Title of Regulation: 18VAC140-20. Regulations Governing the Practice of Social Work (amending 18VAC140-20-10, 18VAC140-20-50, 18VAC140-20-60, 18VAC140-20-70, 18VAC140-20-105).

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

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: December 23, 2009.

Effective Date: January 7, 2010.

Agency Contact: Evelyn B. Brown, Executive Director, Board of Social Work, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4488, FAX (804) 527-4435, or email evelyn.brown@dhp.virginia.gov.

Basis: Regulations are promulgated under the general authority of Chapter 24 (§ 54.1-2400 et seq.) of Title 54.1 of the Code of Virginia. Section 54.1-2400 provides the Board of Social Work the authority to promulgate regulations to administer the regulatory system.

Purpose: The purpose of the amended regulation is clarity and flexibility so applicants, supervisees, and licensees will be better able to comply with requirements. Allowing more flexibility in face-to-face supervision requirements may enable a few persons to complete supervision requirements more quickly and obtain a license to provide social work services. Allowing more flexibility in continuing education requirements will give licensees more options and opportunities to obtain required hours and courses. Changes that allow social workers more time to focus on providing service to clients are beneficial to public health, safety, and welfare. The amendment to specifically prohibit a supervisee (not yet licensed) from representing himself as an independent practitioner protects persons who may be receiving services from such a person.

Rationale for Using Fast-Track Process: The proposed amendments are intended to clarify regulations that have been problematic for licensees and applicants; they address questions that have arisen for which the regulations did not clearly state board policy. Additionally, amendments make supervision requirements consistent and more flexible. Accordingly, the board does not expect the regulatory changes to be controversial.

Substance: The amended regulations clarify regulations pertaining to practice as a candidate for licensure under supervision to eliminate confusing language about full-time and part-time and to allow more flexibility in obtaining hours of face-to-face supervision. An amendment specifies that a supervisee may not directly bill for services or represent himself as an independent practitioner. An amendment specifies that a candidate must reapply for approval if he has not passed the required examination within two years. Finally, amendments to continuing education requirements specify and clarify the subject matter for approved continuing education must pertain to the practice of social work or another behavioral health field, including the two hours of ethics or laws on practice. Amendments require that a request for an exemption must be made prior to the renewal date and allow membership on a social work board to count as two hours of Category II continuing education.

Issues: The primary advantage to persons seeking licensure is more clarity in regulation to address questions and situations that have been problematic. Additionally, more flexibility in the regulation for face-to-face supervision will make the requirement more reasonable to meet. Amendments to the regulation for two hours of ethics and laws will expand the availability of courses and activities that may be used to meet the continuing education requirements. The restriction on supervisees holding themselves out as independent practitioners further protects the public. There are no disadvantages to the public.

The primary advantage to the agency is the resolution of issues and questions that have taken staff and board time to address. Clarity and flexibility in the continuing education requirements and in the supervision requirements may result in fewer hours and meetings for board committees to address nonroutine applications or noncompliance in a continuing education audit. There are no disadvantages to the agency or the Commonwealth.

The Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Social Work (Board) proposes to: 1) allow more flexibility for licensure candidates in obtaining face-to-face supervision, 2) specify that a candidate must reapply for approval if he has not passed the required examination within two years, 3) clarify that supervisees may not directly bill for services rendered or in any way represent themselves as independent, autonomous practitioners or licensed clinical social workers, 4) allow more flexibility for licensees to meet continuing education requirements, and 5) specify that a request for an exemption from continuing education compliance must be made prior to the license renewal date.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. Under both the current and proposed regulations applicants for the clinical social worker license must complete a minimum of 3,000 hours of supervised post-master's degree experience in the delivery of clinical social work services, with at least 100 of those hours being face-to-face supervision. The current regulations require that there be at least one hour of face-to-face supervision every week. The proposed regulations require that there be a minimum of one hour and a maximum of four hours of face-to-face supervision per 40 hours of work experience. This will enable greater flexibility for licensure candidates in obtaining face-to-face supervision in that the 40 hours allows for breaks due to illness or vacation. The increased flexibility should not detract from assurance of supervised work.

