Title of Regulation: 18VAC125-30. Regulations Governing the Certification of Sex Offender Treatment Providers (amending 18VAC125-30-20 through 18VAC125-30-50, 18VAC125-30-70, 18VAC125-30-80, 18VAC125-30-100).

Statutory Authority: §§ 54.1-2400 and 54.1-3605 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: December 16, 2015.

Effective Date: January 15, 2016.

Agency Contact: Jaime Hoyle, Executive Director, Board of Psychology, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4406, FAX (804) 327-4435, or email jaime.hoyle@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia establishes the general powers and duties of health regulatory boards including the responsibility to promulgate regulations. Section 54.1-3605 of the Code of Virginia authorizes the Board of Psychology to promulgate regulations for certification of sex offender treatment providers.

Purpose: The purpose of the amendments is clarification of qualifications for certification and for those who supervise the experience of trainees preparing for certification. Further clarification and specificity may improve the quality and competency of applicants. Likewise, amendments to the standards of practice will provide clear authority for the board to refuse to issue a certificate to an applicant who is found in violation of one of the specified standards. Adherence to the standards of practice in the profession assures that a certificate holder will not face disciplinary action and is able to protect the health, safety, and welfare of his clients. The cliental of this profession can present significant risk of harm to the public, so the board has a unique responsibility for assuring that providers are competent and compliant with accepted standards of practice.

Rationale for Using Fast-Track Process: The board did not adopt any recommended changes that were more restrictive or burdensome, therefore, the board does not expect any of the changes to be controversial or consequential.

Substance: Amendments will: 1) delete a "comparable degree" as an acceptable educational credential to eliminate language that may be confusing to applicants; 2) clarify the types of licenses one must hold to qualify as a supervisor for clinical experience; 3) allow acceptance of continuing education hours offered by one of the state chapters of the Association for the Treatment of Sexual Abusers; 4) specify that the standards of practice apply to applicants as well as certificate holders; and 5) add romantic relationships with clients or trainees as grounds for unprofessional conduct.

Issues: The primary advantage of the amendments is clarification of current rules and practices. There are no disadvantages to 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 Psychology (Board) proposes to amend its Regulations Governing the Certification of Sex Offender Treatment Providers to 1) make several clarifying changes to regulatory text, 2) specify that an applicant providing services under supervision must also abide by the regulation's standards of practice and 3) add romantic relationships with clients or trainees as unprofessional conduct.

Result of Analysis. Benefits likely outweigh costs for these proposed regulatory changes.

Estimated Economic Impact. The Board proposes several clarifying changes to this regulation's text that will not change any entity's rights or responsibilities but should make the regulation easier to understand. The Board proposes, for instance, to specify what licensure (doctor of medicine licensure, clinical nurse specialist licensure, etc.) would be needed to serve as a supervisor for a sex offender treatment provider trainee, rather than just stating that supervisors shall provide supervision only for sex offender treatment services that they are qualified to render. No entity is likely to incur costs on account of proposed changes that are meant solely to clarify licensure rules. To the extent that these changes may reduce confusion about these rules, interested individuals will benefit.

The current regulation specifies that the regulation's standards of practice apply to "persons certified by the Board." Code of Virginia § 54.1-2400(7), however, gives the Board the authority to refuse to issue a certificate for "causes enumerated in applicable law and regulations"… including this regulation’s standards of practice. The Board now proposes to add applicants under supervision to those subject to the standards of practice so that they know they are expected to follow them and may be denied certification if they do not. Trainees are likely to benefit from this change as they are more likely to know to what standards they will be held.

This regulation currently prohibits that certificate holders from engaging in sexual intimacy with clients or with trainees under their supervision. The Board proposes to also prohibit certificate holders from having romantic relationships with these same entities, presumably even if there is no sexual component to the relationship. This change will benefit clients and trainees as it will prohibit relationships where there is an inherent power imbalance.

