Waiving Goodbye to Telehealth Progress

Waiving Goodbye to Telehealth Progress

An interview with Dr. Ben Caldwell, LMFT about the impacts of rolling back the covid telehealth waivers. Curt and Katie talk with Ben about how the expiration of emergency orders will impact the profession. As a case study, we talk through how the California professional boards and associations are navigating these challenges, including looking at disciplinary action that has caused alarm (although we don’t think it should). We also talk about calls to action to get involved now, so you can shape future policy on telehealth, tele-supervision, and remote work.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Interview with Dr. Ben Caldwell, LMFT

Dr. Benjamin Caldwell, PsyD is a California Licensed Marriage and Family Therapist (#42723) and the Continuing Education Director for SimplePractice Learning. He currently serves as adjunct faculty for California State University Northridge in Los Angeles. He has taught at the graduate level for more than 15 years, primarily in Law and Ethics, and has written and trained extensively on ethical applications in mental health care. In addition to serving a three-year term on the AAMFT Ethics Committee, Dr. Caldwell served as the Chair of the Legislative and Advocacy Committee for AAMFT-California for 10 years. He served as Editor for the User’s Guide to the 2015 AAMFT Code of Ethics and is the author for several books, including Saving Psychotherapy and Basics of California Law for LMFTS, LPCCs, and LCSWs.

In this episode we talk about:

  • As a case study: the California Board of Behavioral Sciences rolling back covid waivers and losing the progress made during the pandemic
  • The emergency orders – covid waivers – that are expiring related to telehealth, tele-supervision
  • The specifics of remote supervision when emergency orders are rescinded. Looking at permanent legislation concerns as well as the best-case timeline for when remote supervision can come back
  • The concerns about moving backward and losing all progress made during the pandemic related to electronic and telehealth efforts
  • The short-sightedness of requiring an in-person meeting when starting telehealth or tele-supervision
  • Disciplinary action case regarding remote supervision and a prelicensed individual working from home – but there’s so much more nuance than that
  • Current legislation related to where mental health employees can work (which is actually quite flexible in CA)
  • Equity and access issues related to not allowing clinicians to provide mental health from home
  • On-going responsibilities for supervisors to ensure confidentiality and data security
  • The requirements that supervisors have regardless of where supervisees are working
  • Calls to Action to attend Board meetings for your licensing board, so you can be informed and help to shape future policy.

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Resources mentioned:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

SimplePractice Learning

Motivo’s tool regarding rules for tele-supervision in all 50 states

CA Board of Behavioral Sciences Covid Information

Relevant Episodes:

Covid-19 Legal and Ethical Updates

Post Pandemic Practice

Noteworthy Documentation

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Our Facebook Group – The Modern Therapists Group

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Who we are:

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Music by Crystal Grooms Mangano http://www.crystalmangano.com/

Transcript (Autogenerated)

Curt Widhalm  00:00

This episode of Modern Therapist’s Survival Guide is brought to you by Turning Point

Katie Vernoy  00:03

Turning Point Financial Life Planning helps therapists confidently navigate every aspect of their financial life from practice financials and personal budgeting to investing Tax Management and student loans. Visit Turning Point hq.com. To learn more and enter the promo code modern therapist for 30% off their quickstart coaching package.

Curt Widhalm  00:24

Listen at the end of the episode for more information.

Announcer  00:27

You’re listening to the modern therapist Survival Guide where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Kurt Wilhelm and Katie Vernoy.

Curt Widhalm  00:43

Welcome back modern therapists. This is the modern therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast about all things therapy therapists for therapists. by – I pause here because I don’t know if we can call today’s guest still a therapist he’s but he is not.

Dr. Ben Caldwell  01:04

How dare you Curt!

Curt Widhalm  01:06

We are once again joined by Dr. Ben Caldwell, a longtime friend of the show and returning for like somewhere around his fourth appearance. But talking to us today about some stuff going on in the California Board of behavioral sciences and their attempts to go back to the Dark Ages, in some some legislation that they’re crafting. This is important for all of our listeners, because in preparing for this episodes, I asked them is this just where licensing boards are creating solutions to problems that don’t exist? But let’s allow Ben to introduce himself.

