#272: Health Coach Legal Questions Answered by Lisa Fraley

health coach legal questions

From state laws to scope of practice, client forms and insurance…we know you have questions. Lisa Fraley is here to help you make legally sound decisions for your health coaching practice. Get Lisa’s DIY legal templates (the same ones Michelle uses!) at HealthCoachPower.com/legal

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Full transcript:

Michelle:
Hello there, health coaches. You know what? When I started my health coaching practice, I didn't know what I didn't know. And that's always true when we're doing something for the first time. I didn't really understand what scope of practice meant. I don't think I had ever even heard those terms. No one was talking about it back then and there were no green or red states, at least not that I knew about, and I had not even considered the idea of getting insurance. What the only client forum I had was the generic client agreement given to me by my Health Coach Certification program. And I just stumbled along. I just did things as I thought I needed to do them, and it was a hot mess. I got to tell you, I see many of you doing something similar except these days you are all so much smarter, way smarter.

You know about state laws, you're asking about your scope of practice. You're wondering what legal documents you need in various situations to protect yourself, et cetera, et cetera. I am impressed with all of you and today I'm bringing you answers from an expert. This episode is brought to you by Practice Better. My favorite practice management software. Many, many coaches in our community are using and love Practice Better. It handles all your billing, all your scheduling, so much more to streamline your entire practice. And for a limited time, you can get a bonus kitchen cleanout program. It's built right into the Practice Better platform, and you can start using it with your clients right away. Plus you'll get 30% off your first three months when you go to health coach power.com/pb to get started and all the details will be in the show notes. I'm happy to introduce you guys today to my friend Lisa Fraley. Lisa, thank you so much for being here.

Lisa:
Thank you for having me, Michelle. It's great to be back.

Michelle:
Yes, I realized quite a bit of time had passed since she'd been on the show, so I was like, Lisa, we have to do this again. We have so many new coaches in our community who are struggling with these legal issues. Can you introduce yourself, tell everybody why you're so uniquely suited to help us?

Lisa:
Well, thank you for that. So I'm Lisa Fraley, legal coach and attorney. And I think the reason why I've worked with so many health coaches and holistic practitioners and online practitioners is because I come from a background of healthcare law where I worked in a giant law firm a million hours a day just like you're supposed to when you get out of school. And of course my self experience eating way too much sugar, living on caffeine, eating handfuls of m and ms in my work drawer and stressed out when I was working till nine o'clock at night. And so I went to health coaching school myself and went to IN back from 2011 to 2012. And what happened was I had a lot of friends in the health coaching world who were like, but Lisa, you're a lawyer who understands what we do. Can you help us? You get coaching, you are a coach yourself. You understand the online space and nutrition laws and whatnot. Can you help us?

So I decided way back in 2012 to start opening my practice as a legal coach and attorney. And the other piece that I think makes me unique that I'm sure you're alluding to is that I do, of course believe the law protects you in all the ways we think of to reduce your risk and to help you feel safe and secure and to help you use contracts and things like that. And I also believe that the law has not just a practical side, but also an energetic side. And that means when you show up with legal documents in place, your energy actually shifts. And this is a really unique way to look at the law. Most lawyers don't look at the law this way.

And I found that when I opened up to the energetics of the law, as I like to say, I got this download one day that there were seven main legal steps that aligned with the seven main choppers of the body. And I wrote my book, easy Legal Steps about that. I do lots of podcasts about that in my legally enlightened podcasts, but I try to help people see that the law can protect you in practical ways, but also impact how you show up in your business on an energetic side too, in ways that align with the chakras, not your typical lawyer. Hashtag not your typical lawyer for sure.

Michelle:
Exactly. I told you guys, she gets us and it's such a breath of fresh air because whenever you're looking for legal help or maybe help with your accounting or you need outside services and it's someone who doesn't understand the health coaching industry, it can be really hard to explain what you're trying to do and have them take you seriously. So Lisa, first of all, just thank you. For everything.

Lisa:
Thank you. I'm grateful. I'm lucky.

