Report Title:

Clinical Social Workers; Licensing

 

Description:

Requires licensing of independent clinical social workers; protects practice of independent clinical social work; protects title of licensed clinical social workers and clinical social workers; creates board; establishes license application requirements; requires continuing education before renewal of license; exempts employed clinical social worker employed by federal, state, or county government. (HB917 HD1)

 

HOUSE OF REPRESENTATIVES

H.B. NO.

917

TWENTY-FIRST LEGISLATURE, 2001

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO CLINICAL SOCIAL WORKERS.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The potential for harm to the public health, safety, and welfare is great when those persons who represent themselves to the public as clinical social workers are not adequately qualified in education and experience. Private citizens seeking mental health services are often in great emotional pain, can be extremely vulnerable, and cannot readily discern the qualifications of those who offer psychotherapeutic services. Without State regulation of the profession to ensure that the public is protected, citizens are at a distinct disadvantage and unable to know who is qualified to treat mental, emotional, and behavioral disorders. Hawaii is one of only a few states in the nation that does not have a clinical level of social work licensure in place to protect the public, or address the issue of independent clinical social work practice. In contrast to other states, Hawaii has no practice act, no supervision or experience requirements for licensure, no continuing education requirements, no standards for confidentiality, no state board to oversee the licensure law, and no test to qualify practitioners at either the advanced or clinical levels. In fact, Hawaii is one of only a few states whose social work licensing law identifies only one level of licensure, thus allowing the new graduate master of social work immediate access to licensure upon completion of the second lowest possible national licensing examination.

The purpose of this Act is to protect the health, safety, and welfare of the people of Hawaii from those social work practitioners who are unauthorized, unqualified, and otherwise inadequately prepared to practice in the area of clinical social work. The Act requires licensure for independent clinical social workers and sets forth minimum standards of qualification, levels of education, and experience for those persons who seek to represent themselves to the public as independent clinical social workers.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"CHAPTER

INDEPENDENT CLINICAL SOCIAL WORK

-1 Definitions. As used in this chapter, unless the context clearly requires a different meaning:

"Board" means the board of independent clinical social work.

"Board approved clinical supervisor" means a licensed independent clinical social worker and other licensed mental health professionals who have met the qualifications for state licensure at the highest level of their profession, and who are approved by the board.

"Clinical social work" includes assessment, description, differential diagnosis, evaluation, interpretation, treatment planning, behavior modification, and prevention. The purpose of such services is to treat, enhance, promote, and maintain behavioral, psychological, and social functioning. Various interventions may include but are not limited to: counseling, short- and long-term psychotherapy, psychoanalysis, behavior modification, play therapy, sand therapy, hypnosis, brief therapy, eye movement desensitization and reprocessing, biofeedback, teaching, grief therapy, coaching, consulting, addictions treatment, certified body oriented processes, crisis intervention, forensic work, critical incident stress debriefing, sex therapy, and clinical supervision. The licensed independent clinical social worker may diagnose conditions found in the most current diagnostic and statistical manual and, when appropriate, refer for additional medical consultation.

"Clinical social work modalities and settings" means:

(1) Modalities that may include: individual, couple, marital, family, and group psychotherapy; and

(2) Settings that may include: inpatient, outpatient, home-visits, workplace, school, and private practice offices.

"Department" means the department of commerce and consumer affairs.

"Director" means the director of commerce and consumer affairs.

"Independent practice of clinical social work" means the application of clinical social work knowledge and skills by a licensed clinical social worker who regulates and is responsible for his or her own practice or treatment procedures.

"Licensed independent clinical social worker" means:

(1) A professional social worker engaged in the specialized treatment of mental health disorders using scientific and applied knowledge and theories in the practice of clinical social work;

(2) A person who has met the licensing requirements set forth in this chapter, which include and exceed those required of a licensed social worker; and

(3) Whose scope of clinical practice is differentiated from a licensed social worker in the following ways:

(A) The ability to practice autonomously in any setting, including an independent practice of clinical social work;

(B) The ability to provide independent clinical assessment, diagnoses, and treatment planning in all settings, including private practice; and

(C) The ability to provide independent psychotherapy services in all settings, including private practice.

"Licensed social worker" means a person who has met the qualifications for, and is currently licensed and entitled to title protection in order to practice at the intermediate or generalist level of practice as set forth in chapter 467E.

"Practice at the licensed independent clinical social worker level" includes theories that are based on the person-in-environment perspective, and other bio-psycho-social developmental theories, human behavior, psychopathology, various causes and effects of physical illness and disability; unconscious motivation, interpersonal relationships, family dynamics, environmental conditions, social systems, and cultural diversity.