Dr. Ben Caldwell  01:50

It’s always good to be with you both. I’m Ben Caldwell, I’m the Education Director for simple practice learning and I am in point of fact a California licensed MFT.

Katie Vernoy  02:02

Yeah ….you two.

Curt Widhalm  02:06

So at the core of this is a subcommittee meeting which these are fantastic meetings, if you’ve ever seen TV shows like Parks and Rec, where they’re open meetings for the government discusses things and people are allowed to show up. And many of these meetings are kind of lackluster as far as entertainment value. But important stuff happens at them. And recent telehealth subcommittee meeting of the California BBs happened here a couple of weeks ago. And Dr. Caldwell was there and relayed some information of some discussions as far as with COVID restrictions changing and some stories that we’re going to share in this episode today that are going to illustrate why this is important enough for us to dedicate an episode to what should hopefully have been a rather boring meeting.

Dr. Ben Caldwell  03:06

Yeah, those those meetings are they are not compelling television. I’ll put it that way. But it is important for us to be involved and aware of what’s happening there. Because that that is how the proverbial sausage gets made when it comes to the policies that ultimately impact our work and can move us forward, backward or sideways kind of depending on what gets done. licensing boards generally around the country. They have open meetings and their their public meetings, anybody can show up anybody can be heard. And in general, I think boards are actually pretty responsive to the questions needs and desires of those people who do show up. It’s just that very, very few people do. You know the BBS governs now more than 100,000, licensees and registrants across it’s different license and registration types in California. And most of these meetings, there’s five or 10, licensees are registered to actually show up, even if it means that the meetings are going to take longer, and there’s going to be a little more argument on both sides. It’s probably better for more people to be at those meetings and be heard and have some influence on the process.

Katie Vernoy  04:17

So I think this is a point of advocacy. And so I think one of the calls to action I’ll just put it out right now is if you are a registrant or a licensee in a state, but especially California, since that’s where we’re talking about, like, go to some of these meetings or at least understand what’s happening at these meetings so that if you want to make a statement you can but to frame this a little bit, I guess I am hearing that in this meeting that there are COVID waivers that were coming to a close that people have a response to There was also some ideas around telehealth and tele supervision. So So what is it actually that we’re talking about? What should people be paying attention to right now as covered waivers are coming to a close.

Dr. Ben Caldwell  05:04

So, across the country, there have been emergency orders that were put into place around the beginning of the pandemic. That allowed for things like the increased use of Interstate practice, that allowed for increased use of telehealth with with less restriction. And that allowed for some other kinds of intended to be temporary changes that made it easier for us to engage in continuity of care, as everybody was stuck at home. Where we are now is that a lot of those emergency orders either have expired, or are going to be expiring in the relatively near term. Now California has hung on to a lot of those emergency orders and waivers longer than some other states have. But even in California, the waivers that have been issued by the Department of Consumer Affairs throughout the pandemic. Those are it sounds like it kind of in the process of winding down. And one of those waivers that has been really attention getting in California is the waiver that allows associates in private practice settings, to engage in online video supervision. If you go pre pandemic, can you look at sort of the the normal California law, video based supervision is only allowed for associates in nonprofit and other what the law calls exempt settings. Private Practice doesn’t typically allow it. There was this waiver put into place at the beginning of COVID to allow for video based supervision in private practice. That waiver has been extended 60 days at a time throughout the pandemic. And the current extension of that waiver is set to expire at the end of October. I know that camped and others are continuing to advocate for additional extensions to that waiver. But the Department of Consumer Affairs ultimately makes the decision and they it sounds like had a meeting with some of their boards and bureaus. And what the BBs said in the most recent telehealth committee meeting was that it is and I wrote this down because it the language struck me quote, very highly unlikely, unquote, that there will be a further extension of that waiver.

