SurveyMonkey Powered Online Survey

The Board of Behavioral Sciences (BBS) is conducting a survey of BBS registrants and licensees, as well as behavioral health agency directors. This survey is voluntary and anonymous. The purpose of the survey is:

1. To gather information about different types of work settings in which clinical services (assessment, diagnosis and/or treatment) are provided; and,

2. To gather the information about the clinical services provided to consumers by unlicensed or unregistered staff working in “exempt” settings.

An “exempt” setting is currently defined in law as a governmental entity, a school, or an entity that is both nonprofit and charitable (a 501c3). Such settings are permitted under BBS law to provide clinical services (assessment, diagnosis and/or treatment) through unlicensed and unregistered staff members, even if that staff member is not pursuing licensure as a mental health professional.

All BBS registrants, licensees and agency directors are encouraged to complete the survey, regardless of work setting type.

Please answer the following questions based on your CURRENT, PRIMARY work setting in which clinical services (assessment, diagnosis and/or treatment) are provided.

Question Title

* 1. What type of license or registration do you hold with the BBS? (Mark all that apply)

LCSW

LEP

LMFT

LPCC

ASW

MFT Intern

PCC Intern

I hold the above license or registration and am also an Agency Director

I am an Agency Director who does not hold a BBS license or registration

Question Title

* 2. Which of the following best describes the CURRENT, PRIMARY setting in which you perform one or more of the following?

Provide clinical services (defined as assessment, diagnosis, and/or treatment);

Provide clinical supervision; and/or

Serve as an agency director.

Public school

Private school - For profit

Private school - Nonprofit

Religious Institution

Federal agency

State agency

County or city agency

Other governmental agency

Private practice

Nonprofit and charitable entity - registered 501(c)(3)

Other Not-for-profit entity

Professional corporation (ownership solely composed of licensed health professionals)

For-profit entity not otherwise listed

Other setting (describe)

Question Title

* 3. If you answered "Other Not-for-profit entity" in question 2, please describe the type of nonprofit structure, if known.

Question Title

* 4. If the setting is a for-profit entity, what is the ownership structure? (Mark all that apply)

Private practice

Professional corporation (ownership solely composed of licensed health professionals)

Investor-owned corporation

Employee-owned corporation

Unknown

N/A

Other For-profit (please describe)

Question Title

* 5. What is the main focus/purpose of this setting? (Mark all that apply)

School

Religious Institution

Mental health clinic/counseling center

Residential mental health treatment center

Psychiatric hospital

Psychosocial rehabilitation program

Integrated primary care/behavioral health care program

Integrated behavioral health care and substance abuse treatment program

Medical hospital

Employee assistance program

Online counseling clinic

Crisis care/intervention program

Victims of crime program

Domestic violence program

Culturally-focused mental health program

Military member or veteran’s service program

Case management program

Homeless shelter or service program

Jail or correctional facility

Offender treatment/re-entry program

State hospital

Inpatient alcohol and drug treatment program

Outpatient alcohol and drug treatment program

Supported employment program

Prevention/early intervention program

Developmental/Intellectual disability program

Pediatric day health/respite care facility

Skilled/intermediate care nursing and/or assisted living facility

Self-help organization

Family and/or children’s services program

Young adult transitional services program

Older adult service program

Other (please specify)

Question Title

* 6. How is this setting and/or program funded? (Mark all that apply)

Federal funding or grants

State funding or grants

Local government funding or grants

Donations and/or foundation grants

Third-party reimbursement

Private payment

Unknown

Other (please specify)

Question Title

* 7. Is the setting any of the types listed below?

Public school

Private school

Religious institution

Federal agency

State agency

County or city agency

Other governmental agency

Nonprofit and charitable entity - registered 501(c)(3)

Yes

No (stop here – survey ends)

Unknown (stop here – survey ends)

Question Title

* 1. What type of license or registration do you hold with the BBS? (Mark all that apply)

Question Title

* 2. Which of the following best describes the CURRENT, PRIMARY setting in which you perform one or more of the following? Provide clinical services (defined as assessment, diagnosis, and/or treatment); Provide clinical supervision; and/or Serve as an agency director.

Question Title

* 3. If you answered "Other Not-for-profit entity" in question 2, please describe the type of nonprofit structure, if known.

Question Title

* 4. If the setting is a for-profit entity, what is the ownership structure? (Mark all that apply)

Question Title

* 5. What is the main focus/purpose of this setting? (Mark all that apply)

Question Title

* 6. How is this setting and/or program funded? (Mark all that apply)

Question Title

* 7. Is the setting any of the types listed below? Public school Private school Religious institution Federal agency State agency County or city agency Other governmental agency Nonprofit and charitable entity - registered 501(c)(3)

* 2. Which of the following best describes the CURRENT, PRIMARY setting in which you perform one or more of the following?

Provide clinical services (defined as assessment, diagnosis, and/or treatment);

Provide clinical supervision; and/or

Serve as an agency director.

* 7. Is the setting any of the types listed below?

Public school

Private school

Religious institution

Federal agency

State agency

County or city agency

Other governmental agency

Nonprofit and charitable entity - registered 501(c)(3)