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A Short Course on Encryption and Cloud Storage

Course excerpt from Ethics & Risk Management: Expert Tips 8

Encryption and cloud storage is a complicated area because it requires an analysis of the interplay of several variables, including confidentiality, encryption, cloud storage and HIPAA. Each of these variables is complex, but there are ways to make the situation more manageable.

Cloud storageEncryption and cloud storage. Let’s consider a few common questions:

“For the purposes of HIPAA, if you have adequately encrypted your data, does your cloud storage provider need to sign a Business Associate Agreement (BAA)?”

The bottom line is that there is no crystal-clear answer to this question. The Department of Health and Human Services (HHS) hasn’t specifically addressed this issue, so we are faced with the question of how to interpret the security rule.

There are two basic interpretations: “no,” and “yes.” Both have some support, and if you proceed with one interpretation you should consider the countervailing position.

First, the basics: HIPAA Covered Entities (CEs) who work with vendors are required to have their vendors sign BAAs. This is required because it allows the federal government to enforce the provisions of HIPAA on these third-party vendors.

The public policy at work is that CEs shouldn’t be allowed to offload their legal responsibilities to a third party that isn’t subject to regulatory oversight. BAAs are required whenever a third-party vendor has access to Protected Health Information (PHI).

Here’s where it gets complicated. PHI is identifiable data, but if the data are encrypted they are not identifiable. In such a case, why is a BAA necessary?

The interpretation against requiring a BAA for encrypted data finds some support in one of HIPAA’s safe harbor provisions, which states that losses of encrypted data do not trigger a breach notification (the letter CEs send out that apologetically admits to the disclosure of protected health information).

The reason why breach notifications is not required for encrypted data are that the data remain inaccessible if encrypted. The covered entity has essentially lost gibberish.

Thus, this interpretation goes, BAAs are also not required because the vendor does not have access to protected health information. That makes sense. However, it should be noted that this is a fairly permissive interpretation and HHS has declined to endorse this position.

The competing interpretation, which appears to be strongly supported by the official commentary on related regulations (especially the 2013 HITECH amendments to the HIPAA Privacy and Security Rules), is that BAAs are required even when the data are encrypted.

Support for this position includes: HHS has not made the criteria for breach notifications the same as the criteria for needing a BAA.

The statutory exceptions for BAAs, such as those with incidental access (e.g., a janitor or electrician) or those who are mere “conduits,” do not apply to cloud storage providers. HHS has indicated that a data storage company is not a conduit because of the “persistent nature” of its contact with the data. Thus, it is persistency, and not the degree of access, that HHS has specifically indicated warrants consideration for the purposes of BAAs.

Commentary prior to the adoption of the security rule asked whether or not BAAs could be something that CEs could address, and thus render unnecessary. In other words, the question was asked, “if we as CEs take adequate security measures to ensure the protection of PHI, can we make BAAs unnecessary?” HHS specifically declined to make BAAs an “addressable” requirement.

Besides the issue of protecting PHI, BAs have additional responsibilities. These responsibilities include accessibility, data integrity, etc. If encryption enabled vendors to escape “business associate” (BA) status, HHS would have no jurisdiction. (From a risk management perspective, the execution of a BAA is something that many CEs do to “distribute” the risk.)

The definition of BA isn’t explicitly restricted to those who have access to PHI. The definition also includes those who perform “any other function or activity regulated by this subchapter.” (See 45 CFR 160.103(1)(i)(B)) The amount of functions and activities that are regulated under HIPAA is huge.

I want to emphasize that I understand the argument that where vendors have absolutely no access to PHI because the data are encrypted, the vendor doesn’t have encryption keys, etc., then HIPAA is (theoretically) a non-issue. It makes a lot of sense. However, we just don’t know at this time if HHS agrees with that position and we have some strong evidence that casts this position as too narrow.

However, the ambiguity also applies to the other interpretation: We don’t know if HHS agrees with the position that the storage of encrypted PHI (where the vendor has zero access to the PHI) still requires a BAA.

I hope this helps or at least provides some things to consider.