Curt Widhalm  07:28

So I am aware of some efforts towards legislation to make that piece more permanent. And assuming that there’s no substantial opposition to it. Like that would go into effect in 2023, based on at the earliest based on the way that California’s legislative system works.

Dr. Ben Caldwell  07:50

Correct. That was one of the things that was actively discussed in that telehealth committee meeting. And they talked about kind of what the policy should be on an ongoing basis for allowing remote supervision across all work settings. I think there’s general consensus that remote supervision should be allowed across all work settings. But there is this anxiety. And I keep asking folks for hard evidence to back it up. But I have yet to see any not say it doesn’t exist. But I haven’t seen any where some board members, some practitioners, some people are just weirdly nervous about allowing remote supervision across all work settings. And to the point where one of the proposals that the BBs was was weighing out in this committee meeting was a 5050 model, where remote supervision would be allowed across all work settings, but you’d have to do no more than 50% of supervision remotely. And the other half would have to be in person, which eliminates a lot of the prospective benefit of telehealth supervision or tele supervision. And thankfully of those people who did show up to the committee meeting, to a person almost universally, they all dragged the committee for even considering this concept because it doesn’t make sense. It just wouldn’t work. And where they landed, I think their proposal that they’re going to carry forward is to allow tele supervision across all work settings, including private practice, conditioned upon there being at least one in person meeting between supervisor and supervisee within 60 days of the beginning of the supervision relationship, and that’s kind of a parallel to the the current requirement for the supervisor to get SSI related to supervision you have to do that within 60 days at the beginning of supervision and that allows for people who are kind of pulled in in agency or hospital or other settings at the last minute so that you don’t have to do a whole bunch of other stuff before you can supervise if you’re needing to take over quickly. But there is a bunch of stuff you have to do within 60 days. I don’t really know why that in person meeting is necessary. But I will take that long before a 5050 kind of approach.

Curt Widhalm  10:11

Now and in hearing this, this sounds like we’ve been through one pandemic, we’ve seen the world transformed. Have we learned nothing about the way that commerce and healthcare has transformed and that many consumers are expecting us to continue to be available?

Dr. Ben Caldwell  10:33

I don’t know that we’ve learned nothing. I also don’t know that we have taken all of the lessons that we potentially could have taken the BBs to their credit, they went out and they did a bunch of surveys about kind of how people felt about tele supervision specifically. And there is clearly not only demand but expectation that that the current telehealth status of our work is largely here to stay. And that the policies we have that govern our work should accommodate that, rather than moving us backward to how things were pre pandemic. And there is some, I guess there’s conflicted opinion about that. But the hope among the majority of practitioners is that we’re not going to have this weird back and forth of, you know, tele supervision was okay for a long time, and then it’s going to be not okay for a little while, and that’s going to be okay. Again, I don’t know if there’s a way to avoid that at this point, it seems kind of inevitable that the the waiver is not going to go all the way through 2023. But I don’t know how we then avoid that kind of forward and back and forward again, kind of process.

Katie Vernoy  11:47

What, what are we seeing across the country? Because I actually right before we started recording, I saw something from motivo. And they had, you know, kind of all the tele supervision laws across 50 states. And I’ll put that that tool in the show notes. But I was noticing that it’s very variable across all 50 states and even across licensure types. I mean, yeah, maybe though. So maybe the question isn’t what is everybody else doing? But but kind of digging more into this anxiety? I mean, to me the in the in person meeting, what is it supposed to accomplish, that you can accomplish? According to this theory, that maybe you don’t agree with? But like, what is it supposed to accomplish? And how is it supposed to improve the supervision relationship?

