Title of Regulation: 18VAC140-20. Regulations Governing the Practice of Social Work (amending 18VAC140-20-10, 18VAC140-20-40, 18VAC140-20-45, 18VAC140-20-51, 18VAC140-20-110).

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

Public Hearing Information:

October 15, 2012 - 9:45 a.m. - Department of Health Professions, 9960 Mayland Drive, 2nd Floor, Richmond, VA

Public Comment Deadline: November 9, 2012.

Agency Contact: Catherine Chappell, Acting 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 catherine.chappell@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia provides the Board of Social Work the authority to determine the qualifications for licensure and reinstatement and to promulgate regulations to administer the regulatory system.

Purpose: The board has adopted amendments to make it less burdensome for persons who have been actively practicing as social workers or clinical social workers in another state to be licensed in Virginia. To do so, regulations need to clarify or define the intent and meaning of "active practice" to ensure current competency to practice. With active practice and no grounds for denial of licensure, the applicant could be licensed by credentials and the requirements for documentation of education and supervised experience could be eliminated.

The board has addressed an issue of competency for applicants who passed the national examination some years ago but were never licensed and never practiced social work in any jurisdiction. To do so, a regulation is proposed to specify that the examination must have been passed within five years prior to application or the applicant must provide evidence of practice in an exempt setting in the category of social work for which he has applied to be licensed.

The board has addressed concerns about persons who are seeking to reinstate or reactivate a license that has been lapsed or inactive for four or more years. If the applicant has been practicing in another state during that period, that practice could serve as evidence of current competency; but if the applicant has not practiced social work for a number of years, there needs to be a period of supervised practice as evidence of competency.

By accepting active, unrestricted practice in other states as evidence of current competency to practice, the board may expand the applicant pool for licensure as clinical social workers to meet the growing need for mental health providers while protecting the health, safety, and welfare of the public such providers serve.

Substance: 18VAC140-20-40 and 18VAC140-20-51 are amended to address the problem of applicants who passed the examination a number of years prior to application but were never licensed in Virginia or in another jurisdiction. The amendment would require that the national licensing examination be passed within five years prior to application or, if the examination was passed before that time period, that the applicant demonstrate evidence of social work practice at the appropriate level (social worker or clinical social worker) within an exempt setting prior to application.

18VAC140-20-45 is amended to eliminate certain application requirements for licensure by endorsement applicants and, at the same time, to clarify the meaning of "active practice" to demonstrate competency in the field of social work. Currently, regulations require an applicant for licensure by endorsement to have actively practiced for 36 of the past 60 months; the amended regulation would provide an alternative of supervised experience equivalent to that required for licensure by examination.

18VAC140-20-110 is amended to address the issue of reactivation and reinstatement for applicants who have either not been practicing social work in recent years or practicing elsewhere in an exempt setting by requiring practice under supervision for at least 360 hours in the 12 months preceding licensure in Virginia.

Issues: The advantage to the public is greater assurance of current competency in knowledge and skill to practice, especially at the clinical level, by requiring recent passage of the licensure examination or evidence of practice in an exempt setting. Likewise, applicants who have allowed a license to lapse or who are inactive would have to demonstrate minimal competency or practice for a short time under supervision. Elimination of some burdensome requirements for licensure by endorsement may encourage social workers to come to Virginia for practice, thus increasing the supply of practitioners. There are no disadvantages.

Currently, if an applicant is denied licensure or if there are questions about eligibility, credentialing issues must be resolved through a lengthy and costly administrative process involving the credentials committee or an informal conference and finally a formal hearing. By clarifying the regulations with more precise rules to follow, an applicant, board staff, and board members will all have a clearer understanding of the competency requirements for licensure and the board will incur less cost. There are no disadvantages.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Social Work (Board) proposes to amend its Regulations Governing the Practice of Social Work to 1) add a definition for active practice, 2) require applicants for licensure to either pass the licensure examination within five years preceding application or provide proof of working in a setting that is exempt from licensure requirements for at least 360 hours per year for two of the five years preceding application, 3) require individuals who are seeking to reinstate an active license or reactivate an inactive license to provide proof of active practice (either in another jurisdiction or in an exempt setting) during three of the five years immediately preceding application or provide proof of 360 hours of supervised practice in the 12 months preceding application and 4) remove some requirements for licensure by endorsement.

