|
Amended
IN
Assembly
June 08, 2026 |
|
Amended
IN
Senate
April 07, 2026 |
CALIFORNIA LEGISLATURE—
2025–2026 REGULAR SESSION
Senate Bill
No. 903
| Introduced by Senator Padilla (Coauthor: Senator Rubio) |
January 21, 2026 |
An act to add Chapter 13.6 (commencing with Section 4989.80) to Division 2 of the Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 903, as amended, Padilla.
Mental health professionals: artificial intelligence.
Existing law establishes various healing arts boards within the Department of Consumer Affairs that license and regulate various healing arts licensees. Existing laws, including the Licensed Marriage and Family Therapist Act, the Educational Psychologist Practice Act, the Clinical Social Worker Practice Act, and the Licensed Professional Clinical Counselor Act, make a violation of those acts a crime.
Existing law regulates the use of artificial intelligence, as defined. Existing law requires a health facility, clinic, physician’s office, or office of a group practice that uses generative artificial intelligence to generate written or verbal patient communications pertaining to patient clinical information to ensure those communications include a disclaimer that indicates to the patient that a communication was generated
by artificial intelligence and instructions describing how a patient may contact a human health care provider, employee, or other appropriate person.
This bill would regulate the use of artificial intelligence by licensed professionals providing psychotherapy services, as defined. The bill, among other things, would prohibit an individual, corporation, or entity from using artificial intelligence to record or transcribe psychotherapeutic communications or sessions or to triage or screen a person for the need for psychotherapy services unless the patient or client or their authorized representative is informed that artificial intelligence will be used and used, informed of the purpose of the
artificial intelligence tool or system, and the patient or client or their authorized representative provides consent, as specified. The bill would prohibit an individual, corporation, or entity from advertising or otherwise purporting to offer psychotherapy services when the services are provided through the use of companion chatbots. The bill would prohibit a licensed professional from allowing artificial intelligence to perform certain acts, including making independent therapeutic decisions or detecting emotions or mental states. The bill would make a violation of the bill’s provisions subject to the jurisdiction of the appropriate health care professional licensing board or enforcement agency, as specified, and would authorize those boards and enforcement entities to pursue any remedies authorized by law.
Existing law, the
Confidentiality of Medical Information Act, generally restricts the persons and entities to whom, and the purposes for which, a health care provider, health care service plan, or contractor may release a patient’s medical information. The Confidentiality of Medical Information Act additionally imposes certain disclosure requirements for the release of medical information that specifically relates to the patient’s participation in outpatient treatment with a psychotherapist. In this regard, the act prohibits a health care provider, health care service plan, or contractor from releasing that information to persons or entities who have requested that information and who are otherwise authorized by specified laws to receive that information, unless the requester makes certain written disclosures to the patient and to the provider of health care, health care service plan, or contractor, as specified. Those disclosures include, among other things, the specific intended uses of the information, and the length of
time during which the information will be kept before being destroyed or disposed of, as specified. Existing law makes a violation of those provisions that result in economic loss or personal injury to a patient punishable as a misdemeanor.
This bill would require the use of artificial intelligence in psychotherapy records patient or client records for psychotherapy services to comply with the confidentiality requirements of the above-described provision of the Confidentiality of Medical Information Act. Act and would prohibit a company or entity from sharing, selling, storing, or training their models on any data
obtained from psychotherapy in a manner inconsistent with any applicable law.
By expanding the scope of existing crimes, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
The people of the State of California do enact as follows:
SECTION 1.
Chapter 13.6 (commencing with Section 4989.80) is added to Division 2 of the Business and Professions Code, toCHAPTER 13.6. Wellness and Oversight for Psychological Resources Act
4989.80.
This chapter may be cited as the Wellness and Oversight for Psychological Resources Act.4989.81.
The purpose of this chapter is to safeguard individuals seeking psychotherapy services by ensuring these services are delivered by licensed professionals. This chapter is intended to protect consumers from unlicensed or unqualified providers, including unregulated artificial intelligence systems, while respecting individual choice and access to community-based and faith-based mental health support and recognizing that artificial intelligence technology has the potential to expand clinical capacity if used in a safe, ethical, and legal manner.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) (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, freely given, informed, voluntary, specific, and unambiguous agreement, either written or verbally,
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 unrelated information. 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.
(d) “Licensed professional” has the same meaning as “psychotherapist” as defined in Section 1010 of the Evidence Code.
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 clinical social worker, a licensed professional clinical counselor, a licensed psychologist, or a licensed physician and surgeon certified in psychiatry, as specified in Section 4980.44.
(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 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 psychologist, a board-certified psychiatrist, a licensed clinical social worker, a licensed marriage and family therapist, or a licensed professional clinical counselor.
(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 psychologist, or a licensed physician and surgeon certified in psychiatry, as specified in Sections 4999.42 to 4999.48, inclusive.
(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 and is supervised by a licensed psychologist, a board-certified psychiatrist, a licensed clinical social worker, a licensed marriage and family therapist, or a licensed professional clinical counselor.