Dr. Ben Caldwell  12:38

The theory goes, that if you meet with the supervisee, in person that provides an opportunity to most effectively gauge whether they are in fact appropriate for tele supervision. That’s the theory. Again, I’ve seen no hard evidence to back that up. And I would even argue that that’s kind of the same anxiety that we saw and heard at the beginning of the the use of telehealth in therapy, where you had a lot of practitioners saying, Well, you know, it’s just not the same as face to face, there’s this thing about the energy in the room, and I need to assess somebody in person to see their little micro expressions and, and pick up on their vibe, and et cetera, et cetera. And that just has not held up to research scrutiny. That telehealth provision of services seems to be every bit as effective as in person services, from the overwhelming majority of studies conducted to date. And I don’t see any reason why supervision would be different in that regard that there’s somehow something magical in an in person supervision meeting, that would require that process for supervision. But we don’t need to do that in standard telehealth care. These are in many ways, parallel but not identical processes. It’s just that in both of them, it seems like we can do our jobs effectively, remotely. And we have been doing that for a year and a half now. And so sometimes in these committee meetings, people will say things like, well, I don’t want to open the floodgates. Well, that ship has sailed, the floodgates have been open for a year and a half. Yeah, and it’s been fine. I’ve seen no evidence that this has created some kind of a massive problem in terms of supervisee misbehavior or treatment failure in therapy. You know, we’ve all been doing the best we can under really, really difficult circumstances. And it’s been an interesting natural experiment. And the results of that experiment are that telehealth and tele supervision can be tremendously tremendously effective and don’t appear to increase risks at least from the best information we have available. Now.

Curt Widhalm  15:00

Now, he brought up CAMFT. And CAMFT has a little bit different opinion in this or at least based on a disciplinary action case that has a lot of nuances to it, but seems to oversimplify it to be like, but there was this one discipline action. Actually two because both the supervisor and the supervisee were disciplined. This case largely was it This was actually all before the pandemic even happened when when these infractions occurred. But can you walk us through what happened and why this is pertinent in this discussion?

Dr. Ben Caldwell  15:45

Yeah, so the the disciplinary action that you’re talking about, I’m familiar with it, it was finalized in 2020. And you’re right that it was based on behavior that had occurred prior to the pandemic. But there is kind of separate from the rest of the the supervision rules in California, there is this one very specific section of the California Business and Professions Code that says, and I’m going to quoted here, because I knew we were going to be talking about it. A trainee associate or applicant for licensure, shall only perform mental health and related services at the places where their employer permits business to be conducted. That section of law is not further limited. There’s no like clause after that, that says, except for x y&z so if you read that, if you take that language at face value, then as long as the employer allows, and as long as the services are otherwise legally and ethically compliant, so you’re still maintaining data security, you’re still protecting confidentiality, you’re still doing all the stuff that you are normally required to do, then it appears to be fine under the law, for a supervisee to work from home. And that’s in statute. That’s not an emergency waiver, that that is the sort of normal case of the law as it exists right now. The disciplinary action that you’re talking about, there were a lot of things going on in that case, beyond just the supervisor, you’re working from home, that is one thing that was happening, but there were a lot of other shenanigans that were happening there. And when you look at the disciplinary action, it reflects this kind of kitchen sink approach to discipline that a lot of boards take where they unearth as many possible violations as they can find, because that gives them some leverage in negotiating what the ultimate discipline against the licensee is going to be. So they document all these different violations. They put them in front of the administrative law judge, if it gets that far if it gets to a hearing, and that becomes the basis for disciplinary action. In this particular case, the administrative law judge looked at the history of the law, the history of that clause that I just quoted, and basically came to the conclusion that well, the legislature didn’t intend to say that you can work from just anywhere. that’s problematic. Yeah, it is. Right? I mean, the the historical record lines up with this, that neither the BBs and in running that legislation, nor the legislature and making the change, really intended to allow for full time work from home. But you and I, and other people were not expected to be psychic about what the laws intent was, we’re supposed to be able to read the law, make sense of it with kind of a plain language, good faith reading, and act accordingly. And the language here quite plainly reads as though it allows work from home, including full time work from home, if the employer allows it and if it is otherwise legally, and ethically compliant. So to your question, Kurt.

Curt Widhalm  19:17

Okay, and even even before you get to the question,

Dr. Ben Caldwell  19:20

yeah

Curt Widhalm  19:20

even before you get to the question. This would also be inconsistent with many licensing boards, definition of therapy taking place where the client is located, and would be completely irrelevant to where those services are being provided, as far as where the practitioner is located.

