The explosion in demand for telehealth throughout the COVID-19 pandemic has led to a reckoning in private practice therapy. For the first time, it has become not only feasible, but the norm to provide the majority of therapy sessions remotely. This opens up a dilemma for therapists: if you don’t need to practice from a physical office, why limit the clientele you serve based on their location? The solution is cross-state licensure.

Cross-licensure allows providers who hold a primary license in one state to obtain a secondary license in another. Each state and therapy profession has its own set of rules and requirements, and navigating this complex web of policies can quickly become a daunting task.

Top 10 Things to Know About Multi-State Licensure for Licensed Social Workers

1. Complete all of the necessary requirements to become licensed in one state. This is ideal because if you start your clinical experience and supervision in one state and then move BEFORE you finish, this whole process becomes even more complicated.

2. Keep good records. Keep a log of your clinical experience and hours of supervision (some states will want to see more detailed information about what you were doing and how you accumulated your hours. Make sure you have your clinical supervisors full name, license number, date of licensure and up-to-date contact information at all times.

3. BEFORE YOU MOVE Or apply for employment in another state – Contact the Licensure Board in the state that you are planning to move to and get the application. You will typically be looking for an “Application By Endorsement” or “Application from Out of State Licensee”.

4. Be prepared to do a lot of phone calling ! It can be difficult to get a live person on the phone. But, if you do, get their direct extension! You need a live, local person to help you. They will know the answers to your questions.

5. Start requesting documents. Typically, you will have to resend (which means pay for) your graduate school transcripts, your ASBW test scores, and a license verification form from your current state. This is the annoying part. This will probably cost you anywhere from $20-$75 or more and will have to be done every time you want to get licensed in a new state. The ASWB does have a Registry which will hold all of your documents and send to them to the new state.

6. Contact your old supervisor. Depending on how long you have been licensed in your current state, you will probably need a signature from your previous supervisor to testify to your clinical experience and supervision hours. If that person is MIA or deceased, then you have more work to do. But, it can still be done.

7. Figure out if you have to take any additional continuing education courses. Each state has their own courses that are required for licensure. In Florida, there is “Laws and Rules” and “Medical Errors”. In other states, it might be “Child Abuse Reporting”. Find out what you need and get certificates for any of those courses. Herein lies another set of fees!

8. Fill out all of the forms. Many require notarized signatures on at least one page and some require a passport style photo. Again, here are some annoying fees, unless your bank does free notary service. Don’t forget to make copies of the forms. It is quite possible that somehow, one of those pages will get lost or separated and that sends your application to the start-over pile.

9. Pay the fees. Usually there is an application fee that is at least $100-$150, however fees vary by state.

10. Wait! And wait! And wait. Some states may respond quickly, but for others, there are review boards that only meet quarterly. It is helpful to know when they meet, so you can get your application before the deadline.

But don’t worry about getting through all these tasks along. 

BeIDT Health is very knowledgeable and familiar with these process and is here to assist the professionals we work with their cross-state licensure process. 

Let BeIDT Health help increase your salary range. We’re here to save you time and frustration…

For therapists, cross-licensure can open the door to a thriving private practice. Some cities and states are simply more saturated with therapists, while others lack enough providers to serve the population. This discrepancy creates a gap in the market that could be filled by out-of-state and cross-licensed therapists. We see this consistently in referral data through our website: providers who are licensed in multiple states receive more client requests because their licensure puts them in front of a larger audience of therapy seekers.

Who cross-state licensure is for;

Cross-state licensure applies only to mental health providers who already hold an active, independent license in at least one US state: it does not apply for first-time licensees or international providers.

Cross-state licensure is intended for providers seeking to serve multiple local clients for an extended period of time. Many states offer provisions for providers who need to practice in a different state for a limited period of time—such as 30 days per year—to cover extenuating circumstances, such as a client caring for a relative out-of-state.

Clinical social work licensure laws are governed by the state social work board in that state (there are four states that have governance by a state agency).  These boards and agencies implement rules as to how the laws that created clinical social work licensure are implemented. Most states have rules that regulate which LCSWs may practice in each state.  The Association of Social Work Boards (ASWB) serves as the organization that develops the clinical social work examination and as a ‘home base’ for social work boards but does not have oversight over them.

Prior to the Covid-19  Pandemic, most boards had some process for becoming licensed in a new state.  Almost no states allowed LCSWs to practice without acquiring a license in each state, except in emergency situations. Some states allowed an LCSW to become licensed in another state if their license had the same or higher standards of licensure than the state in which they were licensed without going through the whole licensure process of gathering supervised experience hours; the ASWB clinical examination only needs to be taken once and is transferable to any state. Some states do require completing supervised clinical hours again, an onerous task for established clinicians.

* LCSWs is used to cover all clinical social work titles including LICSWs, LISWs, etc.

The small group of LCSWs that have chosen to become licensed in more than one state have more options for the patients that they can treat. Being licensed as an LCSW in more than one state means higher costs for being licensed in more than one state, different continuing education standards, and more complicated relationships with third party payers.

Current Clinical Social Work Policies on Reciprocity

Many of the laws and rules governing clinical social work licensure reciprocity have changed since COVID-19 has impacted our ability to see patients in person, roughly since March, 2020 when the State of Emergency was declared nationally. Beginning with Maryland, whose Governor allowed any LCSW licensed in another state to see patients in Maryland through videoconferencing without becoming an LSCW-C in Maryland, many states have relaxed the rules in place for which LCSWs can provide treatment in their state.  It is crucial to check these standards in the state in which you are currently licensed and the state in which a patient resides.

National Policies on Reciprocity

Another outcome of the pandemic is the increased pressure for national reciprocity for LCSWs.  Psychologists have been working toward this goal with a group of states that accepts the license of a psychologist from a state which is affiliated with a group of states who agrees on licensure standards, called PSYPACT.  This is a much easier task for psychologists because all psychologists licensed as psychologists have a doctorate before they become licensed and that process is standardized.  NOTE: psychologists who have a terminal Master’s degree cannot become licensed as a psychologist and generally become licensed counselors.

The Master’s in Social Work is considered the terminal degree for clinical social workers, though there are several ways LCSWs continue to be trained for 2-3 years after receiving an MSW.  The laws and rules governing this training varies widely from state to state and each social work board has a vested interest in the standards that they have created.  Getting social work boards to agree on standards that would allow an LCSW to practice in another state is challenging.

Contact us today to see how we can assist you in meeting your career goals. We are ready help….

[email protected]

(216)329-3500