- Important Information on ESA Recommendations
- HB22-1299 License Registration Fee Relief
- Mental/Behavioral Health Parity Information
- Revised Rules Effective June 30, 2021
- New and Revised Rules - December 15, 2020
- HB20-1206, Concerning the Continuation of Regulation of Mental Health Professionals
- Records Retention Workgroup to Meet
- New Disclosure Required
- Sunset Review Underway
- Mandatory Reporting Reminder
- Toolkit Available from Colorado Crisis Services
- HB17-1011 Implementation
- Streamlined Applications Available
- Education Equivalency Review Process
- Important Legislation Signed by Governor
Emotional Support Animal Recommendations Require Bonafide Provider-Patient Relationship
A bonafide provider-patient relationship should exist between a licensed healthcare professional and an individual seeking an emotional support animal (ESA) for therapeutic benefit prior to the issuance of a recommendation letter in Colorado. This bonafide provider-patient relationship is defined in the mental health, medical and nursing practice acts.
Healthcare professionals must first establish whether a disability exists and if found, determine whether there is sufficient information for a recommednation for an ESA to provide a therapeutic benefit for that disability. In order to make such determinations, licensees must be both sufficiently familiar with the patient and the patient’s disability; and legally and professionally qualified to make this determination.
Nursing and mental health law (Section 12-255-133(3)(a) and 12-245-229(3)(a) Colorado Revised Statutes) further clarifies that “a licensee shall not make a determination … unless the licensee has met with the patient in person.” Registered nurses are permitted to issue ESA recommendations but must be under the direct supervision of a licensed physician.
Physicians shouldn’t make a determination unless having “met with the person or by telemedicine,” according to 12-240-144(3)(a), C.R.S.
Healthcare practitioners under the purview of Division of Professions and Occupations must follow all applicable laws for those seeking an assistance animal.
An ESA is an animal that provides a therapeutic benefit, such as emotional support, comfort, or companionship, to a person with a mental health or psychiatric disability. An ESA is not considered a Service Animal and ESA users don’t receive the same accommodations as service dog users.
ESAs don’t perform specific tasks related to the person’s disability, instead, it is the presence of the animal that relieves the symptoms associated with the serious mental health condition. This condition is documented by a properly formatted prescription letter.
HB22-1299 License Registration Fee Relief for Mental Health Professionals
Revised Rules Effective June 30, 2021
Revised rules for the State Board of Marriage and Family Therapist Examiners went into effect on June 30, 2021. The revisions to Rule 1.6, implemented Colorado House Bill 19-1129 (Prohibiting mental health care providers from engaging in conversion therapy with a patient under eighteen years of age); and revisions to Rules 1.12, 1.22, and Appendix A corrected language in the rules that conflicted with portions of the statutes in Colorado House Bill 20-1326 (Concerning an expansion of an individual's ability to practice an occupation in Colorado through creation of an occupational credential portability program) and Colorado Senate Bill 20-102 (Concerning required disclosures to patients regarding formal actions based on sexual misconduct).
To view the details of this rulemaking project and track all rule changes, see Tracking Number 2021-00122. The Board encourages all licensees and stakeholders to read the revised Rules 1.6, 1.12, 1.22, and Appendix A. Please direct any questions to firstname.lastname@example.org.
New and Revised Rules - 12/15/2020
The new and revised rules for the State Board of Marriage and Family Therapist Examiners went into effect on December 15, 2020, to implement Colorado House Bill 20-1206, House Bill 20-1326, and Senate Bill 20-102. These Bills concern the following:
- Colorado House Bill 20-1206: The continuation of the regulation of mental health professionals, and, in connection therewith, implementing recommendations contained in the 2019 sunset report by the Department of Regulatory Agencies;
- Colorado House Bill 20-1326: Expansion of an individual's ability to practice an occupation in Colorado through creation of an occupational credential portability program; and
- Colorado Senate Bill 20-102: Required disclosures to patients regarding formal actions based on sexual misconduct.
- To view the details of this rulemaking project and track all changes to the Rules, follow Tracking Number 2020-00733. The Board encourages all licensees and stakeholders to read the final, published New and Revised Rules. Please direct any questions to email@example.com.
HB20-1206, Concerning the Continuation of Regulation of Mental Health Professionals
The Division of Professions and Occupations (DPO), within the Colorado Department of Regulatory Agencies (DORA), has been provided the authority by the Colorado State Legislature to create the Mental Health Disciplinary Record Work Group. The Work Group will examine the state’s rules and policies with regard to the retention and use of certain kinds of disciplinary records as it relates to licensing of mental health professionals in the state. The Work Group, created by House Bill 20-1206, will meet throughout the Fall and Winter of 2020, and will make recommendations to the Governor, the Executive Director of DORA and the health committees in the House and Senate about any potential changes the Work Group identifies.
