VAC115-30-50 B.

B. Experience requirements.

1. An applicant for certification as a substance abuse counselor shall have had 2,000 hours of supervised experience in the delivery of clinical practice of substance abuse counseling services.

2. The supervised experience shall include a minimum of one hour and a maximum of four hours per week of supervision 40 hours of work experience between the supervisor and the applicant to total 100 hours within the required experience. No more than half of these hours may be satisfied with group supervision. One hour of group supervision will be deemed equivalent to one hour of individual supervision.

3. Applicants must document successful completion of their The supervised experience on the Verification of Supervision Form at the time of application shall be completed in not less than 12 months and not more than 60 months.

a. Supervisees who began a supervised experience before (insert effective date of this regulation) shall complete the supervised experience by (insert 60 months after the effective date).

b. An individual who does not complete the supervised experience within 60 months may request an extension and shall submit evidence to the board demonstrating the extenuating circumstances that prevented completion of the supervised experience within the required timeframe.

4. Supervised experience obtained more than 10 years from (insert effective date of this regulation) shall not be accepted for certification by examination. The board may make an exception for an applicant who has been providing substance abuse counseling for a minimum of 2,000 hours within the past 60 months and who can submit evidence of such experience.

5. During the supervised experience, supervisees shall use their names and the title "supervisee" in all written communications. Clients shall be informed in writing of the supervisee's status and the supervisor's name, professional address, and phone number.

6. The supervised experience shall consist of 160 hours of experience performing the following tasks with substance abuse clients. Each of the following tasks shall be performed for at least eight hours under supervision as verified by the supervisor on an application for certification:

a. Screening clients to determine eligibility and appropriateness for admission to a particular program;

b. Intake of clients by performing the administrative and initial assessment tasks necessary for admission to a program;

c. Orientation of new clients to program's rules, goals, procedures, services, costs, and the rights of the client;

d. Assessment of client's strengths, weaknesses, problems, and needs for the development of a treatment plan;

e. Treatment planning with the client to identify and rank problems to be addressed, establish goals, and agree on treatment processes;

f. Counseling the client utilizing specialized skills in both individual and group approaches to achieve treatment goals and objectives;

g. Case management activities that bring services, agencies, people, and resources together in a planned framework of action to achieve established goals;

h. Crisis intervention responses to a client's needs during acute mental, emotional, or physical distress;

i. Education of clients by providing information about drug abuse and available services and resources;

j. Referral of clients in order to meet identified needs unable to be met by the counselor and assisting the client in effectively utilizing those resources;

k. Reporting and charting information about a client's assessment, treatment plan, progress, discharge summaries, and other client-related data; and

l. Consultation with other professionals to assure comprehensive quality care for the client.

C. Supervisor qualifications. A board-approved clinical supervisor shall hold an active, unrestricted license or certification and shall be:

1. A licensed substance abuse treatment practitioner;

2. A licensed professional counselor, licensed clinical psychologist, licensed clinical social worker, licensed marriage and family therapist, medical doctor, or registered nurse, and possess either who has either:

a a. A board-recognized national certification in substance abuse counseling obtained by standards substantially equivalent to those set forth in this chapter,;

b. A certification as a substance abuse counselor issued by this board; or

a c. A minimum of one year experience in substance abuse counseling and at least 100 hours of didactic training covering the areas outlined in 18VAC115-30-50 B 1 2 a through h 2 m; or

3. A substance abuse counselor certified by the Virginia Board of Counseling who has: a. Board-recognized national certification in substance abuse counseling obtained by standards substantially equivalent to those set forth in this chapter; or b. Two two years of experience as a Virginia board-certified substance abuse counselor.

D. Supervisor training. In order to be approved by the board after (insert 12 months after the effective date of this regulation), a clinical supervisor shall obtain professional training in supervision consisting of three credit hours or four quarter hours in graduate-level coursework in supervision or at least 20 hours of continuing education in supervision offered by a provider approved under 18VAC115-30-50.

E. Supervisory responsibilities.

1. Supervisors shall assume responsibility for the professional activities of the prospective applicants supervisee under their supervision.

