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)