In this subtitle, the following terms have the meanings indicated. Terms Defined. “Activities and services” means performing the psychological activities or services that are required training for completing the program in psychology. “Applicant” means an individual seeking a license or registration to practice psychology in Maryland. “Board” means the State Board of Examiners of Psychologists. “Central repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services. “Criminal history records check” means the performance of both a State criminal history check by the Central Repository and a national criminal history check by the Federal Bureau of Investigation. “Criminal history records information” means information provided by the criminal history records check regarding an applicant’s criminal arrests, charges, convictions, and the disposition of other pending criminal charges. Fellow. “Fellow” means an individual who has obtained the doctoral degree in psychology, or who has completed all of the academic course requirements for a doctoral degree in psychology, and is gaining additional training and experience in a postdoctoral training program in psychology. “Fellow” includes the term resident. “Intern” means an individual who is: Matriculated in a doctoral degree program in psychology; and Fulfilling program requirements by completing a predoctoral internship training program in psychology. “Practice-oriented program” means a clinical, counseling, or school psychology program, or a combination thereof, or a respecialization program. “Student” means an individual who is: Matriculated in a master's or doctoral degree program in psychology; and Fulfilling program requirements by gaining field or practicum experience. “Supervised course of study” means an organized post-baccalaureate program in psychology with identified faculty and training objectives. An application packet for licensure is complete when the following conditions are met: The completed application packet is: Submitted to the Board and notarized; and Accompanied by the required nonrefundable application fee in the form of a personal check, cashier’s check or money order; An application packet includes: Answers to application questions; Documentation of supervised professional experience; Attestations of supervised professional experience submitted to the Board by the persons providing the references; Official transcripts of all post-baccalaureate studies submitted to the Board by the educational institutions; An Examination for Professional Practice in Psychology (EPPP) score, if applicable, submitted to the Board by the Association of State and Provincial Psychology Boards (ASPPB); and Criminal history records check reports are received by the Board; and An applicant who is a nonresident or is not employed within the State submits a statement to show the reasons for seeking licensure in the State. An application packet for registration is complete when the following conditions are met: The application packet is: Submitted to the Board and notarized; and Accompanied by the required nonrefundable application fee in the form of a personal check, cashier’s check, or money order; Official transcripts of all studies are submitted to the Board by the educational insitutions; and Criminal history records check reports are received by the Board. The official date of receipt of the application is the date on which the Board receives both the: Completed application form; and Required, nonrefundable application fee. The Board shall notify the applicant of missing required documents not more than 15 business days after receipt of the application. An application is terminated when: The application has not been completed within 1 year of the date the application is submitted; or The applicant fails either the EPPP, if applicable, or the Maryland examination. Review of Completed Applications by the Board. The Board shall review an application after the required documents are on file. If the applicant for licensure is applying for limited practice reciprocity, as described in Regulation .07 of this chapter, the application shall be reviewed within 15 business days after the required documents are on file. The Board may request additional information or documentation from the applicant for clarification purposes. An applicant shall be sent notification of the action taken by the Board, to accept or to reject the application. An applicant who is informed of acceptance shall be notified of the time and place of the examinations required in Regulation .06 of this chapter. An applicant who is informed of acceptance shall submit the required examination fees to the Board. The Board may not approve an applicant for licensure or registration until the Board has: Received and reviewed the criminal history records information; and Approved the application. An applicant whose application for licensure or registration is rejected shall be notified of the basis for that rejection. An applicant may appeal a rejection of application for licensure or registration by notifying the Board in writing, by certified mail, within 60 days of receipt of the Board’s decision, and by: Submitting new or additional evidence to verify or clarify qualifications; or Requesting an informal hearing before the Board. An applicant who fails an examination may begin the application process again by submitting: A new application for licensure or registration along with the required application fee; and At least one current letter of reference. Abbreviated Application. A psychologist who holds an active license to practice psychology in good standing in another state and is certified by the American Board of Professional Psychology or credentialed as a Health Service Psychologist by the National Register of Health Service Psychologists may apply for licensure with the Board on an abbreviated application. An abbreviated application for licensure as a psychologist with the Board shall include: Proof of good standing as a licensed psychologist in another state; Proof of certification by the American Board of Professional Psychology or credentialing as a Health Service Psychologist by the National Register of Health Service Psychologists; A passing score on the Maryland Jurisprudence Examination as set forth in Regulation .06A(2) of this chapter; A criminal history records check; and The required, nonrefundable application fee. The Board may not issue a license on an abbreviated application unless the Board has received the results of the applicant’s criminal history records check. The applicant for licensure shall have a doctoral degree in psychology as defined in Health Occupations Article, §18-101(c), Annotated Code of Maryland. The applicant for registration as a psychology associate shall meet the educational requirement as defined in Health Occupations Article, §18-302(g), Annotated Code of Maryland. An applicant for licensure shall present evidence of having completed 2 years of supervised professional experience before taking the examinations required in Regulation .06 of this chapter. The 2 years of supervised professional experience shall consist of a minimum of 3,250 hours. Supervision Generally. A minimum of 75 percent of the applicant's supervised professional experience shall be supervised by a psychologist qualified to supervise the activities being performed or the services being rendered. The supervisor shall be: Licensed to practice psychology in Maryland; Exempt from licensure under Health Occupations Article, §18-102(3) or 18-301(b), Annotated Code of Maryland; Licensed, certified, or exempt from licensure or certification in the state or country in which the supervised professional experience is obtained; or A student, fellow, intern, or resident while pursuing a supervised course of study that the Board approves as qualifying training or experience as provided in Health Occupations Article, §18-301(b)(3), Annotated Code of Maryland, provided that the student, fellow, intern, or resident is supervised by an individual meeting criteria of §C(2)(a), (b) or (c) of this regulation. The supervisor shall ensure that any additional supervision is by an individual who has the requisite skills and training to provide supervision. Psychology associates accruing supervised professional experience toward licensure shall receive the required amount of supervision specified in COMAR 10.36.07.03. The applicant shall ensure that there is adequate documentation of the supervised professional experience. The Board may require additional information to be submitted by the applicant or supervisor to assess the extent and quality of the applicant's supervised professional experience. For applicants for licensure graduating from programs that are not practice-oriented, supervised professional experience may be accrued in professional work in psychology using the methods, principles, and procedures of psychology, including, but not limited to: Teaching; Research; and Industrial or organizational consultation. In order for the experience to qualify as full-time supervised professional experience, the applicant shall receive a minimum of 1 hour of individual supervision per week at a face-to-face meeting with the supervisor. In exceptional circumstances, the Board may waive the requirement for face-to-face supervision: For pre-doctoral experience, if the academic program director attests to the nature of the circumstances and assures the Board that the quality of the supervision was not compromised; or For post-doctoral experience, if the applicant: Petitions the Board for a waiver before beginning the supervised experience; and Offers an alternative modality for supervision, including but not limited to televideo conferencing that does not substantially diminish the adequacy of the supervision. For applicants for licensure graduating from practice-oriented programs, supervised professional experience may be accrued through: Pre-internship; Internship; Pre-doctoral post-internship; or Post-doctoral experiences. The academic training program director or the post-doctoral training supervisor shall attest to the hours accrued to meet the requirements of this regulation on a form required by the Board. An applicant may utilize pre-internship and pre-doctoral post-internship experience: To accrue up to 1,500 hours toward the supervised professional experience required for licensure; and That occurs following the completion of the first year of the doctoral program. Pre-internship and pre-doctoral post-internship experiences shall: Consist of an organized sequence of training that is of increasing complexity to prepare the student for internship; Follow appropriate academic preparation; Be overseen by the graduate training program; Be an extension of the student's academic coursework and within the scope of education received; Be in service-related activities such as treatment, assessment, interviews, report writing, case presentations, supervision, and consultation for at least 50 percent of the training experience; and Be devoted to face-to-face client contact for at least 25 percent of the training experience. Pre-internship and pre-doctoral post-internship experiences shall contain a written training plan that: Includes the responsibilities of the student, training site, and graduate training program; Describes how the student's time will be allotted; Ensures the quality, breadth, and depth of the training experience by specifying the: Goals and objectives of the training experience; Methods of evaluation of the student's performance; and Rules governing the training experience; Specifies the requirements of supervision to include: The nature of supervision; The identities of supervisors; and The form and frequency of feedback from the agency supervisor to the training faculty; Provides rationale for the training experience based on previous academic preparation and previous training to ensure that the overall experience is organized and sequential; and May be provided to the Board with the application to document the pre-internship or pre-doctoral post-internship experience. Pre-internship and Pre-doctoral Post-internship Supervision Requirements. Every 20 hours of pre-internship experience and pre-doctoral post-internship shall include the following: At least 2 hours of regularly scheduled, formal, face-to-face individual supervision that addresses the direct psychological services provided by the student; and At least 2 hours of other learning activities such as: Case conferences; Seminars on applied issues; Conducting co-therapy with a staff person including discussion of the case; or Group supervision. In exceptional circumstances, the Board may waive the requirement for face-to-face supervision if the academic program director attests to the nature of the circumstances and assures the Board that the quality of supervision was not compromised. Internship experiences shall: Consist of a minimum of 1,750 hours of supervised experience; and Be completed within 24 months. The internship program shall be: Accredited by the American Psychological Association (APA) or the Canadian Psychological Association (CPA); A member program of the Association of Psychology Postdoctoral Internship Centers (APPIC); or Part of an academic program that: Is approved or designated by the: APA; CPA; or Association of State and Provincial Psychology Boards (ASPPB)/National Register; and Includes an internship that is approved by the program's academic training director as meeting its criteria for an internship. Post-Doctoral Supervised Professional Experience—Practice-Oriented Programs. A