2023 Florida Laws and Rules and the end of the COVID-19 PHE
As we move into this 2023-2025 renewal cycle, it’s important to be aware of new laws and rules applicable to our field. Remember, the 3 hour refresher Laws and Rules course is due every 3rd renewal (every 6 years); however, our laws and rules are changing much more frequently! It’s our responsibility to be on top of the changes as they are implemented. We can’t wait until the next time we have to take the laws and rules course.
The most recent change in continuing education is that every renewal period (every 2 years) we should alternate the Ethics and Boundaries course with the Telehealth course. Additionally, becoming a Qualified Supervisor requires a 12 hour course versus a 16 hour course. Every 3rd renewal (every 6 years) Qualified Supervisors must complete a 4 hour Qualified Supervision refresher course.
By far, the question we are asked most frequently is about the CE requirements. It’s quite complicated in Florida. Remember, our renewals are from April 1 of each odd year through March 31st of the next odd year. That 2 year period is called a biennium.
We are currently in April 1, 2023- March 31, 2025 renewal period. Any courses taken in this time will count towards your renewal due March 31, 2025. Additionally, anyone seeking licensure in Florida during this period for the first time will be exempt from that CE requirement to renew and will not need to complete the 25 hours of continuing education until the April 1, 2025-March 31, 2027 renewal. For those new licensees, at renewal time (due March 31, 2025) only the license renewal application and the renewal fee are required.
Effective May 11, 2023, the federal COVID-19 Public Health Emergency (PHE) ends. This PHE made way for flexibilities in how we use teletherapy and it paved the way for having a deeper understanding of how crucial teletherapy is in our every day practice. Because of the benefits, many of the flexibilities under the PHE will become permanent, some have been extended through 2024, and others are set to end.
Many of the ways in which the end of the PHE affects us are through Medicare and Medicaid reimbursement. It is important to note that these federal rules and allowances may differ from our state laws and rules. Furthermore, many of the allowances applicable to Medicare and Medicaid recipients are specific to Federally Qualified Health Centers (FQHC) or Rural Health Clinics (RHCs), which would not be applicable to other settings like private or group practice. When reading through the vast changes, carefully read the specific populations, practitioners, and practice settings that are outlined rather than reading it as a blanket statement that would apply to all of us.
An area that was set to expire but is now extended to November 11 is the allowance of prescribers to prescribe controlled substances via telehealth without first conducting an in-person evaluation. Under this new temporary rule, prescribers who have a relationship with patients can prescribe controlled substances virtually through November 11, 2024. This rule is important for mental health professionals, as the change in the rule may greatly affect our clients with prescriptions for controlled substances, including substances like buprenorphine, which is highly depended on to assist in recovery from opioid dependency.
With the end of the PHE brings the end of HIPAA-related enforcement discretion, which allowed us to use telehealth platforms in good faith rather than researching the business associates agreement (BAA) associated with the platform we use. Our Florida Board encouraged us to identify platforms with BAA immediately; however, after May 11th, the HHS Office for Civil Rights resumes enforcing penalties for practitioners’ noncompliance with the HIPAA telehealth requirements.
Registered interns are permitted to continue practicing via teletherapy through 2024, at which point the State will determine whether to make the rule permanent. In private practice settings, where the registered intern practices under the supervisor’s license, the supervisor must be on the premise with the intern. In agency settings where the registered intern practices under the license of the agency, the supervisor must be immediately available by phone. Please note that this state rule allowance does not mean all agencies must allow interns to use teletherapy. Many agencies require registered interns to practice on site and only facilitate in-person sessions and it is within their right to have more restrictive requirements than is required by state rule.
An area to keep an eye on over the next few months is the Counseling Compact. Florida is one of the 18 states to have signed on to the Compact, which, once fully enacted, will allow LMHCs with clear and active licenses to practice across state lines with other Compact states. There will be a registration process for license verification and there is much work to be done in terms of working through differences in state laws and insurance reimbursement. This is an exciting time for Florida telehealth providers, improving the access to care for many people across the country.
Florida’s laws and rules are ever-changing. It’s our responsibility to be involved in professional organizations, peer-supervision groups, Florida’s Board, and other groups as applicable. We must be aware of how the laws and rules affect our practice and how to continue providing the best possible service to our clients.
HHS.gov : Telehealth policy changes after the COVID-19 public health emergency
health.wusf.usf.edu : End of COVID emergency will usher changes across the US health system
counselingcompact.org : American Counseling Association Counseling Compact News