Michelle:
I've used your documents, your services, we've been, we always send our health coaches over to you because as you guys will always hear me say this, I will say I could try to answer your question, but I'm not a lawyer. I can try to tell you what I think is true, but don't take legal advice from me please.

Lisa:
Which we appreciate and I appreciate because you're so knowledgeable, Michelle. And also just like you're saying, everyone's situation is different and you just never know what their circumstances are that could impact whatever it is that they need to know on the legal front. So I appreciate you sending people my way and I've helped thousands of health coaches now, so I'm so happy to be able to share information here today and also help people whenever you do send them over. So thank you for that.

Michelle:
I thought we could just hit some of the top topics that come up inside our Facebook group all the time. So just to give everybody an overview of what I want to talk to Lisa about today, we want state laws that comes up all the time, scope of practice, client forms and insurance. Those seem to be the big ones. And so I thought we could start with the idea of state laws. Correct me if I'm wrong, but when you and I graduated from health coaching school, I was 2009, you were like 2011, 12, the whole state laws thing was that even in existence?

Lisa:
It was actually. It's just that I think as time has evolved, health coach have gotten deeper into more of the functional medicine side sometimes or doing lab testing or really doing lots of individualized nutrition plans, which is very different, Michelle, than our philosophy that we learned at IN, which was really holding space for people, helping them create different habits, helping them drink more water, helping them figure out what blocks were in the way of them having success with their nutrition. And I think as people have gotten more and more educated, more and more knowledgeable and want to go deeper and deeper, that's where it runs into the laws that regulate what requires a license to be like a registered dietician or certified nutritionist. And what you can do as a coach.

Michelle:
That makes a lot of sense. I mean, in general, it seems like a good idea for us to have more education, and yet there's this downside where we can get into trouble.

Lisa:
That's it. I mean, yes, of course it's good to have more education and you just have to know in your state what your state allows you to do on the nutrition side. If your practice is based in a state that's more restrictive. And there's still about 15 states that are more restrictive that you and I would call red states or orange states, where there still is very limited ability to do one-on-one work around specific nutrition, individualized recommendations, which stinks. But that's just how it is right now. In some of those states, you can do group programs and online courses and some other things. In a couple of those states you can't even do that. And even in one state, my home state of Ohio, which I love so much, you can't do anything. You can't even educate. So that's the strictest state in the country. But in most states, you are able to do some work in some capacity as a health coach. And I have other strategies for what you can do in Ohio, but in general, you want to know what your state allows you to do and not allows you to do so that you don't get yourself into hot water.

Michelle:
And I know right now everybody in Ohio just jumped out of their seat.

Lisa:
I know.

Michelle:
"What are you talking about?" So they should probably contact you directly. I don't want to go into too many specific edge cases.

Lisa:
Yes, yes, yes.

Michelle:
In general though, I have heard you say that offering group programs doing things that are not meant for an individual is in general a safer way to practice. Is that accurate?

Lisa:
That's correct, yes. Except not in Ohio, but yes, in general, yes, that's correct, Michelle, because it's the individualized information you all that actually can get you into sticky areas in some of those restrictive states. It's not that you can't help people with habit change or behavior change as long as you don't get into therapy and as long as you don't get into psychiatry around habits and things and trauma, don't be talking about trauma with your health coaching clients, but if you're helping people figure out why are you eating potato chips at three o'clock instead of an apple and with peanut butter, almond butter or whatever, what is going on here? And helping them try to figure out what that's derived from. You can help people with things like that in most states. But when you get into individualized nutrition recommendations, and certainly no one in any state, let me just emphasize this.

No one in any state can do medical nutrition therapy. Okay, what is medical nutrition therapy? That's when you would be, and only licensed people can work with specific diseases or medical conditions or issues and give nutrition as a recommendation for treating or addressing that medical issue. So for example, if someone has Hashimoto's, you are not going to be a Hashimoto's coach or work with them around Hashimoto's, but you can help them with thyroid health and how to have a better functioning thyroid and what foods you can eat to help support your thyroid. But anything around specific things like a disease, they still need to work with their doctor around. So from a marketing angle, we always want to niche down, but we don't want to niche to a disease. We want to niche down to an area or a system of the body that you want to focus on.

