Badass Therapists Building Practices That Thrive

134 Expanding Your Therapy Practice Across State Lines

• Dr. Kate Walker Ph.D., LPC/LMFT Supervisor • Season 3 • Episode 134

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Speaker 1:

Texas regards counseling as happening where your clients' feet are. That's where counseling is happening. Where does Ohio consider to be doing business? Is your location in Texas, but now you're seeing clients in Ohio, and does Ohio call that doing business in Ohio? Ohio, welcome to Badass Therapists building practices that thrive, where it's all about working smarter, not harder. Now here's your host, dr Kate Walker, who can handle roaches but hates spiders. So you're thinking about expanding your practice into another state. I've been there and in this episode I'm walking you through the steps, strategies and questions you need to ask before you go multi-state. And hey, if you're ready to take bold action in your business, the Smart Practice Sprint is your next move. It's four days of transformation and the first day is completely free. Head to katewalkertrainingcom slash bonus and stick around for the mid-roll. I'll tell you more. Now let's get to work.

Speaker 1:

Hey, this is Dr Kate Walker and we're talking about starting a business across state lines. And it's a big deal now because we're talking about the Counseling Compact. The Counseling Compact is the agreement for counselors in different states to basically do business together. Right, it's allowing someone from a participating state to come to Texas and not have to get a new license or not have to go through all of the backflips one would need to do right. So I like to give this example when I talk about this. You know you have a license that's highly portable and it's actually two I can think of, right, a marriage license and a driver's license. So when you cross a state line you don't have to generally remarry someone or take another driving exam and get a different license, right? Nobody's carrying around 50 licenses in their pockets at least I hope you're not. So those are highly portable licenses and that's due to the agreements among states to let people do that. It removes barriers, right? Otherwise we'd have to stop and do all of these things and it would just be. You know, people would stop traveling, they would stop using highways, they'd maybe stop buying cars, right, so it would greatly impact business and the flow of commerce. So when we think about licensing, we think about a lot of things, including, you know, rules that protect the public, rules that make sure that there are systems and consequences in place for license holders who break those rules, right?

Speaker 1:

So lots of reasons to have a license rather than, say, just a certificate. You know we often talk about coaching. It's a certification, at least in Texas, it is not a license. And so if you have a certificate that says you know how to coach well, that's great. You know how to coach Well in Texas, you don't need a license to coach. So your certificate is good enough. But with counseling it's not enough that to have the certificate or diploma that says, hey, I know how to counsel, right, you must also have a license that says you have permission to do that. So the certificate says you can. The license means you have permission to.

Speaker 1:

So when we talk about doing business now across state lines, this is such a hot topic since COVID, right, because before COVID, you know if not, a lot of us were virtual and so there was really no thought to starting a business that would be virtual and I would have several offices or several locations in different states. Well, you know, after COVID there were lots of agreements among states and there still are where counselors let's say you're a counselor in Texas and you have a client who's in a different state and there may be some sort of an agreement there that allows you to do a certain number of sessions with that client who's maybe visiting that state. So it's temporary, and in Texas LMFTs have even adopted something very similar to that. Lmfts have even adopted something very similar to that where someone could have sort of a temporary license. So with the Counseling Compact, it's an agreement among specific states that allows you to do those things, and we've got a great webinar coming up. You need to come here. It's a free webinar with Dr Kathy Ibanez-Lorente and she is the expert on the counseling compact. She knows everything about the compact. So it's awesome because it's going to be a huge fat check over all of the topics we've covered in April because we've talked about the compact a lot.

Speaker 1:

So when I talk about doing business, you know I start with the basics. First of all, check to see if you need a license. Right, if you are in Texas and you're like you know what, I am going to open myself up to business throughout the country, all of the states. Or maybe you're just saying no, I really, you know, I live close to Louisiana, so I 'd really like to just be able to have a practice in Texas and Louisiana. Well, the first thing to do is to check to see if you need a license to practice in both states, because obviously at least I'm assuming this would not be just that temporary agreement I was just mentioning right, where you just get a few sessions to counsel. You know for a little bit, that would be a very shaky foundation to build your business on right. Well, louisiana says I can have two sessions. So that's my business model. I don't know how many sessions, if any, that Louisiana allows, so don't take my word for it there.

Speaker 1:

But when we talk about building a business foundation, a business plan, and you're planning this out of over five years, let's say what do you want that outcome to be? You know how many. Do you want two full offices in Texas and Louisiana? Do you want a virtual, simply virtual, practice in Texas that also covers Louisiana? Thinking about just trying to develop a plain old business plan where you're forecasting out over several years exactly how much money do you want to make? How many clients do you want to see? How many people do you want working for you? How many hours a week do you want to work? All of those things you know that doesn't change whether you're doing in Texas or in multiple states.