"Practice of social work at the licensed social worker level" means applying the formal knowledge base, theoretical concepts, specific functional skills, and essential social work values that are used to effect change in human behavior, emotional responses, and social conditions, and to help individuals, couples, families, groups, and community organizations enhance or restore their capacities for personal and social functioning and preventing and controlling social problems. Social work practice at this level is the professional application of social work values, principles, and techniques in the following areas:

(1) Information, resource identification and development, and referral services;

(2) Preparation and evaluation of psycho-social assessments and development of social work service plans;

(3) Case management, coordination, and monitoring of social work service plans in the areas of personal, social, or economic resources, conditions, or problems;

(4) Administration, development, implementation, and evaluation of social work programs and policies;

(5) Treatment and prevention of psycho-social dysfunction, disability, or impairment, or both, including emotional and mental disorders;

(6) Social work consultation; and

(7) Research through the formal organization and methodology of data collection and the analysis and evaluation of social work practice data.

"Psychotherapy" means the use of treatment methods within a specialized, formal interaction between a clinician and an individual, family, or group in which a therapeutic relationship is established to understand unconscious processes, intrapersonal, interpersonal, and psycho-social dynamics, and to treat mental and emotional disorders and conditions.

-2 Privileged communication. (a) Individuals licensed under this chapter shall have the same privileged communication as granted to physicians, psychiatrists, and psychologists under the law.

(b) No licensed independent clinical social worker may disclose any information acquired from persons consulting in the professional capacity that was necessary to enable one to render services to those persons, except:

(1) With the written consent of the client, or in the case of death or disability, with the written consent of the client's personal representative;

(2) When the individual is a minor and the information acquired by the licensed independent clinical social worker indicates that the child was the victim or subject of a crime. The licensed independent clinical social worker may be required to testify fully in relation thereto upon any examination, trial, or other proceeding in which the commission of the crime is a subject of inquiry;

(3) When a client discloses the intention to commit a crime or harmful act, and the licensed independent clinical social worker believes there is a need to protect any and all persons from the clear, imminent risk of serious mental or physical harm or injury by the client (or someone else) to another person, or to forestall a serious threat to the public safety; and

(4) When the client or clients bring civil or criminal charges against the social worker.

(c) Nothing in the section shall be construed to prohibit a licensed independent clinical social worker from voluntarily testifying in court hearings concerning matters of adoption, child abuse, child neglect, or other matters pertaining to children, elderly, and physically or mentally impaired adults, except as prohibited under the applicable state and federal laws.

-3 Board of independent clinical social work; appointments. There shall be a board of independent clinical social work which shall consist of seven members, five of whom shall be licensed to practice independent clinical social work for at least five years preceding appointment and one of whom shall be designated by the appointing authority as chairperson. Two members shall be public members. A public member shall not be a social worker, an applicant for licensure under this chapter, a student of social work, or former applicant for licensure under chapter 467E. All members shall be appointed in accordance with section 26-34. The board shall be attached to the department for administrative purposes.

-4 Powers and duties of the board. In addition to any other powers and duties authorized by law the board shall:

(1) Examine the qualifications of applicants for licensure under this chapter to determine their eligibility for licensure as a licensed independent clinical social worker, and keep licensing records on all applicants for licensure;

(2) Administer, coordinate, and enforce this chapter and rules adopted under chapter 91 pursuant thereto. Administer and grade examination for applicants as may be required for the purposes of this chapter. The board shall determine the score of the clinical examination that shall be deemed a passing score. The examination shall be scheduled at least once annually;

(3) Grant authority to a qualified person the use of the title "licensed independent clinical social worker" in Hawaii pursuant to this chapter and the rules adopted thereto;

(4) Discipline a licensed independent clinical social worker for any cause described by this chapter and refuse to license a person for failure to meet licensing requirements or for any cause that would be grounds for disciplining a licensed independent clinical social worker; and

(5) Report disciplinary actions to appropriate governmental and professional organizations.

-5 Fees; disposition. (a) Application, examination, reexamination, initial license, renewal, late renewal penalty fees, and other reasonable and necessary fees required by this chapter, none of which are refundable, shall be as provided in rules adopted by the director pursuant to chapter 91.

(b) Applicants for examination shall be required to pay to the board or the designated testing service, fees covering the cost of initial screening to determine eligibility, and for providing the clinical examination.