maximum of 1,500 hours of the professional supervised experience may be obtained through post-doctoral supervised experience. Post-doctoral supervised experience shall be completed if an applicant does not have 3,250 hours of pre-doctoral supervised experience. A supervisor is ethically and legally responsible for all supervisee work covered by a written supervision agreement. Supervisees shall use titles indicating their training status, such as “psychology resident”, “psychology intern”, or “psychology supervisee”. Supervised experience shall be appropriate to the area or areas of professional activity in which the supervisee intends to practice. There shall be at least 1 hour of individual supervision for every 20 hours of service related activities. The supervisor and the supervisee shall keep records of experience and supervision hours. At the conclusion of the post-doctoral supervision experience: The supervisor shall prepare a written evaluation, including: The hours spent in various service related activities; The number of successfully completed supervised hours; and Any hours not successfully completed; and If any hours were not successfully completed, the Board may require additional hours of supervision. Supervision shall be face-to-face with an on-site supervisor. Under exceptional circumstances, and before beginning a supervised professional experience, an applicant for licensure may petition the Board to waive the requirement for face-to-face supervision or to receive supervision from a psychologist not on site. The Board may waive the requirement for face-to-face supervision only when the alternative modality for supervision, including but not limited to televideo conferencing, does not substantially diminish the adequacy of the supervision. If a supervisee is accruing post-doctoral supervision as a registered psychology associate, the supervisee shall also comply with the requirements of Regulation .04-4 of this chapter. An applicant accruing post-doctoral supervised experience in an activity that is not exempt under Health Occupations Article, §18-301 or 18-102(3), Annotated Code of Maryland, shall apply to the Board for registration as a psychology associate in accordance with COMAR 10.36.07. Exempted activities under Health Occupations Article, §§18-301 and 18-102(3), Annotated Code of Maryland, include: Activities as a student, intern, resident, or fellow while pursuing a supervised course of study in psychology that the Board approves as qualifying training and experience; Activities under the supervision of, and in connection with, a psychologist employed by: Any agency of the federal government; The Maryland Department of Juvenile Services; A political subdivision of this State; or A chartered educational institution; or Non-profit activities of a bona fide religious organization that is exempt from taxation under Section 501(c)(3) of the Internal Revenue Code. Registered psychology associates accruing post-doctoral supervised professional experience toward licensure shall obtain supervision in accordance with the requirements of COMAR 10.36.07. When submitting an application for licensure, an applicant who is a nonresident or does not practice psychology in Maryland and who does not intend to reside or practice in Maryland, shall submit a statement showing that the applicant's licensure would be in the interest of the citizens or government of Maryland. The Board shall determine whether to accept or reject the statement. In the event of unfavorable determination, the Board shall notify the applicant that the application for licensure has been rejected. The applicant may appeal this rejection as specified in Regulation .02 of this chapter. Until licensed to practice psychology in Maryland, an applicant may not practice psychology in Maryland by virtue of holding a valid license or certification to practice psychology in another state unless the Board authorizes a specific exception. The Board requires applicants for licensure to receive passing scores of at least: A scaled score of 500 on the Examination for Professional Practice in Psychology (EPPP) for examinations administered on or after January 1, 2002, or a score of 73 percent on the Examination for Professional Practice in Psychology (EPPP) prepared and scored before January 1, 2002; and 75 percent on the Maryland Examination prepared and scored by the Board. The Board requires applicants for registration to receive a passing score of at least 75 percent on the Maryland Examination prepared and scored by the Board. The Board shall ensure that the Maryland Examination tests applicants for licensure or registration on: The Code of Ethics and Professional Conduct; and Other regulations and laws pertaining to the practice of psychology. The Board shall provide each applicant access to all regulations and laws tested on the Maryland Examination. An applicant is required to take examinations administered by the Board or the Board's agent at the designated times and places. The Board shall refund the examination fee if a written request to cancel the application or examination is received from the applicant: At least 2 weeks before the examination date; or At a later time if the Board determines there was good cause. Limited Examination Reciprocity for Licensure Applicants. The Board shall determine the required examinations for each applicant, although the Maryland Examination may not be waived. The Examination for Professional Practice in Psychology may be waived for an applicant authorized by law to practice psychology in another state that did not require the Examination for Professional Practice in Psychology, if the applicant is currently licensed or certified for the independent practice of psychology in another state. The Examination for Professional Practice in Psychology (EPPP) shall be waived for an applicant licensed or certified for the independent practice of psychology in another state who submits evidence of having attained a score of at least 73 percent on any administration of the Examination for Professional Practice in Psychology (EPPP) before January 1, 2002, or a scaled score of 500 on any administration of the Examination for Professional Practice in Psychology (EPPP) on or after January 1, 2002. The examination for Professional Practice in Psychology shall be waived for an applicant who: Is licensed to practice psychology in another state; and Has met the requirements for and holds a current Certificate of Professional Qualification in Psychology issued by the Association of State and Provincial Psychology Boards. A student, intern, or fellow may qualify for an exception to licensure while performing the activities and services of a supervised course of study in psychology with the following requirements: The identified faculty shall provide the supervision; The individual shall receive the amount of supervision: Set by the educational or internship program; or In accordance with Regulation .04 of this chapter for: Students or interns who want to obtain the professional supervised experience required for licensure, and Fellows; The individual providing psychological services under this exception shall use one of the following titles: Psychology student; Psychology intern; Psychology resident; or Psychology fellow; and This exception to licensure terminates when the requirements of the training program in psychology are completed. Limited Practice Reciprocity. A nonresident certified or licensed to practice psychology may be granted a temporary exception to practice psychology in Maryland if the: Board receives from the applicant a completed application and application fee within 90 days of establishing residence in Maryland and on or before the next application due date; Completed application includes a verification from another state licensing Board or authority that the applicant's license or certification to practice psychology in the other state is in good standing; Applicant is scheduled to take the next Board-administered examinations required for licensure; Board approves the application and sends notification of its action not later than 35 days before the scheduled examination; and Applicant pays the required examination fee to the Board at least 30 days before the scheduled examination. The Board shall withdraw the temporary exception to practice psychology if the applicant fails an examination required by the Board. In granting an extension for examination set forth in Health Occupations Article, §18-301(c), Annotated Code of Maryland, the Board shall determine whether the applicant has good cause for being unable to take the first scheduled examination for which the applicant is eligible. In authorizing an exception set forth in Health Occupations Article, §18-301(d), Annotated Code of Maryland, the Board: Shall determine whether the circumstances warrant an exception to licensure, taking into account the: Qualifications of the nonresident psychologist, Psychological services to be provided, and Duration of the exception to licensure; and May impose any limitations on the psychologist's practice of psychology that the Board considers to be appropriate. Renewal. A license shall expire on March 31, unless it is renewed for an additional term as provided in this section. A license may not be renewed for a term longer than 2 years. At least 90 days before the license expires, the Board shall send a renewal notice to the licensee: By first class mail to the last known address of the licensee; or If requested by the licensee, by electronic means to the last known electronic mail address of the licensee. If a renewal notice sent by electronic means under §A(3)(b) of this regulation is returned to the Board as undeliverable, the Board shall send a renewal notice to the licensee by first–class mail to the last known address of the licensee. The renewal notice shall state: The procedure to follow; Continuing education requirements; The date on which the current license expires; The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and The amount of the renewal fee. A licensee who did not submit to a criminal history records check upon initial licensure with the Board shall submit to a criminal history records check upon the licensee’s first renewal with the Board after January 1, 2019. Every 6 years following the initial submission of a criminal history records check to the Board, a licensee applying for renewal shall submit to a criminal history records check. Upon receipt of a licensee’s criminal history records information in accordance with §A(6) and (7) of this regulation, the Board shall consider the following factors in determining whether to renew a license: The age at which the crime was committed; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references, if provided; and Other evidence that demonstrates whether the licensee poses a threat to the public health or safety. The Board may not renew a license if the Board has not received the results of a criminal history records check required pursuant to §A(6) and (7) of this regulation. Expiration. A license automatically expires when the psychologist fails to meet the renewal requirements by March 31. Inactive Status. A psychologist in good standing may request inactive status for 2 years upon: Notification to the Board; and Payment of the required fee. A licensee on inactive status may apply to have the inactive license status extended for an additional 2 years upon payment of the inactive status fee. The license on inactive status may be reinstated by: Completing an application for renewal; Paying the renewal fee; Verifying that continuing education requirements have been satisfied as set forth in COMAR 10.36.02; and Submitting to a criminal history records check, if the license has been on inactive status for a period of 1 year or more. Renewal. A registration shall expire on March 31 unless it is renewed for an additional term as provided in this section. A registration may not be renewed for a term longer than 2 years. At least 90 days before the registration expires, the Board shall send a renewal notice to the registrant: By first class mail to the last known address of the registrant; or By electronic means to the last known electronic mail address of the registrant. The renewal notice shall state: The date the registration expires; Continuing education requirements; The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the registration expires; and The amount of the renewal fee. Every 6 years following the initial submission of a criminal history records check to the Board, a registrant applying for renewal shall submit to a criminal history records check. Upon receipt of a registrant’s criminal history records information in accordance with §A(5) of this regulation, the Board shall consider the following factors in determining whether to renew a registration: The age at which the crime was committed; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references, if provided; and Other evidence that demonstrates whether the registrant poses a threat to the public health or safety. The Board may not renew a registration if the Board has not received the results of a criminal history records check required pursuant to §A(5) of this regulation. Expiration. A registration automatically expires when the psychology associate fails to meet the renewal requirements by March 31. The Board may not consider a petition for reinstatement of a license or registration to practice psychology that has been revoked until at least 5 years have passed from the date of revocation. The Board shall meet a minimum of six