Regards use of artificial intelligence in therapy services

As Introduced

136th
General Assembly

Regular
Session
H. B. No. 525

2025-2026

Representatives Cockley, Mathews, T.

Cosponsors: Representatives Brennan,
Upchurch, Russo, Newman, Mohamed, Fischer, Bryant Bailey, Brent,
Sims, Somani, Abdullahi, Miller, J., Robinson, Jarrells, White, E.,
Hall, D., Synenberg, Lett

To
enact section 4743.21 of the Revised Code
regarding
the use of artificial intelligence in therapy services.

BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section
1.
That
section 4743.21 of the Revised Code be enacted to read as follows:

Sec.
4743.21.
(A)
As used in this section:

(1)
"Administrative support" means tasks performed to assist a
licensed therapy professional in the delivery of therapy or
psychotherapy services that do not involve communication.
"Administrative support" includes managing appointment
scheduling and reminders, processing billing and insurance claims,
and drafting general communications related to therapy logistics that
do not include therapeutic advice.

(2)
"Artificial intelligence" means a machine-based system
that, for explicit or implicit objectives, infers, from the input it
receives, how to generate outputs such as predictions, content,
recommendations, or decisions that can influence physical or virtual
environments. "Artificial intelligence" includes generative
artificial intelligence.

(3)
"Generative artificial intelligence" means an artificial
intelligence technology system that satisfies all of the following:

(a)
The system is trained on data.

(b)
The system is designed to simulate human conversation with a consumer
through text, audio, or visual communication.

(c)
The system generates nonscripted outputs similar to outputs created
by a human, with limited or no human oversight.

(4)
"Licensed therapy professional" means all of the following:

(a)
A psychologist, independent school psychologist, or school
psychologist licensed under Chapter 4732. of the Revised Code;

(b)
A professional clinical counselor, independent social worker,
independent marriage and family therapist, art therapist, or music
therapist licensed under Chapter 4757. of the Revised Code;

(c)
An independent chemical dependency counselor licensed under Chapter
4758. of the Revised Code;

(d)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code;

(e)
A certified Ohio behavior analyst certified under Chapter 4783. of
the Revised Code;

(f)
Any other professional authorized to provide therapy or psychotherapy
services.

(5)
"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.

(6)
"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 therapy or psychotherapy services.

(7)
"Supplementary support" means tasks performed to assist a
licensed therapy professional in the delivery of therapy or
psychotherapy services that do not involve therapeutic communication
and are not administrative support. "Supplementary support"
includes preparing and maintaining client records and therapy notes,
analyzing anonymized data to track client progress or identify
trends, and identifying and organizing external resources or
referrals for client use.

(8)
"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 all of the following:

(a)
Direct interactions with clients for the purpose of understanding or
reflecting their thoughts, emotions, or experiences;

(b)
Providing guidance, therapeutic strategies, or interventions designed
to achieve mental health outcomes;

(c)
Offering emotional support, reassurance, or empathy in response to
psychological or emotional distress;

(d)
Collaborating with clients to develop or modify therapeutic goals or
treatment plans;

(e)
Offering behavioral feedback intended to promote psychological growth
or address mental health conditions.

(9)
"Therapy or psychotherapy services" means services provided
to diagnose, treat, or improve an individual's mental health or
behavioral health. "Therapy or psychotherapy services" does
not include religious counseling or peer support.

(10)
"Therapy professional licensing board" means all of the
following:

(a)
The state board of psychology;

(b)
The counselor, social worker, and marriage and family therapist
board;

(c)
The chemical dependency professionals board;

(d)
The state medical board;

(e)
Any other professional licensing board in this state that licenses or
certifies a professional authorized to provide therapy or
psychotherapy services.

(B)(1)
Subject to divisions (B)(2) and (C) of this section, a licensed
therapy professional may use artificial intelligence to assist in
providing supplementary support in therapy or psychotherapy services
while engaging in therapeutic communication with a client.

(2)
Before utilizing artificial intelligence in accordance with division
(B)(1) of this section, a licensed therapy professional shall do both
of the following:

(a)
Obtain the written informed consent of the patient or patient's
authorized representative indicating that the patient or the
patient's authorized representative has been informed that artificial
intelligence will be used and for what specific purpose the
artificial intelligence will be used;

(b)
Enter into all necessary business associate agreements to ensure
compliance with the "Health Insurance Portability and
Accountability Act of 1996," 42 U.S.C. 1320d et seq.

(C)
A licensed therapy professional shall not use artificial intelligence
to do any of the following:

(1)
Make independent therapeutic decisions, including diagnosing a
client;

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

(3)
Generate therapeutic recommendations or treatment plans without
review and approval by the licensed therapy professional;

(4)
Detect emotions or mental states.

(D)
All records kept by a licensed therapy professional and all
communications between an individual seeking therapy or psychotherapy
services and a licensed therapy professional shall be confidential
and shall not be disclosed except as required by section 5119.28 of
the Revised Code.

(E)
A licensed therapy professional who violates this section may be
fined by the appropriate therapy professional licensing board an
amount not to exceed ten thousand dollars per violation.