By Adam Alban, PhD, JD

Adam Alban, PhD, JD, hosts a website of general information for mental health professionals in California. He has an M.A. and PhD in clinical psychology from Michigan State University and a JD from American University in Washington, D.C. He operates a law practice specializing in legal assistance to mental health practitioners and also has a clinical psychology practice, the Alban Psychology Group. He may be reached at: alban@clinicallawyer.com.


Ethics & Risk Management: Expert Tips 8 is a 3-hour online continuing education (CE) course that addresses a wide variety of ethics and risk management topics, written by experts in the field.

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.

Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

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20% Off CE in Celebration of our 20th Anniversary!

We’ve reached a major milestone: 20 years of continuous operation as an accredited provider of continuing education! We couldn’t have done it without you.

In celebration of our anniversary, and to thank you for your support, we are offering a 20% discount on all of our CE courses through June 30, 2012.

Use coupon code 20YEARS to apply during checkout @ www.pdresources.org. Coupon valid on FUTURE orders only (cannot be applied retroactively). Expires 6/30/2012.

20% off CE Sale

A History of PDR

Professional Development Resources was incorporated on August 12, 1992 in the State of Florida as a 501(c)(3) not-for-profit corporation. Its mission was – and continues to be – to seek out the most recent scientific and clinical publications in selected professional areas of psychology, mental health, social work, nutrition, speech language pathology, and occupational therapy and to present continuing education topics of current clinical relevance to the named professions for the purpose of improving patient care.

The company’s founder, Leo Christie, PhD, is a Florida-licensed marriage and family therapist who was in private practice in Jacksonville, Florida from 1982 to 1992. With the intention of establishing an outlet for his interest in writing and teaching, Christie founded the new company and set out to explore the possibility of planning and delivering live educational seminars. The vice president and director of continuing education was – and still is – his wife, Dr. Catherine Christie, who is a registered dietitian.

Christie recalls the early years: “The first steps were to become credentialed by the professional boards, select and develop a topic, identify target audiences, implement a marketing plan, and arrange funding for a series of delivery sites in the State of Florida – a daunting process, to say the least. We set out to secure accreditations from some of the Florida licensing boards so that we could award official CE credit to those who attended our conferences. That process took over 8 months. I remember having some difficulty with the Florida Board of Psychology, and it required a personal appeal and some restructuring before we were eventually recognized as a CE provider. We also sought and received approval to offer CE to nurses, under the auspices of the New York Nurses Association, which was a widely accepted accrediting board at the time. In the early years, nurses represented more than 50% of our seminar attendees.

“During the summer and fall of 1993, we completed 12 six-hour seminars in 7 Florida cities. The summer seminars were titled ‘Fears, Phobia, and Panic’ and dealt with the full spectrum of anxiety disorders. In fall, we introduced a new topic ‘Compulsive Behaviors,’ which featured a study of obsessive compulsive disorder. As a startup year, 1993 generated enough revenue to make further planning and development possible for the new company.

From there, the company went on to secure provider accreditation credentials from a number of national and state boards, including the American Psychological Association (APA), the American Council on Pharmaceutical Education (ACPE), the Association of Social Work Boards (ASWB), the National Board for Certified Counselors (NBCC), the American Speech-Language-Hearing Association (ASHA), the American Occupational Therapy Association (AOTA), and the Commission on Dietetic Registration (CDR) of the American Dietetic Association (ADA) [now the Academy of Nutrition and Dietetics]. The speaker circuit grew to the point at which there were four speakers on the road at one time presenting various topics in 46 of the 50 states.

 
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Posted by on January 31, 2012 in General

 

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Renewal Information for Oregon Counselors & MFTs

Oregon-licensed professional counselors and marriage & family therapists (MFTs) must complete forty (40) clock hours of continuing education every 2 years. Six of those 40 hours must be in ethics training.

The reporting period is from the license renewal in one even-numbered year to the next license renewal in the subsequent even-numbered year. For example, if your birth month is June, your CEU reporting period would be from July 1, 2010 through June 30, 2012. You would report when you renew your license in June, 2012.