Dr. Ben Caldwell  19:43

Yeah, that’s right. The licensing boards and ethics codes generally take the stance that therapy happens, where the client is physically located at the time of service, and that’s reflected in our California telehealth laws that’s reflected in professional ethics codes that quite often use that word located very intentionally and specifically. Now, that doesn’t mean that boards can’t restrict where the therapist is providing services from they have that authority if they choose to take it on. But the California standard right now is just what I read to you, if the employer allows it, it’s permitted.

Katie Vernoy  20:20

What was the intent,

Dr. Ben Caldwell  20:23

The intent was to allow for supervisees to leave their agency settings to go do like home visits at client homes, to work in homeless outreach to go provide services at schools and other kind of third party locations, where the the super actually the employer allowed it and where they could again, take those steps to protect and preserve confidentiality, data, security, etc. There’s nothing in the record of that law change that really contemplates full time work from home. Although there’s a whole bunch of laws, where we could say that the current environment, the COVID, environment was not contemplated at the time that that law was created. We we didn’t anticipate being in the middle of a pandemic. Yeah. And so the BBs has said, Well, we probably ought to go back and take a look at this language. Now in light of what we’ve seen since the pandemic of people working from home full time, but it’s weird to me that they are looking at it with the potential impact of kind of walking back this allowance, when again, work from home seems to have largely been fine for a year and a half.

Katie Vernoy  21:38

What’s interesting, because I remember when field based services was coming about, you know, I was working in community mental health at that time, and and there was a huge pushback from providers on how it wouldn’t be as good as someone coming into the clinic. And so that has that same feel to it of, well, maybe it’s not good enough. But I think honestly, you know, the pendulums keep swinging on what’s the best and all of that stuff. But uh, but what I’m really hearing is that the law in itself, as is currently written provides the flexibility and creativity for employers to be adaptive and responsive to the clients they serve. And that also means they can be adaptive and responsive to the workforce, and allow for clinicians to live where they can afford to live and do services in areas that potentially have a different lineup. You know, it, to me, it just seems like walking it back would be hugely detrimental to quality of life and quality of work for clinicians, but also for access for meeting clients where they are I mean, it just it seems, it seems to me that there’s a lot to be worried about if this gets walked back.

Dr. Ben Caldwell  22:57

I agree. And a couple of people brought up very eloquently the the point about access and equity in that recent telehealth committee meeting. You know, one of the great advantages of allowing work from home is that it allows clinicians to provide services, even if the clinician is working from a rural location. And if the clinician has some kind of medical or mental health issue that makes it difficult for them to leave their home. You know, are we just telling those folks well, tough, then you can’t work in the mental health field? I don’t think any of us intends that. And so the question then becomes really how much flexibility and accommodation are we supposed to? Or do we want to put into the law, and I like this statute as it is right now, I recognize that it does not line up with the historical intent. But I think the outcome is fantastic.

Katie Vernoy  23:53

My understanding of the best laws and policies are ones that are specific to what’s most important, but don’t get caught in the details of, you know, kind of current affairs, right, like so if we’re, whether it’s working in the field, whether it’s working telehealth like this, the law itself provides enough guidance around it. And so to specify it becomes more time limited, it would it would date it, and it would make it so it would have to change again soon. Whereas as it’s written, it actually does what it needs to do. At least that’s what I’m hearing that you’re saying.

Dr. Ben Caldwell  24:30

Yeah, I mean, the law is intended to be revised over time. It’s a it’s a living set of documents, right? And so we’re always responding to what’s happening in the larger world around us and hopefully learning more about how professionals work how we can best provide services. From the BBs perspective. They are fundamentally a Public Protection Agency. So they’re most interested in developing laws and regulations that keep clients safe. And to that end, I think we’ve got Now a year and a half worth of data that suggests that when the therapist is working from home that does not seem to impede client safety. Now there is still a supervisor responsibility there in terms of making sure that that supervisee really can provide a confidential and data secure environment. But to your point, Katie, I think that the best laws are ones that both allow and enforce a level of appropriate professional responsibility and judgment. And so do we want to be really prescriptive in terms of how supervisors are supposed to ensure that? Or do we just want to say that supervisors have that responsibility of ensuring that their supervisors are providing data security, confidentiality, etc, and let supervisors kind of do their jobs?

