Professional Licensure and Disciplinary Issues

1. Professional Licensure and Disciplinary Issues Presented by Thomas McGee, Director of the Behavioral Health and Human Services Licensing Board

2. What is IPLA? • Mission/Vision: To protect Hoosiers & provide quality customer service through professional licensing regulation. • Ensure a person is competent to practice a profession. • Prove skill set; not dangerous. • Prohibit persons who are not competent from practicing. • unlicensed practice; dangerous practice. • Educate and support public and practitioners. • Umbrella Agency • 35 boards, commissions, and committees (e.g. Medical & Real Estate). • 70 licensed professions (e.g. pharmacist). • 206 permit types (e.g. pharmacy technician). • 466,000 active licensees. • $18 million dollars generated annually from initial applications, renewal applications, fines and other fees.

3. Indiana Board of Accountancy • Board of Registration for Architects & Landscape Architects • Indiana Auctioneer Commission • State Board of Cosmetology and Barber Examiners • State Board of Funeral & Cemetery Service • Home Inspector Licensing Board • Manufactured Home Installers Licensing Board • State Board of Registration for Professional Engineers • State Board of Registration for Land Surveyors • Indiana Plumbing Commission • Private Investigator & Security Guard Licensing Board • Real Estate Appraiser Licensure & Certification Board • Indiana Real Estate Commission • State Board of Massage Therapy • Acupuncture Committee • Indiana Athletic Trainers Board • Behavioral Health & Human Services Licensing Board • Indiana Board of Chiropractic Examiners • Indiana State Board of Dentistry • Indiana Dietitians Certification Board • Genetic Counselors Committee • Indiana State Board of Health Facility Administrators • Committee of Indiana Hearing Aid Dealer Examiners • Medical Licensing Board of Indiana • Indiana State Board of Nursing • Occupational Therapy Committee • Indiana Optometry Board • Indiana State Board of Pharmacy • Physical Therapy Committee • Physician Assistant Committee • Board of Podiatric Medicine • Indiana State Psychology Board • Respiratory Care Committee • Speech Language Pathology Audiology Board • Indiana Board of Veterinary Medical Examiners

6. IPLA Organizational Structure • Executive Director – Frances Kelly • Deputy Director – Lisa Bentley • Chief Legal Counsel – Marty Allain • Operations Manger – Maureen Bennett • IT Director – Herb Price • 10 Board Directors • 10 Assistant Board Directors

7. IPLA Organizational Structure • IPLA is divided up into 10 groups • Each group is responsible for the day to day operation of multiple boards and committees • Each group has one Board Director and One Assistant Board Director • Various levels of staffing depending on the number of licensees and the overall volume of disciplinary actions handled by the group

8. Where Does the Behavioral Health and Human Services Licensing Board Fit In? 1 of the 35 Boards administered by IPLA Responsible for the licensure, regulation, and discipline of masters-level Behavioral Health and Human Services professionals 8 licensure types 11,000 active licensees Located in Group 5 of IPLA

9. Boards located in Group 5 • Behavioral Health and Human Services Licensing Board • Speech-Language Pathology and Audiology Board • Indiana Athletic Trainers Board • Board of Podiatric Medicine • Committee of Hearing Aid Dealer Examiners

10. Group 5 Staff • Board Director – Thomas McGee • Assistant Board Director – Ronnie Saunders III • Two Case Managers • Danielle Winstead – A through L • Crystal Smith – M through Z • 4 staff members for 20,000 licensees

11. What is the Purpose of the Behavioral Health and Human Services Licensing Board? To ensure that the public will have access to competent, safe, and ethical practitioners in the profession. Allows master-level professionals to become legally recognized as responsible professionals, capable of practicing within professional standards that carry the force of the law.

12. Where Do Boards Come From? The Behavioral Health and Human Services Licensing Board was established by IC 25-23.6 in 1990 by the legislature to serve as a Regulatory Board. Members are appointed by the Governor.