Businesses and Entities Affected. Board staff reports that the Board currently certifies 408 sex offender treatment providers. All of these entities, as well as any future trainees and certificate holders, will be affected by these proposed regulatory changes.

Localities Particularly Affected. No locality will be particularly affected by this proposed regulatory action.

Projected Impact on Employment. This regulatory action is unlikely to have an effect on employment in the Commonwealth.

Effects on the Use and Value of Private Property. This regulatory action is unlikely to affect the use or value of any private property.

Small Businesses: Costs and Other Effects. No small businesses will incur costs on account of this regulatory action.

Small Businesses: Alternative Method that Minimizes Adverse Impact. No small businesses will incur costs on account of this regulatory action.

Real Estate Development Costs. This regulatory action will likely have no effect on real estate development costs in the Commonwealth.

Agency's Response to Economic Impact Analysis: The Board of Psychology concurs with the analysis of the Department of Planning and Budget on proposed amendments pursuant to a periodic review of regulations.

Summary:

The amendments (i) delete "comparable degree" as an acceptable educational credential; (ii) clarify the types of licenses that must be held to qualify as a supervisor for clinical experience; (iii) allow acceptance of continuing education hours offered by one of the state chapters of the Association for the Treatment of Sexual Abusers; (iv) specify that the standards of practice apply to applicants as well as certificate holders; and (v) add romantic relationships with clients or trainees as grounds for unprofessional conduct.

18VAC125-30-20. Fees required by the board.

A. The board has established the following fees applicable to the certification of sex offender treatment providers:

	Registration of supervision	$50
	Add or change supervisor	$25
	Application processing and initial certification fee	$90
	Certification renewal	$75
	Duplicate certificate	$5
	Late renewal	$25
	Reinstatement of an expired certificate	$125
	Replacement of or additional wall certificate	$15
	Returned check	$35
	Reinstatement following revocation or suspension	$500
	One-time reduction in fee for renewal on June 30, 2014	$52

B. Fees shall be paid by check or money order made payable to the Treasurer of Virginia and forwarded to the Board of Psychology. All fees are nonrefundable.

Part II
Requirements for Certification

18VAC125-30-30. Prerequisites to certification.

A. Every applicant for certification by the board shall:

1. Meet the educational requirements prescribed in 18VAC125-30-40;

2. Meet the experience requirements prescribed in 18VAC125-30-50;

3. Submit to the executive director of the board:

a. A completed application form;

b. Documented evidence of having fulfilled the education, experience, and supervision set forth in 18VAC125-30-40 and 18VAC125-30-50; and

c. Reference letters from three licensed health care professionals familiar with and attesting to the applicant's skills and experience.

B. The board may certify by endorsement an individual who can document current certification as a sex offender treatment provider in good standing obtained by standards substantially equivalent to those outlined in this chapter as verified by an out-of-state certifying agency on a board-approved form.

18VAC125-30-40. Educational requirements.

An applicant for certification as a sex offender treatment provider shall:

1. Document completion of one of the following degrees:

a. A master's or doctoral degree in social work, psychology, counseling, or nursing from a regionally accredited university; or

b. The degree of Doctor of Medicine or Doctor of Osteopathic Medicine from an institution that is approved by an accrediting agency recognized by the Virginia Board of Medicine; or

c. A comparable degree acceptable to the board.

Graduates of institutions that are not accredited by an acceptable accrediting agency shall establish the equivalency of their education to the educational requirements of the Virginia Board of Social Work, Psychology, Counseling, Nursing or Medicine.

2. Provide documentation of 50 clock hours of training acceptable to the board in the following areas, with 15 clock hours in each area identified in subdivisions 2 a and b of this section, 10 clock hours in each area identified in subdivision 2 c of this section, and five clock hours in each area identified in subdivisions 2 d and e of this section:

a. Sex offender assessment;

b. Sex offender treatment interventions;

c. Etiology/developmental issues of sex offense behavior;

d. Criminal justice and legal issues related to sexual offending; and

e. Program evaluation, treatment efficacy, and issues related to recidivism of sex offenders.

