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Department of Human Services Department of Human Services  
 
Clinical Supervision of Outpatient Mental Health Services

Date: 02-09-2012


Definition
Clinical supervision is the documented time a clinical supervisor and supervisee spend together to discuss the supervisee's work, to review individual recipient cases, and for the supervisee's professional development. It includes the documented oversight and supervision responsibility for planning, implementation, and evaluation of services for a recipient's mental health treatment.


Coverage Requirements
All mental health practitioners must receive clinical supervision. Clinical supervision must be based on each supervisee's written supervision plan and must:

1. promote professional knowledge, skills, and values development;
2. model ethical standards of practice;
3. promote cultural competency by:
a) developing the supervisee's knowledge of cultural norms of behavior for individual recipients and generally for the recipients served by the supervisee regarding the recipient's cultural influences, age, class, gender, sexual orientation, literacy, and mental or physical disability;
b) addressing how the supervisor's and supervisee's own cultures and privileges affect service delivery;
c) developing the supervisee's ability to assess their own cultural competence and to identify when consultation or referral of the recipient to another provider is needed; and
d) emphasizing the supervisee's commitment to maintaining cultural competence as an ongoing process;
4. recognize that the recipient's family has knowledge about the recipient and will continue to play a role in the recipient's life and encourage participation among the recipient, recipient's family, and providers as treatment is planned and implemented; and
5. monitor, evaluate, and document the supervisee's performance of assessment, treatment planning, and service delivery

Clinical supervision must be conducted by a qualified supervisor using individual and/or group supervision. Individual and/orgroup face-to-face supervision may be conducted via electronic communications that utilize interactive telecommunications equipment that includes at a minimum audio and video equipment for two-way, real-time, interactive communication between the supervisor and supervisee, and meet the equipment and connection standards of telemedicine.

1. Individual supervision means one or more designated clinical supervisors and one supervisee.
2. Group supervision means one clinical supervisor and two to six supervisees in face-to-face supervision.

Clinical supervision must be recorded in the supervisee's supervision record. The documentation must include:

1. date and duration of supervision;
2. identification of supervision type as individual or group supervision;
3. name of the clinical supervisor
4. subsequent actions that the supervisee must take; and
5. date and signature of the clinical supervisor

Clinical supervision pertinent to recipient treatment changes must be recorded by a case notation in the recipient record after supervision occurs.


Clinical Trainees
Medical assistance covers diagnostic assessment, explanation of findings, and psychotherapy performed by a mental health practitioner working as a clinical trainee when:

1) the mental health practitioner is:
a. complying with requirements for licensure or board certification as a mental health professional, (does not include mental health rehabilitative professional), including supervised practice in the delivery of mental health services for the treatment of mental illness; or
b. a student in a bona fide field placement or internship under a program (the individual is only considered a clinical trainee while at their internship/field placement, not at any other employment they may hold at that time.) leading to completion of the requirements for licensure as a mental health professional; and
2) the mental health practitioner's clinical supervision experience is helping the practitioner gain knowledge and skills necessary to practice effectively and independently. This may include supervision of:
a. direct practice;
b. treatment team collaboration;
c. continued professional learning; and
d. job management

Clinical Supervisor
A clinical supervisor must:

1) be a licensed mental health professional;
2) hold a license without restrictions that has been in good standing for at least one year while having performed at least 1,000 hours of clinical practice;
3) be approved, certified, or in some other manner recognized as a qualified clinical supervisor by the person's professional licensing board, when this is a board requirement;
4) be competent as demonstrated by experience and graduate-level training in the area of practice and the activities being supervised;
5) not be the supervisee's blood or legal relative or cohabitant, or someone who has acted as the supervisee's therapist within the past two years;
6) have experience and skills that are informed by advanced training, years of experience, and mastery of a range of competencies that demonstrate the following:
a. capacity to provide services that incorporate best practice;
b. ability to recognize and evaluate competencies in supervisees;
c. ability to review assessments and treatment plans for accuracy and appropriateness;
d. ability to give clear direction to mental health staff related to alternative strategies when a recipient is struggling with moving towards recovery; and
e. ability to coach, teach, and practice skills with supervisees;
7) accept full professional liability for a supervisee's direction of a recipient's mental health services;
8) instruct a supervisee in the supervisee's work, and oversee the quality and outcome of the supervisee's work with recipients;
9) review, approve, and sign the diagnostic assessment, individual treatment plans, and treatment plan reviews of recipients treated by a supervisee;
10) review and approve the progress notes of recipients treated by the supervisee according to the supervisee's supervision plan; 9505.0371
11) apply evidence-based practices and research-informed models to treat recipients;
12) be employed by or under contract with the same agency as the supervisee;
13) develop a clinical supervision plan for each supervisee;
14) ensure that each supervisee receives the guidance and support needed to provide treatment services in areas where the supervisee practices;
15) establish an evaluation process that identifies the performance and competence of each supervisee; and document clinical supervision of each supervisee and securely maintain the documentation record

Clinical Supervisors who supervise clinical trainees must complete Qualified Mental Health Professional Clinical Supervision Assurance Statement form DHS-6330 in order for clinical trainee’s time spent conducting diagnostic assessments, psychotherapy, or explanation of findings to be billed.


Clinical Supervision Plan
The supervision plan must be developed by the supervisor and the supervisee. The plan must be reviewed and updated at least annually. For new staff the plan must be completed and implemented within 30 days of the new staff person's employment. The supervision plan must include:

1) the name and qualifications of the supervisee and the name of the agency in which the supervisee is being supervised;
2) the name, licensure, and qualifications of the supervisor;
3) the number of hours of individual and group supervision to be completed by the supervisee including whether supervision will be in person or by some other method approved by the commissioner;
4) the policy and method that the supervisee must use to contact the clinical supervisor during service provision to a supervisee;
5) procedures that the supervisee must use to respond to recipient emergencies; and
6) authorized scope of practices, including:
a. description of the supervisee's service responsibilities;
b. description of recipient population; and
c. treatment methods and modalities

Legal References
MN Rules 9505.0370, subp. 6 (Definition of Clinical Supervision)
M
N Rules 9505.0370
, subp. 7 (Definition of Clinical Supervisor)
M
N Rules 9505.0370
, subp.17 (Definition of Mental Health Practitioner)
M
N Rules 9505.0370
, subp.28 (Definition of Supervisee)
MN Rules 9505.0371
, subp. 4, items A-E (Clinical Supervision requirements)
MN Rules 9505.0371
, subp. 5, item C (Clinical Trainee requirements)
MN Rules 9505.0371
, subp. 5, item D (Clinical Supervisor requirements)
MN Rules 9505.0370
, subp. 19 (Telemedicine)


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