Result of Analysis. There is insufficient information to accurately gauge whether benefits are likely to outweigh costs for several of these proposed changes. Benefits likely outweigh costs for at least one of these proposed changes.

Estimated Economic Impact. Under current regulations, individuals must pass a national competency exam in order to be licensed as a social worker or clinical social worker but there is no limitation on how long after passing the exam individuals have to apply for licensure. The Board proposes to require that individuals who are seeking licensure to either prove that they passed the licensure examination within the five years preceding application or provide proof of working in a setting that is exempt from licensure requirements for at least 360 hours per year for two of the five years preceding application.

The likely very small group of individuals who pass the licensure exam more than five years before they apply for licensure, and cannot prove that they have worked the proposed requisite number of hours in an exempt setting, will incur costs for retaking the licensure exam as well as fulfilling any new requirements (additional classes, etc) to take the exam if requirements have changed. The public will likely benefit from this change if there is a current malpractice problem that is likely caused by individuals starting to practice years after they initially passed their exam or if information or best practices in these fields are changing so rapidly that a competency exam taken more than five years ago would not be substantively the same as an exam taken in the nearer term. There is insufficient information to know how many potential applicants for licensure might be affected or to quantify any benefit that might accrue to the public.

Currently, individuals who are seeking to reinstate or reactivate a Board issued license must pay a fee and provide proof that they have completed required continuing education. The Board proposes to also require that these individuals provide proof of active practice (either in another jurisdiction or in an exempt setting) during three of the five years immediately preceding application or provide proof of 360 hours of supervised practice in the 12 months preceding application. Licensees who have allowed their licenses to lapse or who have held an inactive license for a number of years, but who have not worked in another state or in an exempt setting, will have to work in a supervised setting (at a likely lower pay level) for at least 360 hours before they can reapply for active licensure. Interestingly, since individuals who are renewing an active license will not have to prove that they have actively practiced during the renewal cycle, licensees who plan to leave the work force for a number of years can avoid having to prove that they have been actively practicing by continuing to maintain an active license. The public will likely only benefit from this change if there is a current malpractice problem that is likely caused by individuals starting to practice after some years of inactivity.

Under current regulations, individuals who are seeking licensure by endorsement must prove that they have been licensed in good standing in another state and that that state has licensing standards that are substantially equivalent to the Board's standards for licensure. Board staff reports that this means applicants for licensure by endorsement now have to provide proof of education and supervised practice that they may not have maintained after they were initially licensed in their originating state. The Board proposes to remove language that requires substantially equivalent standards and instead require that licensure in an applicant's originating state be of a comparable type to that in Virginia. This proposed change will benefit individuals who are applying for licensure by endorsement because they will no longer have to maintain or recompile all of their original licensure documentation.

Businesses and Entities Affected. The Department of Health Professions (DHP) reports that the Board currently regulates 4,967 licensed clinical social workers and 349 licensed social workers. All of these entities, as well as any individuals who may wish to become licensed in the future, will be affected by these proposed regulations.

Localities Particularly Affected. No locality will be particularly affected by this proposed regulatory action.

Projected Impact on Employment. The new time limitations for licensure in this regulatory action may slightly decrease the number of individuals who choose to work in professional fields that are regulated by the Board. Loosening the requirements for licensure by endorsement may slightly increase the number of individuals who choose to work in professional fields that are regulated by the Board. There is insufficient information to ascertain which effect will be larger.

Effects on the Use and Value of Private Property. To the extent that a professional license can be considered valuable private property that entitles an individual to work at a job that unlicensed individuals may not, placing new limitations on obtaining licensure and on license reinstatement/reactivation will slightly lower the value of licensees private property.

