02-514-8 Me. Code R. § B-2

Current through 2024-51, December 18, 2024

Section 514-8-B-2 - Disclosure Statements

1. Licensed Clinical Professional Counselors, Licensed Marriage and Family Therapists and Licensed Pastoral Counselors

A licensed clinical professional counselor, licensed marriage and family therapist and licensed pastoral counselor, including a conditional licensee, shall personally give a copy of the disclosure statement to each client in hand at the commencement of the counseling relationship. The disclosure statement consists of the following items:

A. The name, license number, business address, business telephone number and business hours of the counselor;

B. The counselor's license category, date of initial licensure, and current license expiration date;

C. For each postsecondary degree held by the counselor, the name of the degree, the date the degree was awarded, the area of study in which the degree was earned, and the name of the institution that conferred the degree;

D. A statement indicating the limits and scope of confidentiality. The statement must note the following exceptions to confidentiality:

(1) Threat of serious harm to self or others;

(2) Reasonable suspicion of abuse or neglect of a child, or abuse, neglect or exploitation of an incapacitated or dependent adult;

(3) Court order;

(4) Voluntary release signed by the client or guardian; and

(5) During supervisory consultations.

E. If the counselor is conditionally licensed, a statement to that effect and the following explanation:

"A conditional licensee has met the initial requirements for this license and is working under professional supervision to obtain the experience necessary for full licensure. The counselor may discuss your case with the supervisor. The counselor may ask you for permission to allow the supervisor to sit in on a session. You are free to refuse if this would make you uncomfortable."

F. The areas of competence in which the counselor is licensed;

G. A general statement outlining a proposed course of treatment, including process of intake, assessment, goal-setting and treatment plan;

H. The counselor's fee schedule, method of billing and payment terms;

I. The extent to which the counselor performs pro bono work or offers sliding scale modifications of the fee schedule; and

J. Whether the counselor's services can be paid for by insurance coverage, MaineCare and other third-party payment plans and if so, to what extent.

K. The following statement:

"The practice of counseling is regulated by the Board of Counseling Professionals Licensure. The board is authorized by law to discipline counselors who violate the board's law or rules. To learn about the complaint process, or to file a complaint against a counselor, contact:

Complaint Coordinator

Office of Licensing and Registration

35 State House Station

Augusta, ME 04333

Tel: (207) 624-8660

Web: www.maine.gov/professionallicensing

2. Licensed Professional Counselors

A licensed professional counselor, including a conditional licensee, shall personally give a copy of the disclosure statement to each client in hand at the commencement of the counseling relationship. The disclosure statement consists of the following items:

A. The name, license number, business address, business telephone number and business hours of the counselor;

B. The counselor's license category, date of initial licensure, and current license expiration date;

C. For each postsecondary degree held by the counselor, the name of the degree, the date the degree was awarded, the area of study in which the degree was earned, and the name of the institution that conferred the degree;

D. A statement indicating the limits and scope of confidentiality. The statement must note the following exceptions to confidentiality:

(1) Threat of serious harm to self or others;

(2) Reasonable suspicion of abuse or neglect of a child, or abuse, neglect or exploitation of an incapacitated or dependent adult;

(3) Court order;

(4) Voluntary release signed by the client or guardian; and

(5) During supervisory consultations.

E. If the counselor is conditionally licensed, a statement to that effect and the following explanation:

"A conditional licensee has met the initial requirements for this license and is working under professional supervision to obtain the experience necessary for full licensure. The counselor may discuss your case with the supervisor. The counselor may ask you for permission to allow the supervisor to sit in on a session. You are free to refuse if this would make you uncomfortable."

F. The areas of competence in which the counselor is licensed;

G. A general statement outlining a proposed course of counseling, including process of intake, assessment and goal-setting;

H. The counselor's fee schedule, method of billing and payment terms;

I. The extent to which the counselor performs pro bono work or offers sliding scale modifications of the fee schedule; and

J. Whether the counselor's services can be paid for by insurance coverage, MaineCare and other third-party payment plans and if so, to what extent.

K. The following statement:

"The practice of counseling is regulated by the Board of Counseling Professionals Licensure. The board is authorized by law to discipline counselors who violate the board's law or rules. To learn about the complaint process, or to file a complaint against a counselor, contact:

Complaint Coordinator

Office of Licensing and Registration

35 State House Station

Augusta, ME 04333

Tel: (207) 624-8660

Web: www.maine.gov/professionallicensing

3. Registered Counselors

A registered counselor shall personally give a copy of the disclosure statement to each client in hand at the commencement of the counseling relationship. The disclosure statement consists of the following items:

A. The name, registration number, business address, business telephone number and business hours of the counselor;

B. The date the counselor's registration was initially issued and the current expiration date;

C. That the licensee is a registered counselor and is not a licensed counselor;

D. That unlike licensing, there are no educational or training requirements for registration;

E. For each postsecondary degree held by the counselor, the name of the degree, the date the degree was awarded, the area of study in which the degree was earned, and the name of the institution that conferred the degree;

F. Major fields of training and expertise not described immediately above;

G. A statement indicating the limits and scope of confidentiality. The statement must note the following exceptions to confidentiality:

(1) Threat of serious harm to self or others;

(2) Reasonable suspicion of abuse or neglect of a child, or abuse, neglect or exploitation of an incapacitated or dependent adult;

(3) Court order;

(4) Voluntary release signed by the client or guardian; and

(5) During supervisory consultations.

H. A description of the counselor's practice;

I. A general statement outlining a proposed course of counseling, including process of intake, assessment, goal-setting and treatment plan;

J. The counselor's fee schedule, method of billing and payment terms;

K. The extent to which the counselor performs pro bono work or offers sliding scale modifications of the fee schedule; and

L. Whether the counselor's services can be paid for by insurance coverage, MaineCare and other third-party payment plans and if so, to what extent.

M. The following statement:

"The practice of counseling is regulated by the Board of Counseling Professionals Licensure. The board is authorized by law to discipline counselors who violate the board's law or rules. To learn about the complaint process, or to file a complaint against a counselor, contact:

Complaint Coordinator

Office of Licensing and Registration

35 State House Station

Augusta, ME 04333

Tel: (207) 624-8660

Web: www.maine.gov/professionallicensing

02-514 C.M.R. ch. 8, § B-2