Currently, regulations require that a candidate take an examination within 2 years; but this could allow someone to remain an active applicant indefinitely and require the board to maintain the application file if he attempts passage of the examination once every two years. According to the Department of Health Professions (Department), a candidate who has not passed an examination within two years is unlikely to ever pass unless he obtains some additional education and/or experience to make up deficiencies in knowledge and/or skills. Under the proposed language a candidate can still take an examination once every 90 days; so within a two-year period, he can attempt the exam 8 times.

The Board proposes to specify that continuing education courses used to satisfy the licensure renewal requirement be directly related to the practice of social work or another behavioral health field. Also, the Board proposes to allow additionally flexibility in obtaining ethics training. The proposed amendments will allow for more flexibility in meeting the continuing education requirements by generally allowing courses related to any behavioral health field and by allowing the two hours to pertain to ethics or standards of practice for the behavioral health professions.

The current regulations allow up to 2 hours of continuing education credit for serving as an officer or committee member of a national professional social work association. The Board proposes to grant the same two credit hours for membership on a state social work licensing board, which according to the Department is an activity more likely to educate one in the laws and standards of the profession. Thus this proposed change will produce a net benefit.

Lastly, the Board proposes to specify that a request for an exemption from continuing education compliance must be made prior to the renewal date. The requirement is necessary to ensure the circumstances are legitimate and not used as an excuse to avoid compliance with an audit of continuing education two years after a renewal date.

Businesses and Entities Affected. The proposed amendments potentially affect the 4855 licensed clinical social workers and 302 licensed social workers in Virginia, candidates for licensure, firms and government agencies that employ licensed clinical social workers and licensed social workers, and providers of continuing education.

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposal amendments are not expected to significantly affect total employment.

Effects on the Use and Value of Private Property. The proposals to allow more flexibility for licensees to meet continuing education requirements and for license candidates to obtain face-to-face supervision may allow staff of some firms to use their time more efficiently.

Small Businesses: Costs and Other Effects. The proposals to allow more flexibility for licensees to meet continuing education requirements and for license candidates to obtain face-to-face supervision may allow staff of some small firms to use their time more efficiently. This may moderately reduce costs.

Small Businesses: Alternative Method that Minimizes Adverse Impact. The proposed amendments are not expected to adversely affect small businesses.

Real Estate Development Costs. The proposed amendments are unlikely to significantly affect real estate development costs.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 36 (06). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has adverse effect on small businesses, Section 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB's best estimate of these economic impacts.

Agency's Response to the Department of Planning and Budget's Economic Impact Analysis: The Board of Social Work concurs with the analysis of the Department of Planning and Budget on proposed amended regulations for 18VAC140-20, Regulations Governing the Practice of Social Work, relating to supervision, examination and continuing education.

Summary:

The proposed amendments (i) allow more flexibility for licensure candidates in obtaining hours of face-to-face supervision; (ii) specify that a candidate must reapply for approval if he has not passed the required examination within two years; (iii) clarify that supervisees may not directly bill for services rendered or in any way represent themselves as independent, autonomous practitioners, or licensed clinical social workers; (iv) allow more flexibility for licensees to meet continuing education requirements; and (v) specify that a request for an exemption from continuing education compliance must be made prior to the license renewal date.

Part I
General Provisions

18VAC140-20-10. Definitions.

A. The following words and terms when used in this chapter shall have the meanings ascribed to them in § 54.1-3700 of the Code of Virginia:

Board

Casework

Casework management and supportive services

Clinical social worker

Practice of social work

Social worker

B. The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Accredited school of social work" means a school of social work accredited by the Council on Social Work Education.

"Clinical course of study" means graduate course work which includes specialized advanced courses in human behavior and social environment, social policy, research, clinical practice with individuals, families, groups and a clinical practicum which focuses on diagnostic, prevention and treatment services.

"Clinical social work services" include the application of social work principles and methods in performing assessments and diagnoses based on a recognized manual of mental and emotional disorders or recognized system of problem definition, preventive and early intervention services and treatment services, including but not limited to psychotherapy and counseling for mental disorders, substance abuse, marriage and family dysfunction, and problems caused by social and psychological stress or health impairment.

"Exempt practice" is that which meets the conditions of exemption from the requirements of licensure as defined in § 54.1-3701 of the Code of Virginia.

"Face-to-face supervision" means the physical presence of the individuals involved in the supervisory relationship during either individual or group supervision.

