Title of Regulation: 18VAC140-20. Regulations Governing the Practice of Social Work (amending 18VAC140-20-50).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information:

January 14, 2022 - 10:05 a.m. - Department of Health Professions, Perimeter Center, 9960 Mayland Drive, 2nd Floor, Board Room 2, Richmond, VA 23233

Public Comment Deadline: March 4, 2022.

Agency Contact: Jaime Hoyle, Executive Director, Board of Social Work, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4406, FAX (804) 527-4435, or email jaime.hoyle@dhp.virginia.gov.

Basis: Regulations are promulgated under the general authority of § 54.1-2400 of the Code of Virginia, which provides the Board of Social Work the authority to promulgate regulations to administer the regulatory system.

Purpose: The regulatory change is intended to reduce the burden on supervisors of persons who are gaining experience necessary to become licensed clinical social workers by lowering the number of continuing education requirements needed every five years. The purpose of this regulatory change is to protect the public health and safety in the clinical practice of social work by ensuring that licensed clinical social workers who are responsible for supervisees and the clients they serve are appropriately trained and knowledgeable.

Substance: The board proposes amending 18VAC140-20-50 B 2 to reduce the number of continuing education hours necessary for a supervisor of licensed clinical social workers to obtain from 14 hours within five years immediately preceding registration of supervision to seven hours every five years.

Issues: The advantage to the public is that persons seeking supervisors for clinical experience in order to become licensed in Virginia may find a greater supply of supervisors if the continuing education requirements are less burdensome and expensive; there are no disadvantages to the public. There are no specific advantages or disadvantages to the agency.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Social Work (Board) proposes to reduce the required number of hours of continuing education (CE) in supervision that must be completed by supervisors of persons who are gaining experience necessary to become licensed clinical social workers (LCSWs).

Background. In order to gain licensure, clinical social workers must have supervised experience. In order for someone to qualify to provide such supervision, that person must hold an active, unrestricted license as a clinical social worker with at least two years of post-licensure clinical social work experience and have completed professional training in supervision. After such initial professional training in supervision, every five years the person must complete CE in supervision. The current regulation requires 14 hours of such CE every five years. The Board proposes to lower the required number of hours to seven.

Estimated Benefits and Costs. The National Association of Social Workers Virginia (NASWVA) offers a variety of courses to meet the training requirements for supervisors. The Foundation of Supervision (14-hour course) is recommended for first-time supervisors. Then NASWVA offers several seven-hour courses to expand the participant's evidence-based knowledge of best practices in supervision. Reducing the requirement to seven hours within a five-year period would allow a supervisor to take relevant courses without repetition. Additionally, the Board believes that seven hours of CE in supervision is sufficient for continuing competency in supervision.

As stated, supervisors must hold an active, unrestricted license as clinical social worker. In order to renew such a license the supervisor must complete 30 hours of CE every two years. CE in supervision does count toward the required 30 hours of CE. Thus, reducing the required number of hours of CE specifically in supervision does not affect the total number of hours of required CE but does allow the supervisory LCSW to spend more of that supervisor's CE hours on topics the supervisor may find more personally productive.

Additionally, though the proposed amendment does not effectively reduce the total number of required CE hours, it may allow the licensee to obtain seven hours of the required CE every five years at a lower cost. While the Board accepts coursework offered by other approved providers as listed in 18VAC140-20-105,¹ according to the Department of Health Professions (DHP) NASWVA is most commonly used as the source for CE in supervision. Other known courses on supervision are offered by community services boards, the Association of Social Work Boards, or schools of social work.² A seven-hour credit course with NASWVA costs $151.25 for members and $192.50 for nonmembers.³ Thus, the proposed reduction in required CE hours in supervision could save supervisors some or all of that amount in dollars depending on if they substituted a lower-cost means of obtaining the seven hours or a no-dollar-cost method.⁴

According to DHP, there is a need for more LCSWs to serve as clinical supervisors, and there is a strong need for more licensees. Reducing the cost of continuing to be a supervisor may encourage more LCSWs to become or remain supervisors. This would be beneficial in that more supervisors would help more LCSW candidates obtain the supervised experience they need to become licensed.