times a year with additional meetings being scheduled as the business of the Board may require. The Chairman of the Board shall submit an annual report to the Board for approval before the Board's submission of the report to the Secretary of Health. The Board shall include in the report: A summary of the more important actions of the Board; Relevant statistical and fiscal data; and A summary of concerns or anticipated future changes in the course of action of the Board. Any person may petition the Board in writing for an interpretation of: Health Occupations Article, Title 18, Annotated Code of Maryland; and COMAR 10.36.01—10.36.07. A copy of the Board's interpretation or decision shall be mailed to the petitioner. Health Occupations Article, §§18-206, 18-301(b)(3) and (d), 18-302—18-305, 18-309, and 18-317, Annotated Code of Maryland Effective date: July 25, 1970 Regulation .05G adopted as an emergency provision effective December 23, 1976 (4:2 Md. R. 73); emergency status expired Regulations .01—.17 repealed and new Regulations .01—.15 adopted effective December 20, 1982 (9:25 Md. R. 2484) Regulation .02 repealed effective September 25, 1995 (22:19 Md. R. 1473) Regulation .05 amended as an emergency provision effective October 23, 1987 (14:23 Md. R. 2412); emergency status extended at 15:7 Md. R. 848 Regulation .05 amended effective May 16, 1988 (15:10 Md. R. 1202) Regulation .07 amended effective September 25, 1995 (22:19 Md. R. 1473) Regulation .11 repealed and new Regulation .11 adopted effective October 29, 1990 (17:21 Md. R. 2530) Regulations .01—.15 repealed and new Regulations .01—.12 adopted as an emergency provision effective January 1, 2000 (27:3 Md. R. 325); adopted permanently effective May 1, 2000 (27:8 Md. R. 798) Regulation .01B amended effective September 1, 2010 (37:14 Md. R. 938); March 21, 2011 (38:6 Md. R. 395) Regulation .02L adopted effective December 24, 2001 (28:25 Md. R. 2192) Regulation .02 amended as an emergency provision effective April 1, 2002 (29:7 Md. R. 617); amended permanently effective June 24, 2002 (29:12 Md. R. 928) Regulation .02 amended effective March 21, 2011 (38:6 Md. R. 395) Regulation .04 amended as an emergency provision effective April 1, 2002 (29:7 Md. R. 617); amended permanently effective June 24, 2002 (29:12 Md. R. 928) Regulation .04 repealed and new Regulation .04 adopted effective September 1, 2010 (37:14 Md. R. 938) Regulations .04-1—.04-4 adopted effective September 1, 2010 (37:14 Md. R. 938) Regulation .06G amended effective December 24, 2001 (28:25 Md. R. 2192) Regulation .06 amended as an emergency provision effective April 1, 2002 (29:7 Md. R. 617); amended permanently effective June 24, 2002 (29:12 Md. R. 928) Regulation .08A amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .08C amended effective March 21, 2011 (38:6 Md. R. 395) Chapter revised effective May 25, 2015 (42:10 Md. R. 684) Regulation .02L amended effective February 12, 2018 (45:3 Md. R. 157) Regulation .08A, C amended effective February 12, 2018 (45:3 Md. R. 157) Regulation .09A amended effective February 12, 2018 (45:3 Md. R. 157) This chapter applies to all psychologists and psychology associates who want to renew their licensure or registration in the State. In this chapter, the following terms have the meanings indicated. Terms Defined. “Activity” means any authoring, editing, learning, presenting, program developing, reviewing, or teaching which meets the objectives of continuing education. “Approved program” means an activity by an authorized sponsor. “Authorized sponsor” means an individual or organization whose programs are accepted by the Board as continuing education activity. “Board” means the Board of Examiners of Psychologists. “Continuing education (CE)” means learning experiences that: Are professional activities beyond that required for licensure or registration; Are relevant to psychological practice, education, or science; Enable psychologists and psychology associates to keep pace with emerging issues and technology; and Allow psychologists and psychology associates to develop, maintain, and increase competencies in order to improve services to the public and enhance contributions to the profession. “Continuing education (CE) hour” means approximately 1 hour of continuing education activity, unless stated otherwise in Regulation .04 of this chapter. Course. “Course” means an activity: With one or more instructors who are experts in the topic and impart knowledge or professional skills by a systematic presentation to participants; That may be offered in person or in real time through electronic means; and That allows for interaction between the leader and the participants or among the participants. “Course” includes seminars, symposiums, and workshops. “Independent study” means an activity requiring the study of print or electronic materials offered by approved sponsors approved for CE for independent or home study that is not a course as defined in §B(7) of this regulation. “Peer consultation group” means a group of psychologists that meets in person, in a structured and organized manner, and discusses the clinical practice of psychology in order to broaden professional knowledge and expertise. “Reporting period” means a 2-year period beginning on April 1, except as stated in Regulation .04C of this chapter, during which the completion of a minimum number of CE hours is required to renew a license or registration by March 31 following the reporting period. To qualify for approval by the Board, continuing education activities: Shall meet one or more of the following objectives: Maintains the professional competency of psychologists or psychology associates; Increases the professional skills and knowledge of psychologists or psychology associates; Prepares psychologists or psychology associates for new roles or responsibilities in the practice of psychology; or Expands the science of psychological theory, method, or practice; and May not include: Business meetings; Professional committee meetings; and Presentations and publications primarily intended for a lay audience. A psychologist shall complete a minimum of 40 CE hours during each reporting period with a: Maximum of 20 CE hours in independent study; Minimum of 3 CE hours in activities whose content area is: Laws pertaining to the practice of psychology; Ethics and professional conduct in the practice of psychology; or Managing risks associated with the practice of psychology; Minimum of 3 CE hours in activities designed to enhance competence in the provision of psychological services to culturally diverse populations; and If the psychologist supervised psychology associates during the reporting period, minimum of 3 CE hours in activities designed to enhance competence in the provision of clinical supervision. A psychology associate shall complete a minimum of 20 CE hours during each reporting period with a: Maximum of 10 CE hours in independent study; Minimum of 3 CE hours in activities whose content area is: Laws pertaining to the practice of psychology; Ethics and professional conduct in the practice of psychology; or Managing risks associated with the practice of psychology; and Minimum of 3 CE hours in activities designed to enhance competence in the provision of psychological services to culturally diverse populations. During each reporting period, CE hours may be earned only once for the same activity. Reporting Period. The reporting period for psychologists or psychology associates with license or registration numbers ending with an: Odd digit will be March 31 of odd years; and Even digit or 0 will be March 31 of even years. For psychologists or psychology associates receiving their initial license or registration with less than 12 months before the end of their reporting period, CE hours are not required for that reporting period. Psychologists receiving their initial license with 12 months or more before the end of their reporting period shall be required to complete 20 CE hours. Psychology associates receiving their initial registration 12 months or more before the end of their reporting period shall be required to complete 10 CE hours. CE Audits. The Board shall randomly audit the continuing education documentation of all psychologists and psychology associates. Psychologists and psychology associates selected for an audit shall renew their license or registration by March 1. Within 10 days following notification by the Board, a psychologist or psychology associate who is audited shall provide: Proof of completion of continuing education activities; A completed continuing education reporting form; and Any additional information that may be requested by the Board to evaluate completion of CE requirements. Proof of completion as required in §D(2)(a) of this regulation may include: Certificates of attendance; Transcripts or course syllabi; Reprints of publications; Test results; or Any other proof of completion acceptable to the Board. To earn CE credits for independent study, a psychologist or psychology associate shall: Pass an examination on the activity; and Be awarded a certificate of completion. A psychologist may earn CE credit for participation in a peer consultation group. A peer consultation group shall: Meet to discuss the clinical practice of psychology; Assign a recording secretary to keep attendance and record a brief summary of what was discussed at the meeting; Meet for no less than 1 hour for every session; and Consist of no fewer than three psychologists and no more than six psychologists. The recording secretary: Shall provide a copy of the meeting summary to each psychologist in attendance and keep a copy in a file maintained by the recording secretary; Shall complete, sign, and provide to each psychologist member a certificate at the end of the reporting period that verifies attendance and specifies the number of hours the psychologist participated in the peer consultation group; Shall ensure that another peer consultation group participant act as a substitute recording secretary at any group meeting at which the recording secretary is absent; and May be a role fulfilled by different psychologist participants during the life of the peer consultation group. A psychologist participating in a peer consultation group: Shall provide the certificate of attendance to the Board at the time of renewal to verify participation in the peer consultation group; Shall provide copies of the meeting summaries to the Board in the event of a CE audit; Shall only receive CE credit for hours of peer consultation group meetings actually attended; and May participate in more than one peer consultation group, in which case hours of participation in all peer consultation groups shall be added together to calculate CE credit. CE hours for participating in a peer consultation group may be earned as follows: One CE hour for 7 to 13 hours of participation in a peer consultation group during the reporting period; Two CE hours for 14 to 20 hours of participation in a peer consultation group during the reporting period; Three CE hours for 21 to 27 hours of participation in a peer consultation group during the reporting period; and Four CE hours for 28 or more hours of participation in a peer consultation group during the reporting period. Extra hours of participation in a peer consultation group may not be carried over to the next reporting period for CE credit. The total number of hours that may be used to fulfill CE requirements for scholarly activities included in §C of this regulation may not exceed 30 hours for psychologists or 15 hours for psychology associates during each 2-year reporting period. If the activity has more than one author or presenter, CE hours are awarded only to the first three authors. Approved CE activities include the following: Authoring, editing, presenting, or reviewing a scholarly publication where: A maximum of 20 CE hours for psychologists or 10 CE hours for psychology associates may be earned during each 2-year reporting period for publication by the author or authors of a book during the year of publication; A maximum of 15 CE hours for psychologists or 8 CE hours for psychology associates may be earned for each 2-year reporting period during the year of publication for serving as the: Editor of a book; Author of a book chapter; or Author of a scientific peer-reviewed journal article; A maximum of 15 CE hours for psychologists or 8 CE hours for psychology associates may be earned for each 2-year reporting period for service by the editor or associate editor of a peer-reviewed scientific journal; and A maximum of 15 CE hours for psychologists or 8 CE hours for psychology associates may be earned for each 2-year reporting period for service as an editorial board member of a peer-reviewed scientific journal; Three CE hours may be earned for each hour of presentation of the first offering of scholarly papers or courses for an authorized sponsor with a maximum of 15 CE hours for psychologists or 9 CE hours for psychology associates for each 2-year reporting period; Three CE hours may be earned for developing and presenting a scholarly poster with a maximum of 15 CE hours for psychologists or 9 CE hours for psychology associates for each 2-year reporting period; and A maximum of 4 CE hours may be earned by a psychologist for participation in a peer consultation group during each 2-year reporting period, as specified in Regulation .05-1 of this chapter. CE hours may be earned for attending courses offered by an authorized sponsor specified in Regulation .06 of this chapter. The following organizations and their approved CE sponsors are authorized