13. Who is on the Behavioral Health and Human Services Licensing Board? 11 Members 2 Clinical Social Workers 2 Marriage and Family Therapists 2 Mental Health Counselors 2 Clinical Addiction Counselors 1 Licensed Physician w/ training in psychiatric medicine 2 Consumer Members

14. Who are the current members? Kimble Richardson, L.M.H.C., L.C.S.W., L.M.F.T. , L.C.A.C. George Brenner, L.C.S.W., L.M.F.T., L.C.A.C. Geneva Osawe, L.M.F.T., L.C.S.W., Andrew Harner, L.C.S.W. Carla Gaff-Clark, Ed.D., L.M.H.C., L.C.A.C. Dr. Rex Stockton, Ed.D., L.M.H.C., L.C.S.W., L.M.F.T. Ruth Hallett, Consumer Member, Retired School Teacher Vacant, Social Work Board Member Vacant, Marriage and Family Therapy Member Vacant, Consumer Member Vacant, Psychiatrist

15. Types of Licenses Available (Now) LSW – Licensed Social Worker LCSW – Licensed Clinical Social Worker LMFT – Licensed Marriage and Family Therapist LMFTA – Licensed Marriage and Family Therapist Associate LMHC – Licensed Mental Health Counselor LMHCA – Licensed Mental Health Counselor Associate LAC – Licensed Addiction Counselor LCAC – Licensed Clinical Addiction Counselor

16. How Many People are Currently Licensed in the Behavioral Health and Human Services? 2011 LSW – 2314 LCSW – 4270 LMFT – 993 LMFTA – 62 LMHC – 1741 LAC – 273 LCAC – 1275

17. Legislative Updates Effective July 1, 2009 2 Years of Clinical Social Work Experience after receiving a MSW needed Applicants must now hold an LSW prior to obtaining clinical social work experience Addition of term “Qualified Supervisor” All other requirements will remain the same Addition of Addiction Counselor and Clinical Addiction Counselor

18. Legislative Updates Effective July 1, 2009 IC 25-23.6-8-1.7 & IC 25-23.6-8-2.7 Marriage and Family Therapy Associate License LMFTA Choices for Doctorate Students, graduates prior to July 1, 2009. Apply for the LMFTA Continue to Earn Clinical Hours First Available Date Requirement 500 hours Exam pass/failure – What Happens???

19. Legislative Updates Effective July 1, 2010 IC 25-23.6-8.5-1.5 Mental Health Counselor Associate License LMHCA Choices for Doctorate Students, graduates prior to July 1, 2010. Apply for the LMHCA Continue to Earn Clinical Hours First Available Date Requirement 1500 hours Exam pass/failure – What Happens???

20. Practice of Social Work (IC 25-23.6-1-8) • "Practice of social work" means professional services that are designed to effect change in human behavior, emotional responses, and social conditions of individuals, couples, families, groups, and communities and that involve specialized knowledge and skill related to human development, including an understanding of unconscious motivation, the potential for human growth, the availability of social resources, and knowledge of social systems. The term includes planning, administration, and research for community social services delivery systems. • The term does not include the use of psychotherapy or diagnosis (as defined in IC 25-22.5-1-1.1(c)).

21. LSW Requirements • Bachelors degree in Social Work (BSW) from an institution of higher education approved for candidacy by the Council on Social Work Education • http://www.cswe.org/ • Pass the Intermediate Level ASWB exam ($230) (http://www.aswb.org/) • MSW Applicants are exempt from experience requirement • BSW Applicant • 2 years of experience (3000 hours, 4500 PT) • LSW or LCSW Supervisor ONLY • Post-Baccalaureate • Paid • Full-Time

22. Practice of Clinical Social Work (IC 25-23.6-1-6) • "Practice of clinical social work" means professional services that are designed to help individuals, marriages, couples, families, groups, and communities to enhance or restore their capacity for functioning by: • (1) assisting in the obtaining or improving of tangible social and health services; • (2) providing psychosocial evaluations using accepted classifications, including classifications from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as amended and supplemented, but only to the extent of the counselor's education, training, experience, and scope of practice as established by this article; • (3) using appraisal instruments as an aid in treatment planning that the clinical social worker is qualified to employ by virtue of the counselor's education, training, and experience; and • (4) counseling and psychotherapeutic techniques, casework social work advocacy, and treatment in a variety of settings that include mental and physical health facilities, child and family service agencies, or private practice. • The term does not include diagnosis (as defined in IC 25-22.5-1-1.1(c)).