"Nonexempt practice" is that which does not meet the conditions of exemption from the requirements of licensure as defined in § 54.1-3701 of the Code of Virginia.

"Supervisee" means an individual who has submitted a supervisory contract and has received board approval to provide clinical services in social work under supervision.

"Supervision" means a professional relationship between a supervisor and supervisee in which the supervisor directs, monitors and evaluates the supervisee's social work practice while promoting development of the supervisee's knowledge, skills and abilities to provide social work services in an ethical and competent manner.

18VAC140-20-50. Education and experience requirements for licensed clinical social worker.

A. Education. The applicant shall hold a minimum of a master's degree from an accredited school of social work. Graduates of foreign institutions shall establish the equivalency of their education to this requirement through the Foreign Equivalency Determination Service of the Council of Social Work Education.

1. The degree program shall have included a graduate clinical course of study; or

2. The applicant shall provide documentation of having completed specialized experience, course work or training acceptable to the board as equivalent to a clinical course of study.

B. Supervised experience. Supervised experience in all settings obtained in Virginia without prior written board approval will not be accepted toward licensure. Supervision begun before November 26, 2008, that met the requirements of this section in effect prior to that date will be accepted until November 26, 2012.

1. Registration. An individual who proposes to obtain supervised post-master's degree experience in Virginia shall, prior to the onset of such supervision:

a. Register on a form provided by the board and completed by the supervisor and the supervised individual; and

b. 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. A minimum of one hour and a maximum of four hours of face-to-face supervision shall be provided each week 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. Experience shall be acquired in no less than two nor more than four years.

b. Supervisees shall average no less than 15 hours per week in face-to-face client contact for a minimum of 1,380 hours. The remaining hours may be spent in ancillary duties and activities supporting the delivery of clinical services.

3. An individual who does not complete the supervision requirement after four years of supervised experience shall submit evidence to the board showing why the training should be allowed to continue.

C. 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 three years of postlicensure 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.

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 graduate course or 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 member of his immediate family or provide supervision for anyone with whom he has a dual relationship.

D. 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, and implementing a professional and ethical relationship with clients;

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

7. Maintain documentation, for five years postsupervision, of which clients were the subject of supervision.

E. Supervisees may not directly bill for services rendered or in any way represent themselves as independent, autonomous practitioners, or licensed clinical social workers. 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. Clients shall be informed in writing of the supervisee's status and the supervisor's name, professional address, and phone number.

18VAC140-20-60. Education and experience requirements for licensed social worker.

A. Education. The applicant shall hold a bachelor's or a master's degree from an accredited school of social work. Graduates of foreign institutions must establish the equivalency of their education to this requirement through the Foreign Equivalency Determination Service of the Council on Social Work Education.

B. Master's degree applicant. An applicant who holds a master's degree may apply for licensure as a licensed social worker without documentation of supervised experience.

C. Bachelor's degree applicant. Supervised experience in all settings obtained in Virginia without prior written board approval will not be accepted toward licensure. Supervision begun before November 26, 2008, that met the requirements of this section in effect prior to that date will be accepted until November 26, 2012.

1. Hours. Bachelor's degree applicants shall have completed a minimum of 3,000 hours of full-time supervised post-bachelor's degree experience or the equivalent in part-time experience in casework management and supportive services under supervision satisfactory to the board. A minimum of one hour and a maximum of four hours of face-to-face supervision shall be provided each week for the period of supervision per 40 hours of work experience for a total of at least 100 hours.

2. Experience shall be acquired in no less than two nor more than four years from the beginning of the supervised experience.

D. Requirements for supervisors.

1. The supervisor providing supervision shall hold an active, unrestricted license as a licensed social worker with a master's degree, or a licensed social worker with a bachelor's degree and at least three years of postlicensure social work experience or a licensed clinical social worker in the jurisdiction in which the social work services are being rendered. If this requirement places an undue burden on the applicant due to geography or disability, the board may consider individuals with comparable qualifications.