-6 License required. (a) Except as otherwise provided in this chapter, it is unlawful to represent one's self as a "licensed independent clinical social worker," "independent clinical social worker", "licensed clinical social worker", or "clinical social worker" or use the acronyms "L.I.C.S.W.", "I.C.S.W.", "L.C.S.W.", or "C.S.W." or engage in the practice of clinical social work without having first obtained a license as provided in this chapter.

(b) Licensed social workers may not engage in independent practice of clinical social work without a license required by this chapter.

(c) Licensed social workers may not provide psychotherapy without a license as provided in this chapter.

-7 Exemptions. This chapter shall not apply to:

(1) Any person doing work within the scope of practice or duties of the person's profession that overlaps with the practice of clinical social work; provided the person does not identify the person's self as a clinical social worker, licensed clinical social worker, independent clinical social worker, or licensed independent clinical social worker;

(2) Any person employed by a federal, state, or county government agency in a clinical social worker position but only at those times when that person is carrying out the functions, duties, and responsibilities of that government employment; and

(3) Any person who is a student enrolled in a doctoral or master's degree program accredited by the council on social work education who is performing work that is incidental to that person's course of study; provided the person is designated by a title which clearly indicates the person's status as a student.

-8 Licensing requirements. The board shall consider the following as minimum evidence that an applicant is qualified to be a licensed independent clinical social worker:

(1) The applicant is professionally competent, and has demonstrated knowledge in the practice of clinical social work;

(2) The applicant holds a master's degree in social work degree from a college or university program accredited by the Council on Social Work Education, or deemed to be equivalent to an accredited program, or a doctoral degree in social work as accepted by the regional accreditation of schools;

(3) The applicant demonstrates that the applicant has completed a minimum of three thousand two hundred hours of post-master's professional clinical social work experience in direct clinical related client contact within the scope of the definition of clinical social work. The experience shall have been gained in not less than two or more than six years, and shall have been gained within the six years immediately preceding the date on which application for licensure was filed;

(4) The applicant shall have participated in not less than one hundred hours of direct supervision during the period stated in paragraph (3). A minimum of fifty of these one hundred hours must be under individual supervision provided by someone who has had at least five years of clinical social work practice experience and who is a licensed independent clinical social worker. The remaining supervisory hours may have been obtained during group supervisory sessions (a group consisting of not more than six people), or may have been obtained under supervision of other mental health practitioners licensed to practice psychotherapy in this State at the highest level of licensure of their profession, and as approved by the board;

(5) All applicants for licensure of the licensed independent clinical social worker shall pass the American Association of Social Work Board's written licensing examination at the clinical level;

(6) Applicants who have obtained the board certified diplomate administered by the American Board of Examiners for Clinical Social Work, or the diplomate in clinical social work administered by the National Association of Social Workers, or the qualified clinical social worker administered by the National Association of Social Workers, within two years of the effective date of this Act shall be deemed to have satisfied the licensure requirements of this chapter and eligible for application for licensure; and

(7) Those who currently hold active licensed independent clinical social worker or licensed clinical social worker licenses from those states whose requirements are substantially equivalent to the Hawaii licensed independent clinical social worker, as approved by the board and who have taken and passed the clinical level written national examination administered by the American Association of State Social Work Boards or an equivalent examination as approved by the board, shall be deemed to have satisfied the licensure requirements of this chapter and shall be eligible for application for licensure.

-9 Application for examination. (a) Any person eligible for licensure who wishes to be licensed as a licensed independent clinical social worker shall apply for examination to the board at least ninety days prior to the date of the next examination and in the manner prescribed by the board.

(b) All applications to the board shall be accompanied by a nonrefundable application fee established pursuant to rule.

(c) A person who fails an examination may reapply for a subsequent examination and shall submit another nonrefundable application fee.

-10 Examination for license. (a) An applicant for licensure shall take and pass the clinical level written national examination administered by the American Association of State Social Work Boards pursuant to rules adopted by the board.

(b) An applicant who has achieved the status of diplomate in clinical social work by the National Association of Social Workers, or board certified diplomate by the American Board of Examiners for Clinical Social Work, or qualified clinical social worker by the National Association of Social Workers, within two years of the effective date of this Act shall be deemed to have satisfied the requirements for this section. After that date, an examination shall be required.

(c) An applicant who already holds a clinical social work license from another state with requirements that are substantially equivalent to the licensed independent clinical social worker license as approved by the board, and who has taken and passed the clinical level written national examination, administered by the American Association of State Social Work Boards, or an equivalent examination as approved by the board, shall be considered to have satisfied the requirements for this section.

-11 Issuance of license. The board shall issue a license to any person who meets all licensure requirements and pays the appropriate fees. Once a person has been designated a licensed independent clinical social worker in the State of Hawaii, and maintains this designation, the licensee shall no longer be required to maintain the licensed social worker license as provided in chapter 467E.