The 40 clock hours may be obtained in a variety of ways:

  • Attending college or university courses — 15 clock hours per semester credit or 10 clock hours per quarter credit.
  • Seminars, workshops, conferences and/or trainings.
  • Supervision (maximum of 10 hours)
  • Distance learning trainings must be offered or approved by a provider acceptable to the Board, e.g., NBCC. Distance learning programs must include mechanisms for evaluation, measurement, or confirmation of exchange of information.
  • Home study from approved providers must be offered or approved by a provider acceptable to the Board, e.g., NBCC.

 

Oregon Counselors and MFTs can earn all 40 hours through online courses

Click to view approved online courses

Professional Development Resources is approved as a provider of continuing education by the National Board of Certified Counselors (NBCC Provider #5590) and by the American Psychological Association (APA) to offer continuing education for Counselors and MFTs. Oregon licensees may obtain all 40 clock hours through online home study courses offered @ http://www.pdresources.org/Index.aspx.

In order to complete the continuing education requirements, education/training experiences must be in one or more of the following program areas:

  • Counseling or marital and family therapy theory and techniques
  • Human development and family studies
  • Social and cultural foundations
  • The helping relationship
  • Group dynamics
  • Lifestyle and career development
  • DSM diagnosis assessment
  • Research and evaluation
  • Professional orientation and ethics
  • Professional supervision training
  • Disability and life transitions
  • Substance abuse
  • Psychopharmacology
  • Diagnosis and treatment of mental health disorders

Courses in personal growth, computers, administration, management, marketing, or other business classes will NOT count.

Each reporting year, the Board randomly selects 10% of licensees for an audit to check compliance of its continuing education requirements.

The Oregon Board of Licensed Professional Counselors and Therapists: http://www.oblpct.state.or.us/

 
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Posted by on January 27, 2012 in General

 

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Renewal Information for Indiana Social Workers, Counselors & MFTs

Indiana counselors, social workers and MFTs can earn all 40 continuing education hours for renewal online

Click to view approved online courses!

Social Workers, Marriage and Family Therapists, and Mental Health Counselors licensed in the State of Indiana are required to obtain at least forty (40) hours of continuing education in order to renew their license. 20 hours must come from Category I (formal) courses and 1 hour on ethics from a Category I course is required each year. The license renewal deadline is March 31, 2012.

Professional Development Resources is approved as a provider of continuing education by the Association of Social Work Boards (ASWB Provider #1046, ACE Program); by the National Board of Certified Counselors (NBCC Provider #5590) and by the American Psychological Association (APA) to offer continuing education for Social Workers, Counselors and MFTs. Indiana-licensees can earn all 40 hours per renewal through courses @ http://www.pdresources.org/Index.aspx (formal Category I).

Continuing Education Frequently Asked Questions

How many continuing education hours do I need to renew my license?

40 hours of continuing education credits are required for each renewal cycle or 20 CEUs per year.

What is the renewal cycle?

April 1st – March 31st of every even numbered year.

Are there any required courses I must take?

Yes, every licensee is required to take at least 1 hour of ethics in Category I continuing education each year.

How many hours of continuing education do I need if I have been licensed less than 24 months?

You will need 20 hours in order to renew your license.

How many hours of continuing education do I need if I have been licensed less than 12 months?

You do not need any continuing education in order to renew your license.

What are Category I CEUs and how many do I need per licensure cycle?

Category I is defined as continuing education that is formal programming, which includes the following:

  • Formally organized courses.
  • Workshops.
  • Seminars.
  • Symposia.
  • Institutes.
  • Home study programs, including computer; audio; video; and instructional programs, accredited by board-approved organizations.
  • Courses that are relevant to the license holder’s professional skills, which are part of the curriculum of an accredited university, college, or educational institution, shall earn fifteen (15) CEUs for each academic semester hour completed, or ten (10) CEUs for each academic quarter hour completed.
  • Faculty teaching a course for the first time at an accredited university, college, or educational institution shall earn one and one-half (1½) CEUs for every hour taught.

You are required to obtain a minimum of 20 Category I CEUs per renewal cycle.

What are Category II CEUs and how many do I need per licensure cycle?

