Practice Area 172
CLINICAL PRIVILEGE WHITE PAPER Social worker Background The role of the hospital social worker is to provide quality services to patients and their families. These services may include psychosocial assessment and counseling, and can range from pre-admission planning to support during medical treatment and recovery. Discharge planning is another important function as the social worker helps patients and families make their own decisions about post-hospital care. The hospital social worker recognizes groups at high psychosocial risk. These groups include: • • • • •
frail elderly patients, chronically ill people, children and adults with handicapping conditions, victims of maltreatment, and critically ill patients.
Social workers serve patients who are insured, uninsured, and underinsured.
Positions of societies and academies NASW
The National Association of Social Workers (NASW) recommends that hospital social workers be appropriately licensed, have a master’s degree in social work, and have two years’ supervised experience or its equivalent in a hospital setting, according to an NASW spokesperson. “But social work practitioners in today’s environment need more credentials than a master’s degree in social work or a state license that may attest only to minimum competency,” the spokesperson adds. As a result, the NASW offers social workers such credentials as membership in the Academy of Certified Social Workers (ACSW), the Qualified Clinical Social Worker credential, and the Diplomate in Clinical Social Work credential. These credentials demonstrate knowledge and experience beyond state licensing.
Qualifications for membership in the ACSW
• Education: Master’s or doctorate degree in social work from a school accredited by the Council on Social Work Education (CSWE).
A supplement to Briefings on Credentialing 781/639-1872
Criteria reviewed 2006
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Social worker
Practice Area 172 • Experience: Two years of full-time (or 3,000 hours of equivalent part-time), paid post-master’s or post-doctorate social work experience with supervision by a social worker in an agency or organized setting. • Documentation: Completed supervisory evaluation form and two professional references from social work colleagues. • Examination: Tests social work knowledge in assessment and service planning, intervention, professional development and ethical standards, and administration.
Qualifications for Qualified Clinical Social Worker
• Education: Master’s or doctorate degree in social work from a school accredited by the CSWE. • Experience: Two years of full-time (or 3,000 hours of equivalent part-time), paid post-master’s or post-doctoral clinical social work experience in an agency or organized setting, supervised by a clinical social worker with at least two years’ experience. • State regulation: Membership in ASCW or current state social work license or certification. • Documentation: Verification of supervision, current state registration, license, or certification. Also, a professional reference from a social work colleague.
Qualifications for Diplomate in Clinical Social Work
• Education: Master’s or doctorate degree in social work from a school accredited by the CSWE. • Experience: Two years of full-time (or 3,000 hours of equivalent part-time), paid post-master’s or post-doctoral clinical social work experience in an agency or organized setting, supervised by a clinical social worker with at least two years of experience. Three additional years of full-time clinical social work practice or 4,500 hours of part-time practice in not less than three years. Two years of full-time or 3,000 hours of part-time within the last 10 years. • State regulation: Highest level of certification, license, or registration in state.
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A supplement to Briefings on Credentialing 781/639-1872
Criteria reviewed 2006
Practice Area 172
Social worker
• Documentation: Verification of supervision, current state registration, license, or certification. Also, a professional reference from a social work colleague. • Examination: Cognitive advanced examination that tests the applicant’s qualifications to practice social work independently, and completion of a clinical social work skills assessment. For each of the above NASW credentials, applicants must submit an official copy of school transcripts (with the school seal). In addition, applicants must sign an agreement to practice according to NASW’s Code of Ethics and practice standards, and submit to adjudication proceedings if charged with violations. The NASW also created the Academy of Certified Baccalaureate Social Workers (ACBSW) as a social work credential. This credential gives BSWs professional recognition and is modeled after the ACSW. The ACBSW requires at least two years of supervised social work experience in an agency or organized setting. AASSWB
The American Association of State Social Work Boards (AASSWB) publishes information on state licensure of social workers. “Licensure is done in all states at one of four levels of practice,” says an AASSWB spokesperson. “They are licenses to practice social work and there is no specific licensure for hospital social work.” The AASSWB spokesperson also points out that there are certain states where hospital social workers are exempt from licensure. In Virginia, for example, if individuals work in a public or private nonprofit organization or agency, then legally they do not have to be licensed to practice social work. The Credentialing Resource Center recommends that every organization contact the appropriate state board for specific information concerning such exemptions. The following is the AASSWB table that details state by state the levels of social work practice that are regulated. The table does not include exemptions.