2. Supervisors shall not provide supervision for activities for which prospective applicants supervisees have not had appropriate education.

3. Supervisors shall provide supervision only for those substance abuse counseling services that they are qualified to render.

4. At the time of formal the application for certification by examination, the board-approved supervisor shall document minimal competencies in the areas in 18VAC115-30-60 B 6, the applicant's total hours of supervision, length of work experience, competence in substance abuse counseling and any needs for additional supervision or training. The supervisor shall document successful completion of the applicant's supervised experience on the Verification of Supervision Form and shall maintain documentation for five years post supervision.

5. Supervision by any individual whose relationship to the supervisee compromises the objectivity of the supervisor is prohibited.  

18VAC115-30-61. Prerequisites for certification by examination for substance abuse counseling assistant.

A. A candidate Every applicant for certification as a substance abuse counseling assistant shall meet all the requirements of this section, including passing pass a written examination approved by the board. The board shall determine the passing score on the examination prescribed in 18VAC115-30-90.

1. If an applicant fails to achieve a passing score within two years of board approval to sit for the examination, the applicant shall reapply according to regulations in effect at that time.

2. An applicant who has applied twice and has not passed the examination shall not be approved to retake the examination, unless the applicant can provide evidence of extenuating circumstances for failure to pass the examination within the four-year period.

B. Every applicant for examination for certification by the board shall:

1. Meet the educational and experience requirements prescribed in 18VAC115-30-62 and 18VAC115-30-63; and

2. Submit the following to the board within the time frame timeframe established by the board:

a. A completed application form;

b. Official transcript documenting attainment of a high school diploma or, a general education development (GED) certificate, or a post-secondary degree; and

c. The application processing and initial certification fee;

d. Verification of all health or mental health licenses or certificates ever held in Virginia or in any other jurisdiction. In order to qualify for certification, the applicant shall have no unresolved action against a license or certificate. The board will consider the history of disciplinary action on a case-by-case basis; and

e. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).

18VAC115-30-62. Educational requirements for substance abuse counseling assistants.

A. An applicant for certification as a substance abuse counseling assistant shall:

1. Have an official obtained a high school diploma or, a general educational development (GED) certificate, or a post-secondary degree; and

2. Have completed 300 clock hours of substance abuse education from one of the following programs:

a. An A regionally accredited university or college; or

b. Seminars and workshops that meet the educational requirements specified in subsection B of this section and are offered or approved by one of the following:

(1) The American Association of Marriage and Family Counselors and its state affiliates Federal, state, or local governmental agencies; public school systems; or licensed health facilities.

(2) The American Association of Marriage and Family Therapists and its state affiliates.

(3) The American Association of State Counseling Boards.

(4) The American Counseling Association and its state and local affiliates.

(5) The American Psychological Association and its state affiliates.

(6) The Commission on Rehabilitation Counselor Certification.

(7) NAADAC, The Association for Addiction Professionals and its state and local affiliates.

(8) National Association of Social Workers.

(9) National Board for Certified Counselors.

(10) A national behavioral health organization or certification body recognized by the board.

(11) Individuals or organizations that have been approved as continuing competency sponsors by the American Association of State Counseling Boards or a counseling board in another state.

B. Substance abuse education. 1. The education will include 120 hours spent in receiving didactic training in substance abuse counseling. Each applicant shall have received a minimum of 10 eight clock hours in each of the following eight 13 areas:

a. Understanding the dynamics of human behavior;

b. Signs and symptoms of substance abuse;

c. Treatment approaches Counseling theories and techniques;

d. Case management skills and continuum of care;

e. Recovery process and relapse prevention methods;

f. Ethics Professional orientation and ethics;

g. Professional identity in the provision of substance abuse services Cultural competency; and

h. Crisis Trauma and crisis intervention;

i. Pharmacology of abused substances;

j. Co-occurring disorders;

k. Substance abuse counseling approaches and treatment planning;

l. Group counseling; and

m. Prevention, screening, and assessment of substance use and abuse.