Category II is defined as continuing education that is self-directed, which includes the following:

  • Journal clubs, earns one (1) CEU for each hour attended.
  • Office in-services, earns one (1) CEU for each hour attended.
  • Case conferences that are specifically designed for training or teaching, earns one (1) CEU for each hour attended.
  • Services as an instructor, presenter, or supervisor in a relevant professional seminar, workshop, or training conference earns one (1) CEU for each hour of service, but only for the initial instruction, presentation, or supervision given.
  • Research and publication of research results in a recognized professional journal or book form, earns ten (10) CEUs, but may only be claimed for the initial publication of the information.
  • Providing peer review of another licensee’s therapy and skills, which includes consultation, conference, and critique, earns one (1) CEU for each hour spent with the peer for this purpose.
  • Services on boards and commissions and holding office in professional organizations, specifically related to the licensee’s profession, earns one (1) CEU for each hour of service

You are not required to earn any Category II hours however, if you do use Category II hours towards you CEU requirement then you may acquire no more than 20 Category II CEUs per renewal cycle.

How do I document Category II hours?

You can record your hours on a Word document or spreadsheet.  You should include the date of the activity, the type of activity, and the amount of time you spent conducting the activity.

How many hours in Category II hours can I count?

You can count up to 10 Category II hours per year and a maximum of 20 per renewal cycle.

Can I take all of my CEUs in one year or do they have to be split evenly throughout the renewal period?

You can take as many CEUs as you like as long as you take at least 20 CEUs per year, a minimum of 10 of those hours must be Category I.

Can continuing education credits transfer from one renewal period to the next?

No. Credits can only be counted for the period in which they are taken.

Do copies of my completed continuing education certificates need to be sent to the licensure board when I renew my license?

No. Certificates are for your records and will only need to be submitted if you are audited.  However, it is required that licensees maintain copies of their CEU records for a period of four years in the event they are audited by the Board.

What do I do if I am audited?

Once you receive your audit letter you will need to either fax or mail in copies of continuing education certificates to the Board by the deadline stated on the letter.

What happens if I didn’t receive the necessary CEUs during a licensure cycle or can’t produce the necessary documents during an audit?

You will be required to make up the continuing education hours you are short and you will have to pay a fine.  The Board has adopted the proposed schedule as a general guideline for continuing education violations:

Behavioral Health and Human Services Licensing Board: http://www.in.gov/pla/social.htm

 
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Posted by on January 26, 2012 in General

 

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Change to Online Hours Allowed for Georgia Counselors, Social Workers & MFTs

The Georgia Composite Board of Professional Counselors, Social Workers and Marriage and Family Therapists voted August 5, 2011 to adopt amendments to their rule regarding Continuing Education requirements. The primary change involved the number of online CE’s the Board will accept:

Change to Online Hours Allowed for Georgia Counselors, Social Workers & MFTs135-9-.01 Requirements. Amended
(4) A maximum of ten (10) hours of continuing education may be obtained online for each two-year renewal period. This rule change became effective on August 30, 2011

The Board also adopted on a policy during their August 5, 2011 Board meeting to accept all approved online CE hours obtained by a licensee between July 1, 2010 (NOT PREVIOUSLY USED TO SATISFY THE 2010 RENEWAL PERIOD) and September 30, 2011 for the upcoming September 2012 Renewal. This will apply ONLY for the 2012 renewal.

Simply put, this means:

  • Any CE Hours you have obtained between July 1, 2010 and September 30, 2011, if they meet the Board’s CE Hours provider requirements, will be accepted for the renewal of your license in 2012, even if all 35 CE Hours were online or a combination, just as in past years.
  • If you have not yet obtained any CE Hours for the 2012 renewal before September 30, 2011, then this new rule change applies to you: Only 10 CE Hours will be accepted from online (approved) sources.

Professional Development Resources is approved as a provider of continuing education by the Association of Social Work Boards (ASWB Provider #1046, ACE Program); by the National Board of Certified Counselors (NBCC Provider #5590) and by the American Psychological Association (APA) to offer continuing education for Georgia Counselors, Social Workers and Marriage & Family Therapists (MFTs).