23. LCSW Requirements • Masters degree in Social Work (MSW) from CSWE approved University. • Degree could be obtained by an online university if CSWE approved. • Two (2) years of experience in the practice of Clinical Social Work • Must be post MSW experience • Paid • Full-time (Board may consider part-time experience) • At least 4 hours of face to face supervision per each month of experience must be shown • Supervision must be done by an LCSW • Pass the Clinical Level ASWB exam (Association of Social Work Boards) ($260 w/ 150 questions)

24. Practice of Marriage and Family Therapy (IC 25-23.6-1-7) • "Practice of marriage and family therapy" means a specialty that: • (1) uses an applied understanding of the dynamics of marital, relational, and family systems, and individual psychodynamics; • (2) uses counseling and psychotherapeutic techniques; • (3) evaluates and treats mental and emotional conditions, resolves intrapersonal and interpersonal conflict, and changes perceptions, attitudes, and behavior, all within the context of family, marital, and relational systems, including the use of accepted evaluation classifications, including classifications from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as amended and supplemented, but only to the extent of the counselor's education, training, experience, and scope of practice as established by this article; • (4) uses individual, group, couple, sexual, family, and divorce therapy; and • (5) uses appraisal instruments that evaluate individual, marital, relational, communicational, parent and child, and family functioning that the marriage and family therapist is qualified to employ by virtue of the counselor's education, training, and experience. • The term does not include diagnosis (as defined in IC 25-22.5-1-1.1(c)).

25. LMFT Requirements • Master’s Degree in Marriage and Family Therapy or in a related area as determined by the Board from a program accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE). • Must have completed necessary coursework in 13 essential areas • Two (2) years of supervised clinical experience required with at least 50% of clients receiving marriage and family therapy • Association of Marriage and Family Therapy Regulatory Board’s (AMFTRB) Examination ($295)

26. Practice of Mental Health Counseling (IC 25-23.6-1-7.5) • "Practice of mental health counseling" means a specialty that: • (1) uses counseling and psychotherapeutic techniques based on principles, methods, and procedures of counseling that assist people in identifying and resolving personal, social, vocational, intrapersonal, and interpersonal concerns; • (2) uses counseling to evaluate and treat emotional and mental problems and conditions in a variety of settings, including mental and physical health facilities, child and family service agencies, or private practice, and including the use of accepted evaluation classifications, including classifications from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as amended and supplemented, but only to the extent of the counselor's education, training, experience, and scope of practice as established by this article; • (3) administers and interprets appraisal instruments that the mental health counselor is qualified to employ by virtue of the counselor’s education, training, and experience; • (4) uses information and community resources for personal, social, or vocational development; • (5) uses individual and group techniques for facilitating problem solving, decision making, and behavioral change; • (6) uses functional assessment and vocational planning guidance for persons requesting assistance in adjustment to a disability or disabling condition; • (7) uses referrals for individuals who request counseling services; and • (8) uses and interprets counseling research. • The term does not include diagnosis (as defined in IC 25-22.5-1-1.1(c)).

27. LMHC Educational Requirements • 60 hours of graduate coursework • Master’s (no less than 48 hours) or doctoral degree (no less than 96 hours) in an area related to Mental Health Counseling • Counseling • Clinical Social Work • Psychology • Human Services • Human Development • Family Relations • Program accredited by the council for accreditation of Counseling and Related Educational Programs (CACREP) or the Council on Rehabilitation Education (CORE) • On-Line Universities are accepted if CACREP approved.