So it's nuance. It is complicated. I wish it were super simple, but as I always joke, Michelle, to everyone, it's like the human body when your client comes in is like, yeah, I'm having some issues with my gut. I just really want to be able to eliminate more regularly. And they're like, what should I do? Well, chances are you can't answer that in a two sentence answer because you need to know more information. You need to talk about their situation, you need to understand the circumstances. The same is true for law. There are not a lot of super simple answers, just like accounting, just like other types of professions. So that's why it's helpful to learn some of this information and know that you need to know your state laws, know that you don't want to be practicing medical nutrition therapy. And then from there, figure out your specific situation.

Michelle:
Oh my goodness. Okay. So again, everyone who so far thinks that they're working with Hashimoto's clients just jumped out of their chair and said, what? So I feel like when we've spoken in the past helped me understand that it's okay to talk about symptoms associated with or reducing certain symptoms as opposed to curing a disease.

Lisa:
Yeah, that's right. So for example, with Hashimoto's, okay, well, and Michelle, I should also preface this by saying everyone can take whatever level of risk that they wish to take in their own business legally and ethically. As a lawyer, I can only tell you how to follow the law and where to follow the law and that you should follow the law obviously, even though I would like some of these laws to change too. So I'm right there with everyone. Like this is crazy. This is law is so restrictive, but it is what it is. And so right now we have to live in the world the way it is, even though there's progress being made to change the laws to make them more flexible. But right now, what I want you to do, know how to keep yourself safe so that you're not getting yourself into trouble or putting yourself at risk.

So how do you do that? Let's say you're like, but Lisa, my passion is Hashimoto's. I had Hashimoto's, I healed from Hashimoto's, and I want to help other people do that. That is fabulous. That is great. And the thing is, as a health coach, you're not going to be a health coach specifically for Hashimoto's, right? You can say, are you someone living with Hashimoto's? Then what I want to do is help you have better thyroid health. I want to help you figure out what's going on in your gut and in your endocrine system. And if you're allowed in these states to do this using food, of course, then let's figure out your food and your supplements and your lifestyle program or whatever it is you're doing for them to help them have their thyroid operate more functionally and better. But you're not going to be telling them how to get off their thyroid medication or that your program will cure them of their Hashimoto's or your program's going to make them not have Hashimoto's symptoms anymore.

And you want to really just focus on taking them where they are and moving them towards a greater state of health. The focus is on the health, not on the disease. They still need to work around the disease with their doctor. Your job is to say, oh, you have Hashimoto's. Good to know. Now that tells me we need to focus on your thyroid health. We need to focus on your gut. We need to focus on figuring out what's going in your body that allows your body to support Hashimoto's, but we're not here to address specifically.

Michelle:
So it's subtle, you guys. It's really subtle. And Lisa, I appreciate you saying that Everyone can decide for themselves their risk tolerance. It's like anything else. You're not supposed to check your text messages when you get to a stop sign or a red light, and yet how many of us might glance down at the phone at that point? We do it all day in all aspects of our lives where there's the ultimate 100% correct thing, abide by the law, and then there's a range that comes underneath that. So proceed with caution, and thank you for helping to explain that nuance where we can live.

Lisa:
It's just a mindset shift to helping people meet them where they are to get healthier versus addressing the disease state specifically. The example I always love to give is that if you're a physical therapist and someone comes in with a torn ACL and now they're going through 12 weeks of treatment of physical therapy to restore the ACL back to its exact starting point basically, and then you go to the personal trainer, which is like a coach in this analogy, the personal trainer can say, Hey, have you had any injuries? Have you had anything happen to you? And of course the client will say, well, yeah, I had ACL surgery six weeks ago. Well, the personal trainer knows then I don't want to do anything to exacerbate that. I don't want to be taking them running the sprints tomorrow. But the personal trainer's job is not to heal the ACL.