Businesses and Other Entities Affected. The proposed amendment affects the 184 LCSWs registered to provide supervision to supervisees in clinical social work,⁵ providers of CE in supervision, LCSW candidates who are seeking registered supervisors, and entities that employ social workers. According to survey data from a July 2020 report (the most recent available) from the Virginia Healthcare Workforce Data Center,⁶ the primary employers of LCSWs in the Commonwealth are distributed as follows:

Categorized by sector, the report presents the types of employers of LCSWs in Virginia as follows:

The proposed amendment would likely lead to reduced revenue for providers of CE in supervision. Adverse impact is indicated if there is any increase in net cost or reduction in net revenue for any entity, even if the benefits exceed the costs for all entities combined. Thus, an adverse impact is indicated.

Small Businesses⁷ Affected.

Types and Estimated Number of Small Businesses Affected. While NASWVA is most commonly used as the source for continuing education in supervision, according to DHP there are private companies approved to provide CE, including in supervision. The agency is not aware of the specific number of such firms and how many are small businesses.

Costs and Other Effects. The proposed amendment would likely moderately reduce revenue for small businesses that provide CE in supervision.

Alternative Method that Minimizes Adverse Impact. There are no clear alternative methods that both reduce adverse impact and meet the intended policy goals.

Localities⁸ Affected.⁹ Local governments that are having difficulty finding enough qualified LCSWs to employ may be particularly affected by the proposed amendment in that it may result in a moderate increase in the supply of LCSWs. The proposed amendment does not appear to introduce costs for local governments.

Projected Impact on Employment. The proposed reduction in required supervision CE hours may encourage more LCSWs to become or remain supervisors. This may in turn allow more LCSW candidates to obtain the supervised experienced they need to become licensed. Hence, the proposal may moderately increase the supply of LCSWs, leading to a modest increase in the employment of LCSWs.

Effects on the Use and Value of Private Property. As discussed, the proposed amendment may lead to a moderate increase in the supply of LCSWs. This may moderately reduce the cost to firms of hiring social workers, which may in turn have a small positive impact on their value. As also discussed, the proposed amendment would likely lead to some reduced revenue for providers of CE in supervision. This could have a small negative impact on their value.

The proposed amendments do not affect real estate development costs.

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¹See https://law.lis.virginia.gov/admincode/title18/agency140/chapter20/section105/

²Source: DHP

³Source: DHP

⁴Workshops, seminars, conferences, or courses in the behavioral health field offered by federal, state or local social service agencies, public school systems, or licensed health facilities and licensed hospitals would count for CE. Some of these could potentially be offered free of charge. Various other entities may also offer CE if approved by specified organizations. Some of this CE could also be free of charge.

⁵Data source: DHP

⁶See https://www.dhp.virginia.gov/media/dhpweb/docs/hwdc/behsci/0904LCSW2020.pdf

⁷Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

⁸"Locality" can refer to either local governments or the locations in the Commonwealth where the activities relevant to the regulatory change are most likely to occur.

⁹§ 2.2-4007.04 defines "particularly affected" as bearing disproportionate material impact.

Agency's Response to Economic Impact Analysis: The Board of Social Work concurs with the economic impact analysis of the Department of Planning and Budget.

Summary:

The proposed amendments reduce the number of continuing education (CE) hours necessary to continue being approved as a supervisor, retaining the requirement for 14 hours of CE for the initial registration of supervision but changing to seven hours of CE relating to provision of supervision every five years thereafter.

18VAC140-20-50. Experience requirements for a licensed clinical social worker.

A. Supervised experience. Supervised post-master's degree experience without prior written board approval will not be accepted toward licensure, except supervision obtained in another United States jurisdiction may be accepted if it met the requirements of that jurisdiction. Prior to registration for supervised experience, a person shall satisfactorily complete the educational requirements of 18VAC140-20-49.

1. Registration. An individual who proposes to obtain supervised post-master's degree experience in Virginia shall, prior to the onset of such supervision, or whenever there is an addition or change of a supervisor:

a. Register on a form provided by the board;

b. Submit a copy of a supervisory contract completed by the supervisor and the supervisee;

c. Submit an official transcript documenting a graduate degree and clinical practicum as specified in 18VAC140-20-49; and

d. Pay the registration of supervision fee set forth in 18VAC140-20-30.

