Mobility Among Social Workers — Thoughts From a Regulator
Mobility (or portability) is a focus of many licensees of social work and other mental health regulatory boards. Mobility allows licensees to easily work in other states, which is helpful in a variety of ways. For clients, it can help increase the number of practitioners who can provide much-needed services. For licensees, it creates opportunities to work where they most want to live, and move where others are moving. After attending the spring 2015 Association of Social Work Boards (ASWB) educational conference, as well as talking with colleagues and stakeholders, I am excited about the opportunities mobility presents for social workers and their potential clients. Nonetheless, from the perspective of a licensing administrator, I have been contemplating a number of questions and issues regarding mobility.
Licensing is very specific to each state; this presents one of the major challenges. The laws, rules, and policies in each state have developed after several decades of experience in regulating social work practice. Not all states have provisions in their laws that allow for one form of mobility: endorsement. Endorsement is a process that can facilitate licensing by awarding a license to persons already licensed in one state who generally meet the requirements of the state to which they are relocating. Moving forward on mobility may be simpler for those boards with laws that call for endorsement. Nevertheless, if endorsements have proven to be problematic in the past, it may be challenging to achieve mobility. If no provision is in current law, getting such legislative approval may prove difficult. Nonetheless, the arguments regarding the social and economic benefits of mobility may encourage action.
The distinct, state-based types of licensure could pose the most significant challenge to mobility. States with licensing similar to the ASWB model practice act, which separates bachelor, masters, clinical, and advanced generalist practices, may find it more expedient to participate in mobility. States, such as Ohio, that do not separate macro and clinical licensing may find mobility challenging as it will require possible changes in license types. While not insurmountable, the system of licensing does become important when changes will result in different statuses or access to work. It is easy to think everyone will value reciprocity in the same way, but that is not likely the case. There are multiple interests at play; people become committed to both a title and its scope of practice. Moving to a different licensing structure may necessitate different testing and credentialing. Stakeholders, including licensees, associations, and educators, will have to be involved in crafting these changes to ensure their support.
Similar to license types, each state has its own set of standards that are reflected in laws, rules, and scopes of practice. While there are many similarities, state laws and rules have evolved based on the practice of social work in that state. Thus, even those states that have used the ASWB model laws as the foundation for regulation may be challenged in aligning their laws and rules with those of other states. States may be able to achieve a compact, or initially at least, may be more successful as states work together individually. For example, the Ohio board is in discussions on an agreement with Kentucky regarding a reciprocity process for counselors. This initial agreement is giving the Ohio board an opportunity to explore these issues and confront concerns about compromising what we view as very important requirements.
States currently report discipline to the National Practitioner Data Bank, and often, ASWB for its database. That gives the public and potential employers nationwide the ability to check on a licensee. Additional checks on discipline occur when a licensee wishes to move from one state to another. Each of these offers an important protection, even if fragmented; there is some "gatekeeping". Relinquishing this control requires a system to which all states will report discipline, and employers who rely upon it to ensure persons moving from one state to another are qualified.
Ohio has been able to keep its licensing costs relatively reasonable, a point of pride for the state. As a result, there is concern that costs could increase through mobility, or alternatively, income could decrease as licensees move from state to state, possibly impacting public protection. Such costs could conceivably apply only to those who seek mobility, particularly if a national clearinghouse is involved in licensure. Given the concerns related to licensing fees that have been shared with me, it is difficult to believe there is significant room for additional fee increases. The reality is that many of our licensees are in positions that are modestly compensated.
While mobility is exciting, it also introduces uncertainties. Cooperation can conquer those uncertainties nationally and state by state: being open to changes that protect the public while ensuring a vibrant social work profession.
— Brian Carnahan is executive director of the State of Ohio Counselor, Social Worker, & Marriage and Family Therapist Board.