Commonwealth of Massachusetts
Board of Registration of Genetic Counselors

Guidelines for General Supervision of Provisionally Licensed Genetic Counselors 

[Adopted December 4, 2008]

Massachusetts General Laws ("M.G.L.") Chapter 112, section 230, requires a provisionally licensed genetic counselor ("provisional licensee") to practice as a genetic counselor under the general supervision and direction of a fully licensed genetic counselor ("full licensee") or a licensed physician with current ABMG certification in clinical genetics ("licensed physician"), at all times during which the provisional licensee practices as a genetic counselor.  The law also authorizes the Board to adopt regulations governing such supervision and direction, which are found at 270 CMR 3.03.  

The Board has adopted the following Guidelines for General Supervision of Provisionally Licensed Genetic Counselors ("Supervision Guidelines") to assist provisional licensees and their supervisors to comply with 270 CMR 3.03(3) and (4), which generally define the elements of the required supervisory relationship.  

Board Regulations at 270 CMR 2.00 - 4.00 Referenced in Supervision Guidelines:

270 CMR 2.03, Definitions

General supervision means the supervision provided by a fully licensed genetic counselor, or a licensed physician with current ABMG certification in clinical genetics, who has the overall responsibility to assess the work of the supervisee, whether a provisional or full licensee.  General supervision shall not require the physical presence of such licensee's supervisor where such licensee provides genetic counseling services, but the supervisor shall be readily accessible for consultation and assistance whenever such licensee provides such services.

Provisionally licensed genetic counselor or provisional licensee means a person licensed by the Board to engage in supervised practice as a provisionally licensed genetic counselor pursuant to M.G.L. c. 13, § 100, having met and maintained the qualifications for provisional licensure under M.G.L. c. 112, §§ 228, 229, and 230, and Board regulations promulgated thereunder.

Supervisor means a Massachusetts fully licensed genetic counselor, or a Massachusetts fully licensed physician with current ABMG certification in clinical genetics, who has the overall responsibility to assess the work of the supervisee, whether a provisional or full licensee. The supervisor of a provisional or full licensee shall not be required to be physically present where such licensee provides genetic counseling services, but the supervisor shall be readily accessible for consultation and assistance whenever such licensee provides such services.

270 CMR 3.03(3)(a) - (e)

(3)  The supervisor of a provisionally licensed genetic counselor shall be responsible for providing general supervision and direction to the provisional licensee, which supervision shall be of a level sufficient to ensure that the provisional licensee performs all genetic counseling services in accordance with generally accepted standards of professional practice.  In accordance with Guidelines for the General Supervision of Provisionally Licensed Genetic Counselors developed by the Board and as may be amended from time to time, general supervision and direction of a provisional licensee shall include, but may not be limited to:

       (a)  assessing and documenting the professional competence, skill, and 
       experience of the provisional licensee;

270 CMR 3.03(3)(a)	The supervisor shall interview the provisional licensee regarding past clinical experiences. Information obtained shall include, at a minimum, the number of clinical cases with clinical type and the role of the provisional licensee in each case.  From the information obtained, the supervisor shall assess the provisional licensee’s clinical skills.	
					
       (b) determining the nature and level of supervision required by the
       provisional licensee;

270 CMR 3.03(3)(b)	The supervisor shall assess the communication, critical thinking, interpersonal, and counseling skills of the provisional licensee and recommend skill development exercises as needed based on assessment.
Based on the assessment, the supervisor shall determine the frequency and nature of the supervision.	

       (c)  developing, before beginning the accrual of supervision, an annual
       supervision contract signed and dated by the supervisor and the provisional
       licensee that shall be on file with both parties and made available to the
       Board in a timely manner upon request;

270 CMR 3.03(3)(c)	The annual supervision contract between the supervisor and the provisional licensee shall be typewritten and, at a minimum, contain:
•  the full name and license number of the provisional 
   licensee, and license expiration date  
•  the full name, license number, and ABGC or 
   ABMG certification number of the fully licensed 
   genetic counselor OR fully licensed physician who
   will serve as supervisor 
•  a statement that the named supervisor, who is professionally competent and can provide adequate supervision to ensure that the accepted standards of practice are followed,  is able to make the time commitment to provide supervision to the named provisional licensee, and has agreed to supervise the named provisional licensee 
•  the worksite name, address and telephone number for the supervisor and provisional licensee
•  the practice setting
•  a statement of the purpose and frequency of meetings  to conduct chart or case reviews in accordance with 270 CMR 3.03(3)(e)
•  a statement of the purpose and frequency of    supervision meetings in accordance with 270 CMR 
   3.03(3)(d)
•  the specific method(s) by which the supervisor shall 
   be available to supervise the provisional licensee and 
   manner in which client confidentiality will be         maintained
 • a description of the availability of the supervisor and how the provisional licensee can contact the supervisor when needed 
• a plan for coverage when the supervisor is not available 
•  a statement that both the supervisor and provisional 
   licensee have read and understand Board regulations
   at 270 CMR 2.00 - 4.00 and agree to comply therewith 
•  the signature of the provisional licensee
•  the signature of the supervisor
•  the date the parties entered into the supervision
   contract
•  date of the supervision contract annual review and
   renewal by the parties

(d)  convening regular meetings to review the provisional licensee's clinical services and administrative practices, and maintaining a written record of such supervisory meetings, which written record shall be made available to the Board in a timely manner upon request; and

270 CMR 3.03(3)(d)	The written record of regular supervisory meetings between the supervisor and provisional licensee to review clinical services and administrative practices shall minimally occur twice a year face to face and at a minimum contain: 
•  the full name and license number of the provisional 
   licensee  
•  the full name, license number, and ABGC or 
   ABMG certification number of the fully licensed 
   genetic counselor OR fully licensed physician who
   serves as supervisor  
•  the date of the supervision meeting
•  a concise description of the meeting objectives
•  the date of the next scheduled supervisory 
   meeting.

       (e)  conducting regular chart or case reviews with the provisional licensee.

270 CMR 3.03(3)(e)     
	In addition to formal supervisory meetings, 
the supervisor and provisional licensee shall discuss progress, challenges, communication skills, critical thinking, interpersonal and counseling skills, professional development and any other issues related to supervision.  The supervisor shall maintain documentation of the date of each review and summary. 

270 CMR 3.03(4)
		     
(4)  The supervisor of a provisionally licensed genetic counselor shall not be required to be physically present where the provisional licensee provides clinical genetic counseling services, but the supervisor shall be readily accessible for consultation and assistance whenever the provisional licensee provides such services.  
	
270 CMR 3.03(4)	The supervisor shall be readily available to the provisional licensee in person, by telephone, by email or by other electronic means.