Small Businesses: Costs and Other Effects. DHP does not know how many affected entities would qualify as small businesses but does know that many licensed clinical social workers are small business independent practitioners. The new time limitations for licensure in this regulatory action will likely make it harder for individuals who have not practiced in their chosen field for several years to restart their businesses when they choose to return to work. Conversely, changes to requirements for licensure by endorsement will likely make it easier for licensed clinical social workers from other states to set up small businesses in the Commonwealth.

Small Businesses: Alternative Method that Minimizes Adverse Impact. The Board could eliminate adverse effects for individuals who have passed the national exam but who have not chosen to seek licensure within a five year period, as well as for individuals who are seeking reinstatement or reactivation of licensure, by choosing not to promulgate new time limitations for licensure. Absent some history of disciplinary actions that could likely have been avoided if these restrictions had been in place, or some evidence that the material covered by the national exam changes frequently enough that the knowledge of individuals who passed that exam five years ago is stale, the public and licensees would likely benefit from the Board taking a second look at these proposed restrictions.

Real Estate Development Costs. This regulatory action will likely have no effect on real estate development costs in the Commonwealth.

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 14 (10). 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, § 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 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 requirements for licensure.

Summary:

Regulations governing the practice of social work are amended to (i) require that the national licensing examination be passed within five years prior to application or, if the examination was passed before that time period, that the applicant demonstrate evidence of social work practice at the appropriate level (social worker or clinical social worker) within an exempt setting prior to application; (ii) eliminate certain application requirements for licensure by endorsement applicants and, at the same time, clarify the meaning of "active practice" to demonstrate competency in the field of social work and provide an alternative to the experience requirement; and (iii) address the issue of reactivation and reinstatement for applicants who have either been practicing in another U.S. jurisdiction or exempt setting, or have not been practicing in recent years by requiring active practice in three of the past five years immediately preceding application, or practice under supervision for at least 360 hours in the 12 months preceding licensure in Virginia.

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.

"Active practice" means post-licensure practice at the level of licensure for which an applicant is seeking licensure in Virginia and shall include at least 360 hours of practice in a 12-month period.

"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.

Part II
Requirements for Licensure

18VAC140-20-40. Requirements for licensure by examination as a licensed clinical social worker.

Every applicant for examination for licensure as a licensed clinical social worker shall:

1. Meet the education requirements prescribed in 18VAC140-20-49 and experience requirements prescribed in 18VAC140-20-50.

2. Submit in one package to the board office:

a. A completed notarized application;

b. Documentation, on the appropriate forms, of the successful completion of the supervised experience requirements of 18VAC140-20-50 along with documentation of the supervisor's out-of-state license where applicable. Applicants whose former supervisor is deceased, or whose whereabouts is unknown, shall submit to the board a notarized affidavit from the present chief executive officer of the agency, corporation or partnership in which the applicant was supervised. The affidavit shall specify dates of employment, job responsibilities, supervisor's name and last known address, and the total number of hours spent by the applicant with the supervisor in face-to-face supervision;

c. The application fee prescribed in 18VAC140-20-30;

d. Official transcript or transcripts in the original sealed envelope submitted from the appropriate institutions of higher education directly to the applicant; and

e. Documentation of applicant's out-of-state licensure where applicable.

3. An applicant for licensure by examination shall provide evidence of passage of the examination prescribed in 18VAC140-20-70. If the examination was not passed within five years preceding application for licensure, the applicant may qualify by documentation of providing clinical social work services in an exempt setting for at least 360 hours per year for two of the past five years.

18VAC140-20-45. Requirements for licensure by endorsement.