2. The supervisor shall:

a. Be responsible for the social work practice of the prospective applicant once the supervisory arrangement is accepted by the board;

b. Review and approve the assessment and service plan of a representative sample of cases assigned to the applicant during the course of supervision. The sample should be representative of the variables of gender, age, assessment, length of service and casework 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. The supervisor shall be available to the applicant on a regularly scheduled basis for supervision. The supervisor will maintain documentation, for five years post supervision, of which clients were the subject of supervision;

c. Provide supervision only for those casework management and support services activities for which the supervisor has determined the applicant is competent to provide to clients;

d. Provide supervision only for those activities for which the supervisor is qualified; and

e. Evaluate the supervisee in the areas of professional ethics and professional competency.

3. Supervision between members of the immediate family (to include spouses, parents, and siblings) will not be approved.

Part III
Examinations

18VAC140-20-70. Examination requirement.

A. An applicant for licensure by the board as a social worker or clinical social worker shall pass a written examination prescribed by the board.

B. The board shall establish passing scores on the written examination.

C. A candidate approved by the board to sit for an examination shall take that examination within two years of the date of the initial board approval. If the candidate has not taken passed the examination by the end of the two-year period here prescribed, the applicant shall reapply according to the requirements of the regulations in effect at that time.

18VAC140-20-105. Continued competency requirements for renewal of an active license.

A. Licensed clinical social workers shall be required to have completed a minimum of 30 contact hours of continuing education and licensed social workers shall be required to have completed a minimum of 15 contact hours of continuing education for each biennial licensure renewal. Courses or activities shall be directly related to the practice of social work or another behavioral health field. A minimum of two of those hours must pertain to ethics or the standards of practice and for the behavioral health professions or to laws governing the profession practice of social work in Virginia, or the Code of Ethics of one of the social work professional associations listed under subdivision B 1 d.

1. The board may grant an extension for good cause of up to one year for the completion of continuing education requirements upon written request from the licensee prior to the renewal date. Such extension shall not relieve the licensee of the continuing education requirement.

2. The board may grant an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the licensee such as temporary disability, mandatory military service, or officially declared disasters upon written request from the licensee prior to the renewal date.

B. Hours may be obtained from a combination of board-approved activities in the following two categories:

1. Category I. Formally Organized Learning Activities. A minimum of 20 hours for licensed clinical social workers or 10 hours for licensed social workers shall be documented in this category, which shall include one or more of the following:

a. Regionally accredited university or college academic courses in a behavioral health discipline. A maximum of 15 hours will be accepted for each academic course.

b. Continuing education programs offered by universities or colleges accredited by the Council on Social Work Education.

c. Workshops, 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.

d. Workshops, seminars, conferences or courses in the behavioral health field offered by an individual or organization that has been certified or approved by one of the following:

(1) The Child Welfare League of America and its state and local affiliates.

(2) The National Association of Social Workers and its state and local affiliates.

(3) The Association of Black Social Workers and its state and local affiliates.

(4) The Family Service Association of America and its state and local affiliates.

(5) The Clinical Social Work Federation Association and its state and local affiliates.

(6) Individuals or organizations who have been approved as continuing education sponsors by the The Association of Social Work Boards or any state social work board.

(7) Any state social work board.

2. Category II. Individual Professional Activities. A maximum of 10 of the required 30 hours for licensed clinical social workers or a maximum of five of the required 15 hours for licensed social workers may be earned in this category, which shall include one or more of the following:

a. Participation in an Association of Social Work Boards item writing workshop. (Activity will count for a maximum of two hours.)

b. Publication of a professional social work-related book or initial preparation/presentation of a social work-related course. (Activity will count for a maximum of 10 hours.)

c. Publication of a professional social work-related article or chapter of a book, or initial preparation/presentation of a social work-related in-service training, seminar or workshop. (Activity will count for a maximum of five hours.)

d. Provision of a continuing education program sponsored or approved by an organization listed under Category I. (Activity will count for a maximum of two hours and will only be accepted one time for any specific program.)

e. Field instruction of graduate students in a Council on Social Work Education-accredited school. (Activity will count for a maximum of two hours.)

f. Serving as an officer or committee member of one of the national professional social work associations listed under subdivision B 1 d of this section or as a member of a state social work licensing board. (Activity will count for a maximum of two hours.)

g. Attendance at formal staffings at federal, state or local social service agencies, public school systems or licensed health facilities and licensed hospitals. (Activity will count for a maximum of five hours.)

h. Independent Individual or group study including listening to audio tapes, viewing video tapes, reading, professional books or articles. (Activity will count for a maximum of five hours.)