The personal trainer's job is to know about the ACL and then help the person do a marathon training program or a running program or something that isn't going to exacerbate the ACL. Do you see the difference? So medical is where you're dealing with the disease, specifically health and wellness is where you're actually taking them where they are and helping them move forward, being aware of what they're experiencing and helping to strengthen that system of the body, but not actually getting yourself into a place where someone comes after you for perceiving that you're providing treatment for Hashimoto's. That's what we're trying to avoid.

Michelle:
And we would most likely be getting in hot water if what type of person, what type of person would be angry that a health coach was trying to treat Hashimoto's?

Lisa:
Like who would report you potentially. Okay. A couple things. One, it could be if something actually happens to that person with their Hashimoto's and something gets worse or they have another illness and they come back and blame you for making their Hashimoto's worse or whatever. Number two, it could be other dieticians get upset when they think health coaches are moving into medical nutrition therapy and addressing specific medical diseases with nutrition therapy, which is medical nutrition therapy, which is in most states, almost all states requires license. So dieticians, I love dieticians. I'm not picking on them at all, but they understandably feel like people are treading on their turf and also breaking the locks. And then third, Michelle is also the investigators. Sometimes we'll look at websites and do searches, and if they see all of your website, Hashimoto, Hashimoto, Hashimoto, Hashimoto, then they may just choose to investigate you and say, Hey, are you working with people around Hashimoto's? Are you licensed? Are you providing them a nutrition plan for their Hashimoto's? And if you say yes, they may say, well, then you're violating the dietetics law or you're violating a medical law, and this is the unlicensed practice of dietetics or the unlicensed practice of medicine. And that's what we're trying to avoid.

Michelle:
So they're out there, they're doing Google searches.

Lisa:
Yeah, I don't want to cause undue stress and worry for people. And this is real though. I mean, I can probably tell you over the course of my work, about 50 health coaches have come to me being investigated or threatened with investigation or had things happen to them. And I personally think it's going to get worse before it gets better until the laws change. So I just want people to be aware and use caution. You can still help people with thyroid help. It's totally fine. Just don't put all your emphasis on the Hashimoto's and put more of your emphasis on here's what you can do to support your thyroid. Here's to help your thyroid function better. Here's what you can do to feel better and have more energy and not be so drained and lose weight and do all the things that health coaches love to do. Right? It's just where you're placing your emphasis.

Michelle:
Got it. Okay. That's great. And so a lot of this is crossing over with the question of scope of practice and what we can't do. That's right. As we talk about all of this, we're talking about the states within the United States. Are there laws like this in other countries that our international listeners need to be aware of?

Lisa:
Yeah, it's some for sure. Certainly Canada has laws around holistic health and dietetics. Some states are, some provinces are more restrictive. There some, there's more freedom in other countries. In Europe, there aren't as many laws. But the thing is, if you are outside of the us but you have clients in the us, you still have to follow the laws in the US because you could still be charged with the unlicensed practice of medicine in a state or the unlicensed practice of dietetics if you're doing something in a state which requires a license to do. So, it's good for everyone to be aware of it. And...

Michelle:
I get that question a lot. What about me? I live in Australia. What about me?

Lisa:
I know, and I don't mean to be Debbie Downer. I promise you. What I do is try to help you figure out what you can do, what you can do, how to say things, what terms to use, how to say things safely, how to focus on your work safely, how to offer group courses or online courses or not get yourself in trouble. So it sounds really kind of a bummer what we're saying right now, and it's also just an opportunity for learn how to make a small shift to be able to do what you want to do, but not get yourself into a position where someone would question the work that you're doing.

Michelle:
So what would be the best way if one of our listeners is like, ah, what about me? What about my website? What about this course that I've been planning to run? How can they go about getting that audited or looked at so that they know for sure?

Lisa:
Yeah, we do that for sure. Well, you can talk of course to any lawyer that you wish you understands health coaching, and you also could schedule a free legal chat with my team, which is just lisa fraley.com/legal chat. And what we do in that call is gather your questions, gather your concerns, figure out what you do and who you are and where you're located and who you're trying to serve, and then we help provide you with next steps. Sometimes it's a DIY legal template. Sometimes it's a paid consultation. Sometimes we refer you to another lawyer. It just kind of depends, but we will help you so you don't feel like you have to be worried and wondering, how do I find out about my own situation? We will help you with that.

