4989.82.
For purposes of this chapter, the following definitions apply:(a) “Administrative support” means tasks performed to assist a licensed professional in the delivery of psychotherapy services that do not involve psychotherapeutic communication. “Administrative support” includes, but is not limited to, all of the following:
(1) Managing appointment scheduling and reminders.
(2) Processing billing and insurance claims.
(3) Drafting general communications related to therapy logistics that do not include
therapeutic advice.
(b) “Artificial intelligence” means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.
(c) “Companion chatbot” has the same meaning as in Section 22601.
(d) (1) “Consent” means a clear, explicit affirmative act by an individual that meets both of the following requirements:
(A) Unambiguously communicates the individual’s express,
informed, and voluntary agreement, either verbally or in writing, and documented in the record.
(B) Is revocable by the individual.
(2) “Consent” does not include an agreement that is obtained by any of the following:
(A) The acceptance of a general or broad terms of use agreement or a similar document that contains descriptions of artificial intelligence along with other information unrelated to the privacy of medical information.
(B) An individual hovering over, muting, pausing, or closing a given piece of digital content.
(C) An agreement obtained through the use of deceptive
actions.
(e) “Licensed professional” means any of the following:
(1) A person authorized to practice medicine in this state who devotes, or is reasonably believed by the patient to devote, a substantial portion of their time to the practice of psychiatry.
(2) A person licensed as a psychologist under Chapter 6.6 (commencing with Section 2900).
(3) A person licensed as a clinical social worker under Chapter 14 (commencing with Section 4991), when they are engaged in applied psychotherapy of a nonmedical nature.
(4) A person who is serving as a school psychologist and holds a credential authorizing that
service issued by the state.
(5) A person licensed as a marriage and family therapist under Chapter 13 (commencing with Section 4980).
(6) A person registered as a registered psychological associate who is under the supervision of a licensed psychologist as required by Section 2913, or a person registered as an associate marriage and family therapist who is under the supervision of a licensed marriage and family therapist, a licensed educational psychologist, a licensed clinical social worker, a licensed professional clinical counselor, a licensed psychologist, or a licensed physician and surgeon certified in psychiatry, as specified in
subdivision (g) of Section 4980.03.
(7) A person registered as an associate clinical social worker who is under supervision as specified in Section 4996.23.
(8) A psychological trainee, as defined in Section 2911, who is under the primary supervision of a licensed psychologist.
(9) A marriage and family therapist trainee, as defined in subdivision (c) of Section 4980.03, who is fulfilling their supervised practicum required by subparagraph (B) of paragraph (1) of subdivision (d) of Section 4980.36 or subdivision (c) of Section 4980.37 and is supervised by a licensed
marriage and family therapist, a licensed educational psychologist, a licensed clinical social worker, a licensed professional clinical counselor, a licensed psychologist, or a licensed physician and surgeon certified in psychiatry, as specified in subdivision (g) of Section 4980.03.
(10) A person licensed as a registered nurse pursuant to Chapter 6 (commencing with Section 2700) who possesses a master’s degree in psychiatric-mental health nursing and is listed as a psychiatric-mental health nurse by the Board of Registered Nursing.
(11) An advanced practice registered nurse who is certified as a clinical nurse specialist pursuant to Article 9 (commencing with Section 2838) of Chapter 6 and who participates in expert clinical practice in the specialty of
psychiatric-mental health nursing.
(12) A person rendering mental health treatment or counseling services as authorized pursuant to Section 6924 of the Family Code.
(13) A person licensed as a professional clinical counselor under Chapter 16 (commencing with Section 4999.10).
(14) A person registered as an associate professional clinical counselor who is under the supervision of a licensed professional clinical counselor, a licensed marriage and family therapist, a licensed clinical social worker, a licensed educational psychologist, a licensed psychologist, or a licensed physician and surgeon certified in psychiatry, as specified in
subdivision (h) of Section 4999.12.
(15) A clinical counselor trainee, as defined in subdivision (g) of Section 4999.12, who is fulfilling their supervised practicum required by paragraph (3) of subdivision (c) of Section 4999.32 or paragraph (3) of subdivision (c) of Section 4999.33.
(16) A licensed educational psychologist.
(17) A social work intern.
(18) An advanced practice registered nurse who is certified as a nurse practitioner pursuant to Article 8 (commencing with Section 2834) of Chapter 6 and who holds a national certification by an organization accredited by the National Commission for Certifying Agencies or the Accreditation Board for
Specialty Nursing Certification as a psychiatric-mental health nurse practitioner across the lifespan.
(f) “Peer support” means services provided by individuals with lived experience of mental health conditions or recovery from substance use disorders that are intended to offer encouragement, understanding, and guidance without clinical intervention.