Curt Widhalm  25:50

So I want to talk in generalities, that almost sounded like a real word. I want to talk generally about some of the disciplinary stuff that this seems to be based on because you talked about the administrative law judge, looking at the intention behind the law. But at face value, some of the concerns about oversight seems to be really the foundations of a lot of these anxieties, the the, some of the cardigan cartel pearl clutching seems to be based on here. Now, my understanding is this disciplinary action is already written into law as far as the kinds of oversights that a supervisor should be having over their supervisees. Anyway, am I correct in that?

Dr. Ben Caldwell  26:49

Yeah, so with the, the disciplinary action I was talking about earlier, there, there were so many problematic things happening in terms of the supervisee sort of acting independently, with the blessing of the supervisor, as best as can be read, they’re to go out and get office space and set things up, like it was a supervisees own business, do independent billing, etc, etc, there’s a there’s a lot of stuff there in terms of the oversight that the supervisor was supposed to be providing that they were not providing, apparently.

Curt Widhalm  27:26

And that is already in the law as far as this kind of stuff. And so if I’m hearing and making up what I have not attended this meeting, making up what I imagined that the conversation is, well, if there’s even less oversights by not having met them physically, one time that this is going to prevent all sorts of future bad supervisee behavior. When you know, I have a practice, I have supervisees, in my practice, they can do stuff off the clock anyway, that would do any of these things anyway, that are already against the law.

Dr. Ben Caldwell  28:08

Yeah, and that’s one of the challenges, I think, from a from a regulatory framework, but also for for you and me and everybody else, as supervisors, you know, we do the best we can and ensuring that the behavior of our supervisees is legally and ethically compliant. And there are those situations where, you know, there may be a disciplinary action against a supervisee, but not their supervisor, because the supervisee did go off kind of on their own didn’t tell the supervisor about stuff they were doing. And the supervisor was providing the kind of expected and intended level of supervision. I don’t think there’s any amount of in person requirement or any level of regulation that is going to effectively prevent every supervisee, who has sort of ill intent from going out and doing what they decide on their own to do. I think the question becomes this balance of how much regulation do you do? How prescriptive Do you get in telling supervisors how to do their jobs? And what what levers Do you want to pull to try to ensure that supervision happens in the way that you would like for it to happen, you know, one of the levers you can pull is requiring a certain level of in person supervision. But does that actually impact anything in terms of legal and ethical compliance beyond that? I don’t know.

Curt Widhalm  29:35

It would seem with a lot of the waivers and stuff that have been in place across the country that we would not want to become overly restrictive for when and if there is a next pandemic or worldwide event. In your opinion here does the direction that these discussions are going at the at the licensing board and Possibly, and other licensing boards across the country seem to be ignoring some of that flexibility that would allow for a profession to need to respond in an event, like a pandemic, if it were to happen again.