Michelle:
Awesome. Thank you for sharing that. That's going to put a lot of people's minds at ease for sure. As you mentioned that, you mentioned the DIY templates. You have a lot of forms, legal forms that we can purchase and customize. I've done this with several of them for my own business now. That's one way that we can protect ourselves. And the other way that everyone always talks about protecting themselves is by purchasing insurance. So I wondered if you could speak to those two.

Lisa:
Totally. And I love that you asked this question, Michelle, in the same breath. Okay. Because people don't realize, they're like sisters is how I like to say it. So here's the deal. The reason why it's recommended that you have both is because they protect you in different ways. So for example, legal documents like your client agreement or your website documents or the terms of use that you would use for a group program. Those are legal documents that you sign and the client signs or just the client signs, but basically they're terms that say, Hey, listen, this information is just information education for you. This isn't medical advice. You need to still work with your own doctor and you're limiting your liability upfront. So if something does go wrong, they've already agreed in advance that they're not going to sue you or they can only get the money back that they paid for the course or that there's limitations on how you're responsible.

You still have to be ethically responsible and you can't be negligent and you have to do things properly. But this limits your liability in a lot of ways on the front end before something goes wrong, which gives you peace of mind. It gives the client peace of mind. Everyone's on the same page. It's a really helpful thing to have that can just allow you to relax and do your work. So it helps you on the front end. I like to say before anything would go wrong. Now insurance, its sister helps you on the backend after something goes wrong, right? Something happens and then you have to file an insurance claim, and then your insurance policy would support you and protect you read all the fine print, but presumably, and so you can get health coaching insurance to protect you on the backend after something goes wrong if something were to go wrong.

And then that's what would kick in. So you want to limit your liability on the front end. And then also people sleep better at night and sometimes it's required to have insurance. If you speak in corporate settings or do retreats or things like that, you do want to have it to protect you if something goes wrong on the backend. So they're sisters, but if you have to choose, honestly, Michelle, I know people say right away, get insurance if you have to choose the legal document, if you have a limited budget, choose the legal document. Why? Because you're already reducing your risk on the front end to protect you first. If something goes wrong, if something does go wrong, which there's a lesser chance of that happening, then you would have insurance to protect you. But I want everyone to reduce their risk on the front end. That's the easiest and best way to protect yourself, especially when you're starting out, but at any point in your business.

Michelle:
Sure, absolutely. And then of course, if you've ever had insurance for anything, your house, your car, it never quite pays out the way you think you need it to once you get there.

Lisa:
Yeah, there's a lot of fine print, a lot of exclusions and exceptions.

Michelle:
Right. Right. Exactly. That's why you said read the fine print read, read the fine print, fine print.

Lisa:
That's right.

Michelle:
You got it. Precisely. Awesome. So maybe just going back to those forum for a minute. You have so many. When we think about, for example, we have our health coaches doing one-on-one private coaching. We have a lot of coaches offering online courses, maybe a five day like a mini course. Great. What forms would you recommend in these cases?

Lisa:
Totally fabulous. And I love that you're helping people, Michelle, do all the things because in different states they can do different things. So I think it's so great. So for those of you doing one-on-one Health Coaching, the form that we recommend is the DIY client agreement. Okay? I have several types of client agreements, but just for one-on-one coaching, you just need the DIY client agreement. You just download it, fill in the blanks, there's little notes in the margin to help you. There's an audio guide to help you, so you're not by yourself. You can definitely fill it in. It's not hard. It's super easy. I made it that way on purpose, plain English, easy to understand the whole thing. And so that would be what you need for your one-on-one clients, but that's what you would use that for. Then if you have a group program or an online course or a DIY self-study program or video course or audio course where there's no one-on-one involved, no one-on-one calls, all those things I just named, there's no one-on-one calls video course, audio course, DIY five day paid challenge, all those things like six week online course, you would use what I call terms of use.