sponsors of continuing education acceptable to the Board: American Psychological Association; Association for Psychological Science; American Medical Association; National Association of Social Workers; National Association of School Psychologists; Maryland Department of Health (MDH); National Institutes of Health; and Accredited academic institutions. The Board shall deny a renewal application if: The psychologist or psychology associate did not complete required continuing education hours within the reporting period; or The psychologist or psychology associate did not fulfill audit requirements within 30 days. Upon denying a renewal application, the Board shall notify the psychologist or psychology associate by certified mail that the psychologist’s or psychology associate’s renewal application has been denied for failure to comply with the continuing education requirements. A psychologist or psychology associate may request a hearing on the denial of the renewal application. The request shall be: In writing; and Received by the Board within 30 days of the notification of denial. If requested by the psychologist or psychology associate, the Board shall convene a hearing within a reasonable time on the denial of the renewal application. A hearing conducted under this regulation may not be held in accordance with the Maryland Administrative Procedure Act. Inactive Status. A psychologist on inactive status who applies for a reactivation of the license with less than 1 year remaining in the reporting period shall: Provide documentation of a minimum of 20 CE hours completed during the current reporting period with not more than 10 hours in independent or home study; and Pay the renewal fee as specified in COMAR 10.36.06. A psychologist on inactive status who applies for a reactivation of the license with more than 1 year remaining in the reporting period shall: Provide documentation of a minimum of 20 CE hours completed during the current reporting period, with not more than 10 hours in independent or home study; Complete the remaining 20 CE hours required by the end of the reporting period, with not more than 10 hours in independent or home study; and Pay the renewal fee as specified in COMAR 10.36.06. Expired License or Registration. A psychologist who applies for reinstatement of a license that expired less than 1 year from the date of application shall: Provide documentation of a minimum of 20 CE hours completed during the current reporting period, with not more than 10 CE hours in independent study; Complete the remainder of continuing education requirements by the end of the reporting period; and Pay the reinstatement and renewal fees as specified in COMAR 10.36.06. A psychology associate who applies for reinstatement of a registration that expired less than 1 year from the date of application shall: Provide documentation of a minimum of 10 CE hours completed during the current reporting period, with not more than 5 CE hours in independent study; Complete the remainder of continuing education requirements by the end of the reporting period; and Pay the reinstatement and renewal fees as specified in COMAR 10.36.06. A psychologist who applies for reinstatement of a license that expired more than 1 year but less than 5 years from the date of application shall: Provide documentation of 40 CE hours for the current reporting period; and Pay the reinstatement and renewal fees as specified in COMAR 10.36.06. A psychology associate who applies for reinstatement of a registration that expired more than 1 year but less than 5 years from the date of application shall: Provide documentation of 20 CE hours for the current reporting period; and Pay the reinstatement and renewal fees as specified in COMAR 10.36.06. A psychologist whose license has been expired for more than 5 years and who did not make application to go on inactive status shall reapply for licensure. A psychology associate whose registration has been expired for more than 5 years shall reapply for a registration. The Board may not approve an application for reinstatement until it receives documentation of the minimum CE requirements as set forth in this regulation. The Board may approve modifications of the CE requirements. To request modifications of the CE requirements, a psychologist or psychology associate shall: Make a written request; Provide evidence of a disability or inability to access activities; and Specify acceptable procedures for completion and documentation of the required hours within the reporting period. Health Occupations Article, §18-309(f), Annotated Code of Maryland Effective date: February 24, 1978 (5:4 Md. R. 227) Regulation .01A; .03B; .04A and C; .05A, C, and D; and .06 amended effective July 19, 1982 (9:14 Md. R. 1431) Chapter revised effective February 20, 1989 (16:3 Md. R. 344) Regulations .02 — .06 repealed and new Regulations .02 — .06 adopted as an emergency provision effective January 1, 2000 (27:3 Md. R. 325); adopted permanently effective May 1, 2000 (27:8 Md. R. 798) Regulation .06A amended as an emergency provision effective July 1, 2008 (35:17 Md. R. 1482); amended permanently effective October 6, 2008 (35:20 Md. R. 1775) Regulations .01 — .06 repealed and new Regulations .01 — .09 adopted effective December 31, 2009 (36:26 Md. R. 1995) Regulation .01 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .02B amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .03A amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .04 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .05 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .05-1 adopted effective May 25, 2015 (42:10 Md. R. 684) Regulation .07 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .08 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .09B amended effective May 25, 2015 (42:10 Md. R. 684) This chapter applies to all contested case hearings held under the authority of Health Occupations Article, §18-315, Annotated Code of Maryland, which concern possible action to be taken by the State Board of Examiners of Psychologists under Health Occupations Article, §18-313, Annotated Code of Maryland, regarding the licensure or registration, or discipline of psychologists and psychology associates. This chapter does not apply to conferences or other informal investigations or proceedings. Written notice of charges and a hearing shall be sent by the Chairman of the Board to the licensee, registrant, or applicant for licensure or registration at least 30 days before the hearing. The notice shall state the date, time, and place of the hearing. It also shall state the issues or charges involved in the proceedings. If, by reason of the nature of the proceeding, these issues cannot be fully stated in the notice of the hearing in advance or if subsequent amendment of the issues is necessary, the issues and charges shall be clarified and fully stated as soon as practicable. The written notice of charges and a hearing shall be served on the party in person. Instead of personal service, the Board may serve the notice by registered or certified mail, restricted delivery, return receipt requested. All parties in interest appearing before the Board at formal contested case hearings have the right to appear in person, alone, or by or with counsel. Prehearing and Case Resolution Conferences. The Board may set a prehearing conference, or a case resolution conference, or both, upon motion of either party, or on its own motion. The case resolution conference may be used to attempt to settle the case. The prehearing conference may be used to prepare for the hearing by: Delineating the issues, Stipulating to facts, laws, and other matters, Arranging a schedule, and Arranging for the submission of names of witnesses to be called and the subject matter of testimony to be presented in the hearing. Discovery on Request. By written request served on the other party and filed with the Board or the Office of Administrative Hearings, a party may require another party to produce, within 15 days, the following: A list of witnesses to be called; Copies of documents intended to be produced at the hearing; or Both §B(1) and (2) of this regulation. Mandatory Discovery. Each party shall provide to the other party not later than 15 days before the prehearing conference, if scheduled, or 45 days before the scheduled hearing date, whichever is earlier: The name and curriculum vitae of any expert witness who will testify at the hearing; and A detailed written report summarizing the expert's testimony, which includes the opinion offered and the factual basis and reasons underlying the opinion. If the Board or the Office of Administrative Hearings, as appropriate, finds that the report is not sufficiently specific, or otherwise fails to comply with the requirements of this section, the Board or the Office of Administrative Hearings, as appropriate, shall exclude from the hearing the testimony of the expert and any report of the expert. The Board or the Office of Administrative Hearings, as appropriate, shall consider and decide arguments regarding the sufficiency of the report: At the prehearing conference, if scheduled; or Immediately before the scheduled hearing. If an expert adopts a sufficiently specific charging document as the expert's report, that adoption satisfies the requirements set forth in this section. Parties are not entitled to discovery of items other than as listed in §§B and C of this regulation. Both parties have a continuing duty to supplement their disclosures of witnesses and documents. Absent unforeseen circumstances which would otherwise impose an extraordinary hardship on a party, witnesses or documents may not be added to the list: After the prehearing conference, if scheduled; or Later than 15 days before the hearing, if a prehearing conference is not scheduled. The prohibition against adding witnesses does not apply to witnesses or documents to be used for impeachment or rebuttal purposes. All motions shall be accompanied by a memorandum of points and authorities and shall be filed with the Board at least 15 working days before the hearing. A copy shall be served on the opposing party. A response shall be filed with the Board at least 10 working days before the hearing and a copy served on the opposing party. The Board at its discretion will entertain motions on the day of the hearing. Construction. In hearings conducted by an administrative law judge of the Office of Administrative Hearings, this regulation shall, whenever possible, be construed as supplementing and in harmony with COMAR 28.02.01. In the event of a conflict between this regulation and COMAR 28.02.01, this regulation applies. Board Majority. Each hearing shall be held before a quorum of the Board unless the hearing authority is delegated pursuant to State Government Article, §10-205, Annotated Code of Maryland. A delegation of authority shall be subject to the provisions of State Government Article, §10-216, Annotated Code of Maryland. If hearing authority is not delegated, Board action shall be by a majority vote of those Board members present at the Board hearing. Duties of Presiding Officer. Unless the Board's hearing authority is delegated, the Chairman, or a Board member designated by the Chairman, shall be the presiding officer. The presiding officer shall: Have complete charge of the hearing; Permit the examination of witnesses; Admit evidence; Rule on the admissibility of evidence; Adjourn or recess the hearing from time to time. The presiding officer may set reasonable time limits on arguments and presentation of evidence. The presiding officer shall be responsible for order in the hearing and can suspend the proceedings as necessary to maintain order. Legal Advisor and Counsel for the Board. The presiding officer may request the Office of the Attorney General to participate in any hearing to present the case on behalf of the State. The member of the Office of the Attorney General presenting the case on behalf of the State shall have all of the following rights: The submission of evidence; Examination and cross-examination of witnesses; Presentation of summation and argument; and Filing of objections, exceptions, and motions. The presiding officer may also request a representative of the Office of the Attorney General to act as legal advisor to the Board on questions of procedure, evidence, and law. Order of Procedure. The case on behalf of the State shall be presented first. The respondent shall then present his case. After that, rebuttal shall be permitted. Examination of Witnesses and Introduction of Evidence. The Board has the power to administer oaths and to compel the attendance of witnesses by subpoena. The Board shall issue subpoenas for any and all witnesses requested in writing by a party. The rules of evidence in all hearings in this chapter shall be as set forth in State Government Article, §§10-213 and 10-214, Annotated Code of Maryland. Each party has the right to: Call witnesses and present evidence; Cross-examine every witness called on behalf of the State or other party; Present summation and argument and file objections, exceptions, and motions. If a party is represented by counsel, the submission of evidence, examination, and cross-examination of witnesses, and filing of objections, exceptions, and motions shall be done and presented solely by that counsel. After the direct testimony of the witness is presented and after cross-examination, the Board members may ask questions. If an accused or complainant fails to appear at a hearing after due notice, the Board may reschedule the hearing, or at its discretion, proceed upon the