Public Comments for Private Practice Guidelines


NASW’s Task Force for Private Practice Guidelines is seeking public comments for the attached document, Clinical Social Workers in Private Practice: A Reference Manual. This manual provides a useful set of guidelines for clinical social workers starting a private practice and for seasoned clinical social workers seeking specific information related to the practice and business side of a private practice. Your comments are important to us and will determine how the task force moves forward. The public comment period begins December 4, 2020 and ends January 4, 2021. The manual is available for review at https://www.socialworkers.org/Practice/Clinical-Social-Work/Clinical-Social-Workers-in-Private-Practice-Comment

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Last Post 14 Jan 2021 01:00 PM by  CCooper
Clinical Social Workers in Private Practice: A Reference Manual
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Sharon Payne





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04 Jan 2021 12:17 PM
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From: Sharon L. Payne LCSW CSAC Emeritus Professor of Social Work Virginia Wesleyan University, Private Practitioner

Page 11 I found the first paragraph confusing. The recommendation that SW'ers achieve 5 years supervised practice and additional coursework is certainly valid but seems to represent the disconnect between SW programs certified by CSWE that do not prepare students nor inform them about the path forward to practice and what it entails. This is a glaring problem and one that needs our attention.

Page 11-- the use of the term malpractice insurance is old. Professional liability insurance is more inclusive of the coverage we require.

Page 14-- "appropriate" social media presence. Here I would specify that practitioners follow the excellent document: Standards for the Use of Technology in SW Practice

Page 16--no where in the document do you address the possible structures that the practitioner should consider--solo practice, LLC etc. It is mentioned later I believe but not emphasized. This is crucial and I have colleagues who have suffered as a result of not being protected from partners' misdeeds. A more detailed explication of various structures would be useful with the caveat of course that we cannot give legal advice. We should suggest that legal advice should be sought from someone who understands small business structure and medical practice structures.

Page 21- again speaks to issues of group practice but not legal structure and the need to protect oneself

Page 22- goes into explicit agreement with the group- this area could use emphasis that this is a business agreement and needs to be legally formalized. The best of colleagues can have disagreements when money and property are concerned. A handshake is not the way to establish a business.

Page 36--reiterates the Code of Ethics

Page 47-reiterates the Code

Page 57-3rd party payers section doesn't provide the new practitioner information about where to learn what you recommend they need to know

Page 70- initially I didn't see the technology code being referenced but saw it here. The formatting of the document doesn't allow it to stand out.

The latter part of the document simply reiterated the Code of Ethics in many sections which isn't a bad thing because many practitioners are not conversant with what the Code says and doesn't say. However, the more explicit the information the better and the Code isn't explicit about establishing a practice. Formatting of this document with a detailed Table of Contents and perhaps bolded sections where the Code of Ethics is restated would make it more readable and useful. It's a lot to read through and clearly took a lot of work. Thank you for doing this for the next generation of clinicians.

Jennifer Henkel, ASWB





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04 Jan 2021 02:35 PM
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Thank you for the opportunity to review and provide comment on NASW’s proposed private practice guidelines. The guidelines will provide a practical and useful resource for clinical social work licensees throughout the United States. ASWB is the membership association of the 64 social work regulatory authorities in the United States and Canada.

ASWB publishes the Model Social Work Practice Act (model law) which informed the review and comment of the proposed private practice guidelines. First adopted in 1997, the Model Law reflects best practices for social work regulation. It is regularly reviewed and affirmed by all ASWB member jurisdictions during the association’s annual business meeting. More information about the model law is available on the ASWB website: https://members.aswb.org/best-practices/model-social-work-practice-act/

The document can be found here: https://www.aswb.org/wp-content/uploads/2013/10/Model_law.pdf



Page 9

Definition of private practice

The proposed definition of private practice encompasses two separate activities, both private AND independent practice. This may contribute to confusion in that state social work regulations more often than not differentiate between the two activities whether explicitly or implicitly. In many states, masters and/or bachelors social workers may practice autonomously or independently, however they are restricted from owning a private practice. Yet still in other states, a masters social worker is restricted from independent practice but not private practice. While the private practice guidelines offered by NASW emphasize clinical social work practice, differentiating these two practice activities is best practice and consistent with the social work laws in most states. Further, the proposed practice guidelines discuss independent practice in several different areas. Offering a definition for independent practice separate from private practice will provide clarity for the users.