All the terms that lawyers use are called legal terms, so they get very confusing with their names. So I named DIY terms of use, which by the way is associated with the fifth chakra. I forgot to mention that. The client agreement for one-on-one associated with the second chakra, the sacral chakra to hold and support your one-on-one client relationship. This one, the terms of use is associated with your throat chakra because now you're going one to many. You're reaching many people through your group program or your online course. So this is where you'll have people check the box and agree to the terms in Practice Better, which I love, love, love, just like you do, Michelle. You want people to upload the terms of use to Practice Better and have people check the box and agree to it for their group program or online course with the one-on-one client agreement, you can also do that through Practice Better and have you sign the document and the client sign the document. So Practice Better makes it really easy for you to upload these documents and then just use what you need for one-on-one and use what you need for online or group courses.

Michelle:
Main. Okay, agree. Those seem to be like the two documents. I mean, there are certainly others that you might need another situations, but those would be the two to go to first. That's right. And coaches are always again asking me, well, what about this? Well, what about that? Well, I bought this product. Well, I bought this also. How come my health coach in school didn't tell me any of this? That comes up a lot. So you guys, my big answer for you is I don't know. I don't know.

Lisa:
Well, I can tell you why. So here's why you all your health coaching school didn't tell you this because we want to grant them some grace because just like medical school and dental school and chiropractic school and all kinds of schools, they aren't in a position actually to teach you law other than the fact that you need to know the laws. Because why? Because students come from every state in the US and students from countries around the world, and laws are different everywhere, and they change, right? So let's say your school said, well, I want to teach you the law. They would teach you the law today. Well, it can change next year. It's like the human body. It's a moving, living being. So I want them to tell people, you need to know law. You need to talk to a lawyer when you have a business, you need to talk to an accountant when you have a business.

But they aren't positioned to do that, and they're not lawyers, and they shouldn't be teaching people law because that's not their expertise. But they should tell you that you need to talk to a lawyer. But you all, it's no different. Even in law school, when I went to law school, we learned sample laws. We learned the law in California for murder. One is this, and the law in New York defines it as this. But when we went back to our own legal practices, we had to find out, I had to find out what the law was in the state of Ohio because it's not California, it's not New York. So everyone has to learn the laws of their state. If you're opening a restaurant, you have to learn the laws of your state in your city about how you can organize your restaurant. So this is no different than every other profession. It just feels yucky when you get out of school and you're like, what? They didn't tell me I couldn't do one-on-one in this state. What's up with that? But it's just how it is, and that's why we want to empower you to feel like you can get this information and have this information very easily, and we'll help you figure it out. So then off you can go and you can feel really confident and safe and secure and empowered to move forward in your business in ways that feel legal and good to you.

Michelle:
Thank you for explaining that, and I think that's fair and same in the way that I support health coaches. I don't know where you live and what your situation is, and people are everywhere, and the law's always changing. And my goodness, I am not at all the person who can sort it out for you, but Lisa is. So Lisa, thank you so much for joining us today. We always appreciate having you as part of our health coaching world.

Lisa:
Thank you, Michelle, and thank you everyone for what you're doing. Please feel positive and excited and empowered, and then we can just talk about any small shifts you might need to make to stay in compliance with the law, but know that for the most part, in most states, you can do most of what you want to do. Just sometimes we have to tweak a little bit, and that's okay. We can do that, and you can still make a fabulous income and really, really help people, which is where I know your heart is. So thank you to everyone, and thank you, Michelle for having me to explain this to everyone. I really appreciate it.

Michelle:
And I should mention that all of Lisa's DIY legal documents are available. If you go to healthcoachpower.com/legal, you'll see she's got a ton, but you're going to look for that client agreement and the terms of use. Again, that's healthcoachpower.com/legal.
And this episode is sponsored by That Clean Life. I only accept sponsors from brands that I have used and loved and trust, and same with guests on the show. I only have guests on the show who I love and have used That Clean Life is an amazing resource for health coaches to create recipe books to help clients do their own meal planning. How very legally compliant is that on any type of diet? And for a limited time, I have a discount to share with you. You can get 20% off your first four months when you join at healthcoachpower.com/tcl. That's it everybody. We'll see you next week. Thanks again, Lisa. Thank you.