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Criteria reviewed 2006
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Social worker
Practice Area 172
LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE
TITLE
INITIALS
EDUCATION
EXPERIENCE
EXAM REQUIRED
BOARD APPROVAL
Alabama
Private Independent Practice Licensed Certified Social Worker Licensed Graduate Social Worker Licensed Bachelor Social Worker
PIP LCSW LGSW LBSW
DSW/MSW DSW/MSW MSW BSW
2 yrs POST 2 yrs POST 0 0
Advanced Advanced Intermediate Basic
Alaska
Licensed Clinical Social Worker
LCSW
DSW/MSW
2 yrs POST
Clinical
Arizona
Certified Independent Social Worker CISW Certified Master Social Worker CMSW Certified Baccalaureate Social Worker CBSW
DSW/MSW DSW/MSW BSW
2 yrs POST 0 0
Clin/Adv Intermediate Basic
Arkansas
Licensed Certified Social Worker Licensed Master Social Worker Licensed Social Worker
LCSW LMSW LSW
MSW MSW BSW
2 yrs POST 0 0
Clin/Adv Intermediate Basic
YES
California
Licensed Clinical Social Worker Associate Clinical Social Worker
LCSW ASW
MSW MSW
2 yrs POST 0
Clinical N/R
YES
Colorado
Licensed Clinical Social Worker
LCSW
DSW or MSW
1 yr POST 2 yrs POST
Clin/Adv Clin/Adv
NO
Connecticut
Licensed Clinical Social Worker
LCSW
DSW/MSW
3,000 hrs POST
Clin/Adv
YES
Delaware
Licensed Clinical Social Worker
LCSW
DSW/MSW
2 yrs POST
Clinical
YES
District of Columbia
Licensed Licensed Licensed Licensed
LICSW LISW LGSW LSWA
MSW MSW MSW BSW
3,000 hrs POST 3,000 hrs POST 0 0
Clinical Advanced Intermediate Basic
YES
Florida
Licensed Clinical Social Worker Certified Master Social Worker
LCSW CMSW
DSW/MSW MSW
3 yrs (2 yrs POST) 3 yrs (2 yrs POST)
Clinical Intermediate
YES
Georgia
Licensed Clinical Social Worker Licensed Master Social Worker
LCSW LMSW
MSW MSW
3 yrs POST 0
Advanced Intermediate
YES
Hawaii
Licensed Social Worker
LSW
DSW/MSW
0
Intermediate
N/S
Idaho
Independent Practice Certified Social Worker Social Worker
CSW CSW SW
DSW/MSW DSW/MSW BSW
2 yrs POST 0 0
Intermediate Intermediate Basic
YES
Illinois
Licensed Clinical Social Worker
LCSW LSW
2,000 hrs POST 3,000 hrs POST 0 3 yrs POST
Clinical Clinical Intermediate Intermediate
YES
Licensed Social Worker
DSW or MSW MSW or BSW
Indiana
Clinical Social Worker Social Worker
CSW SW
MSW MSW or BSW
2,000 hrs POST 0 2 yrs POST
Clinical Intermediate Intermediate
YES
Iowa
Licensed Social Worker
LSW
DSW/MSW
2 yrs POST
Clinical
YES
4
Ind. Clinical Social Worker Independent Social Worker Graduate Social Worker Social Work Associate
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YES
YES YES
Criteria reviewed 2006
Practice Area 172
Social worker
LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE
TITLE
INITIALS
EDUCATION
EXPERIENCE
EXAM REQUIRED
BOARD APPROVAL
Kansas
Specialist Clinical Social Worker Master Social Worker Baccalaureate Social Worker
LSCSW MSW BSW
DSW/MSW MSW BSW
2 yrs POST 0 0
Clinical Intermediate Basic
YES
Kentucky
