22 TAC §781.301
The Texas State Board of Social Worker Examiners (board)
adopts an amendment to §781.301 concerning the allowance of social workers
at all levels of license to participate as case managers in the medical case
management program administered by the Texas Department of Health (TDH) with
changes to the proposed text as published in the
Texas Register
on December 15, 2000, (25 TexReg 12316).
The General Appropriations Act, House Bill 1, Article IX, Rider 167, passed
by the 75th legislature, requires that each state agency review and consider
for readoption each rule adopted by that agency pursuant to the Government
Code, Chapter 2001 (Administrative Procedure Act). The Texas State Board of
Social Worker Examiners has reviewed §781.301 and has determined that
reasons for readoption, with the inclusion of this amendment, of §781.301
continues to exist.
A Notice of Intention to Review the section as required by Government Code, §2001.039,
(Rider 167), was published in the
Texas Register
on May 20, 1998, (23 TexReg 5742). No comments were received in regards
to this notice.
In March 1999, the board was approached by the TDH regarding case managers
at all levels of license participating in the Texas Health Steps Program.
The board determined the program as structured was in violation of the private
practice provision of the board rules and began negotiations with the TDH
for a mutual resolution to the dilemma. In December 2000, the board published
a proposed exemption for the program in the
Texas
Register
allowing for a 45-day public comment period. The board received
a total of 50 (22 prior to the public comment period, 26 during the public
comment period, and 2 after the public comment period ended) comments regarding
the proposed rule.
The following comments were received concerning the proposed rule.
Comment: Of the 5 comments opposing the rule received during the public
comment period, three of them were concerned as to the ability of those at
the Social Worker Associate, Licensed Social Worker and Licensed Master Social
Worker level of licensure to work independent of supervision.
Response: The board took no action regarding the proposed rule, however,
the board did attempt to work with the TDH regarding this issue of supervision
for several months prior to the promulgation of this rule. The board was informed
that while direct supervision, in accordance with board rule definitions did
not occur, TDH Central Office and Regional staff provide ample oversight.
The TDH Texas Health Steps Medical Case Management (THSteps MCM) Program stated
that there was not enough staff to provide direct oversight of the providers
and that requiring the contracting of supervision services by the providers
was a great expense to the providers. No change was made as a result of the
comments.
Comment: One commenter felt that the THSteps MCM program needed to expand
their acceptance of individuals with other forms of licensure and not restrict
services to only social workers and nurses.
Response: The board took no action regarding the proposed rule nor did
the board have jurisdiction regarding the rules promulgated for the TDH MCM
program. No change was made as a result of the comments.
Comment: During the comment period one group raised a question as to the
legal authority of the board to promulgate, through rules, an exemption that
would go against the enabling legislation.
Response: During their March 3, 2001, board meeting, the board voted that
the program, as structured, was in violation of the private practice portion
of the rules and law. The board at that time voted against the adoption of
the rule, as proposed because it did not have the authority to promulgate
a rule that would be in violation of the enabling legislation. No change was
made as a result of the comments.
In March 2001, shortly after the board voted against adoption of the rule,
as part of the 77th Legislative Session, House Bill 3365 was introduced that
mandated the Texas State Board of Social Worker Examiners to promulgate rules,
within 120 days of passage, that would allow all levels of licensure to participate
as case managers in the medical case management programs administered by the
TDH. The bill passed and was signed by the Governor on May 28, 2001. The board
did not pull the proposed rule as published in the
Texas Register
on December 15, 2000, (25 TexReg 12316), after voting
against the adoption of the rule in March 2001, based on the filing of House
Bill 3365. The board amended §781.301(b)(5) to state that all levels
of licensed social workers may provide medical case management services.
The commenters were Texas Tech University Health Sciences Center at Amarillo,
Coalition of Health Services, Texas Society for Clinical Social Work, and
numerous individuals.
The amendment is adopted, as amended, under the Occupations Code, §505.201,
which provides the board with the authority to adopt rules necessary for the
performance of its duties and implement Rider 167 and Government Code, §2001.039.
§781.301.Qualifications for Licensure.