2. The education shall include 180 hours of experience performing the following tasks with substance abuse clients while under supervision:

a. Screening clients and gathering information used in making the determination for the need for additional professional assistance;

b. Intake of clients by performing the administrative tasks necessary for admission to a program;

c. Orientation of new clients to program's rules, goals, procedures, services, costs and the rights of the client;

d. Assisting the client in identifying and ranking problems to be addressed, establish goals, and agree on treatment processes;

e. Implementation of a substance abuse treatment plan as directed by the supervisor;

f. Implementation of case management activities that bring services, agencies, people and resources together in a planned framework of action to achieve established goals;

g. Assistance in identifying appropriate crisis intervention responses to clients' needs during acute mental, emotional or physical distress;

h. Education of clients by providing information about drug abuse and available services and resources;

i. Facilitating the client's utilization of available support systems and community resources to meet needs identified in clinical valuation or treatment planning;

j. Reporting and charting information about client's treatment, progress, and other client-related data; and

k. Consultation with other professionals to assure comprehensive quality care for the client.

Each of these tasks shall be performed for at least eight hours under supervision and shall be verified as a part of the application by the supervisor.

C. Groups and classes attended as a part of a therapy or treatment program shall not be accepted as any part of the educational experience.

18VAC115-30-63. Experience requirements for substance abuse counseling assistants.

A. In addition to the didactic training required in 18VAC115-30-62, the education shall include 180 hours of experience in a practicum or internship consistent with § 54.1-3507.2 C of the Code of Virginia performing the following tasks with substance abuse clients while under supervision:

1. Screening clients and gathering information used in making the determination for the need for additional professional assistance;

2. Intake of clients by performing the administrative tasks necessary for admission to a program;

3. Orientation of new clients to program's rules, goals, procedures, services, costs, and the rights of the client;

4. Assisting the client in identifying and ranking problems to be addressed, establishing goals, and agreeing on treatment processes;

5. Implementation of a substance abuse treatment plan as directed by the supervisor;

6. Implementation of case management activities that bring services, agencies, people, and resources together in a planned framework of action to achieve established goals;

7. Assistance in identifying appropriate crisis intervention responses to a client's needs during acute mental, emotional, or physical distress;

8. Education of clients by providing information about drug abuse and available services and resources;

9. Facilitating the client's utilization of available support systems and community resources to meet needs identified in clinical valuation or treatment planning;

10. Reporting and charting information about the client's treatment, progress, and other client-related data; and

11. Consultation with other professionals to assure comprehensive quality care for the client.

B. Each of these tasks shall be performed for at least eight hours under supervision and shall be verified as a part of the application by the supervisor.

C. Groups and classes attended as a part of a therapy or treatment program shall not be accepted as any part of the educational experience.

Part III
Examinations

18VAC115-30-90. General examination requirements for substance abuse counselors and substance abuse counseling assistants. (Repealed.)

A. Every applicant for certification as a substance abuse counselor or substance abuse counseling assistant by examination shall pass a written examination approved by the board. The board shall determine the passing score on the examination.

B. Every applicant for certification by endorsement shall have passed an examination deemed by the board to be substantially equivalent to the Virginia examination.

Part IV III
Renewal and Reinstatement

18VAC115-30-110. Annual renewal of certificate.

A. Every certificate issued by the board shall expire on June 30 of each year.

B. Along with the renewal form, the certified substance abuse counselor or certified substance abuse counseling assistant shall submit the renewal fee prescribed in 18VAC115-30-30 and shall attest to completion of continuing education as required by 18VAC115-30-111.

C. Certified individuals shall notify the board of a change in the address of record or the public address, if different from the address of record within 60 days. Failure to receive a renewal notice and application forms shall not excuse the certified substance abuse counselor from the renewal requirement.

18VAC115-30-111. Continuing education requirements.

A. Certified substance abuse counselors shall be required to have completed a minimum of 10 contact hours of continuing education in substance abuse and certified substance abuse counseling assistants shall be required to have completed a minimum of five contact hours of continuing education in substance abuse prior to renewal each year.

1. Continuing education hours shall be offered by an approved provider listed in 18VAC115-30-50 A or 18VAC115-30-62 A, and the course content shall be consistent with 18VAC115-30-50 B or 18VAC115-30-62 B.

2. Attestation of completion of continuing education is not required for the first renewal following initial certification in Virginia.