Speaker 1:

But number one you've got to check to see if you need a license, even when Texas becomes a part of the compact right. We know that the compact is in legislative works, right, it's being talked about, it's being perhaps debated, it's being perhaps set to calendar and voted on, but we're not part of the compact yet. Even when we do become part of the compact, of the compact, yet Even when we do become part of the compact, there are states out there who will never be part of the compact. So you may be listening to this and you're an LMFT. Well, the LMFTs aren't going to be a part of the compact. They have no intention of being part of the compact at this point in time.

Speaker 1:

So you need to check, first and foremost, what kind of a license you need in the other state where you want to do business, right. So, step one business plan. Just like you would do anything else, right? Whether you're going to open a popsicle stand on the corner in your hometown. Right, you'd want to do a business plan. What's the demand for popsicles? What do popsicles go for, what's your overhead, what's your profit, what are your projections for popsicles? What do popsicles go for? What's your overhead, what's your profit, what are your projections going to be? You're going to do that, right. Step two do you need a license? And you have to take one extra 0.5 step. Do you still need a license after the compact has passed?

Speaker 1:

So you need to do your homework to see which states are actually in the compact now and or not in the compact but forecasted to be right. There are a few states that are like Texas, that are debating it and about to be in the compact, but then there are states that have no intention of ever being in the compact, right. So don't make a business plan if you can't do business there. That's step one. Step two All right. Step three if you take insurance, see how that works across state lines.

Speaker 1:

A lot of folks are discovering, if they want to be digital nomads internationally, that, yeah, they can do counseling across state lines. They check to make sure in this particular country and the laws were friendly to that and it was all good, but then they discovered that their it was all good, but then they discovered that their insurance was like no go, we're not going to reimburse you in Turkey, or we're not going to reimburse you in Algiers, right? So if you are credentialed with insurance and you did step one beautifully, but you make insurance a piece of that puzzle, but you make insurance a piece of that puzzle. You need to do your homework with your insurance to make sure that they would recognize what you're doing as counseling and if they would reimburse it, and then, if it's yes, figure out what rate. Right? Well, I think you know there are going to be different rates for different locations, for different modalities, right, face-to-face or virtual. Obviously I'm saying obviously that's my paradigm for today's talk, that you would be virtual.

Speaker 1:

And then, additionally, whether you take insurance or not, check with your malpractice insurance. Right, malpractice insurance is playing catch up with all of this too, right? So imagine you are part of the compact. Let's say you did your homework, you did your business plan, you figured out okay, this is a compact state, it's going to work. Once we become part of the compact, I can do this counseling across state lines. Well, I don't know what the rules are. Let's just, I'm going to pick a state in Ohio, right, the rules are, let's just, I'm going to pick a state in Ohio, right. And so you start seeing clients in Ohio and you break one of their rules. Someone files a complaint against you in Ohio for this rule breach. And your insurance is like we didn't know you were counseling in Ohio, we had no idea.

Speaker 1:

So what then? So part of your business plan, right? Steps one, step two, we're on three now checking with insurance, checking with your malpractice insurance. Now I haven't even gotten to the good step yet. So let's talk about money. Hey, badass listeners, quick pause. If you're tired of spinning your wheels and ready to grow a private practice that actually pays the bills, you need to check out my Smart Practice Sprint. This live four-day virtual experience is designed to help you simplify your marketing structure a HIPAA-compliant business and book more clients fast. And the best part, day one is totally free. It starts June 2nd, so go to katewalkertrainingcom slash bonus to grab your spot now. That's katewalkertrainingcom slash bonus, because it's time to stop guessing and start growing. All right back to the show.

Speaker 1:

I'll start with taxes in your business plan and the business formation when you sell stuff right, like this handy dandy coffee mug from Lampas Estates. If I wanted to sell that coffee mug in Ohio, that would be called a nexus right? That would be one of my locations. Well, because it's a thing that I can hold in touch, it would be subject to sales tax in Ohio. I would have to track all of that. I would have to make sure I understood okay, I've got to file sales tax in Texas and then I've got a location in Ohio and you might say, but Kate, you're not in Ohio. Well, if I had Amazon drop shipping from Ohio, there's a possibility that I might still owe sales tax from Ohio. Please don't quote me on this. I'm not a tax attorney. So, understanding where you need to file taxes, if you need to file taxes, if there are federal and state income tax rules, right. So it's not just counseling, it's not just doing business, right, because we've talked about this before and you can go back to other trainings.

Speaker 1:

Texas regards counseling as happening where your client's feet are. That's where counseling is happening. I don't know about doing business, right. Where do they consider doing business? Where does Ohio consider to be doing business? So, understanding this, so you can form your business in the right way DBA, s-corp LLC, pllc. What that needs to look like as you now? Okay, now you are a multi-state business with multiple locations, or is your location in Texas? But now you're seeing clients in Ohio and does Ohio call that doing business in Ohio? I don't know. That's something you would have to check.

