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 currently scheduled.

Public Comment Deadline: March 3, 2021.

Effective Date: March 18, 2021.

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, TDD ()-, 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: While the regulatory change is primarily intended to clarify existing requirements, an amendment to the definition of face-to-face will allow persons obtaining supervised experience to use technology that is real-time and interactive in providing their social work services to clients. Additionally, an amendment will clarify that persons who have completed their supervised hours but have not yet passed the licensing examination must remain under supervision until licensed if they continue to provide clinical services. The purpose of these regulatory changes is to protect public health and safety in the clinical practice of social work while persons are registered for supervised experience.

Rationale for Using Fast-Track Rulemaking Process: There is no mandate for this regulatory change; the impetus comes from recommendations of the Regulation Committee to eliminate burdensome requirements, to clarify current provisions, and to eliminate any ambiguity in the regulations. The regulatory action is less burdensome and does not add any new requirement, so it is not expected to be controversial.

Substance: The board proposes amendments to clarify that the definition of face-to-face may include the use of technology in the contact between a supervisee and a client and to add a definition for a supervisory contract. Other amendments (i) clarify that the educational requirements must be completed before persons begin their post-graduate supervised experience; (ii) eliminate the requirement that a supervisee notify the board whenever there is a change of location or supervised experiences; and (ii) reiterate that a person must remain under supervision until issued a license.

Issues: The primary advantage to the public is the possibility of greater access to licensed clinical social workers by reducing some of the burden for supervisees. There may be greater access for supervisees who will be able to provide face-to-face services to clients through the use of interactive technology. There are no disadvantages to the public. 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 to eliminate the requirement that a supervisee notify the Board whenever there is a change of location or supervised experiences, and clarify that the definition of "face-to-face" may include the use of technology in the contact between a supervisor and a supervisee as well as between a supervisee and a client.

Background. This regulation contains rules for the provision of clinical services in social work under supervision. The impetus for the proposed changes comes from recommendations of the Regulation Committee to eliminate burdensome requirements, to clarify current provisions, and to eliminate any ambiguity in the regulations.

Estimated Benefits and Costs. One of the proposed amendments would eliminate the requirement that a supervisee notify the Board whenever there is a change of location or supervised experiences. Currently, a supervisee must notify the Board whenever there is an addition or change of supervised practice, supervisor, clinical social work services, or location. Each notification of such changes must be accompanied by a $25 fee. The amendment would eliminate three of the four required notifications: a change or addition of supervised practice, services, or location. The required notification for the change in supervisor would remain the same. According to the Department of Health Professions (DHP), it was determined that the only change that is pertinent is a change in supervisor because that is the person who is accountable to the Board for the services of a supervisee to a client.

DHP reports that 611 notifications were received in 2019 and estimates that half of these notifications were for non-supervisor related changes, which would no longer be required under the proposed language. Thus, this change would eliminate approximately 305 notifications, provide $7,625 in fee avoidances for the supervisees as well as the time and effort to file these notifications, and reduce the Board's revenues and administrative workload by an equivalent amount.

The Board also proposes to (a) clarify that the definition of "face-to-face" may include the use of interactive technology in the contact between a supervisee and a client and (b) add a definition for a "supervisory contract." These changes would essentially clarify that the use of technology is allowed in the contact between a supervisor and a supervisee as well as between a supervisee and a client. DHP points out that these clarifications are in keeping with current practice: the regulation does not prohibit the use of interactive technology in the delivery of services or supervision, and the use of technology is already believed to be a common practice among the regulated community. However, Board staff receive questions about whether such a practice is allowed, and thus this clarification would be beneficial by addressing such questions and eliminating the need to contact Board staff. A benefit would also be conferred to the extent these changes cause practitioners who are not aware of this option to elect to provide services through interactive means.

Other proposed amendments in the action would clarify that the educational requirements must be completed before a person begins their post-graduate supervised experience and reiterate that a person must remain under supervision until issued a license. These changes are not expected to create any significant economic effects other than clarifying existing requirements.

Businesses and Other Entities Affected. This regulation primarily affects persons who are currently approved to provide supervision for clinical social work practice and those persons who want to begin their supervised experience. There are currently 2,697 registered clinical supervisees and the Board received 730 initial applications to begin supervised experience in 2019.¹ No supervisees appear to be adversely² or disproportionately affected.

Small Businesses³ Affected. The proposed amendments do not appear to adversely affect small businesses.

Localities⁴ Affected.⁵ The proposed amendments do not introduce costs for local governments. Accordingly, no additional funds would be required

Projected Impact on Employment. The proposed amendments do not appear to affect total employment.

Effects on the Use and Value of Private Property. One of the proposed changes would eliminate approximately 305 notifications, provide $7,625 in fee avoidances for the supervisees as well as the time and effort to file these notifications. Consequently, to the extent a supervisee has an ownership interest in a business they may be working for, the asset value of such a business may moderately increase.

The proposed amendments do not affect real estate development costs.

____________________________________________________

¹ Data source: DHP

² 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.

³ 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."

⁴ "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.

⁵ § 2.2-4007.04 defines "particularly affected" as bearing disproportionate material impact.

Agency's Response to the 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" may include the use of technology in the contact between a supervisee and a client and add a definition for "supervisory contract"; (ii) clarify that the educational requirements must be completed before persons begin their post-graduate supervised experience; (iii) eliminate the requirement that a supervisee notify the board whenever there is a change of location or supervised experiences; and (iv) clarify the requirement that a person must remain under supervision until issued a license.

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:

Baccalaureate social worker

Board

Casework

Casework management and supportive services

Clinical social worker

Master's 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 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 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 in the delivery of clinical social work services by a supervisee and may include the use of technology that provides real-time, visual interactive contact among the individuals involved.

"LBSW" means a licensed baccalaureate social worker.

"LMSW" means a licensed master's social worker.

"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.

“Supervisory contract” means an agreement that outlines the expectations and responsibilities of the supervisor and supervisee in accordance with regulations of the board.

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

a. Register on a form provided by the board and;

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

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

b. 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 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 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.