B. The board may grant an extension for good cause of up to one year for the completion of continuing education requirements upon written request from the certificate holder prior to the renewal date. Such extension shall not relieve the certificate holder of the continuing education requirement.

C. The board may grant an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the certificate holder such as temporary disability, mandatory military service, or officially declared disasters upon written request from the certificate holder prior to the renewal date.

D. All certificate holders are required to maintain original documentation, including official transcripts showing credit hours earned or certificates of participation, for a period of three years following renewal.

E. The board may conduct an audit of certificate holders to verify compliance with the requirement for a renewal period. Upon request, a certificate holder shall provide documentation of credit hours or participation.

F. Continuing education hours required by disciplinary order shall not be used to satisfy renewal requirements.

18VAC115-30-120. Reinstatement.

A. A person whose certificate has expired may renew it within one year after its expiration date by paying the late renewal fee prescribed in 18VAC115-30-30 and the certification fee prescribed for the year the certificate was not renewed.

B. A person who fails to renew a certificate after one year or more shall apply:

1. Apply for reinstatement, pay;

2. Pay the reinstatement fee for a lapsed certificate and;

3. Submit verification of any other health or mental health license or certificate ever held in another jurisdiction;

4. Submit a current report from the U.S. Department of Health and Human Services National Practitioner Data Bank; and

submit 5. Submit evidence of a minimum of 20 hours of substance abuse education that is consistent with course content specified in subsection B of 18VAC115-30-50 B for substance abuse counselors and in 18VAC115-30-62 for substance abuse counseling assistants to demonstrate the continued ability to perform the functions within the scope of practice of the certificate. Courses shall be offered or approved by a provider listed in 18VAC115-30-50 A or 18VAC115-30-62 A.

Part V
Standards of Practice; Disciplinary Actions; Reinstatement

18VAC115-30-140. Standards of practice.

A. The protection of the public health, safety, and welfare and the best interest of the public shall be the primary guide in determining the appropriate professional conduct of all persons whose activities are regulated by the board.

B. Persons certified by the board shall:

1. Practice in a manner that is in the best interest of the public and does not endanger the public health, safety, or welfare.

2. Be able to justify all services rendered to clients as necessary for diagnostic or therapeutic purposes.

3. Practice only within the competency area for which they are qualified by training or experience.

4. Report to the board known or suspected violations of the laws and regulations governing the practice of certified substance abuse counselors or certified substance abuse counseling assistants.

5. Neither accept nor give commissions, rebates, or other forms of remuneration for referral of clients for professional services. Make appropriate consultations and referrals based on the best interest of clients.

6. Stay abreast of new developments, concepts, and practices that are necessary to providing appropriate services.

7. Document the need for and steps taken to terminate a counseling relationship when it becomes clear that the client is not benefiting from the relationship. Document the assistance provided in making arrangements for the continuation of treatment for clients when necessary, following termination of a counseling relationship.

8. Not willfully or negligently breach the confidentiality between a practitioner and a client. A breach of confidentiality that is required or permitted by applicable law or beyond the control of the practitioner shall not be considered negligent or willful.

C. In regard to client records, persons certified by the board shall:

6. 1. Disclose counseling records to others only in accordance with the requirements of state and federal statutes and regulations, including, but not limited to §§ 32.1-127.1:03 (Patient Health Records Privacy Act), 2.2-3704 (Virginia Freedom of Information Act), and 54.1-2400.1 (Mental Health Service Providers; Duty to Protect Third Parties; Immunity) of the Code of Virginia; 42 USC § 290dd-2 (Confidentiality of Drug and Alcohol Treatment Records); and 42 CFR Part 2 (Alcohol and Drug Abuse Patient Records and Regulations) applicable law.

2. Maintain client records securely, inform all employees of the requirements of confidentiality, and provide for the destruction of records that are no longer useful in a manner that ensures client confidentiality.

3. Ensure confidentiality in the usage of client records and clinical materials by obtaining informed consent from the client or the client's legally authorized representative before (i) videotaping, (ii) audio recording, (iii) permitting third-party observation, or (iv) using identifiable client records and clinical materials in teaching, writing, or public presentations.