Speaker 1:

So the compact is about portability. It's about where you can practice where you have permission to practice, right, business law, taxes, those types of things. That is how the government says you can do business. And oh, by the way, we're going to need a chunk of that. So here's how we want you to do it. So you would need to do your homework as far as your business structure, and then finally and this is the thing I always bring up you know, structure. And then finally and this is the thing I always bring up you know, texas is huge, and I don't just mean in miles. Right, texas is populated.

Speaker 1:

When I hear about counselors who are wanting to stretch their business across state lines, my first thought is why are there not enough people here? Oh well, you know I live in a therapist-saturated town, or I live in a place where there's just no people. Again, I'm thinking how many people do you need to make your practice full? I mean, even if you were working 20 direct hours a week, right? Because 20 direct hours a week, that's 40 hours of work. Even if we were bumping that up to 30 direct hours a week, right? So that's 30 people a week. That's the same. 30 people for four weeks times 12 months, give or take, you know, for attrition here and there.

Speaker 1:

I like to say, okay, let's say you needed 300 people, right, 300 people in a year for your practice and you're trying to market to get 300 people, right. You're not like Amazon or I don't know Leslie Poole company and you're trying to market to 10,000 people or 10 million people, right? If you live in a state like Texas with a bunch of people, even if you're in rural wherever, and you wanted to market to folks in Dallas or Houston or Austin or South Texas, and you look and you say, wow, how can I get 300 people in a year to click the button to make a consultation so that I can talk to them? I can give them my 10 minutes consultation, I can take them through my opening speech to help them understand what they get from counseling with me, and I can direct them back to my website for all of my resources so that I become and position myself as an expert in my community. Right?

Speaker 1:

I mean, as you think about marketing, would you prefer to market to a niche that you know or when you think about? Well, I'm going to start marketing to people in Ohio. Yeah, I have an assistant in Ohio and they just had a snowstorm. They just had like tornadoes, they just. I mean, there are things going on in Ohio that I know nothing about and I listened to her and she kind of helps me understand.

Speaker 1:

But marketing is all about making sure that you're attractive to a niche that you know. Right, a people, a specialty, maybe people that are available a certain time of day. I know I've talked to you guys about if you market to small business owners who perhaps are available at a specific time of day or a particular day of the week. I've talked to you about maybe those of you who work in the Houston area, working with people who are working offshore, who are on four off two. So you start looking at things and you think, okay, if I just need 300 people and I live in the most populated state, maybe I just need to adjust my marketing rather than think about going across state lines. Right, because if you heard me talk a couple of weeks ago, this compact works both ways. It's not just about you seeing other opportunities in other states. Right, folks are coming here because we do have a lot of people and they do not see us as oversaturated and they do not see us as having therapist heavy communities. Right. They see Texas as a huge opportunity because perhaps they do live in a state that doesn't have a lot of people in it. So I want you to think about it both ways, and that's what we've been talking about in April.

Speaker 1:

And I do want to look at your marketing material. I want to look at your websites. I want you to talk to me about your marketing plans, maybe questions about how your business is structured, things that you're wondering about. Okay, why isn't this working? Right? Because, as we think about marketing, I'm going to ask you questions about your ideal client, right? Do you know this person? Do you know where they shop? Do you know where they take their kids on weekends? Do you know what they like to do for fun? What kind of pets do they have? And do this for me. Do some homework. Google ideal client or ideal customer, and it will help you understand, as you go through that exercise, how marketing really works. Right, it's not about taking your fishing pole from your pond to the ocean, thinking, well, there's more fish out there, so I'm going to catch more. No, it's about understanding how to work with the population that you know and making yourself more attractive to that population. All right. Thanks for listening.

Speaker 1:

If today's episode got you fired up to finally build the private practice you've been dreaming about, don't miss the Smart Practice Sprint. It's happening virtually so you can join from anywhere. Starting June 2nd, we'll spend four days getting your messaging clear, your HIPAA compliance dialed in and your client calendar moving from crickets to booked Head to katewalkertrainingcom. Slash bonus to register, remember, night one is completely free. And here's the exciting part I'll be taking this sprint on the road in Texas.

Speaker 1:

Soon I'm going to be coming to DFW, austin, houston, el Paso. So wherever you are, I'll be coming to a city near you. Can't wait to see you inside the Sprint and maybe shake your hand in person real soon. I'm Dr Kate Walker. Thank you so much for listening. Thank you to the lovely Ridgely Walker for the interesting facts about me that we use in our introduction and do me a favor when you get a second, please like, share and subscribe and write us a review. That's really how we get picked up by other RSS feeds and we get this information out to the mental health badasses who need it. Thanks again, and keep saving the world with excellent therapy. You.