Use of artificial intelligence in psychotherapy services regulated, and civil penalties provided.

A bill for an act

relating to health occupations; regulating use of artificial intelligence in

psychotherapy services; providing for civil penalties; proposing coding for new

law in Minnesota Statutes, chapter 214.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

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[214.165] REGULATING USE OF ARTIFICIAL INTELLIGENCE IN

PSYCHOTHERAPY SERVICES.

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Subdivision 1.

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Definitions.

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(a) For purposes of this section, the terms defined in this

subdivision have the meanings given.

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(b) "Administrative or supplementary support" means tasks performed to assist a licensed

professional in the delivery of therapy or psychotherapy services that do not involve

therapeutic communication. Administrative or supplementary support includes but is not

limited to:

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(1) preparing and maintaining client records, including but not limited to therapy notes;

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(2) managing appointment scheduling and reminders, performed by the licensed

professional, by an employee of the licensed professional, or by a business associate

according to a business associate agreement. For purposes of this clause, "business associate"

has the meaning given in Code of Federal Regulations, title 45, section 160.103;

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(3) processing billing and insurance claims;

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(4) analyzing anonymized data to track client progress or identify trends for review by

a licensed professional;

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(5) identifying and organizing external resources or referrals for client use; and

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(6) drafting general communications related to therapy logistics that do not include

therapeutic advice.

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(c) "Ambient listening" means the ability of a device to hear and process sounds and

transcribe conversations.

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(d) "Artificial intelligence system" means any machine-based system that, for any explicit

or implicit objective, calculates from the inputs the system receives how to generate outputs,

including but not limited to content, decisions, predictions, or recommendations, that can

influence physical or virtual environments. Artificial intelligence system includes but is not

limited to a chatbot.

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(e) "Licensed professional" means an individual who holds a valid license issued in

Minnesota to provide therapy or psychotherapy services, including but not limited to:

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(1) a licensed psychologist providing clinical services under sections 148.88 to 148.981;

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(2) a licensed social worker, graduate social worker, independent social worker, or

independent clinical social worker under chapter 148E;

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(3) a licensed professional counselor or licensed professional clinical counselor under

sections 148B.50 to 148B.75;

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(4) a licensed marriage and family therapist under sections 148B.06 to 148B.392;

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(5) a licensed alcohol and drug counselor authorized to provide therapy or psychotherapy

services under chapter 148F;

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(6) a licensed behavioral analyst under sections 148.9981 to 148.9995;

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(7) a licensed physician under chapter 147; and

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(8) any other health professional authorized in Minnesota to provide therapy or

psychotherapy services.

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(f) "Peer support" means services provided by individuals with lived experience of

mental health conditions or recovery from substance use that are intended to offer

encouragement, understanding, and guidance without clinical intervention.

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(g) "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, therapy,

or psychotherapy services.

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(h) "Therapeutic communication" means any verbal, nonverbal, or written interaction

conducted in a clinical or professional setting that is intended to diagnose, treat, or address

an individual's mental, emotional, or behavioral health concerns. Therapeutic communication

includes but is not limited to:

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(1) directly interacting with clients for the purpose of understanding or reflecting the

client's thoughts, emotions, or experiences;

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(2) providing guidance, therapeutic strategies, or interventions designed to achieve

mental health outcomes;

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(3) offering emotional support, reassurance, or empathy in response to psychological or

emotional distress;

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(4) collaborating with clients to develop or modify therapeutic goals or treatment plans;

and

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(5) offering behavioral feedback intended to promote psychological growth or address

mental health conditions.

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(i) "Therapy or psychotherapy services" means services provided to diagnose, treat, or

improve an individual's mental health or behavioral health. Therapy or psychotherapy

services include but are not limited to psychological or psychosocial assessment services.

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Subd. 2.

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Prohibited uses of artificial intelligence.

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(a) An individual, corporation, or

entity must not provide, advertise, or otherwise offer therapy or psychotherapy services to

the public in Minnesota unless the therapy or psychotherapy services are conducted by an

individual who is a licensed professional.

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(b) A licensed professional must not use artificial intelligence systems to:

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(1) make independent therapeutic decisions;

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(2) directly interact with clients in any form of therapeutic communication;

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(3) generate therapeutic recommendations or treatment plans without review and approval

by the licensed professional; or

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(4) provide psychological or psychosocial assessment services.

