Reform slow for licensure restrictions
Blame a little something called the Tenth Amendment.
The U.S. Constitution guarantees states rights. That means individual states get to determine who may practice psychology and what type of license they must have. But things can get confusing when a psychologist licensed in one state has to travel to another to provide services for a client. Skype and other examples of modern technology make the situation even more complicated.
Massachusetts allows psychologists licensed in another state to provide services within its borders one day per month or 12 days per year. Vermont requires the filing of an application form and payment of a $50 fee for a temporary license good for 10 days or 80 hours in any 12-month period. Maine and Rhode Island both allow out-of state psychologists to practice no more than 10 days per calendar year. Rhode Island requires that no more than five days occur consecutively.
“If someone is here longer, they need to get a license,” says Peter M. Oppenheimer, Ph.D., chair of the Rhode Island Psychological Association’s Legislative Committee, adding he’s not aware of any interest in changing the provision. “Our temporary permit is for trainees.”
Most states allow out-of-state psychologists to practice up to 30 days per year, according to Stephen DeMers, Ed.D., executive officer of the Association of State & Provincial Psychology Boards (ASPPB), headquartered in Peachtree City, Ga.
“But then a day isn’t defined. Is a day 24 hours?” DeMers asks. “If you have 20 ten minute conversations on different days, do you add those up to one day?”
Connecticut and New Hampshire currently have no provision to permit a temporary license. That will change in N.H. next July 1 when a new statute takes effect permitting out of state psychologists who meet certain criteria to practice for up to 30 or 90 days per year without applying for a license. Another provision permits temporary practice for up to 60 days for nonresident psychologists responding to a declared disaster in New Hampshire.
Connecticut and New Hampshire have no provision to permit a temporary license. Only three New England states – Rhode Island, Connecticut and Maine – allow a non-resident psychologist to come to the state to testify as an expert witness without first obtaining a license.
Not allowing temporary practice can lead to problems during a crisis. DeMers recalls that after the fatal shootings of three professors at the University of Alabama at Huntsville in 2010, out-of-state psychologists who volunteered to provide counseling for students and faculty had to get an executive order from the governor because Alabama has no temporary license provision.
Reform initiatives in recent years led by the ASPPB and the American Psychological Association’s Div. 13 (Society of Consulting Psychology) to convince states to amend licensure laws and other regulations to facilitate professional mobility have made slow progress.
“It’s just so difficult to get states to work together. Things move very slowly,” says Judith Blanton, Ph.D., a California-based organizational business consultant and past Div. 13 president who serves as a liaison between Div. 13 and the ASPPB. “The good news is that people are trying to work together.”
More good news: A three-year, $1 million grant from the U.S. Department of Health and Human Service’s Health Resources and Services Administration awarded this year to the ASPPB will help a joint task force on telepsychology develop proposals for state licensing boards to reduce regulatory barriers. The task force comprised of representatives from ASPPB and APA will continue developing a universal online application system for seeking licensure, certification or registration in any participating state, province or territory in the United States or Canada.
The online application program called Psychology Licensure Universal System (PLUS) also facilitates applying for the ASPPB Certificate of Professional Qualification (CPQ), which documents that an individual has met specific requirements in licensure, education, examination and training and has never been subject to disciplinary action. Forty-four jurisdictions accept the CPQ including Conn., Maine, N.H., R.I. and Vermont. Massachusetts may waive at least one licensure requirement for CPQ holders.
PLUS may also be used to seek the ASPPB Interjurisdictional Practice Certificate (IPC). Information collected is saved in a credentials bank where it can be accessed later by the psychologist or forwarded to another licensing board, organization, entity or individual. In 2008, ASPPB launched the IPC, which allows psychologists to provide temporary services in those jurisdictions that accept the IPC for at least 30 work days per year without obtaining full licensure. So far, only Georgia, Idaho, Kentucky, Mississippi and South Carolina currently accept the IPC for temporary practice. Ohio is in the process of accepting the IPC.