investigation, report, documents, witnesses, and records before it. At the end of the hearing any party may submit briefs of the issues of fact and law involved in the hearing, which briefs shall be filed in the form, with the number of copies, and at the time as the presiding officer may designate. The Board shall prepare an official record which shall include all pleadings, testimony, exhibits, and other memoranda or material filed in the proceeding. A stenographic record of the proceedings shall be made at the expense of the Board. This record need not be transcribed, however, unless requested by a party, or by the Board. The cost of any typewritten transcripts of any proceedings, or part of them, shall be paid by the party requesting the transcript. Each decision and order rendered by the Board shall be in writing and shall be accompanied by findings of fact and conclusions of law. A copy of the decision and order and accompanying findings and conclusions shall be delivered or mailed promptly to each party or his attorney of record. In any order involving patients or clients of a psychologist or psychology associate these individuals will not be referred to by name if in the Board’s opinion confidentiality is in their best interests. If the psychologist or psychology associate is found not to be in violation of Health Occupations Article, Title 18, Annotated Code of Maryland, the Board immediately shall order a dismissal of the charges and the exoneration of the accused, and no further action may be taken by the Board on the charges involved. Upon a finding not in violation of Health Occupations Article, Title 18, the Board shall expunge the record of the proceedings. Any party aggrieved by the decision and order may apply for rehearing within 10 days after service on him of the decision and order. The application shall state the grounds for rehearing. The Board shall grant or deny the application within 30 days of its submission to the Chairman of the Board. Action on the application shall lie at the discretion of the Board. Unless otherwise ordered, neither the rehearing nor the application for rehearing shall stay the enforcement of the order, or excuse the persons affected by it for failure to comply with its terms. On rehearing, the Board shall only consider facts not presented in the original hearing, including facts arising after the date of the original hearing, and may by new order abrogate, change, or modify its original order. Any person whose license or registration has been revoked or suspended by the Board, or any person placed on probation or reprimanded by the Board, may seek judicial review of the Board’s decision. This review shall be in accordance with the provisions of State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. Health Occupations Article, §§18-206 and 18-315; State Government Article, §10-206; Annotated Code of Maryland Effective date: Regulations .01 — .08 adopted as an emergency provision effective September 29, 1980 (7:21 Md. R. 1988); emergency status expired February 14, 1981 Regulations .01 — .09 adopted effective December 3, 1984 (11:24 Md. R. 2069) Regulation .05A, B amended effective November 26, 1990 (17:23 Md. R. 2732) Chapter revised effective September 4, 2000 (27:17 Md. R. 1620) Regulation .01 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .02A amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .07 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .09 amended effective May 25, 2015 (42:10 Md. R. 684) Effective date: December 10, 1990 (17:24 Md. R. 2837) Chapter repealed effective March 13, 1995 (22:5 Md. R. 367) This chapter governs the professional conduct of licensed psychologists, registered psychology associates, and applicants for both. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the Maryland Board of Examiners of Psychologists. “Client” means the individual, couple, family, group, business, agency, school, organization, or association that the psychologist or psychology associate provides, or has provided, with professional services. “Multiple relationship” means a relationship in which an individual is concurrently participating in two or more roles with another. “Psychologist” means an individual who is licensed by the Board to practice psychology. “Psychology associate” means an individual who is registered by the Board to practice psychology under the supervision of a psychologist. “Public statement” means any oral, printed, or electronic communication or announcement made by or on behalf of a psychologist, psychology associate, or applicant, and directed to another individual or group. “Sexual intimacies” means acts engaged in with or without clothing involving: Genital contact; Nongenital contact with the hips, loin, thigh, buttocks, or breasts; Exposure or observation of genitals or nude portions of a body involving breasts, buttocks, or genitals; or Other behaviors engaged in for the purpose of sexual arousal or sexual gratification. In General. A psychologist shall be fully responsible for the psychologist’s professional decisions and professional actions; A psychologist and psychology associate shall be jointly responsible for the psychology associate’s professional decisions and professional actions. A psychologist or psychology associate shall: Notify the Board in writing within 60 days if a license, certificate, permit, or registration granted by another authority for the practice of psychology has been limited, restricted, suspended, revoked, or subjected to other disciplinary action by the particular licensing or granting authority; Provide psychological services only in the context of clear professional and scientific relationships and roles accepted by the standard of practice of the discipline of psychology; Make known the psychologist’s or psychology associate’s commitment to the Code of Ethics and Professional Conduct and resolve potential conflicts with the Code of Ethics and Professional Conduct in a responsible manner; Treat all individuals in a fair and objective manner without discrimination based on age, gender, race, ethnicity, culture, national origin, disability, socioeconomic status, or another basis proscribed by law; Interact with individuals in the workplace in a respectful manner without engaging in behavior that is harassing or demeaning; and Comply with a Board order. A psychologist or psychology associate may not: Knowingly or willfully destroy, damage, alter, obliterate, or otherwise obscure a medical record or billing record or other information about a patient in an effort to conceal the information from use as evidence in an administrative, civil, or criminal proceeding; Intimidate or influence an individual to withhold or change testimony in hearings or proceedings before the Board or those otherwise delegated to the Office of Administrative Hearings; Hinder, prevent, or otherwise delay an individual from making information available to the Board in furtherance of an investigation of the Board; or Take credit for work the psychologist or psychology associate has not actually performed or supervised. Supervision. A psychologist shall: Be responsible for the actions of those the psychologist supervises; and Ensure that those the psychologist employs act in accordance with the Maryland Psychologists Act and the provisions of this chapter. Research. A psychologist or psychology associate shall: Respect the dignity and protect the welfare of research subjects, and comply with all relevant statutes, regulations, and institutional and administrative rules concerning treatment of research subjects; Take responsibility for the ethical treatment of research participants by collaborators, supervisees, and employees; Acquire, care for, use and dispose of animals in compliance with laws, regulations, and applicable professional standards; Ensure appropriate consideration of the comfort, health and humane treatment of animals used in research; Make clear, either as a researcher or a writer, the nature of the participation, as well as the costs and the psychologist's obligations to be accepted by research participants; Obtain required approval from host institutions before conducting research; and Report research findings accurately, presenting only the psychologist’s or psychology associate’s work or making appropriate citations when needed. Teaching. A psychologist or psychology associate shall ensure that statements in course catalogs, seminar brochures, and course outlines are accurate and not misleading, particularly in terms of the: Subject matter to be covered; Nature of course experiences; and Basis for evaluating performance. Professional Competence. A psychologist or psychology associate shall: Limit practice to the areas of competence by which proficiency has been gained through education, training, and experience; Acquire the special education and training needed to address the cultural differences of special populations; Avoid unfair discrimination based on age, gender, race, ethnicity, culture, national origin, disability, socioeconomic status, or other basis proscribed by law; Use interventions and assessment techniques only when the psychologist or psychology associate knows that the circumstances are appropriate applications of those interventions and techniques, supported by reliability, validation, standardization, and outcome studies; Maintain competence by meeting the requirements of continuing education as set forth in COMAR 10.36.02; Engage in ongoing consultation with other psychologists, psychology associates, or relevant professionals and seek appropriate education, training, and experience, when developing competence in a new service or technique; and Document and maintain appropriate records of professional and scientific work. Impaired Competence. A psychologist or psychology associate shall: Represent accurately and objectively the psychologist’s or psychology associate’s professional qualifications; and Seek competent professional assistance to determine whether to suspend, terminate, or limit the scope of professional or scientific activities when the psychologist or psychology associate becomes or is made aware that the psychologist’s or psychology associate’s competence is impaired. A psychologist or psychology associate may not: Undertake or continue a professional relationship with a client when the competence or objectivity of the psychologist or psychology associate is or could reasonably be expected to be impaired due to: Mental, emotional, physiological, pharmacological, substance abuse, or personal problems; or The psychologist’s or psychology associate’s present or previous familial, social, sexual, emotional, financial, supervisory, political, administrative, or legal relationship with the client or a person associated with or related to the client; or Engage in other relationships that could limit the psychologist’s or psychology associate’s objectivity or create a conflict of interest or the appearance of a conflict of interest. Public Statements and Advertising. A psychologist or psychology associate shall: Represent accurately and objectively the psychologist’s or psychology associate’s professional qualifications, education, experience, and areas of competence; Correct others who misrepresent the psychologist’s or psychology associate’s professional qualifications or affiliations; and Identify a paid advertisement as a paid advertisement. A psychologist or psychology associate may not: Misrepresent, directly or by implication, the affiliations or the purposes or characteristics of institutions and organizations with which the psychologist or psychology associate is affiliated; Claim organizational membership in a manner that suggests specialized competence or qualifications that the psychologist or psychology associate does not have; Make public statements that contain: False, fraudulent, misleading, or deceptive statements; Partial disclosures of relevant facts that misrepresent, mislead, or deceive; or Statements that create false or unjustified expectations of favorable results; or Solicit, either in person or through others, business or testimonial endorsements from clients who are vulnerable to undue influence. Informed Consent. When conducting research or providing assessment, psychotherapy, counseling, or consulting with an individual or organization in person or by electronic transmission or other forms of communication, a psychologist or psychology associate shall: In general: Obtain informed consent using appropriate language understandable to the client; Vary appropriate informed consent forms and procedures to ensure that the client: Has the capacity to consent; Has been provided with information concerning participation in the activity that reasonably might affect the willingness to participate, including limits of confidentiality and monetary costs or reimbursements; Is aware of the voluntary nature of participation and has freely and without undue influence expressed consent; and Is given the opportunity to ask questions and receive answers regarding the activity; In research, make clear to the client: The nature of the participation as well as the costs and other obligations to be accepted by research participants; The purpose and nature of any evaluations, treatment, or educational or training procedure; All aspects of research including any risks and consequences of the research that will reasonably be expected to influence willingness to participate; The right to withdraw from treatment or research at any time; and The notification that permission shall be given by the client, student, or research participant