Licensed Independent Practice Certified Social Worker Licensed Social Worker
LCSW CSW LSW
DSW/MSW DSW/MSW BSW or BA
2 yrs POST 0 0 2 yrs
Clinical Intermediate Basic Basic
YES
Louisiana
Board Certified Social Worker
BCSW
MSW
2 yrs POST
Clin/Adv
YES
Maine
Licensed Clinical Social Worker Licensed Master Social Worker Licensed Social Worker
LCSW LMSW LSW
DSW/MSW DSW/MSW BSW
2 yrs POST 0 0
Clinical Intermediate Basic
YES
Maryland
Certified Social Worker—Clinical Certified Social Worker Graduate Social Worker Social Work Associate
LCSW LCSW LGSW LSW
DSW/MSW DSW/MSW DSW/MSW BSW
2 yrs POST 2 yrs POST 0 0
Clinical Advanced Intermediate Basic
YES
Massachusetts
Licensed Independent Clinical Social Worker
LICSW LCSW LSW
DSW/MSW DSW/MSW BSW or BA or 1 yr college or HS AA/BA
3 0 0 2 1 8 0
Clinical Intermediate Basic Basic Basic Basic Basic
NO
MSW MSW or BA 2 yrs college or 1 yr exp.
2 yrs POST 4,000 hrs POST 2 yrs POST 1 yr POST 0
N/R N/R N/R N/R N/R
NO
Licensed Certified Social Worker Licensed Social Worker
yrs
yrs yr yrs
Licensed Social Work Associate
LSWA
Certified Social Worker Social Worker
CSW SW
Social Work Technician
SWT
Licensed Independent Clinical Social Worker
LCSW LISW LGSW LSW
DSW/MSW DSW/MSW MSW BSW
2 yrs POST 2 yrs POST 0 0
Clinical Advanced Intermediate Basic
YES
Licensed Independent Social Worker Licensed Graduate Social Worker Licensed Social Worker Mississippi
Licensed Certified Social Worker Licensed Master Social Worker Licensed Social Worker
LCSW LMSW LSW
DSW/MSW DSW/MSW BSW
2 yrs POST 0 0
Clin/Adv Intermediate Basic
YES
Missouri
Licensed Clinical Social Worker
LCSW
DSW/MSW
2 yrs POST
Clin/Adv
NO
Montana
Licensed Social Worker
LSW
DSW/MSW
2 yrs POST
Advanced
YES
Nebraska
Certified Master Social Worker Certified Social Worker
CMSW CSW
DSW/MSW MSW/BSW
3,000 hrs POST 0
Clin/Adv N/R
YES
Nevada
Licensed Clinical Social Worker Licensed Independent Social Worker
LCSW LISW
DSW/MSW DSW/MSW
3,000 hrs POST 3,000 hrs POST
Clinical Adv/Int
YES
Michigan
Minnesota
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Social worker
Practice Area 172
LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE
TITLE
INITIALS
Licensed Social Worker
LSW
Licensed Associate in Social Work New Hampshire
EDUCATION
EXPERIENCE
EXAM REQUIRED
BOARD APPROVAL
LSWA
MSW/BSW or MA/BA Emp. in SW
0 3,000 hrs POST 0
Basic Basic N/R
Certified Clinical Social Worker
CCSW
DSW/MSW
2 yrs POST
Clinical
YES
New Jersey
Licensed Clinical Social Worker Licensed Social Worker Certified Social Worker
LCSW LSW CSW
DSW/MSW DSW/MSW BSW or BA
2 yrs 0 0 1 yr
Clinical Intermediate N/R N/R
YES
New Mexico
Licensed Independent Social Worker LISW Licensed Master Social Worker LMSW Licensed Baccalaureate Social Worker LBSW
MSW MSW BSW
2 yrs POST 0 0
Clin/Adv Intermediate Basic
YES
New York
Certified Social Worker
CSW
MSW
0
Clin/Adv/Int
NO
North Carolina
Certified Certified Certified Certified
CCSW CSWM CMSW CSW