Dr. Ben Caldwell  30:17

Yeah, I mean, as Katie said, the, the way that boards are moving and the sort of default states for boards across the country, it’s all over the map. There are some that that really had flexible policies in place before the pandemic. There are some who I think I’ve taken lessons from the pandemic and are wanting to move in a direction of flexibility. And there are others who might say, once the pandemic is and take this with a giant grain of salt, more or less over, that they just want to go back to what the default state had been before that. It’s, it’s a reasonable thing to ask what should be sort of the the normal state of regulation for mental health work. And then what should be the exception, where we do things a little bit differently because an emergency demands it. I think that at least the preponderance of what I’ve seen in Policymaking around the country, boards are kind of moving in the direction of more allowance of telehealth more allowance of even temporary practice across state lines. Of course, all the professions are working hard on trying to improve license portability. And those are good changes. policy does appropriately, move slowly. You know, we don’t want the law to be so reactive to current events, that you’re getting constant whiplash, you’re being pushed and pulled in different directions based on the events of the past few weeks or past few months. But I think we are going to see some lasting change, especially around telehealth regulation. What’s going to be weird, not just in California, but in a bunch of places around the country, is that with putting into policy, what we’ve learned from the pandemic, we’ve got sort of this exceptional state right now, where where lots of places are still under some form of emergency authorizations, we’re going to go back to the prior default state, at least for a little while, as new policies are being crafted run through state legislatures and implemented, and then we’re going to step forward again, to a new normal, that better accounts for the flexibility that has been shown to be really effective during the pandemic. It’s, it is a weird forward than back then forward again. And I don’t think every state board is going to land in the same place in terms of the adaptations they want to make on an ongoing basis. But I do think the, the overall path is a good one. It’s a path toward increased use of telehealth increased authorization for telehealth. It’s a path toward better license portability. It’s a path toward flexibility in the supervision process. But it’s not a straight line to get there.

Curt Widhalm  33:18

If you’ve hung with us this late in the episode, the call to action here really is keep an eye on your licensing boards. And to know that there is a lot of stuff that you might have to sit through, but could drastically impact the way that you go about your business or the way that you go about your practice. And these are the kinds of mundane things that those of us who’ve been in the advocacy world for a while. We hear complaints 5678 years later of like, Well, why didn’t anybody say anything. And that could have steered a direction, you know, that prevented some of this stuff from happening. And as Dr. Caldwell was pointing out here that for many states, this might be a forced return back to pre pandemic ways while the legislative process catches up with some of the actions that we’ve been able to do during this pandemic. But go and be a part of those conversations as that legislation is being crafted so that way, you can actually talk with licensing boards, law makers about how this has played out in the real world. And that is something that is tremendously impactful when talking with people like politicians who have no idea about what we do. So thank you for spending some time with us today. And where can people find out more about you and the stuff that you’re working on?

Dr. Ben Caldwell  35:01

They can find out more about me and my stuff at simple practice learning.com. And just I want to thank you both as always, for having me on, these are really important conversations to have. And I couldn’t have said that better for it. if folks want to know what policy changes are coming down the pike show up, come to these meetings. It’s it’s not unusual that we will hear from people to change takes effect saying, what How did this happen? I didn’t know about this. Well, if you go to your board meetings, you can know about those changes a year or more ahead of time. And in fact, you can have real influence on what those changes are going to look like. I love it. When more folks come to these board meetings, it makes for better conversation and informed decision making for everybody.

Katie Vernoy  35:48

And it’s probably a little less boring for you,

35:50

It is a lot less boring. Listen, like in parks and rec people sometimes will show up with the most off the wall. Wild comments that have nothing to do with anything. And if there is I’ll admit this certain part of my heart that is it warmed when that happens.

Katie Vernoy  36:13

I’ve got my marching orders. I’ll be there next time.

Curt Widhalm  36:17

Until next time, I’m Curt Widhalm with Katie Vernoy and Dr. Ben Caldwell.

Katie Vernoy  36:22

Thanks again to our sponsor Turning Point

Curt Widhalm  36:25

we wanted to tell you a little bit more about our sponsor turning points. Turning Points is a financial planning firm that’s focused exclusively on serving mental health professionals to help you navigate all the important elements of your personal finances like budgeting, investing, selecting retirement plans, managing student loan debt and evaluating big purchases, like your first home. And because they specialize in serving therapists and private practice, so help you navigate the finances of your practice as well. They’ll help you navigate bookkeeping, analyze the financial implications of changes like hiring clinicians or diversifying your income sources. They’ll even help you consider strategies like S corp tax collection,

Katie Vernoy  37:02

and for listeners of MTSG you’ll receive 30% off the price of their quickstart coaching intensive just enter promo code modern therapist when signing up. And don’t forget to visit Turning Point hq.com to download your free finance quickstart guide for therapists.

Announcer  37:19

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