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

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

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: July 24, 2019.

Effective Date: August 8, 2019.

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 purpose of the regulatory change is greater access to supervisors for persons seeking licensure by making the qualification for supervisors less burdensome, which will facilitate the publication of a listing of persons who have been approved as supervisors. The reduction in required hours of continuing education and the elimination of continuing education in supervision every five years is not expected to decrease the quality of supervision. The additional hours of ethics currently proposed for all licensees in a separate regulatory action (from two to six hours every two years) will ensure that those providing supervision are adequately educated in issues relating to ethical practice and able to train supervisees in such practice to protect public health, safety, and welfare.

Rationale for Using Fast-Track Rulemaking Process: The impetus for this action was a question about the necessity of continuing education hours in supervision every five years, as some board members felt the subject matter was repetitive and not necessary. Additionally, the action will facilitate board publication of a list of approved supervisors, which is something applicants seeking supervision have been requesting.

Substance: In 18VAC140-10, the definition of "face-to-face" is amended to include interactions between a client and a supervisee in the context of the requirement in 18VAC140-50 that a supervised experience must include "a minimum of 1,380 hours of supervised experience in face-to-face client contact in the delivery of clinical social work services." By amending the definition to be inclusive of client contact, the board has clarified that the requirement may be met by the physical presence of the individuals or by the use of technology that provides real-time, visual contact among the individuals involved.

In 18VAC140-50 B, the requirements for supervisors are amended to reduce the hours of continuing education required to qualify for board approval from 14 hours to 12 hours and to eliminate the requirement that those hours must be within the five years immediately preceding registration for supervision.

Issues: The primary advantage to the public is the possibility of greater access to licensed clinical social workers by reducing the burden for becoming an approved supervisor to oversee the required clinical experience. There are no disadvantages to the public; supervisors (who are licensees) will have to have at least six hours of continuing education every two years in ethics and standards of practice affecting their profession. There are no advantages and disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Social Work (Board) proposes amendments to: 1) clarify that the definition of "face-to-face" includes the contact a supervisee and a client must have, 2) reduce the number of hours of continuing education (CE) required to become an approved supervisor, 3) and eliminate the requirement that those hours must be repeated every five years to remain an approved supervisor.

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

Estimated Economic Impact. Among the requirements to become a licensed clinical social worker, applicants must complete 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. Supervisees must 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.

The Board proposes to amend the definition "face-to-face" to clarify that the requirement may be met by the physical presence of the individuals or by the use of technology that provides real-time, visual contact among the individuals involved. To the extent that some supervisees did not know that the use of technology that provides real-time, visual contact would count toward this requirement, the clarification may reduce their burden in fulfilling the face-to-face client contact requirement.

"Supervision" is defined in the regulation as "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." The current regulation requires that the supervisor has received professional training in supervision, consisting of a three credit-hour graduate course in supervision or at least 14 contact hours of CE offered by an approved provider. These hours can be part of the 30 contact hours of CE required for license renewal every two years.

The Board proposes that the required hours of CE that are dedicated to supervision training be reduced from 14 to 12. The Board believes that 12 hours are sufficient for competence, and are easier to obtain in a two-day conference. This would not reduce the total amount of CE required for license renewal, but would enable licensees to spend two hours of training in coursework that they may find more useful and potentially less costly. Thus, this proposed amendment would likely produce a net benefit.

Additionally, the current regulation specifies that the graduate course or hours of continuing education in supervision be obtained by a supervisor within five years immediately preceding registration of supervision. Removal of this restriction would also likely enable supervisors to spend their CE time more productively without significantly affecting their competence as supervisors.

Businesses and Entities Affected. The proposed amendments affect the 2,039 registered clinical social worker supervisees and their supervisors.

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

Projected Impact on Employment. The proposed amendments are unlikely to significantly affect total employment.

Effects on the Use and Value of Private Property. The proposed amendments are unlikely to significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendments would not affect real estate development costs.

Small Businesses:

Definition. Pursuant 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."

Costs and Other Effects. The proposed amendments may moderately reduce costs for small firms that employee clinical social workers.

Alternative Method that Minimizes Adverse Impact. The proposed amendments do not adversely affect small businesses.

Adverse Impacts: 

Businesses. The proposed amendments do not adversely affect businesses.

Localities. The proposed amendments do not adversely affect localities.

Other Entities. The proposed amendments do not adversely affect other entities.

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¹Adverse impact is indicated if there is any increase in net cost for any entity, even if the benefits exceed the costs for all entities combined.

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

Summary:

The amendments (i) clarify that the definition of "face-to-face" includes the contact a supervisee and a client must have, (ii) reduce the number of hours of continuing education required to become an approved supervisor, and (iii) eliminate the requirement that those hours must be repeated every five years to remain an approved supervisor.

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.

"Ancillary services" means activities such as case management, recordkeeping, referral, and coordination of services.

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

"Clinical social work services" include means 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 psychosocial interventions, 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 means practice that 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 or the physical presence of the supervisee and a client or the use of technology that provides real-time, visual contact among the individuals involved.

"Nonexempt practice" is that which means practice that 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. 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.

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 supervised practice, supervisor, clinical social work services, or location:

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 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 12 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 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 the supervisors 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 supervisee 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 supervisee. It is the applicant's supervisee'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 supervisee 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 supervisee 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.