18VAC125-30-50. Experience requirements; supervision.

A. Registration of supervision.

1. In order to register supervision with the board, individuals shall submit:

a. A completed supervisory contract;

b. The registration fee prescribed in 18VAC125-30-20; and

c. Official graduate transcript.

2. The board may waive the registration requirement for individuals who have obtained at least five years documented work experience in sex offender treatment in another jurisdiction.

B. An applicant for certification as a sex offender treatment provider shall provide documentation of having 2,000 hours of postdegree clinical experience in the delivery of clinical assessment/treatment services. At least 200 hours of this experience must be face-to-face treatment and assessment with sex offender clients.

1. The experience shall include a minimum of 100 hours of face-to-face supervision within the 2,000 hours experience with a minimum of six hours per month. A minimum of 50 hours shall be in individual face-to-face supervision. Face-to-face supervision obtained in a group setting shall include no more than six trainees in a group.

2. If the applicant has obtained the required postdegree clinical experience for a mental health license within the past 10 years, he can receive credit for those hours that were in the delivery of clinical assessment/treatment services with sex offender clients provided:

a. The applicant can document that the hours were in the treatment and assessment with sex offender clients; and

b. The supervisor for those hours can attest that he is was licensed and qualified to render services to sex offender clients at the time of the supervision.

B. C. Supervised experience obtained in Virginia without prior written board approval shall not be accepted toward certification. Candidates shall not begin the experience until after completion of the required degree as set forth in 18VAC125-30-40. An individual who proposes to obtain supervised postdegree experience in Virginia shall, prior to the onset of such supervision, submit a supervisory contract along with the application package and pay the registration of supervision fee set forth in 18VAC125-30-20.

C. D. The supervisor.

1. The supervisor shall assume responsibility for the professional activities of the applicant.

2. The supervisor shall not provide supervision for activities for which the prospective applicant has not had appropriate education.

3. The supervisor shall hold a current and unrestricted license as a clinical nurse specialist, doctor of medicine or osteopathic medicine, professional counselor, clinical social worker, or clinical psychologist and shall provide supervision only for those sex offender treatment services which he is qualified to render.

4. At the time of formal application for certification, the board approved supervisor shall document for the board the applicant's total hours of supervision, length of work experience, competence in sex offender treatment, and any needs for additional supervision or training.

D. Registration of supervision.

1. In order to register supervision with the board, individuals shall submit in one package:

a. A completed supervisory contract;

b. The registration fee prescribed in 18VAC125-30-20; and

c. Official graduate transcript.

2. The board may waive the registration requirement for individuals who have obtained at least five years documented work experience in sex offender treatment in another jurisdiction.

E. Supervised experience obtained prior to April 10, 2002, may be acceptable if they met the board's requirements that were in effect at the time the supervision was rendered.

18VAC125-30-70. Supervision of unlicensed persons.

Those persons providing ancillary services as part of an identified sex offender treatment program in an exempt practice situation and not meeting the educational and experience requirements to become an applicant shall practice provide such services under the supervision of a certified sex offender treatment provider.

Part III
Renewal and Reinstatement

18VAC125-30-80. Annual renewal of certificate.

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

B. Along with the renewal application, the certified sex offender treatment provider shall:

1. Submit the renewal fee prescribed in 18VAC125-30-20; and

2. Attest to having obtained six hours of continuing education in topics related to the provision of sex offender treatment within the renewal period. Continuing education shall be offered by a sponsor or provider approved by the Virginia Board of Social Work, Psychology, Counseling, Nursing, or Medicine or by the Association for the Treatment of Sexual Abusers or one of its state chapters. Hours of continuing education used to satisfy the renewal requirements for another license may be used to satisfy the six-hour requirement for sex offender treatment provider certification, provided it was related to the provision of sex offender treatment.

