Licensing Update, May 2002

Issues in Crafting a Bill That Will Pass, Strengthen the Profession, and Enhance Consumer Protection.

(May 2002)

As Currents was going to press in the beginning of May, the New York State legislature was entering what would likely be the final six weeks of a six month session. If licensing is to pass into law this session, resulting in enhanced protection for consumers of social work services, it will happen in the time remaining. Most likely, if it moves toward passage, it will be within the last days before the State legislators return home.

In the months since November, the New York City Chapter has worked with the New York State Chapter of NASW to refine the bill that passed the Higher Education Committees in both the Senate and Assembly last year. This work focused on creating the optimal balance between what master levels social workers do and what is restricted within a scope of practice for licensed clinical social workers.

For the purposes of getting licensing written in law, clinical practice is referred in narrow terms relating to the conducting of a differential diagnosis and the activities aimed toward the amelioration of the diagnosed condition.

A key reason for defining clinical social work narrowly, and discussed in past issues of the newsletter, is to avoid stringent requirements that would result in social work service providers being unable to employ staff that could provide necessary services. For example, many, if not most, social workers conduct assessments and provide counseling. To restrict such functions to licensed clinical social workers would lead to serious work force shortages in numerous agencies. These concerns have been taken into consideration in the drafting.

Another issue, of especial importance to private practitioners, has been whether licensed clinical social workers would need to refer clients who are seriously mentally for an evaluation with a psychiatrist or a physician. The New York State Medical Society has lobbied for such a requirement, and they carry a great deal of weight in the legislature. While social workers in mental health agencies already work with psychiatrists, and those in private practice typically refer when there is serious mental illness, this requirement raises concerns.

Many social workers point out that some of the diagnoses defined by the Medical Society as serious mental illness, namely obsessive-compulsive disorder, panic disorder, and attention deficit hyperactivity disorder, are not necessarily serious mental illnesses and that these conditions fall along a continuum. In addition, some clients prefer not to see psychiatrists for their problems. There is also concern that social workers' autonomy will be undermined.

NASW is looking closely at these issues to determine whether or not further changes can be made in the licensing bill and whether any version that the legislature will consider passing is one that the social work profession and the larger service providing community can live with.

NASW is also concerned that some other groups, including mental health counselors and marriage and family therapists, will obtain licensure this year. This prospect has increased the importance of passage of licensing for the social work profession. That this is an election year at the State level, including the election for Governor, is believed to make this current legislative session ripe for getting bills passed.

According to the Chapter's Executive Director, Robert Schachter, "NASW has done a tremendous amount to position itself within the legislature to get a bill passed, and this has been helped by the collaborative efforts of the New York City and New York State Chapters in alliance with 1199/SEIU." He also points out that the bill's prime sponsors, Gary Pretlow in the Assembly, and Tom Libous in the Senate, have assumed tremendous leadership on behalf of the profession.

Dr. Schachter is also cautious: "it is too easy to underestimate the difficulty of moving a proposed licensing bill to passage. It is easy to underestimate the competing forces involved within the legislature. It is easy to underestimate the stakes involved, no matter which way things turn out. It is also easy to underestimate how long it can take to have another opportunutity for passage. The last time the profession was this close was 1974"

He also said that we should remember why the profession has been pursing licensing for the past 10 years: "it will enhance consumer protection, define in law what social work is and who can do it, it will set standards consistent with the rest of the country, it will help enhance the public's understanding of the profession, and it will require government and funders to be clear about who providers social work services.