(g) (1) “Psychotherapeutic communication” means any verbal, nonverbal, or written interaction in a clinical or professional setting that is conducted for the purpose of diagnosing or treating a mental health or substance use disorder or concern. “Psychotherapeutic communication” includes, but is not limited to, any of the following:
(A) Direct
interactions with patients or clients for the purpose of diagnosing or treating a mental health or substance use disorder or concern.
(B) Providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes.
(C) Collaborating with patients or clients to develop or modify therapeutic goals or treatment plans for a mental health or substance use disorder or concern.
(2) “Psychotherapeutic communication” does not include general wellness education, instruction, or guidance that is intended to promote overall health and well-being rather than to diagnose or treat a specific mental, emotional, or behavioral health disorder or concern.
(h) “Psychotherapy services” means services provided to diagnose or treat an individual’s mental health or substance use disorder. “Psychotherapy services” does not include religious counseling or peer support.
(i) “Religious counseling” means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith based and are not represented as clinical mental health services or psychotherapy services.
(j) “Supplementary support” means tasks performed to assist a licensed professional in the delivery of psychotherapy services that do not involve psychotherapeutic communication and that are not administrative support. “Supplementary support” includes, but is not
limited to, any of the following:
(1) Preparing and maintaining patient or client records, including psychotherapy and progress notes.
(2) Analyzing data to track patient or client progress or identify trends, reviewed by a licensed professional.
(3) Identifying and organizing external resources or referrals for patient or client use.
(4) Using artificial intelligence tools that assist licensed professionals with documentation, workflow management, or other functions that enhance clinical capacity, provided the licensed professional maintains responsibility for all clinical decisions and communications.
(k) “Triage or screening” means the assessment of an individual’s health concerns and symptoms for the purpose of determining the urgency, clinical nature, or appropriate level of the individual’s need for psychotherapy services.
4989.84.
(a) An individual, corporation, or entity shall not advertise or otherwise purport to offer psychotherapy services when the services are provided through the use of companion chatbots. This includes by claiming the companion chatbot is a therapist or provides therapy.(b) When used in connection with the provision of psychotherapy services or conducting triage or screening, an individual, corporation, or entity
shall not allow artificial intelligence to do any of the following without review and approval by a licensed professional:
(1) Make therapeutic decisions.
(2) Directly interact with patients or clients in any form of psychotherapeutic communication, unless the tool or system is approved or cleared by the United States Food and Drug Administration for that use and is compliant with the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).
(3) Generate therapeutic recommendations, assessment results, diagnoses, or treatment plans.
(4) Detect emotions or mental states.
(5) Perform triage or screening.
(c) (1) If a licensed professional uses artificial intelligence in connection with psychotherapy services or triage or screening, the licensed professional shall be responsible for ensuring the licensed professional and anyone under their supervision uses the artificial intelligence in a manner that is clinically appropriate and compliant with this chapter.
(2) A licensed professional shall not be subject to
discipline or any other enforcement action under this chapter for a violation that results solely from any feature, configuration, function, or other element of an artificial intelligence tool or system that is not within the control of the licensed professional if use of the tool or system was expressly or effectively required by the licensed professional’s employer or contracting entity, including a violation that results solely from a function or element that prevents the licensed professional from using the tool or system in compliance with this chapter. For purposes of this paragraph, the licensed professional’s required use of the tool or system shall not be considered a cause of the violation.
(d) If a licensed professional uses artificial intelligence required or authorized by their employer or contracting entity, the employer or contracting entity shall be responsible for
both of the following:
(1) Ensuring the artificial intelligence is deployed in compliance with this chapter.
(2) Directing the licensed professional to use the artificial intelligence in compliance with this chapter.
(e) Nothing in this chapter shall be construed to prohibit, or to require prior review and approval by a licensed professional of, the use of artificial intelligence to do any of the following:
(1) Recommend, in response to an individual’s articulated expression of serious mental health concerns, that the individual discuss their need for psychotherapy services with a licensed professional.
(2) Administer a standardized screening questionnaire to an individual, collect the individual’s responses, score them in accordance with the instrument’s standardized scoring rules, and transmit the responses and any resulting score to a licensed professional for review, provided that the artificial intelligence tool or system does not use the responses or score to assess, evaluate, advise, inform, or make any decision regarding the condition of the individual or the urgency, clinical nature, or appropriate level of the individual’s need for psychotherapy services.
(3) Schedule, confirm, cancel, or send reminders regarding appointments, or provide logistical information in preparation for a visit, provided that those functions do not involve psychotherapeutic communication and do not constitute triage or screening.