(a)
The following education and experience is required for
the specified licenses and specialty recognitions:
(1)
LMSW--a doctoral or master's degree in social work from
a CSWE accredited college or university;
(2)
LSW--a baccalaureate degree in social work from a CSWE
accredited college or university;
(3)
SWA-the following degrees and experience:
(A)
a baccalaureate degree from an accredited college or university
and one year of full-time social work experience as defined in §781.304(c)
of this title (relating to Required Documentation of Qualifications for Licensure)
under the supervision of a LSW or LMSW or a person with an equivalent social
work license if the experience was completed in another state; or
(B)
an associate of arts degree in a behavioral science from
an accredited college or university and three years of full-time social work
experience as defined in 781.304(c) of this title under the supervision of
a LSW or LMSW or a person with an equivalent social work license if the experience
was completed in another state;
(C)
supervision under the appropriately licensed social worker
who had direct oversight for the individual's social work services, had regular
supervisory conferences with the individual at least 50 hours per year over
the full period of required supervision, and evaluated the individual's provision
of social work services. (Under this subsection, supervision by a SWA will
be accepted if the supervision began before the effective date of these rules
changes and is completed within three years for applicants with associate
degrees and within one year for applicants with bachelors degrees.); and
(D)
applicant must document the completion of six hours of
continuing education specifically in the area of professional values and code
of ethics for social workers.
(4)
LMSW-ACP-
(A)
qualified to be licensed as a LMSW;
(B)
three years of full-time experience in a clinical social
work position after completion of the qualifications for licensure as a LMSW
or its equivalent if the experience was completed in another state;
(C)
two years of supervision (as part of the three years of
experience) under a LMSW-ACP supervisor or its equivalent if the experience
is completed in another state. Clinical supervision from a non-social worker
received in another state will be accepted if such supervision is accepted
under the rules for social work licensing in that state; and
(D)
identification with and continued participation in the
social work profession as evidenced by licensure as an LMSW, active membership
and participation in social work organizations and experience in social work
positions; and
(5)
LMSW-AP-
(A)
qualified to be licensed as a LMSW;
(B)
three years of full-time experience in a non-clinical social
work position after completion of the qualifications for licensure as a LMSW
or its equivalent if the experience was completed in another state;
(C)
two years of supervision (as part of the three years of
experience) under a LMSW-ACP, LMSW-AP supervisor or its equivalent if the
experience is completed in another state. Supervision from a non-social worker
received in another state will be accepted if such supervision is accepted
under the rules for social work licensing in that state;
(D)
identification with and continued participation in the
social work profession as evidenced by licensure as a LMSW, active membership
and participation in social work organizations and experience in social work
positions.
(b)
Only a person who is licensed and recognized by the board
as a LMSW-ACP or LMSW-AP is qualified for the private, independent practice
of social work. No further recognition is necessary.
(1)
As a private practitioner, a LMSW-ACP may provide any clinical
or nonclinical social work services.
(2)
A LMSW-AP must restrict his or her private, independent
practice to the provision of nonclinical social work services.
(3)
A licensee must not engage in any private, independent
practice that falls within the definition of professional social work practice
(relating to definitions) without being licensed and recognized by the board
as a LMSW-ACP or LMSW-AP, unless the person is licensed in another profession
and acting solely within the scope of that other license. The person may not
use the titles "licensed master social worker," "licensed social worker,"
or "social work associate" or any other title or initials that states or implies
licensure or certification in professional social work services unless one
holds the appropriate license.
(4)
A licensee who is not an LMSW-AP or LMSW-ACP may not provide
direct social work services to clients from a location that she or he owns
or leases and that is not owned or leased by an employer or other legal entity
with responsibility for the client. This does not preclude in home services
such as in home health care or the use of telephones or other electronic media
to provide services in an emergency.
(5)
All levels of licensed social workers (SWA, LSW, LMSW,
LMSW-AP, or LMSW-ACP) may provide medical case management services under the
medical assistance program under Chapter 32, Human Resources Code, to the
extent administered by the Texas Department of Health. This paragraph expires
September 1, 2003.
(c)
An applicant for AP and ACP recognition is not eligible
for a temporary or provisional license.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on June 13, 2001.
TRD-200103342
Deborah Hammond, LMSW-ACP
Chair
Texas State Board of Social Worker Examiners
Effective date: July 3, 2001
Proposal publication date: December 15, 2000
For further information, please call: (512) 458-7236