Announcement of Public Workshop, "Examining Health Care Competition" ("Health Care Workshop") Project No. P13-1207
I am a Licensed Clinical Social Worker in private practice in Marietta, Georgia, a northern suburb of Atlanta. I work with children and adults with Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Disorder, Tourette's Syndrome, anxiety, depression and more. Technology has opened up many options for working with clients, however, the laws have not quite caught up. Current laws hinder practitioners from accessing more clients, particularly those in rural communities. I know of a psychiatrist in Atlanta who works for a specialized hospital. She often treats patients in Alabama but the patients must drive over the state line into Georgia in order to access a secure telephone line so she can treat them. Patients who can't afford gas, live too far, or don't have cars cannot do this. Clearly, clients do not always have good accessibility for treatment or have to go to extreme lengths to have access. Technology would bring these services closer to everyone. Rural populations, elderly, and disabled people stand to gain the most from easier, lawful use of technology. Currently, Social Work Licensing is done from state to state. This licensing prohibits portability when one moves. Social Workers need to re-take licensing tests which are often timely and costly. Having national standards or laws for reciprocal practice would alleviate this problem. Additionally, if a Social Worker has a client move out of state or go away to college, we are not allowed to Skype or practice with that client by phone because we are not licensed in the state the client is living in. We are only allowed to practice in our own states. I have never understood this application of the law. If I am practicing in my state, where I am licensed, why does it matter where the recipient of my services is residing? When I have a client that I have worked with for many years go away to school, it is very disruptive to their therapy to tell them I can no longer work with them unless they are in Georgia. Often clients are not ready to terminate therapy when a life circumstance demands that they move. The client/therapist relationship continues to be important in helping them be successful in their lives particularly at the stressful time of a move. If allowed to use technology across state lines these relationships would be allowed to continue. Life coaches are not licensed. Sometimes counselors and Social Workers choose not to get licensed due to the cost, investment of time, and effort. Therefore, they may practice all over the country with no restrictions. This does not allow for Licensed Social Workers or counselors to compete fairly. Coaches and non-licensed professionals can do webinars and teleseminars and create a national client base while Social Workers are limited to practicing only in their state of residence. The very laws aimed to protect consumers actually limits their choices and constricts the opportunity for practitioners and consumers alike. Thank you very much for your consideration of these current issues of providing clinical care. There are many people to be served and the more opportunities we provide to connect clients and patients to services the better individual lives and our greater communities will be.