-12 Renewals. Every license issued under this chapter shall be renewed triennially on or before June 30, with the renewal deadline occurring every three years thereafter. Failure to renew a license shall result in a forfeiture of the license. Licenses that have been so forfeited may be restored by payment of renewal and penalty fees within one year of that person's license expiration date. Failure to restore a forfeited license within one year of the date of expiration shall result in the automatic termination of that license. To be reinstated after the applicant must begin the certification process as if the applicant had never been licensed in the State of Hawaii, and satisfy all licensing requirements.

-13 Prerequisites for license renewal. Prior to the license renewal of a clinical social worker, the licensee shall provide the board with proof of having attended thirty-six hours of continuing education during the three-year period preceding the application for renewal. Failure to satisfy the continuing education requirement by the license expiration date shall result in the license being automatically terminated. To reactivate a license the licensee shall reapply for licensure anew.

-14 Revocation, suspension, denial, or condition of licenses; fines. (a) In addition to any other acts or conditions provided by law, the board may refuse to renew, reinstate, or restore, or may deny, revoke, or suspend, or make conditions on any license, or fine any licensee for any one or more of the following acts or conditions on the part of the applicant or licensee:

(1) Failure to meet or maintain the conditions and requirements necessary to qualify for the granting of a licensed independent clinical social worker license;

(2) Having been found to be addicted to, dependent on, or a habitual user of a narcotic, barbiturate, amphetamine, hallucinogen, opiate, or cocaine, or other illegal drugs or derivative drugs of a similar nature;

(3) Practicing the profession of clinical social work while impaired by alcohol, drugs, or mental instability;

(4) Procuring a licensed independent clinical social work license through fraud, misrepresentation, or deceit;

(5) Aiding or abetting an unlicensed person to directly or indirectly use the title "licensed clinical social worker", or "licensed independent clinical social worker", "clinical social worker" or "independent clinical social worker";

(6) Engaging in professional misconduct, incompetence, gross negligence, or manifest incapacity in the practice of clinical social work as defined by the Clinical Social Work Federation Code of Ethics;

(7) Having been the subject of revocation, suspension, or other disciplinary action by another state or federal agency against a licensee or applicant for any reason provided by this section;

(8) Having been convicted of a criminal offense, including pleading nolo contendere, for a crime directly related to the qualifications, functions, or duties of the clinical social work profession;

(9) Failing to report in writing to the board any disciplinary decision issued against the licensee or the applicant in another jurisdiction within sixty days of the disciplinary decision;

(10) Knowingly employing, utilizing, or attempting to employ or utilize, or aiding, or abetting at any time any unlicensed person to engage in the practice of clinical social work;

(11) Violating this chapter or the Clinical Social Work Federation Standards of Practice for Clinical Social Work or its rules;

(12) Committing any dishonest, corrupt, or fraudulent act or any act of sexual abuse or sexual relations with a client, or sexual misconduct which is substantially related to the qualification, function, or duties of a licensed independent clinical social worker;

(13) Harassing, intimidating, or abusing, sexually or otherwise, a client or patient;

(14) Committing any unethical practice of clinical social work as defined by the board in accordance with its own rules; and

(15) Functioning outside the licensee's professional competence established by education, training, supervision, and experience.

(b) Any licensee who violates this section may be fined up to a maximum of $1,000 per violation.

-15 Prohibited acts; penalties. (a) No person shall:

(1) Use in connection with the person's name, any designation tending to imply that the person is a licensed independent clinical social worker, unless the person is duly licensed and authorized under this chapter;

(2) Represent oneself as a licensed independent clinical social worker during the time the person's license was forfeited, terminated, suspended, or revoked; or

(3) Advertise or make a representation, either publicly or privately, as being a clinical social worker, licensed clinical social worker, independent clinical social worker, or licensed independent clinical social worker, or as being able to perform psychotherapy and professional services described in the definitions and practice of licensed independent clinical social worker, without having a valid unrevoked license, except as otherwise provided in this chapter.

(b) Any person who violates this section shall be subject to a fine up to but not more than $1,000, and each day's violation shall be deemed a separate offense.

-16 Consumer right of action. Any person who suffers damage as a result of a violation of this chapter shall be entitled to injunctive relief to restrain further violations and may sue to recover damages in any circuit court of the State. In any action brought under this chapter, the prevailing party shall be entitled to the recovery of all legal costs, including reasonable attorneys' fees."

SECTION 3. This Act shall take effect on July 1, 2050.