28. LMHC Required Coursework • Human growth and development • Social and cultural foundations of counseling • Helping relationship, including counseling theory and practice • Group dynamics, processes, counseling, and consultation • Lifestyle and career development • Assessment and appraisal of individuals • Research and program evaluation • Professional orientation and ethics • Foundations of mental health counseling • Contextual dimensions of mental health counseling • Knowledge and skills for the practice of mental health counseling and psychotherapy • Clinical instruction • KEEP ALL SYLLABI AND COURSE DESCRIPTIONS

29. LMHC Experience and Supervision Requirements • Supervised Clinical Experience (During School and for credit that appears on the transcript) • 100 hour practicum • 600 hour internship • 300 hour advanced internship • Must have 100 hours of face-to-face supervision • Experience Requirement (Post Graduate) • 21 months no more than 48 months • 3000 hours • 100 hours of face-to-face supervision

30. LMHC Qualified Supervisor • Supervisor supervising within their scope of experience • LCSW • LMFT • Licensed physician who has training in psychiatric medicine • Licensed psychologist • Licensed clinical nurse specialist in psychiatric or mental health nursing • Mental Health professional of equivalent status if the supervision was provided in a state where no regulation exists

31. LMHC Exam • National Clinical Mental Health Counseling Examination (NCMHCE) administered by the National Board for Certified Counselors (NBCC) ($185) • http://www.nbcc.org/ • Board approval required • Offered the 1st week of every month.

32. Practice of Addiction Counseling(IC 25-23.6-1-5.7) "Practice of addiction counseling" means the providing of professional services that are delivered by a licensed addiction counselor, that are designed to change substance use or addictive behavior, and that involve specialized knowledge and skill related to addictions and addictive behaviors, including understanding addiction, knowledge of the treatment process, application to practice, and professional readiness. The term does not include the use of psychotherapy or diagnosis

33. LAC Grandfathering Requirements Option 1 NAADAC Level II or higher Certification; or Certification as an addiction counselor or therapist approved by the Board and; 10 Years of addiction counseling experience and Submit an application prior to July 1, 2011 Option 2 3-years of addiction counseling experience Hold a valid license as a LSW, LCSW, LMFT, LMHC or psychologist Submit an application prior to July 1, 2011 Cannot have a conviction of violence or be convicted of anything that has a direct bearing on your ability to practice competently in the previous 2-years.

34. LAC Licensure Requirements Bachelors Degree in Addiction Counseling or related area. Pass Licensure Examination 2 Years of supervised addiction counseling experience 150 hours of supervision 100 must be individual supervision 50 must be group supervision

35. LAC Education Requirements 40 Semester hours or 60 quarter hours Coursework Requirements: Addictions Theory Psychoactive drugs Addictions counseling skills Theories of personality Developmental psychology Abnormal psychology Treatment planning Cultural competency Ethics and professional development 350 hour supervised practicum, internship, or field experience

36. Practice of Clinical Addiction Counseling (IC 25-23.6-1-5.9) "Practice of clinical addiction counseling" means the providing of professional services that are delivered by a licensed clinical addiction counselor, that are designed to change substance use or addictive behavior, and that involve specialized knowledge and skill related to addictions and addictive behaviors, including understanding addiction, knowledge of the treatment process, application to practice, and professional readiness. The term does not include diagnosis

37. LCAC Grandfathering Requirements Option 1 Masters or Doctorate Degree earned prior to July 1, 2011 and NAADAC Level II or higher Certification; or Certification as an addiction counselor or therapist approved by the Board and Submit an application prior to July 1, 2011 Option 2 Masters or Doctorate Degree earned prior to July 1, 2011 and 5-years of clinical addiction counseling experience Hold a valid license as a LSW, LCSW, LMFT, LMHC or psychologist Submit an application prior to July 1, 2011 Option 3 Bachelors Degree earned prior to July 1, 2011 Hold a NAADAC Level IV Certification; or Certification at the Internationally Certified Advanced Alcohol and Other Drug Abuse Counselor level from the International Certification and Reciprocity Consortium 20 Years of clinical addiction counseling experience Submit an application by July 1, 2011 Cannot have a conviction of violence or be convicted of anything that has a direct bearing on your ability to practice competently in the previous 2-years.