Division Convenes Work Group to Study Disciplinary Records Retention in the Mental Health Professions
Pursuant to House Bill 20-1206 (HB-1206) “Sunset Mental Health Professionals”, the Division of Professions and Occupations (Division) has convened the Mental Health Records Retention Workgroup, to study, take public comment on, and make recommendations with respect to how the Division handles and uses certain disciplinary records in its licensing decisions, and how & when those records are made public.
The Work Group will meet several times throughout the fall and winter of 2020, with the National Conference of State Legislatures (NCSL) facilitating, and will make its final recommendations to the General Assembly, Governor, and the Division by January 1, 2021.
The following individuals have been appointed to be Voting Members of the Work Group:
- Ronne Hines, Director, Division of Professions and Occupations
- Senator Brittany Pettersen (D-22)
- Sen. Cheri Jahn (Ret.)
- Felicidad Fraser-Solak
- Brian Gonzales
- Angela Green
- Terri Hurst
- Mita Johnson
- Tim Ranney
- Ana Vizoso
The Work Group is currently scheduled to meet on the following dates, with additional meeting dates added as necessary:
- September 17, 2020, from Noon to 2:30 p.m., Agenda, Presentation
- October 19, 2020, from 2-5 p.m., Agenda, Presentation
- The work group will meet as subcommittees, November 5, 2020, from Noon to 3:00 p.m., Agenda
- November 19, 2020, from 1-4 p.m., Agenda
- December 10, 2020 from 1:30 - 3:30 p.m.. Agenda
As part of the Division's outreach efforts to the public, the Division hosted a townhall meeting on Wednesday, October 14, 2020, 11:00 a.m - noon, to gather comments from interested members of the public. The recording of the townhall may be accessed here.
The Division will host an additional townhall meeting on Thursday, November 12, from 9:00 - 10:00 a.m., to gather comments from interested members of the public. Please click here to register for the townhall - registration is required to attend.
New Disclosure Required
On May 14, 2019, Governor Jared Polis signed House Bill 19-1174 Out of Network Healthcare Services. The bill includes provisions for how health insurance carriers will reimburse providers (doctors, hospitals and other health care providers) for out-of-network emergency and non-emergency care. The new law went into effect on January 1, 2020, and also requires healthcare providers to develop and provide consumer disclosures about the potential effects of receiving emergency or non-emergency services from an out-of-network provider, and the possibility of “surprise billing.” As part of the implementation of House Bill 19-1174 Out-of-network Surprise Billing, the Division of Professions and Occupations is providing a sample disclosure form. Please feel free to use your own form if you prefer.
Sunset Review Underway
The Colorado Office of Policy, Research and Regulatory Reform is conducting a sunset review of the Marriage and Family Therapist Examiner.Analysis in a sunset review is performed to determine whether the regulatory program is necessary and should be continued, modified or eliminated. This review will produce a report with recommendations to the Colorado General Assembly and result in subsequent legislation based on the recommendations in the report. Your input is an important component of a successful sunset review. If you would like to submit comments online, please visit COPRRR's website.
Mandatory Reporting Reminder
Did you know you are a mandatory reporter? Under Colorado law, more than 40 professions are required to report suspected child abuse and elder abuse. These professions include many regulated through the Division of Professions and Occupations (DPO) at DORA, such as:
- Physicians (including physician assistants and physicians in training),
- Dentists and dental hygienists,
- Nurses (including registered nurses, licensed practical nurses, and nurse practitioners),
- Nursing home administrators,
- Occupational therapists,
- Physical therapists,
- Mental health professionals (including psychologists, social workers, professional counselors, marriage and family therapists, registered psychotherapists and all candidates for licensure),
Online trainings help mandatory reporters recognize and report abuse, neglect and exploitation. Licensees of the regulatory boards at DPO may accrue credit towards continuing education and continuing competency requirements for completing the trainings (should they exist for their profession).
Section 19-3-304, C.R.S. outlines the persons required by law to report child abuse and/or neglect. To assist mandatory reporters, a training is available on the Colorado Department of Human Services website at http://coloradocwts.com/mandated-reporter-training.
Section 18-6.5-108, C.R.S outlines the persons required by law to report abuse and exploitation of at-risk elders and at-risk adults with intellectual and developmental disabilities. Further information and an online training can be found on the Colorado Department of Human Services website.
If you have further questions regarding these requirements, please contact the Colorado Department of Human Services.
For questions regarding mandatory reporting of at-risk elders and at-risk adults with intellectual and developmental disabilities, please contact the Office of Community Access and Independence's Division of Aging and Adult Services at firstname.lastname@example.org.
Toolkit Available from Colorado Crisis Services
Colorado Crisis Services is Colorado's first statewide resource for mental health, substance use or emotional crisis help, information and referrals. It was formed by Gov. John Hickenlooper, in partnership with the Colorado Department of Human Services, to strengthen Colorado's mental health system by providing greater access to mental health services, and ensuring Coloradans get the right services in the right locations at the right time. A new toolkit is available to help the many organizations and mental health professionals that work with Colorado Crisis Services. The toolkit provides links to branding graphics and consistent messaging for public information related to Colorado Crisis Services.
