Following state and federal law

“Adhere to relevant state and federal laws and regulations that apply to your clinical practice” (NBCC, 2027 task 6.3)

Counseling is governed by a web of state and federal laws: licensure, confidentiality and privilege, privacy rules, mandated reporting, duty to warn or protect, involuntary commitment, minors' rights and more. Counselors must know the laws that apply where they practice and where their clients are located. The exam tests the major federal laws and recognition that many rules vary by state.

Key points

HIPAA sets privacy, security and breach notification rules for covered entities and their business associates; HITECH strengthened enforcement and breach notification.
FERPA governs education records at schools that receive federal funds; rights belong to parents and pass to the student at age 18 or on entering postsecondary education.
42 CFR Part 2 protects records of federally assisted substance use disorder programs and generally requires specific written consent for disclosure.
All states require counselors to report suspected child abuse or neglect; reporting rules for elder and dependent adult abuse, and the details of who reports and how fast, vary by state.
Duty to warn or protect after Tarasoff is not uniform: some states mandate action, some permit disclosure, and some have no statute; know your state's law.
State law governs licensure, scope of practice, minors' consent, privilege and involuntary commitment criteria and procedures.
The ADA prohibits disability discrimination, and practitioners who bill health plans electronically must have a National Provider Identifier (NPI).

In practice

A counselor moving to a new state reviews its licensure law, duty-to-protect statute, minor consent rules and abuse reporting law before seeing clients, and finds that the new state permits rather than requires disclosure to protect a third party.

A school counselor receives a request from a noncustodial parent for a student's counseling file. She checks FERPA, the school's policy and any court orders on file before responding.

Check yourself

Is the duty to warn the same across all states?

No, states differ: some require action, some permit disclosure, and some have no statute.

At what point do FERPA rights pass from parents to the student?

When the student turns 18 or enters a postsecondary institution.

Which federal regulation gives extra protection to records of federally assisted substance use disorder programs?

42 CFR Part 2.

NBCC's knowledge and skills for Domain 6

Knowledge of: State laws (state licensure law, supervision requirements, abuse reporting, license renewal, CAQH); Federal laws (e.g., HIPAA, FERPA, immigration policy, HI-TECH, ADA, NPI); Codes of ethics; Third-party reimbursement, insurance and billing (e.g., CPT codes); Counseling Compact; Emerging technologies in Counseling; Crisis policies and procedures; Recording keeping and reporting requirements and procedures; Appropriate logistics for telemental health services; Scope of practice (e.g., letters of support, working with special populations); Alternative medical-assisted/pharmacological interventions; Accessing state licensure board; Executing voluntary and involuntary commitments.

Skill in: Maintaining confidentiality; Discerning reputable training providers and programs; Troubleshooting technological difficulties during telemental health session (e.g., session disconnects, video not working); Billing and third-party reimbursement.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.