Agreement reached on licensing social workers in New York State
Proposed legislation would replace the certification of social workers, create a clinical title and support employment in organizational settings

(April 1995)

The month of February marked a historic occasion within the profession. Agreement involving key social work organizations was reached on licensing social workers. The organizations include, in addition to the NYC Chapter, the State Chapter of NASW, the New York State Association of Deans of the Schools of Social Work, and the Clinical Society of New York State. Other social work organizations are reviewing the proposal and are expected to support the measure. It is also expected that the agreement will result in legislation being introduced in both the New York State Assembly and Senate.

Currently, New York State provides certification for social workers. This form of legal regulation of the profession protects the title of "certified social worker", restricting its usage to a specific group of individuals. Licensing does more than certification: it defines through a scope of practice statement in law what social workers do and restricts anyone who is not licensed from engaging in the activities within the scope.

The scope of practice in the agreement, which reflects legal language of legislation, is as follows (Italics added for emphasis for the reader):

"Social work practice is the professional application of social work theory and methods to the prevention, diagnosis and treatment of individual, family, group, organizational and societal dysfunction; mental, emotional, addictive and behavioral disorders; and to the enhancement of human life and person-environment transactions. Social work practice is based on knowledge of: biopsychosocial development and impairment; social justice; human behavior and racial, cultural, gender, social class, linguistic, sexual orientation, and other diversities; mental, emotional, addictive and behavioral disorders; developmental disabilities; the biopsychosocial aspects of disability and physical illness; interpersonal relationships; environmental resources and stressors; the functioning of social systems and the impact of environmental conditions on people. Professional social work services may include, but are not limited to: assessment; differential diagnosis; treatment planning and evaluation; measurement of psychosocial functioning; crisis intervention; outreach; short- and long-term treatment; psychotherapy; client education; case management; mediation; advocacy; discharge, referral, and continuity of care planning; consultation; supervision; research; administration; education; social group work; community organization; and, social policy analysis and development. Social work practice also may encompass other current or developing modalities and techniques that are consistent with this scope."

This language was worked out over 18 months of discussions and reflects concerns about the breadth of the profession and at the same time includes enough specificity to assure that professionals in direct practice can be assured of having the legal support to engage in what they traditionally do. For example, the current statute for the CSW does not mention that social workers do diagnosis, and this omission has resulted at times in social workers being prohibited from performing this function.

Eligibility for the license (LSW) will be comparable to what now exists for CSW's: obtaining a masters degree in social work. The proposal calls for "grandparenting" in everyone who holds a CSW.

In addition to the basic license, there are other important features of the proposal. Foremost is the creation of a second title, called Licensed Independent Clinical Social Worker (LICSW). This title was created, to a significant extent, to address the trend in the field of managed care, with managed care companies becoming primary reimbursors of social work services. These companies, which are increasingly national in scope, and to the extent that they have developed their own standards, have required social workers to hold licenses designating that they are qualified to engage in clinical work. With more than half of all the states issuing clinical licenses, New York State is compelled to create an equal standard lest consumers be prohibited from seeing social workers when they choose to.

The New York City Chapter Board of Directors supported this part of the licensing proposal because of its recognition of this trend, and its magnitude. The Board, primarily through its Licensing Task Force, also added as a requirement for the LICSW title, three years of organizationally-based experience under the supervision of an experienced social worker. This requirement addresses the concern within the profession that many social workers have been going into independent practice without first obtaining experience in such settings. NASW has a long history of requiring experience before social workers engage in autonomous practice, and this proposal will set a standard of three years in law. In addition, and valued within the Chapter, is assuring that social workers are working in settings where social workers are greatly needed, working with the most disadvantaged and dependent and dependent individuals, groups and families in the State.

Some concern was expressed that having a clinical title would create a sense that there is a select group within the profession, set apart from the rest of social work. The Chapter's position on this is that clinical practice as basically equivalent to direct practice at the masters level with individuals, families and groups, and approximately 80% of all social workers are engaged in such practice. In addition, the bill does not have a special scope of practice for the clinical title; clinical work is addressed, along with other social work functions, in the scope under the LSW. This means that social workers in direct practice are qualified to engage in clinical social work at the LSW level. The distinguishing feature for the LICSW is that social workers meet a standard for engaging in independent practice where there is less accountability than in an organizational setting.

Eligibility for the LICSW will also include, in addition to organizational experience and supervision, passing a clinical exam that now exists through the American Association of State Social Work Boards (AASSWB). Social workers with this title will also first have to obtain the LSW. Social workers who currently hold credentials referred to as the "P" and "R" designations, which pertain to group health insurance reimbursement, are proposed to be grandparented to receive the LICSW title. It is anticipated that the LICSW will eventually, if not immediately, replace the "P" and "R" altogether.

Other features in the bill include minimum requirements for continuing education. Currently, the State of New York does not have a policy of such a requirement for the professions. If this section of the bill is ultimately included in licensing social workers, the exact requirements will need to be spelled out in regulation.

The bill also addresses which groups will be exempted from practicing within the social work scope of practice. As required by law, the existing licensed mental health professions, primarily psychiatry and psychology, will be exempt. Both social work interns and BSW's will be permitted to practice under the scope provided that they are supervised by a social worker who has the license. Other exemptions are extended to staff holding social work titles in public agencies, but the exemption will be lifted as each person leaves their job.

Who is exempted and who is not is important. It determines whether licensed social workers must be utilized to carry out social work functions. Common practice is that many organizations employ just about anyone to do social work. In other states some organizations have pursued exemptions from social work licensing for their type of setting. It remains to be seen how this will play out in New York State as the bill is deliberated in the legislature.

One feature of the bill addresses an age old concern: that anyone can claim that they do social work. Having a scope of practice for the LSW will prohibit anyone from making such claims.

When the profession first came together to enact the certification law, which was passed in 1965, it was felt that gaining consensus on a scope of practice for the profession was too difficult. With so many views on what social workers do, agreement was reached to not define practice. The agreement now reached is what each organization would consider, from their own point of view, a compromise. What is completely clear, however, is that there is widespread agreement that the profession needs to set aside its differences and get licensing passed as soon as possible.

Article submitted by Robert Schachter

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