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Subd. 3.

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Permitted uses of artificial intelligence.

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A licensed professional may use

artificial intelligence systems to assist in providing administrative or supplementary support

in therapy or psychotherapy services if the licensed professional maintains full responsibility

for all interactions, outputs, and data use associated with the system.

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Subd. 4.

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Public protections.

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(a) If a licensed professional uses a chatbot to communicate

with a client as part of administrative or supplementary support, the chatbot must immediately

communicate to the client that the chatbot is not a human being and that the client should

consult with a family member, friend, or licensed professional if the client communicates

one or more of the following to the chatbot:

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(1) thoughts or feelings related to the client's mental health;

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(2) symptoms the client is experiencing, if the symptoms could be those of a mental

illness;

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(3) a mental health diagnosis or condition; or

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(4) thoughts of self-harm or harm to others.

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(b) A licensed professional must not use ambient listening to assist in providing

administrative or supplementary support unless the client provides written, informed consent

to its use. Before a licensed professional uses ambient listening to assist in providing

administrative or supplementary support, the licensed professional must:

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(1) provide the client with information on and the potential risks of using ambient

listening, including but not limited to:

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(i) the purposes for which the licensed professional would use ambient listening;

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(ii) where data collected via ambient listening is stored;

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(iii) who has access to data collected via ambient listening;

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(iv) whether any data collected via ambient listening is used to train a large language

model;

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(v) the timing and method for destruction of data collected via ambient listening;

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(vi) that the licensed professional will not penalize the client in any manner if the client

declines to permit ambient listening; and

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(vii) that the licensed professional maintains responsibility for proofreading, correcting

errors, and signing and dating case notes created via ambient listening; and

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(2) provide the client with an opportunity to consent or decline to consent to the use of

ambient listening.

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(c) If a client consents to the use of ambient listening, both the client and the licensed

professional must sign and date the consent form.

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Subd. 5.

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Enforcement, penalties, and hearings; licensed professionals.

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(a) Any

licensed professional found in violation of this section must pay a civil penalty to the

health-related licensing board responsible for regulating the relevant profession in an amount

not to exceed $50,000 per violation.

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(b) The health-related licensing board responsible for regulating the relevant profession

must determine the amount of the penalty so as to deprive the licensed professional of any

economic advantage gained by reason of the violation, to discourage similar violations, or

to reimburse the board for the cost of investigation and proceeding, including but not limited

to fees paid for services provided by the Court of Administrative Hearings, legal and

investigative services provided by the Office of the Attorney General, court reporters,

witnesses, reproduction of records, board members' per diem compensation, board staff

time, and travel costs and expenses incurred by board staff and board members.

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(c) The health-related licensing board responsible for regulating the relevant profession

must provide the licensed professional with written notice of the finding of a violation and

the imposition of a civil penalty that includes the reasons for the finding, the amount of the

civil penalty, and the right to request a hearing under chapter 14. A licensed professional

must request a contested case hearing under chapter 14 from the health-related licensing

board within 30 days of receiving the notice in this paragraph.

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(d) A licensed professional found in violation of this section must pay the civil penalty

within 60 days after notice of the violation and imposition of civil penalty under paragraph

(c) or after the date of an order issued following a contested case hearing under chapter 14,

whichever is later.

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(e) Each health-related licensing board responsible for regulating a licensed professional

under this section has the authority to investigate any actual, alleged, or suspected violation

of this section by a licensed professional; determine whether a licensed professional violated

this section; and impose appropriate disciplinary action. Nothing in this section limits the

duty of a health-related licensing board to regulate licensed professionals in a manner that

protects the health, safety, and welfare of people in Minnesota.

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Subd. 6.

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Enforcement; other individuals, entities, corporations.

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The attorney general

may enforce this section under section 8.31 against an individual other than a licensed

professional, a corporation, or an entity that violates this section.

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Subd. 7.

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Exceptions.

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This section does not apply to:

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(1) religious counseling;

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(2) peer support; or

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(3) self-help materials and educational resources that are available to the public and do

not purport to offer therapy or psychotherapy services.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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