HB17-1011 - Statute of Limitation Discipline Mental Health Professional
On March 16, 2017, Governor John Hickenlooper signed House Bill 17-1011 Statute of Limitation Discipline Mental Health Professional. The bill went into effect July 1, 2017. Currently, mental health professionals are required to maintain client records for a period of seven years from the date of termination of services. This new state law requires mental health professionals to notify former clients that records may not be maintained after seven years. This notice must be provided to the client in writing no later than 180 days after the end of the client's treatment. The notice may be included with the disclosures provided during the initial client contact or sent to the client's last known address.
In addition, any complaint filed with the Division of Professions and Occupations in the Department of Regulatory Agencies (DORA) against a mental health professional alleging a maintenance of records violation must be made within seven years after the former client discovered or reasonably should have discovered the violation. The applicable board in the Division of Professions and Occupations must either take disciplinary action on the complaint or dismiss the complaint within two years.
We hope this clarifies this new requirement pertaining to client records. If you have any questions, please send them to email@example.com.
Streamlined Applications Available
The application process for new graduates and those who may be applying for additional credentials has been streamlined. The new candidate applications are now online and may be utilized immediately by students that have completed a degree but not yet graduated. These include:
- psychologist candidate (PSYC)
- licensed professional counsel candidate (LPCC)
- marriage and family therapist candidate (MFTC)
- licensed social worker (LSW)
House Bill 16-1103 clarified that graduates must "have completed" their degrees (rather than "hold") in order to fulfill the educational requirements for licensure. This change expedited the licensure process significantly.
Often, new graduates do not receive, or "hold" their actual degree certificate for many weeks after graduation. As a result, they must wait to apply, even if they have a job offer. Now any applicants who are awaiting graduation, but have completed all of their program requirements, may have their school complete the Certification of Master's or Doctoral Education form rather than provide a transcript. Once completed, the form can be uploaded as part of your application.
For LPCC, MFTC and PSYC, there is no test required. Providing this form and meeting the rest of the qualifications is all that is needed for a candidate permit. LSWs must pass the Association of Social Work Boards Exam. Therefore, applicants who have not graduated, but who want to begin accruing hours, can use the Certification of Master's Education form to apply to take the test for licensure.
Education Equivalency Review Process
To make the education equivalency review process more efficient and improve customer service to our applicants, the Division has contracted with the Center for Credentialing and Education (CCE) to conduct all education equivalency reviews. This includes services for the Board of Addiction Counselor Examiners, the Board of Licensed Professional Counselor Examiners, the Board of Marriage and Family Therapist Examiners, and the Board of Psychologist Examiners.
The new process will allow applicants to seek a review prior to submitting an application and paying an application fee. Applicants will now know if they meet educational requirements for licensure, prior to filing an application. The Division expects this new process to expedite the application process and reduce the regulatory burden.
For questions, please contact the Program Director of the Mental Health Programs, Reina Sbarbaro-Gordan, at firstname.lastname@example.org. For inquiries related to the Center for Credentialing Education, please call 888-817-8283 or visit their website at www.cce-global.org.
Important Legislation Signed by Governor
On April 15, 2016, Governor Hickenlooper signed House Bill 16-1103 Concerning Clarifying License Pathways for the Mental Health Professional Workforce. Effective January 1, 2017, the new law will affect psychologists, social workers, marriage and family therapists, professional counselors, and any other individual who is actively working toward mental health licensure and is enrolled in a professional training program at an approved school. DORA supported the bill as part of its ongoing initiative to streamline the application process, reduce regulatory burden, and move qualified professionals into the workforce more quickly to increase access to mental health services.
The bill has two key components:
- Clarifies that graduates must "have completed" their degrees (rather than "hold") in order to fulfill the educational requirements for licensure. This change will expedite the licensure process significantly. Often times, new graduates do not receive, or "hold" their actual degree certificate for many weeks after graduation. As a result, they must wait to apply, even if they have a job offer. With this change, applications can be submitted with an unofficial transcript or a letter from the academic program as soon as an applicant completes a graduate program.
- Clarifies the recommended pathway a student should take for licensure in Colorado. For instance, the legislation clarifies that students participating in internships do not need to register with DORA as registered psychotherapists. However, as soon as they hold their degree, they are encouraged to register as a candidate under the board that will govern their licensure. This type of clarification helps simplify the process and reduces the regulatory burden on students.
In order to implement the new law, the Mental Health Boards housed at DORA's Division of Professions and Occupations will assess whether rulemaking is necessary. If so, the Boards will hold Stakeholder Meetings and Rulemaking Hearings during the Summer and Fall of 2016. Mental health professionals who want to follow the implementation process should check their respective Board websites for updated information beginning June 1, 2016.