NASW might consider clarifying that that private practice encompasses autonomous or independent practice; as well as incorporating the definitions for independent and private practice suggested by the ASWB model law.

The referenced definitions are as follows:

ASWB Model Social Work Practice Act p. 7
Section 109. Definitions.
(t) Independent Practice means practice of social work outside of an organized setting, such as social, medical, or governmental agency, in which the social worker assumes responsibility and accountability for services provided.
(w) Private Practice means the provision of Clinical Social Work services by a licensed Clinical Social Worker who assumes responsibility and accountability for the nature and quality of the services provided to the Client in exchange for direct payment or third-party reimbursement.

Page 11

Independent practice is not exclusive to clinical practice

As discussed above independent practice is not exclusive to clinical practice. The practice guidelines should be reviewed for any instances where it may suggest otherwise. For instance, this statement is not representative of the majority of state regulatory frameworks, where independent practice is permitted by bachelors and/or masters licensees: “Many states have legal regulations for private practitioners at a clinical or independent practice, and practitioners must be licensed or certified at this level to engage in independent private practice.” This statement may further contribute to confusion because of the lack of definition for independent practice.

Use of the term “independent clinical social worker”

In all states except one the receipt of the clinical license permits an individual to practice autonomously or independent of supervision. Nebraska requires an additional period of supervision to obtain the licensed independent mental health practitioner (licensed independent clinical social worker). Therefore, the use of the term “independent clinical social worker” is redundant. Further it may contribute to confusion as it relates to earlier comments made regarding independent practice being permitted by bachelors and masters licensees.

Page 12

Scope of practice

There are states that prohibit diagnosis and psychotherapy by licensed social workers
https://movingsocialwork.org/news/scoping-out-the-rules-mobility-and-scope-of-practice-requirements/

Page 41

Private practitioner’s qualifications and experience, including… please add “license”

Matters involving informed consent. Consider adding more information related to client welfare, self-determination, nondiscrimination, and a professional disclosure statement.
ASWB Model Social Work Practice Act p. 52 for more information.

Page 56
Privileged Communication

ASWB Model Social Work Practice Act has extensive information on privileged communications and implications in regulation
Article V. Confidentiality
Section 501. Privileged Communications and Exceptions.

mbarmail





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04 Jan 2021 04:21 PM
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This document is excellent and an invaluable asset. My one concern is the paragraph in the self care section (beginning with "In short we need friends...) It does not add to the premise of self care and is not consistent with the rest of the document.

BruceThyer





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08 Jan 2021 02:30 PM
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The NASW Code of Ethics requires social workers to evaluate their own practice. I urge that language reflecting this ethical obligation be included in this Private Practice guidelines.

Bruce Thyer, Ph.D., LCSW

CCooper





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14 Jan 2021 01:00 PM
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This is a very helpful document. I commend the parties who put so much time and effort into the project. Comments:
1. Thank you for stressing the issue of collecting co-pay, deductible under insurance contracts. This is a frequent problem. Most people think of it as helping clients, not as fraud. Important to understand the fraud element.
2.p 62 'determine if the plan is private of self funded'. There is much misunderstanding of the make up of insurance plans and companies. Consider clarification by listing the types of plans, recommend ways to locate the regulatory group that has oversight.
3.p.72 reasons for termination: add destruction of practitioner property
Thanks for this opportunity to comment. Look forward to seeing the final product.
Charlotte B. Cooper,LCSW
Director of Clinical Reimbursement Project, NASW/Tx
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Clinical Social Workers in Private Practice: A Reference Manual

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