 
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Posted by on January 24, 2012 in General

 

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Renewal Information for South Dakota Counselors & MFTs

South Dakota Counselors and MFTs can earn all 40 hours of continuing education online

South Dakota Counselors and MFTs can earn all 40 hours of continuing education online. Click to view approved coursework.

South Dakota-licensed Counselors and Marriage & Family Therapists (MFTs) are required to renew their licenses annually on December 31st. 40 hours of continuing education are required on odd-numbered years. 4 of these hours must relate to ethics.

Professional Development Resources is approved as a provider of continuing education by the National Board of Certified Counselors (NBCC Provider #5590); by the American Psychological Association (APA); and by the National Association of Alcoholism & Drug Abuse Counselors (NAADAC, Provider #000279). South Dakota-licensed Counselors and MFTs can earn all 40 hours through courses offered at www.pdresources.org. Over 100 courses are available, including ethics.

Continuing Education Compliance Period

The continuing education compliance period begins January 1 of each even-numbered year and ends December 31 of each odd-numbered year. The first compliance period for a new licensee begins after the second renewal date.

Continuing Education Requirements

During the continuing education compliance period, each licensee must complete at least 40 contact hours of approved continuing education. Four of those contact hours shall be on the subject of ethics as it relates to counseling. This shall be documented by a published program, title, or description.

Sources of Continuing Education Credit

The licensee may obtain hours of continuing education credit by attending and participating in continuing education courses, workshops, clinics, forums, lectures, programs, seminars, distance learning programs, or other educational activities either previously approved by the board pursuant to § 20:68:07:09 or otherwise meeting the requirements in this chapter and approved by the board pursuant to § 20:68:07:08. A continuing education unit equals 10 contact hours and a semester of academic credit equals 15 contact hours.

Continuing education activities must be geared toward professionals and must focus on increasing knowledge or skills, or both, in the practice of counseling.

The licensee is responsible for financing the costs of continuing education.

Approval of Sponsors

The board will accept continuing education credits for programs accredited, approved, or presented by the following national organizations:

  • National Board for Certified Counselors (NBCC)
  • American Psychological Association (APA)
  • American Association of Marriage and Family Therapists (AAMFT)
  • National Association of Social Workers (NASW)
  • Commission on Rehabilitation Counselor Certification (CRCC)
  • American Medical Association Physician’s Recognition Award Category 1 Credit (AMA PRA Category 1 Credit)
  • Joint Commission for Accreditation of Health Care Organizations (JCAHCO)

Standards for Approval

A continuing education course, workshop, clinic, forum, lecture, program, seminar, distance learning program, or other educational activity is qualified for approval by the board pursuant to this section, § 20:68:07:09, or § 20:68:07:10 if it meets the following requirements:

  • It constitutes an organized program of learning which contributes directly to the professional competence of the licensee in serving the public;
  • It relates to the practice of counseling;
  • It is conducted by individuals considered experts in the subject matter of the program because of education, training, or experience; and
  • It is accompanied by a paper, manual, or written outline which substantially pertains to the subject matter of the program.

South Dakota Counselors and Marriage and Family Therapist Examiners: http://dss.sd.gov/behavioralhealthservices/licensingboards/board_examiners.asp

 
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Posted by on December 16, 2011 in General

 

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Renewal Information for Tennessee-Licensed Professional Counselors and MFTs

Tennessee LPCs and MFTs can earn 5 hours per year online

Click to view approved online CE

Professional Counselors and Marital & Family Therapists (MFTs) in Tennessee are required to renew their licenses every 2 years. 10 hours of continuing education (CE) are required during each calendar year. 5 hours are allowed from online courses each year. Online courses must be offered by an approved provider and include a posttest.