Every applicant for licensure by endorsement shall submit in one package:

1. A completed application and the application fee prescribed in 18VAC140-20-30.

2. Documentation of social work licensure in good standing obtained by standards substantially equivalent to those outlined in 18VAC140-20-49 and 18VAC140-20-50 for a licensed clinical social worker or 18VAC140-20-60 for a licensed social worker, required for licensure in another jurisdiction as verified by the out-of-state licensing agency on a board-approved form. Licensure in the other jurisdiction shall be of a comparable type as the licensure that the applicant is seeking in Virginia.

3. Verification of a passing score as established by the board on a board-approved national exam at the level for which the applicant is seeking licensure in Virginia.

4. Official transcript or transcripts in the school's original sealed envelope.

5. 4. Verification of active practice in another jurisdiction for 36 out of the past 60 months or evidence of supervised experience requirements substantially equivalent to those outlined in 18VAC140-20-50 and 18VAC140-20-60.

6. 5. Certification that the applicant is not the respondent in any pending or unresolved board action in another jurisdiction or in a malpractice claim.

18VAC140-20-51. Requirements for licensure by examination as a licensed social worker.

A. In order to be approved to sit for the board-approved examination for a licensed social worker, an applicant shall:

1. Meet the education requirements prescribed in 18VAC140-20-60 A.

2. Submit in one package to the board office:

a. A completed notarized application;

b. The application fee prescribed in 18VAC140-20-30; and

c. Official transcript or transcripts in the original sealed envelope submitted from the appropriate institutions of higher education directly to the applicant.

B. In order to be licensed by examination as a licensed social worker, an applicant shall:

1. Meet the education and experience requirements prescribed in 18VAC140-20-60; and

2. Submit, in addition to the application requirements of subsection A, the following:

a. Documentation, on the appropriate forms, of the successful completion of the supervised experience requirements of 18VAC140-20-60 along with documentation of the supervisor's out-of-state license where applicable. An applicant whose former supervisor is deceased, or whose whereabouts is unknown, shall submit to the board a notarized affidavit from the present chief executive officer of the agency, corporation or partnership in which the applicant was supervised. The affidavit shall specify dates of employment, job responsibilities, supervisor's name and last known address, and the total number of hours spent by the applicant with the supervisor in face-to-face supervision;

b. Verification of a passing score on the board-approved national examination; and

c. Documentation of applicant's out-of-state licensure where applicable.

3. An applicant for licensure by examination shall provide evidence of passage of the examination prescribed in 18VAC140-20-70. If the examination was not passed within five years preceding application for licensure, the applicant may qualify by documentation of providing social work services in an exempt setting for at least 360 hours per year for two of the past five years.

18VAC140-20-110. Late renewal; reinstatement; reactivation.

A. A social worker or clinical social worker whose license has expired may renew that license within four years after its expiration date by:

1. Providing evidence of having met all applicable continuing education requirements.

2. Paying the penalty for late renewal and the biennial license fee for each biennium as prescribed in 18VAC140-20-30.

B. A social worker or clinical social worker who fails to renew the license for four years or more and who wishes to resume practice shall apply for reinstatement, pay the reinstatement fee and provide documentation of having completed all applicable continued competency hours equal to the number of years the license has lapsed, not to exceed four years. An applicant for reinstatement shall also provide evidence of competency to practice by documenting:

1. Active practice in another U.S. jurisdiction for at least three of the past five years immediately preceding application;

2. Active practice in an exempt setting for at least three of the past five years immediately preceding application; or

3. Practice as a resident under supervision for at least 360 hours in the 12 months immediately preceding licensure in Virginia.

C. A social worker wishing to reactivate an inactive license shall submit the renewal fee for active licensure minus any fee already paid for inactive licensure renewal, and document completion of continued competency hours equal to the number of years the license has been inactive, not to exceed four years. An applicant for reactivation shall also provide evidence of competency to practice by documenting:

1. Active practice in another U.S. jurisdiction for at least three of the past five years immediately preceding application;

2. Active practice in an exempt setting for at least three of the past five years immediately preceding application; or

3. Practice as a resident under supervision for at least 360 hours in the 12 months immediately preceding licensure in Virginia.