2. Hours. The applicant shall have completed a minimum of 3,000 hours of supervised post-master's degree experience in the delivery of clinical social work services and in ancillary services that support such delivery. A minimum of one hour and a maximum of four hours of face-to-face supervision shall be provided per 40 hours of work experience for a total of at least 100 hours. No more than 50 of the 100 hours may be obtained in group supervision, nor shall there be more than six persons being supervised in a group unless approved in advance by the board. The board may consider alternatives to face-to-face supervision if the applicant can demonstrate an undue burden due to hardship, disability, or geography.

a. Supervised experience shall be acquired in no less than two nor more than four consecutive years.

b. Supervisees shall obtain throughout their hours of supervision a minimum of 1,380 hours of supervised experience in face-to-face client contact in the delivery of clinical social work services. The remaining hours may be spent in ancillary services supporting the delivery of clinical social work services.

3. An individual who does not complete the supervision requirement after four consecutive years of supervised experience may request an extension of up to 12 months. The request for an extension shall include evidence that demonstrates extenuating circumstances that prevented completion of the supervised experience within four consecutive years.

B. Requirements for supervisors.

1. The supervisor shall hold an active, unrestricted license as a licensed clinical social worker in the jurisdiction in which the clinical services are being rendered with at least two years of post-licensure clinical social work experience. The board may consider supervisors with commensurate qualifications if the applicant can demonstrate an undue burden due to geography or disability or if supervision was obtained in another United States jurisdiction.

2. The supervisor shall have received professional training in supervision, consisting of a three credit-hour graduate course in supervision or at least 14 hours of continuing education offered by a provider approved under 18VAC140-20-105. The After the initial graduate course or 14 hours of continuing education in supervision, at least seven hours of continuing education in supervision shall be obtained by a supervisor within five years immediately preceding registration of supervision.

3. The supervisor shall not provide supervision for a family member or provide supervision for anyone with whom he has a dual relationship.

4. The board may consider supervisors from jurisdictions outside of Virginia who provided clinical social work supervision if they have commensurate qualifications but were either (i) not licensed because their jurisdiction did not require licensure or (ii) were not designated as clinical social workers because the jurisdiction did not require such designation.

C. Responsibilities of supervisors. The supervisor shall:

1. Be responsible for the social work activities of the supervisee as set forth in this subsection once the supervisory arrangement is accepted;

2. Review and approve the diagnostic assessment and treatment plan of a representative sample of the clients assigned to the applicant during the course of supervision. The sample should be representative of the variables of gender, age, diagnosis, length of treatment, and treatment method within the client population seen by the applicant. It is the applicant's responsibility to assure the representativeness of the sample that is presented to the supervisor;

3. Provide supervision only for those social work activities for which the supervisor has determined the applicant is competent to provide to clients;

4. Provide supervision only for those activities for which the supervisor is qualified by education, training, and experience;

5. Evaluate the supervisee's knowledge and document minimal competencies in the areas of an identified theory base, application of a differential diagnosis, establishing and monitoring a treatment plan, development and appropriate use of the professional relationship, assessing the client for risk of imminent danger, understanding the requirements of law for reporting any harm or risk of harm to self or others, and implementing a professional and ethical relationship with clients;

6. Be available to the applicant on a regularly scheduled basis for supervision;

7. Maintain documentation, for five years post-supervision, of which clients were the subject of supervision; and

8. Ensure that the board is notified of any change in supervision or if supervision has ended or been terminated by the supervisor.

D. Responsibilities of supervisees.

1. Supervisees may not directly bill for services rendered or in any way represent themselves as independent, autonomous practitioners, or licensed clinical social workers.

2. During the supervised experience, supervisees shall use their names and the initials of their degree, and the title "Supervisee in Social Work" in all written communications.

3. Clients shall be informed in writing of the supervisee's status and the supervisor's name, professional address, and phone number.

4. Supervisees shall not supervise the provision of clinical social work services provided by another person.

5. While providing clinical social work services, a supervisee shall remain under board approved supervision until licensed in Virginia as a licensed clinical social worker.