C. Certificate holders shall notify the board in writing of a change of address of record or of the public address, if different from the address of record, within 60 days. Failure to receive a renewal notice and application form(s) form or forms shall not excuse the certified sex offender treatment provider from the renewal requirement.

Part IV
Standards of Practice; Disciplinary Action; Reinstatement

18VAC125-30-100. 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 certified practitioners who provide services to sex offenders.

B. Persons certified by the board and applicants under supervision shall:

1. Practice in a manner that ensures community protection and safety.

2. Treat all sex offender clients with dignity and respect, regardless of the nature of their crimes or offenses.

3. Provide only services and use only techniques for which they are qualified by training and experience.

4. Disclose to sex offender clients all experimental methods of treatment and inform clients of the risks and benefits of any such treatment.

5. 4. Inform sex offender clients of (i) the purposes of an interview, testing, or evaluation session and; (ii) the ways in which information obtained in such sessions will be used before asking the sex offender client to reveal personal information or allowing such information to be divulged; (iii) the methods of interventions, including any experimental methods of treatment; and (iv) the risks and benefits of any treatment.

6. 5. Inform sex offender clients of the limits of confidentiality and any circumstances which may allow an exception to the agreed upon confidentiality, including (i) as obligated under dual-client situations, especially in criminal justice or related settings; (ii) when the client is a danger to self or others; (iii) when under court order to disclose information; (iv) in cases of suspected child abuse; and (v) as otherwise required by law.

7. 6. Not require or seek waivers of privacy or confidentiality beyond the requirements of treatment, training, or community safety.

8. 7. Explain to juvenile sex offender clients the rights of their parents or legal guardians, or both, to obtain information relating to the sex offender client.

9. 8. Maintain sex offender client records securely, inform all employees of the rules applicable to the appropriate level of confidentiality, and provide for the destruction of records which are no longer useful.

10. 9. Retain sex offender client records for a minimum of five years from the date of termination of services.

11. 10. Stay abreast of new developments, concepts, and practices which are important to providing appropriate professional services.

12. 11. Never engage in dual relationships with sex offender clients or former clients, or current trainees that could impair professional judgment or compromise the sex offender client's or trainee's well-being, impair the trainee's judgment, or increase the risk of sex offender client or trainee exploitation. Engaging in sexual intimacies or romantic relationships with sex offender clients or former clients, or with current trainees is strictly prohibited.

13. 12. Report to the board known or suspected violations of the laws and regulations governing the practice of sex offender treatment providers, as well as any information that a sex offender treatment provider is unable to practice with reasonable skill and safety because of illness or substance abuse or otherwise poses a danger to himself, the public, or clients.

14. 13. Provide clients with accurate information concerning tests, reports, billing, acceptable means of payment responsibilities, therapeutic regime, and schedules before rendering services.

15. 14. Maintain cooperative and collaborative relationships with corrections/probation/parole officers or any responsible agency for purposes of the effective supervision and monitoring of a sex offender client's behavior in order to assure public safety.

16. 15. Consider the validity, reliability, and appropriateness of assessments selected for use with sex offender clients. Where questions exist about the appropriateness of utilizing a particular assessment with a sex offender client, expert guidance from a knowledgeable, certified sex offender treatment provider shall be sought.

17. 16. Recognize the sensitivity of sexual arousal assessment testing and treatment materials, safeguard the use of such materials in compliance with § 18.2-374.1:1 of the Code of Virginia, and use them only for the purpose for which they are intended in a controlled penile plethysmographic laboratory assessment.

18. 17. Be aware of the limitations of plethysmograph and that plethysmographic data is only meaningful within the context of a comprehensive evaluation or treatment process or both.

19. 18. Be knowledgeable of the limitations of the polygraph and take into account its appropriateness with each individual client and special client population.

20. 19. Comply with all laws of the Code of Virginia applicable to the practice of sex offender treatment providers.