Professional Development Resources is approved as a provider of continuing education by the National Board of Certified Counselors (NBCC Provider #5590) and by the American Psychological Association (APA) to offer online continuing education for Tennessee-licensed Professional Counselors and MFTs. Over 100 courses are available at: http://www.pdresources.org/Index.aspx

The administrative staff of the Division of Health Related Boards supports the Board by issuing licenses to those who meet the requirements of the law and rules. Renewal notices are mailed from the Board’s administrative office forty-five (45) days prior to the expiration of the license to the current address on record. Licenses can be renewed on-line one hundred twenty (120) days prior to expiration at Tennessee.gov/health. Click on the “License Renewal” link and follow the prompts. Licensees are responsible for renewing their licenses on time and keeping the Board apprised of current information. It is a violation of the law and of the board’s rules to practice on an expired license.

The due date for certificate and license renewal is the last day of the month in which a licensee’s birthdate falls pursuant to the Division of Health Related Board’s biennial birthdate renewal system as contained as the expiration date on renewal certificates.

Continuing Education

Each person registered with the board is required to complete 10 clock hours of continuing education during each calendar year.

Those persons who hold two (2) certificates and/or licenses regulated by the Tennessee Board for Professional Counselors, Marital and Family Therapists and Clinical Pastoral Therapists shall complete fifteen (15) clock hours of continuing education each calendar year. A person who holds three (3) certificates and/or licenses shall complete twenty (20) clock hours of continuing education each calendar year. In each case, at least five (5) clock hours shall be directly related to the practice of each profession for which the person is licensed or certified.

Ethics and Jurisprudence Course Requirement

Three (3) clock hours of the ten (10) clock hour annual requirement shall, every two (2) years, pertain to the following subjects:

  • Professional ethics; and/or
  • Tennessee Code Annotated, Title 63, Chapter 22; and/or
  • Official Compilation, Rules and Regulations of the State of Tennessee, Chapter 0450-1.

Those persons who hold two (2) certificates and/or licenses regulated by the Tennessee Board for Professional Counselors, Marital and Family Therapists and Clinical Pastoral Therapists shall have three (3) clock hours of the fifteen (15) clock hour annual requirement pertain to ethics and jurisprudence every two (2) years. A person who holds three (3) certificates and/or licenses shall have three (3) clock hours of the twenty (20) clock hour annual requirement pertain to ethics and jurisprudence every two (2) years.

A person is not required to complete continuing for a profession in the calendar year that his/her license and/or certificate was initially approved.

Acceptable Continuing Education

Acceptable continuing education shall consist of master or doctoral level course work from a nationally or regionally accredited institution of higher education; attendance at educational events sponsored or approved by national, state, regional, or local professional associations in the field; or events related to the practice of the profession for which a nationally or regionally accredited institution of higher education grants CEUs.

Multi-Media – continuing education courses may be presented in the traditional lecture and classroom formats or, with successful completion of a written post experience examination to evaluate material retention, in Multi-Media formats.

A maximum of five (5) clock hours may be received for multi-media courses during each calendar year. Those persons who hold two (2) certificates and/or licenses regulated by the Tennessee Board for Professional Counselors, Marital and Family Therapists and Clinical Pastoral Therapists may receive a maximum of seven and one-half (7½) clock hours for multi-media courses during each calendar year. Those persons who hold three (3) certificates and/or licenses may receive a maximum of ten (10) clock hours for multi-media courses during each calendar year.

Each person registered with the board must retain proof of attendance and completion of all continuing education requirements. This documentation must be retained for a period of four years from the end of the calendar year in which the continuing education was acquired. This documentation must be produced for inspection and verification, if requested in writing by the board during its verification process. The board will not maintain continuing education files.

The board will conduct a randomly selected audit of individual records to assure that the continuing education requirements have been met. An individual’s records may be audited during consecutive renewal periods.

Pre-approved course providers – Continuing education courses which pertain to the practice of counseling shall be considered approved if provided or sanctioned by the following entities:

  • American Association for Marriage and Family Therapy
  • American Association of Pastoral Counselors
  • American Association of Sex Educators, Counselors, and Therapists
  • American Counseling Association
  • American Psychiatric Association
  • American Psychological Association
  • National Association of Social Workers
  • National Board for Certified Counselors

The Tennessee Board for Professional Counselors and Marital and Family Therapists: http://health.state.tn.us/Boards/PC_MFT&CPT/index.htm

 
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Posted by on December 8, 2011 in General

 

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