38. LCAC Licensure Requirements Master’s or Doctorate Degree in Addiction Counseling/Therapy or related area. Pass Licensure Examination 2 Years of supervised addiction counseling experience 200 hours of supervision 100 must be individual supervision 100 must be group supervision

39. LCAC Education Requirements 27 graduate semester hours or 41 quarter hours Coursework Requirements: Addictions counseling theories and techniques Clinical problems Psychopharmacology Psychopathology Clinical appraisal and assessment Theory and practice of group addiction counseling Multicultural counseling Research methods in addictions Legal, ethical and professional standards (2 hours) Appraisal and assessment for individual or interpersonal disorder or dysfunction (2 hours) 700 hour supervised practicum, internship, or field experience 280 face to face client contact hours by a LCAC with 5 years of experience 105 hours of supervision by a LCAC with 5 years of experience

40. Responsibilities of Licensees Practicing within your scope of expertise Continuing Education Renewal Discipline Remain Professional at all times

41. Continuing Education Education provided by Board-approved providers obtained by a licensee in order to maintain, improve, or expand the licensee’s skills and knowledge. 20 CEUs per year, 40 per renewal cycle (honor system, 1-10% audit) 1 hour of ethics per year, 2 per renewal cycle Minimum of 50% from Category I Formally organized courses Workshops Seminars, Symposia or Institutes Home study programs Faculty teaching a course for the first time College or graduate courses Maximum of 50% from Category II Journal clubs Case conferences for training or teaching Services as an instructor, presenter or supervisor Research or publication Peer Review Services on Boards, commissions, or professional organizations

42. Continuing Education Discipline When failure to do CE leads to Discipline? Audit Letter Non-compliance Fine ($100-$1000) Suspension Reported to National Data Bank

43. Continuing Education Issues • Waiver Request • Submit a letter or Email • 45 days prior to license renewal • Extreme hardship • Board will consider waiver requests outside of the renewal period, but they have full discretion as to whether a waiver will be granted.

44. Renewal Process Renew prior to April 1st of every even numbered year. (April 1, 2012) Complete your CE prior to renewing Pay $50 renewal fee (on-line or request a renewal form) Notice given 60 prior to expiration date Keep Address updated with the Board

45. How do I renew an expired license? • Contact the agency for a renewal application • Expired less than 3-years • Submit renewal application • $50 renewal fee and $50 late fee • Show proof of 40 hours of CE • Expired more than 3-years • Submit a renewal application • $50 renewal fee and $50 late fee • Show proof of 40 hours of CE • Submit a letter explaining “Why you allowed your license to lapse and what you have been doing since it expired.” • Reviewed at next available board meeting.

46. Should I allow my license to expire? • Should always retire your license over allowing it to expire. • $50 to reinstate a retired license • Amount of CE is based on years Retired • 0-3 – 20 hours • 3-6 – 40 hours • 6-10 – 60 hours • 10 years – appear before the board for determination

47. Board Action • Personal Appearances • Positive responses on applications or renewal applications • Expired Renewals • Failed exam attempts • Coursework Issues

48. Potential Violations • Violation Examples • Inappropriate Relationships with clients • Loaning money to clients • Borrowing money from clients • Poor record keeping • Addictions • Criminal Activity • Practicing with an expired license • Practicing outside of your scope of expertise

49. Discipline Process • File a complaint with Consumer Protection Division of the Office of the Attorney General (OAG) at www.indianaconsumer.com. • OAG investigates complaints and contacts a board designee to review information • Official Complaint is filed with the Board • Hearing before the Board is scheduled • Board deliberates and dismisses action or issues a discipline

50. Sanctions • Upon finding a licensure violation, the Board may impose a sanction. • Revocation of license – can reapply after 7-years • Suspension of license. • Probation upon the license. • Reprimand • Censure • Once discipline is issued in a final order, the National Practitioners Databank is notified. Status is also changed to reflect the Board decision.