(16) A licensed educational psychologist.
(17) A social work intern.
(e) “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.
(f) (1) “Psychotherapeutic 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.
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 clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences. 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)Offering emotional support, reassurance, or empathy in response to psychological or emotional distress.
(D)
(C) Collaborating with clients to develop or modify therapeutic goals or treatment plans. patients or clients to develop or modify therapeutic goals or treatment plans for a mental health or substance use disorder or concern.
(E)Offering behavioral feedback intended to promote psychological growth or address mental health conditions.
(2) “Psychotherapeutic communication” does not include the discussion of a patient’s use of artificial intelligence in a clinical setting. 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.
(g) “Psychotherapy services” means services provided to diagnose, treat, or improve or treat an individual’s mental health or substance use disorder condition.
disorder. “Psychotherapy services” does not include religious counseling or peer support.
(h) “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.
(i) “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 anonymized data to track patient or client progress or identify trends, subject to review 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.
(j) “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.
(k) “Use of artificial intelligence” means the use of artificial intelligence tools or systems to assist in providing administrative support or supplementary support in
psychotherapy services.
4989.83.
(a) An individual, corporation, or entity shall not use artificial intelligence to record or transcribe psychotherapeutic communications, psychotherapy sessions, or triage or screening unless both of the following conditions are satisfied:(1) The patient or client, or the patient’s or client’s legally authorized representative
representative, is informed verbally or in writing of both of the following:
(A) That artificial intelligence will be used.
(B) The specific purpose of the artificial intelligence tool or system that will be used.
(2) The patient or client, or the patient’s or client’s legally authorized representative representative, provides
consent to the use of artificial intelligence.
(b) A patient does not surrender any of their rights to care if the patient or their legally authorized representative does not provide consent to the use of artificial intelligence. artificial intelligence being used to record or transcribe psychotherapeutic communications, psychotherapy sessions, or triage or screening.
4989.84.
(a) An individual, corporation, or entity shall not(b) When providing psychotherapy services or conducting triage or screening, an individual, corporation, or entity may use artificial intelligence only to the extent the use meets the requirements of this chapter and shall not allow artificial intelligence to do any of the following:
(1) Make independent therapeutic decisions.
(2) Directly interact with patients or clients in any form of psychotherapeutic communication, unless
the tool or system is consistent with the United States Food and Drug Administration
guidance for low-risk general wellness products or clinical support software, approved 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 without review and approval by the licensed professional.
(4) Detect emotions or mental states.
(5) Assess an individual’s health concerns or symptoms for the purpose of determining the urgency, clinical nature, or appropriate level of the individual’s need for
psychotherapy services.
(c) If a licensed professional uses artificial intelligence in connection with psychotherapy services or triage or screening and the use has not been selected, provided, directed, or mandated by an employing or contracting entity, the licensed professional shall be responsible for both of the following:
(1) Ensuring the artificial intelligence is deployed in compliance with this chapter.
(2) Ensuring the artificial intelligence is used in a clinically appropriate manner.
(d) If a licensed professional uses artificial intelligence required or authorized by their employer or contracting entity, the following shall apply:
(1) The employer or contracting entity shall be responsible for both of the following:
(A) Ensuring the artificial intelligence is deployed in compliance with this chapter.
(B) Directing the licensed professional to use the artificial intelligence in compliance with this chapter.
(2) The licensed professional shall use artificial intelligence in a clinically appropriate manner.
4989.85.
Use of artificial intelligence in4989.86.
(a) A violation of this chapter is subject to the jurisdiction of the appropriate health care professional licensing board or enforcement agency.(b) The appropriate health care professional licensing board may pursue an injunction or restraining order to enforce the provisions of this chapter, as authorized by Section 125.5.
(c) This section does not limit the authority of a health care professional licensing board or enforcement agency to pursue any remedy otherwise authorized by law.
(d) The appropriate health care professional licensing boards may
adopt rules and regulations necessary to implement this
chapter.
4989.87.
This chapter does not apply to any of the following:(a) Religious counseling.
(b) Peer support.
(c) Self-help materials and educational resources that are available to the public and do not purport to offer psychotherapy services.
(d) Artificial intelligence used solely for training or simulation purposes.
(e) Research, as defined in Section 164.501 of Title 45 of the Code of Federal Regulations, conducted by an
academic or nonprofit research institution that is conducted in accordance with applicable ethics, confidentiality, privacy, and security rules of Part 164 (commencing with Section 164.102) of Title 45 of the Code of Federal Regulations, the Federal Policy for the Protection of Human Subjects, also known as the Common Rule, good clinical practice guidelines issued by the International Council for Harmonisation, or human subject protection requirements of the United States Food and Drug Administration.
(f) Any artificial intelligence tool or system that has been reviewed and cleared, authorized, or approved for use by the United States Food and Drug Administration, or another federal agency tasked with approving artificial intelligence for use in health care, provided the tool or system is used consistent with its approved indication and applicable federal requirements.