4. Maintain timely, accurate, legible, and complete written or electronic records for each client, to include counseling dates and identifying information to substantiate the substance abuse counseling plan, client progress, and termination.

5. Maintain client records for a minimum of five years or as otherwise required by law from the date of termination of the counseling relationship with the following exceptions:

a. At minimum, records of a minor child shall be maintained for five years after attaining the age of majority (18 years);

b. Records that are required by contractual obligation or federal law to be maintained for a longer period of time; or

c. Records that have been transferred to another mental health service provider or given to the client or the client's legally authorized representative.

D. In regard to dual relationships, persons certified by the board shall:

7. 1. Not engage in dual relationships with clients, former clients, supervisees, and supervisors that are harmful to the client's or supervisee's well being, well-being or which that would impair the substance abuse counselor's, substance abuse counseling assistant's, or supervisor's objectivity and professional judgment, or increase the risk of client or supervisee exploitation. This prohibition includes, but is not limited to, such activities as counseling close friends, former sexual partners, employees, or relatives; or engaging in business relationships with clients.

Engaging 2. Not engage in sexual intimacies or romantic relationships with current clients or supervisees is strictly prohibited. For at least five years after cessation or termination of professional services, certified substance abuse counselors and certified substance abuse counseling assistants shall not engage in sexual intimacies or romantic relationships with a client or those included in collateral therapeutic services. Since Because sexual or romantic relationships are potentially exploitative, certified substance abuse counselors and certified substance abuse counseling assistants shall bear the burden of demonstrating that there has been no exploitation. A client's consent to, initiation of, or participation in sexual behavior or involvement with a certified substance abuse counselor or certified substance abuse counseling assistants does not change the nature of the conduct nor lift the regulatory prohibition.

8. 3. Recognize conflicts of interest and inform all parties of obligations, responsibilities, and loyalties to third parties.

E. Upon learning of evidence that indicates a reasonable probability that another mental health provider is or may be guilty of a violation of standards of conduct as defined in statute or regulation, persons certified by the board shall advise their clients of their right to report such misconduct to the Department of Health Professions in accordance with § 54.1-2400.4 of the Code of Virginia.

18VAC115-30-150. Grounds for revocation, suspension, restriction or denial of certificate; petition for rehearing disciplinary action, denial of initial certification, or denial of renewal of certification.

In accordance with subdivision 7 of § 54.1-2400(7) 54.1-2400 and § 54.1-2401 of the Code of Virginia, the board may revoke, suspend, restrict, impose a monetary penalty, or decline to issue or renew a certificate based upon the following conduct:

1. Conviction of a felony or of a misdemeanor involving moral turpitude, or violation of or aid to another in violating any provision of Chapter 35 (§ 54.1-3500 et seq.) of Title 54.1 of the Code of Virginia, any other statute applicable to the practice of substance abuse counseling, or any provision of this chapter;

2. Procuring a certificate, including submission of an application or supervisory forms, by fraud or misrepresentation;

3. Conducting one's practice in such a manner so as to make it a danger to the health and welfare of one's clients or to the public; or if one is unable to practice substance abuse counseling with reasonable skill and safety to clients by reason of illness, abusive use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition;

4. Negligence in professional conduct or nonconformance with the standards of practice outlined in 18VAC115-30-140 or Violating or abetting another person in the violation of any provision of any statute applicable to the practice of substance abuse counseling or any regulation in this chapter;

5. Performance of functions outside the board-certified area of competency in accordance with regulations set forth in this chapter and §§ 54.1-3507.1 and 54.1-3507.2 of the Code of Virginia;

6. Performance of an act likely to deceive, defraud, or harm the public;

7. Intentional or negligent conduct that causes or is likely to cause injury to a client;

8. Failure to cooperate with an employee of the Department of Health Professions in the conduct of an investigation;

9. Failure to report evidence of child abuse or neglect as required in § 63.2-1509 of the Code of Virginia or elder abuse or neglect as required in § 63.2-1606 of the Code of Virginia; or

10. Action taken against a health or mental health license, certification, registration, or application in Virginia or another jurisdiction.