before the use of observation or electronic taping, recording, or filming procedures; and In therapeutic relationships, explain to the client: The clarification of reasonable expectations; The nature and purpose of testing, reports, and consultations; The limits of confidentiality; Specific information concerning fees, billing, and electronic services available in the payment of fees; Psychotherapeutic schedules; and The process and conditions of termination of therapy. Financial Arrangements and Fees. A psychologist or psychology associate shall: Make advance financial arrangements that are clearly understood by the client; Inform the client about the possibility of initiating a collection procedure before using that procedure; Comply with the provisions regarding patient referrals contained in Health Occupations Article, §§1-301 — 1-306, Annotated Code of Maryland; Make full disclosure in advance to the client of any remuneration given or received for making or accepting referrals; and Refrain from signing statements for insurance purposes as though the psychologist or psychology associate provided a service that was actually provided by someone else. A psychologist or psychology associate shall: Perform evaluations and diagnostic services in a professional relationship when assessment data is indicated by the professional context; Administer psychological tests in keeping with accepted standards of practice and avoid use of obsolete measurement techniques; Use appropriate or specialized assessment instruments when working with individuals from special populations; Use appropriate scoring devices, norms, and standards in evaluating test protocols; Select scoring and interpretive programs and services on the basis of evidence of the validity of the programs and procedures; Report the results of assessment procedures by: Using adequate interpretative aids or explanations; Including any deficiencies of the assessment norms for the individual assessed, and any relevant reservations or qualifications which affect the validity, reliability, or other interpretation of results; and Avoiding misuse of automated interpretative reports; Base recommendations or decisions on test results that are reasonably current and not obsolete; Supply a manual or other printed material which fully describes the development of the assessment procedure or service, the rationale, evidence of validity and reliability, and characteristics of the normative population when offering an assessment procedure or automated interpretation service to other professionals; and Release test results only to patients and clients as appropriate. A psychologist or psychology associate may not: Release test protocols or raw data to persons who are not qualified to interpret and use the information appropriately, except as required by law; Encourage or promote the use of psychological assessment techniques or computerized assessment and interpretation by unqualified persons; or Reproduce test materials or describe psychological tests or other assessment devices in popular publications, lectures, or public presentation in ways that might compromise their validity. A psychologist or psychology associate shall: Take appropriate steps to disclose to all involved parties conflicts of interest that arise, with respect to a psychologist’s or psychology associate’s clients, in a manner that is consistent with applicable confidentiality requirements; and Make arrangements for another appropriate professional to deal with emergency needs of the psychologist’s or psychology associate’s clients as appropriate, during periods of anticipated absences from professional availability. Exploitation. A psychologist or psychology associate may not: Exploit or harm clients, colleagues, students, research participants, or others; Take actions that violate or diminish the legal and civil rights of clients or of others who may be affected by the action; Exploit the trust and dependency of clients, students, and subordinates; Allow personal, social, religious, organizational, financial, or political situations and pressures to lead to a misuse of their influence; or Enter into a new nonpsychological, nonprofessional relationship with a former client that is considered exploitative dependent on, but not limited to: The nature, duration, and intensity of professional services rendered to the client; The length of the professional relationship; The length of time between the termination of the professional relationship and the initiation of the nonprofessional relationship; The mental stability of the psychologist or psychology associate and former client; The circumstances of termination, including, but not limited to, statements or actions of the psychologist or psychology associate suggesting or inviting the possibility of a post-termination relationship; and The likelihood of adverse impact on the client. Sexual Misconduct. A psychologist or psychology associate may not: Engage in sexual intimacies with a current client; Engage in sexual intimacies with a former client: For at least 2 years after the cessation or termination of professional services; or After the 2 years following the cessation or termination of professional services if the sexual relationship is exploitative in light of the following factors: The nature, duration, and intensity of professional services rendered to the client; The length of the professional relationship; The length of time between the termination of the professional relationship and the initiation of the nonprofessional relationship; The mental stability of the psychologist or psychology associate and former client; The circumstances of termination including, but not limited to, statements, or actions of the psychologist or psychology associate suggesting or inviting the possibility of a post-termination sexual or romantic relationship; and The likelihood of adverse impact on the former client; Engage in sexual intimacies with individuals known to be the parents, guardians, spouses, domestic partners, sexual partners, children, or siblings of the client or for at least 2 years after cessation or termination of professional services; Terminate a professional relationship with a client for the purpose of engaging in sexual intimacies with one of the individuals set forth in §C(3) of this regulation; Engage in sexual behavior with a client in the context of a professional evaluation, treatment, procedure, or service to the client, regardless of the setting in which the professional service is rendered; or Engage in sexual behavior with a client under the pretext of diagnostic or therapeutic intent or benefit. Harassment. A psychologist or psychology associate may not: Engage in sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, which behavior occurs in connection with the psychologist’s or psychology associate’s professional role; Engage in sexual harassment of the psychologist’s or psychology associate’s past or present clients, supervisees, research participants, or employees, with deliberate or repeated comments, gestures, or physical contacts of a sexual nature; or Create a hostile workplace or educational environment by unwelcome and offensive behaviors that are sufficiently severe or intense to be abusive of a reasonable individual in that environment whether it consists of a single act or of multiple persistent or pervasive acts. A psychologist or psychology associate shall: Provide psychological services for minor children or for adults who have legal guardians only with appropriate authorization; and Take special care to protect the interests of minors or clients who are unable to give voluntary, informed consent. Termination of Services. A psychologist or psychology associate shall: Make or recommend referral to other professional, technical, or administrative resources if the referral is clearly in the best interest of the client; and Unless precluded by the actions of the client, terminate the professional relationship in an appropriate manner, notify the client in writing of this termination, and assist the client in obtaining services from another professional, if: It is reasonably clear the client is not benefiting from the relationship; A multiple relationship develops or is discovered after the professional relationship has been initiated; Impaired competency or objectivity develops or is discovered after a professional relationship has been initiated; or The psychologist or psychology associate has been threatened or otherwise endangered by the client or another person with whom the client has a relationship. A psychologist or psychology associate shall: Maintain confidentiality regarding information obtained from a client in the course of the psychologist’s or psychology associate’s work; Discuss the requirements and limitations of confidentiality at the beginning of the professional relationship or at the intake interview; Safeguard information obtained in clinical or consulting relationships or evaluative data concerning children, students, employees, and others obtained in the course of practice, teaching, research, or other professional services; Release mental health records or other confidential information only as permitted or required by law; Obtain written permission for the electronic recording of interviews; Avoid undue invasion of privacy by ensuring that written and oral reports contain only data relevant to the purpose of the evaluation; Treat any assessment result or interpretation regarding an individual as confidential information; and Obtain informed written consent before presenting in writing, lecture, or other public forums identifying information obtained during the course of professional work, and disguise this information when case reports or other confidential information are used as a basis for teaching or research. Legal and Ethical Limits. A psychologist or psychology associate shall inform: Clients of the legal and ethical limits of confidentiality; Clients below the age of minority, or who have legal guardians, of the limits the law imposes on the right of confidentiality with respect to communications with the psychologist or psychology associate, to the extent that the client can understand, at the beginning of the professional relationship; Research participants of any limits to confidentiality as part of the informed consent; and Clients of the duty imposed by law to inform authorities of abuse and neglect of children and vulnerable adults. Record Keeping. A psychologist or psychology associate shall: Keep records of a patient's condition and assessment results; Maintain clinical records of informed consent, presenting problems, diagnosis, fee arrangements, dates and substance of each billed service, original test data with results and other evaluative material, and the results of any formal consultations with other professionals; Make provisions for maintaining confidentiality in the storage and disposal of written and electronic records; Ensure that professional records are maintained for a period consistent with State and federal laws; Limit access to client records and ensure that a person working under the psychologist’s or psychology associate’s authority including, but not limited to office personnel, comply with the requirements for confidentiality of client material; and Provide evaluations or treatment reports within a reasonable time consistent with State and federal laws on proper and lawful requests by a client, insurance carrier, court, institution, or other authorized health provider. Health Occupations Article, §§1-212, 18-311, and 18-313(7), Annotated Code of Maryland Effective date: October 26, 1992 (19:21 Md. R. 1891) Regulation .05B amended effective June 26, 2000 (27:12 Md. R. 1140) Regulations .01 — .08 repealed and new Regulations .01 — .08 adopted effective November 10, 2003 (30:22 Md. R. 1582) Regulation .01 amended effective June 7, 2004 (31:11 Md. R. 857); May 25, 2015 (42:10 Md. R. 684) Regulation .02B amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .03 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .04 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .05 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .06 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .07 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .08 amended effective May 25, 2015 (42:10 Md. R. 684) These regulations govern all those licensed or applying for licensure by the Board, or registering as a psychology associate. The following fees are established by the Board: Licensure application fee — $300; Psychology associate registration application fee — $200; Examination fees: National examination — $650; State examination — $250; Verification of licensure or registration — $20; Biennial licensure renewal fee — $400; Biennial registration renewal fee — $300; Late fee — $50; Inactive status fee (every 2 years) — $200; Reinstatement fee for license — $700; Reinstatement fee for registration — $600; Penalty for returned check — $50; Duplicate license or registration: Wall certificate — $50; Wallet card — $30; Temporary Exception to Practice — $100. Roster of licensed psychologists or registered psychology associates — $150. Application fees are nonrefundable. Examination fees shall be refunded if the request to cancel an examination is received in writing 2 weeks before the examination date. Fees are subject to change by action of the Board of Examiners of Psychologists. Licensees and applicants shall be notified of the change. For licensure renewal due between January 1 and March 31, 2000, a licensee whose license number is an odd number shall submit one-half of the biennial renewal fee for a 1-year license. The Maryland Health Care Commission (MHCC) assesses a fee for health care professionals which the applicant shall pay at the time of license renewal as specified in COMAR 10.25.02. Health Occupations Article, §§18-206, 18-207, 18-301, and 18-310, Annotated Code of Maryland Effective date: October 26, 1992 (19:21 Md. R. 1892) Regulation .02 amended as an emergency provision effective December 17, 2001 (29:1 Md. R. 18); amended permanently effective March 18, 2002 (29:5 Md. R. 504) Regulation .02 amended effective March 21, 2011 (38:6 Md. R. 395); May 25, 2015 (42:10 Md. R. 684) Regulation .02C amended effective September 27, 1993 (20:19 Md. R. 1472); September 20, 1999 (26:19 Md. R. 1448); August 6, 2001 (28:15 Md. R. 1397) Regulation .02F amended effective September 27, 1993 (20:19 Md. R. 1472) Regulation .02L adopted effective December 12, 2013 (40:24 Md. R. 2017) Regulation .05 adopted effective September 20, 1999 (26:19 Md. R. 1448) Regulation .06 adopted effective September 20, 1999 (26:19 Md. R. 1448) This chapter applies to: Registered psychology associates; and Licensed psychologists who supervise psychology associates. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the Board of Examiners of Psychologists. “Full-time” means the provision of psychological services through direct client contact at least 26 hours per week. “Registered psychology associate” means an individual who meets the requirements set forth in the Maryland Psychologists Act and is registered by the Board to practice psychology under the supervision of a licensed psychologist. “Supervisor” means a psychologist licensed in Maryland with at least 2 years of post-licensure experience who supervises a registered psychology associate. Requirements of the Supervisory Relationship. A supervisor of a registered psychology associate shall supervise only in those areas within the supervisor’s competence as determined by education, training, and experience. A supervisor shall ensure that a registered psychology associate is practicing within the scope of the registered psychology associate’s competence as demonstrated by the registered psychology associate’s documented education, training, and experience in the particular practice area. A supervisor: May delegate some supervisory responsibilities to another psychologist licensed by the Board to: Ensure competent supervision of a registered psychology associate in areas outside the area of expertise of the supervisor; or Provide temporary supervision when the supervisor is unavailable; and Shall: Document the delegated supervision in accordance with Regulation .05B(1) of this chapter; and Continue to assume responsibility for the psychological services and activities performed by the registered psychology associate during the period in which supervisory responsibilities have been delegated. Adequate and appropriate supervision shall be determined by the: Education, training, and experience of the registered psychology associate; Nature and extent of services performed by the registered psychology associate; and Setting in which the services are performed. Adequate and appropriate supervision for full-time provision of psychological services by each registered psychology associate shall consist of: One hour or more per week for a registered psychology associate who has earned a doctoral degree in psychology; Two hours or more per week for a registered psychology associate who has been admitted to a candidacy for a doctoral degree in clinical psychology, counseling psychology, school psychology, or education with a field of specialization in psychology or counseling psychology in a program accredited by the Council for Higher Education, who has satisfactorily: Completed at least 3 years of postgraduate education in psychology; and Passed preliminary doctoral examinations; or Three hours or more per week for all other registered psychology associates. In addition to the requirements set forth in §A(5) of this regulation, adequate supervision of a registered psychology associate shall include a minimum of 1 hour of supervision for every 5 hours of comprehensive evaluation and testing of a client. The amount of supervision required by §A(5) and (6) of this regulation: May be reduced by one-half for a registered psychology associate who has had 3 years of full-time experience, or its equivalent, as a psychology associate; and May be reduced proportionately for a registered psychology associate who provides services less than full-time. Adequate and appropriate supervision shall be: Provided to a registered psychology associate at a face-to-face meeting, which may include videoconferencing, unless granted an exemption by the Board; and Exclusive of supervision on administrative issues. If the supervisor is not practicing at the same site as the registered psychology associate, the supervisor shall conduct quarterly site visits at the location where the registered psychology associate is providing services,. The registered psychology associate shall inform the supervisor of all complaints, regardless of nature or origin, related to conduct of or services provided by the registered psychology associate. Termination of the Supervisory Relationship. Either party to the supervisory relationship may terminate the supervisory relationship. In the event of a termination of a supervisory relationship, the registered psychology associate may only continue to practice psychology under the supervision of another licensed psychologist who meets the requirements of this chapter. The registered psychology associate and the supervisor in the terminated supervisory relationship shall submit notice of the termination to the Board in accordance with Regulation .06 of this chapter. Responsibilities of the Supervisor. A supervisor shall be available for emergency consultation and direction of a registered psychology associate, and for client management. A supervisor may supervise a maximum of five registered psychology associates. A supervisor may not engage in supervision that would constitute a multiple relationship. A supervisor shall take responsibility for all services provided by a registered psychology associate under the supervisor’s supervision. A supervisor shall comply with additional continuing education requirements for supervisors set forth in COMAR 10.36.02. A registered psychology associate: Shall make personal reference as a “registered psychology associate under the supervision of a licensed psychologist” in all promotional materials and other communications relating to the provision of psychological services; and May not make personal reference as a psychologist, either orally or in writing. A supervisor or registered psychology associate shall inform all clients of the supervision arrangement and its possible implications for insurance reimbursement and confidentiality. A supervisor and registered psychology associate shall ensure that those who are billed for services by the registered psychology associate are informed that the registered psychology associate provided the services under the supervision of a licensed psychologist. A registered psychology associate may not engage in, or give the appearance of, practicing psychology independently of the supervisor. The recordkeeping requirements of this regulation are in addition to the recordkeeping requirements in COMAR 10.36.05. Supervisory Sessions. A supervisor and registered psychology associate shall maintain appropriate documentation of the nature and extent of the supervision provided or delegated, including the: Dates and duration of supervisory sessions; Client names or other identification for all cases; Outcome of each case reviewed; Signatures of both the supervisor and registered psychology associate; and Reason for any delegation of supervisory responsibility. A supervisor and registered psychology associate shall provide documentation of supervisory sessions upon request by the Board. Documentation of the supervisory sessions shall be maintained by the supervisor and registered psychology associate for at least 5 years. Clinical Records. A registered psychology associate shall have the supervisor co-sign all clinical documents, including: Evaluations; Authorizations for release; Treatment plans; and Report. Except as otherwise required, after the initial entry of the supervisor’s name and license number in a client file or medical record, a registered psychology associate may omit repetitive references to the supervisor. Routine entries made by a registered psychology associate do not have to be cosigned by the supervisor, unless failure to do so would result in a misrepresentation of the services provided. Documentation of site visits shall be maintained by the supervisor and the registered psychology associate for at least 5 years, and shall include: Date and time of visit; Site location; and Any issues or concerns relating to the registered psychology associate’s provision of services at the site. The supervisory relationship is subject to review by the Board. At the time of renewal of the supervisor, the supervisor shall submit to the Board a list of all registered psychology associates supervised by the supervisor on a form approved by the Board that includes the beginning and ending dates of supervision for each registered psychology associate: Supervised during the previous licensure period; and Currently being supervised. At the time of renewal of the registered psychology associate, the registered psychology associate shall submit to the Board the name and license number of any supervisors who provided supervision to the registered psychology associate: During the previous registration period; and During the present registration period. A supervisor and registered psychology associate shall immediately report to the Board in writing the date of termination of the supervisory relationship. A registered psychology associate shall immediately report in writing to the Board any change of supervisor or addition of a supervisor. Health Occupations Article, §§18-101, 18-206, and 18-301, Annotated Code of Maryland Effective date: September 25, 1995 (22:19 Md. R. 1473) Regulations .05 — .07 amended effective April 16, 2001 (28:7 Md. R. 690) Regulation .07 amended effective March 21, 2011 (38:6 Md. R. 395) Regulations .01 — .07 repealed and new Regulations .01 — .06 adopted effective May 25, 2015 (42:10 Md. R. 684) This chapter establishes standards for the imposition of sanctions and monetary penalties for violations of the Maryland Psychologists Act. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the State Board of Examiners of Psychologists. “License” means a license issued by the Board to practice psychology. “Licensee” means a psychologist who is licensed by the Board to practice psychology. “Penalty” means monetary penalty. “Registrant” means a psychology associate who is registered by the Board to practice psychology under the supervision of a licensed psychologist. “Registration” means a registration issued by the Board to practice psychology under the supervision of a licensed psychologist. “Sanction” means a formal disciplinary action against a license such as a reprimand, probation, suspension, or revocation. If the Board finds that there are grounds under Health Occupations Article, §18-313, Annotated Code of Maryland, to suspend or revoke a license or registration or to reprimand a licensee or registrant, the Board may impose a penalty as set forth in this chapter: Instead of suspending the license or registration; or In addition to suspending or revoking the license or registration. Subject to the provisions of this chapter, the Board may impose sanctions and penalties for violations of the Maryland Psychologists Act and its regulations according to the guidelines set forth in the following categories: If a licensee or registrant is found in violation of more than one category enumerated in this regulation, the category or categories containing the highest maximum sanction and penalty shall control. Notwithstanding the guidelines set forth in this regulation, in order to resolve a pending disciplinary action, the Board and licensee or registrant may agree to a surrender of a license or registration or to a consent order with terms, sanction, and penalty agreed to by the Board and the licensee or registrant. A departure from the guidelines set forth in this regulation alone is not grounds for any hearing or appeal of a Board action. Depending on the facts and circumstances of each case, and to the extent that they apply, the Board may consider the following mitigating and aggravating factors in determining whether the sanction in a particular case should fall outside the range of sanctions established by the guidelines. These factors may include, but are not limited to, the following: Mitigating Factors: The licensee’s or registrant’s lack of a prior disciplinary record; The licensee or registrant self-reported the violation to the Board; The licensee’s or registrant’s full and voluntary admissions of misconduct to the Board and cooperation during Board proceedings; Implementation of remedial measures to correct or mitigate harm arising from the misconduct; Timely good-faith effort to make restitution or to rectify consequences of misconduct; Evidence of rehabilitation or rehabilitative potential; Absence of premeditation to commit the misconduct; Absence of potential harm to public or adverse impact; The licensee’s or registrant’s conduct was an isolated incident and not likely to recur; and Aggravating Factors: The licensee or registrant has a previous criminal or administrative disciplinary history; The violation was committed deliberately or with gross negligence or recklessness; The violation had the potential for, or caused, serious patient or public harm; The violation was part of a pattern of detrimental conduct; The licensee or registrant was motivated to perform the violation for financial gain; The vulnerability of the patient or patients; The licensee or registrant lacked insight into the wrongfulness of the conduct; The licensee or registrant committed the violation under the guise of treatment; and Previous attempts at rehabilitation of the licensee or registrant were unsuccessful. The existence of one or more of these factors does not impose on the Board or an Administrative Law Judge any requirement to articulate its reasoning for not exercising its discretion to impose a sanction outside of the range of sanctions set forth in this chapter. Nothing in this regulation requires the Board or an Administrative Law Judge to make findings of fact with respect to any of these factors. A licensee or registrant shall pay to the Board a penalty imposed under this chapter as of the date the Board’s order is issued, unless the Board’s order specifies otherwise. Filing an appeal under State Government Article, §10-222, Annotated Code of Maryland, or Health Occupations Article, §18-316, Annotated Code of Maryland, does not automatically stay payment of a penalty imposed by the Board under this chapter. If a licensee or registrant fails to pay, in whole or in part, a penalty imposed by the Board under this chapter, the Board may not restore, reinstate, or renew a license or registration until the penalty has been paid in full. In its discretion, the Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and Management to institute and maintain proceedings to ensure prompt payment. Practicing on an Expired License or Registration. The Board may impose a civil fine against a psychologist or psychology associate who practices psychology on an expired license or registration in the amount of $100 per day of practice past the expiration date of the license or registration. The Board may not impose a fine under §A(1) of this regulation against a psychologist or psychology associate for practicing psychology on an expired license or registration if the psychologist’s license or the psychology associate’s registration is reinstated within 30 calendar days of the expiration date of the license or registration and the licensee or registrant complies with COMAR 10.36.02.08B. Practicing Without a License or Registration. The Board may impose a civil fine of no less than $5,000 and no more than $50,000 against an individual who practices psychology without a license or registration. Factors determining the amount of the fine shall include, but not be limited to, the following: The extent to which the individual derived any financial benefit from the unauthorized practice; The willfullness of the unauthorized practice; Actual or potential harm caused by the unauthorized practice; and The length of time in which the individual engaged in the unauthorized practice. Health Occupations Article, §§1-606, 18-313, 18-313.1, and 18-404, Annotated Code of Maryland Effective date: October 2, 2000 (27:19 Md. R. 1726 Regulations .01 — .06 repealed and new Regulations .01 — .06 adopted effective February 20, 2012 (39:3 Md. R. 259) Regulation .02B amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .03 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .04 amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .05A amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .06A, C amended effective May 25, 2015 (42:10 Md. R. 684) Regulation .06E repealed effective March 17, 2014 (41:5 Md. R. 347) Regulation .07 adopted effective March 17, 2014 (41:5 Md. R. 347) Regulation .07 amended effective May 25, 2015 (42:10 Md. R. 684) This chapter governs the professional conduct of licensed psychologists who are performing child custody evaluations or who otherwise render an opinion on legal or physical custody. This chapter is not intended to negate the psychologist’s obligations to comply with other provisions of this subtitle. This chapter does not apply to the following types of proceedings: Child in need of assistance (CINA) proceedings in accordance with Courts and Judicial Proceedings Article, Title 3, Subtitle 8, Annotated Code of Maryland; Department of Juvenile Services proceedings in accordance with Courts and Judicial Proceedings Article, Title 3, Subtitle 8A, Annotated Code of Maryland; or Termination of parental rights (TPR) proceedings in accordance with Family Law Article, Title 5, Subtitle 3, Annotated Code of Maryland. In this chapter, the following terms have the meanings indicated. Terms Defined. “Child” means an individual younger than 18 years old. “Child custody evaluation” means an assessment performed by a psychologist in order to render findings and recommendations regarding custody or visitation that are in the best interest of a child. “Child Custody Proceeding” means a proceeding in which legal custody, physical custody, or visitation with respect to a child is an issue. Before performing a child custody evaluation, a psychologist shall: Obtain a copy of: The court order; or An agreement signed by the parties; Review the scope of the evaluation as defined by the court’s order or the signed agreement and insure that the order or agreement is consistent with the provisions of this chapter; and Obtain the necessary signed informed consent from the parties, which shall include: The scope of the custody evaluation; The process for conducting the child custody evaluation; Limits to confidentiality; The basis and rate of fees and expenses for which the client will be responsible; and The timeline on which payments are due to the psychologist. To be considered competent to conduct child custody evaluations, a psychologist shall have education, training, experience, or supervision in the following areas: Child and adult development and psychopathology; Family dynamics and psychopathology, including the impact of divorce; Maryland law governing: Divorce; Child custody proceedings; Child abuse and neglect; and Family violence; and Performing psychological assessments of: Children; Adults; and Families. A psychologist conducting a child custody evaluation shall have competence to effectively address common issues that may arise in conducting child custody evaluations such as: Age; Disability; Ethnicity; Gender; Gender identity; Language; National origin; Race; Religion; Culture; Sexual orientation; and Socioeconomic status. A psychologist shall have an awareness of the literature relevant to conducting child custody evaluations. In order to determine legal and physical custody arrangements that serve the child’s best interests, a psychologist conducting a child custody evaluation shall: Assess the following: Parenting skills and capacities of the adults; and The child’s psychological functioning and developmental needs; Use multiple methods of data gathering, including, but not limited to: Individually interviewing and assessing each party and each child, if age appropriate; Observing the interactions of the child with each parental figure, in the respective households, whenever possible; and Requesting and assessing additional relevant information whenever possible, such as: Third-party interviews; Medical records; School records; and Legal documents; Remain impartial and objective; Interpret assessment data and clinical information in a manner consistent with current standards of practice; Base recommendations on the needs and best interests of the child, as supported by the: Evaluation data; and Applicable law; Create and maintain professional records in accordance with COMAR 10.36.05; Include appropriate disclaimers regarding the limitations of the recommendations, such as: Unavailability of information; Lack of cooperation of the parties; Lack of compliance with court orders; or Inconclusive assessment data; and Decline to conduct the evaluation as set forth in COMAR 10.36.05 if the psychologist feels that the psychologist’s objectivity would be impaired. In the event a psychologist determines sufficient information is not available, the psychologist may decline to make recommendations. A psychologist performing a child custody evaluation may not: Engage in multiple relationships with any of the parties to the pending child custody proceeding, including serving as a: Mediator; Therapist; Life coach; Parenting coordinator; or Litigation consultant; or Render an opinion concerning the psychological functioning or custodial fitness of a individual involved in the custody proceeding who has not been personally evaluated by the psychologist during the current child custody evaluation. Health Occupations Article, §18-206, Annotated Code of Maryland Effective date: August 22, 2011 (38:17 Md. R. 1013) This chapter applies to all psychologists and psychology associates in Maryland who engage in the practice of psychology using telepsychology. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the Maryland Board of Examiners of Psychologists. “Client” means the individual, couple, family, group, business, agency, school, organization, or association that the psychologist or psychology associate provides, or has provided, with professional services. “Psychologist” means an individual who is licensed by the Board to practice psychology. “Psychology associate” means an individual who is registered by the Board to practice psychology under the supervision of a licensed psychologist. Telepsychology. “Telepsychology” means the use of interactive audio, video, or other telecommunications or electronic media by a psychologist or psychology associate who engages in the practice of psychology at a location other than the location of the client. “Telepsychology” does not include: An audio-only telephone conversation between a psychologist or psychology associate and a client; An electronic mail message between a psychologist or psychology associate and a client; A facsimile transmission between a psychologist or psychology associate and a client; or A text message or other type of message sent between a psychologist or psychology associate and a client by a short message service or multimedia messaging service. An individual shall be licensed with the Board as a psychologist or registered with the Board as a psychology associate in order to engage in the practice of psychology using telepsychology in Maryland if one or both of the following occurs: The individual practicing telepsychology is physically located in Maryland: or The client is in Maryland. Before providing telepsychology services, a psychologist or psychology associate shall develop and follow a procedure to: Verify the identification of the client receiving telepsychology services; Obtain informed consent specific to telepsychology services using appropriate language understandable to the client; Prevent access to data by unauthorized persons through encryption, or other means; Notify clients in the event of a data breach; Ensure that the telepsychology practitioner provides a secure and private telepsychology connection and complies with federal and state privacy laws; Establish safety protocols to be used in the case of an emergency, including contact information for emergency services at the client’s location; and Ensure that any psychological testing instruments used are designed, validated, or appropriate for use via telepsychology. A psychologist or psychology associate shall: Obtain or confirm an alternative method of contacting the client in case of a technological failure; Determine whether the client is in Maryland and identify the client’s specific location; For an initial telepsychology interaction only, disclose the psychologist’s or psychology associate’s name, location, license number, and contact information; Identify all individuals present at each location and confirm they are permitted to hear the client’s health information; and Be held to the same standards of practice and documentation as those applicable for in-person sessions. A psychologist or psychology associate may not treat a client based solely on an online questionnaire. Before engaging in the practice of psychology using telepsychology, a psychologist or psychology associate shall evaluate the client to determine that delivery of telepsychology is appropriate considering at least the following factors: The client’s: Diagnosis; Symptoms; Medical and psychological history; and Preference for receiving services via telepsychology; and The nature of the services to be provided, including anticipated: Benefits; Risks; and Constraints resulting from their delivery via telepsychology. The client evaluation set forth in §A of this regulation shall take place at an initial in-person session, unless the psychologist or psychology associate documents in the record the reason for not meeting in person. The Board shall use the same standards in evaluating and investigating a complaint and disciplining a psychologist or psychology associate who practices telepsychology as it would use for a psychologist or psychology associate who does not use telepsychology technology in the licensee’s practice. The failure of a psychologist or psychology associate to comply with this chapter shall constitute unprofessional conduct and may be subject to disciplinary action by the Board. Health Occupations Article, §§1-901—1-903, Annotated Code of Maryland Effective date: May 20, 2019 (46:10 Md. R. 489)