DSW/MSW DSW/MSW DSW/MSW BSW
2 yrs POST 2 yrs POST 0 0
Clinical Clinical Intermediate Basic
YES
North Dakota
Private Practice Licensed Certified Social Worker Licensed Social Worker
LCSW LCSW LSW
DSW/MSW DSW/MSW BSW
3 yrs POST 0 0
Clin/Adv/Int Intermediate Basic
YES
Ohio
Licensed Independent Social Worker Licensed Social Worker Registered Social Work Assistant
LISW LSW RSWA
DSW/MSW AA
2 yrs POST 0 0
Clin/Adv Basic N/R
NO
DSW/MSW/BSW
Oklahoma
License for Private Practice Licensed Social Worker Licensed Social Work Associate
LSW LSW LSWA
DSW/MSW DSW/MSW BSW
2 yrs POST 2 yrs POST 2 yrs POST
Clinical Advanced Int/Basic
YES
Oregon
Licensed Clinical Social Worker Clinical Social Work Associate
LCSW CSWA
DSW/MSW DSW/MSW
2 yrs POST 0
Clinical N/R
YES
Pennsylvania
Licensed Social Worker
LSW
DSW/MSW
0
Intermediate
NO
Puerto Rico
Licensed Social Worker
LSW
BSW
2 yrs POST
N/R
NO
Rhode Island
Licensed Ind. Clinical Social Worker Licensed Clinical Social Worker
LICSW LCSW
DSW/MSW MSW/BSW
2 yrs POST 0
Clinical Intermediate
YES
South Carolina
Licensed Independent Social Worker LISW Licensed Master Social Worker LMSW Licensed Baccalaureate Social Worker LBSW
DSW/MSW DSW/MSW BSW
2 yrs POST 0 0
Clin/Adv Intermediate Basic
YES
South Dakota
Independent Practice Certified Social Worker Social Worker
2 yrs 0 0 2 yrs
Advanced Intermediate Basic Basic
YES
Nevada
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Clinical Social Worker Social Work Manager Master Social Worker Social Worker
CSW-PIP DSW/MSW CSW DSW/MSW SW BSW or BA
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Criteria reviewed 2006
Practice Area 172
Social worker
LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE
TITLE
INITIALS
EDUCATION
EXPERIENCE
EXAM REQUIRED
BOARD APPROVAL
South Dakota
Social Work Associate
SWA
AA/BA
0
Basic
Tennessee
Independent Practitioner Certified Master Social Worker
LCSW CMSW
DSW/MSW DSW/MSW
2 yrs 0
Clinical N/R
YES
Texas
Advanced Clinical Practitioner Advanced Practice Licensed Master Social Worker Licensed Social Worker Social Work Associate
LMSW-ACP
DSW/MSW DSW/MSW DSW/MSW BSW BA/AA
3 yrs POST 3 yrs POST 0 0 1 yr/3 yrs
Clinical Advanced Intermediate Basic
YES
Basic (Associate)
Utah
Clinical Social Worker Certified Social Worker Social Service Worker
CSW CSW SSW
DSW/MSW DSW/MSW MSW/BSW or BA
2 yrs POST 0 0 1 yr POST
Clinical Intermediate Basic Basic
NO
Vermont
Licensed Clinical Social Worker
CSW
DSW/MSW
2 yrs POST
Clinical
YES
Virginia
Licensed Clinical Social Worker Licensed Social Worker
LCSW LSW
MSW MSW or BSW
2 yrs POST 0 2 yrs POST
Clinical Basic Basic
YES
Virgin Islands
Certified Independent Social Worker Certified Social Worker Social Worker
CISW CSW SW SWA
2 yrs POST 0 0 2 yrs POST 0
Clin/Adv Intermediate Basic Basic Basic
YES
Social Work Associate
DSW/MSW DSW/MSW BSW or BA AA/BA
Washington
Certified Social Worker
CSW
DSW/MSW
2 yrs POST
Clin/Adv
YES
West Virginia
Licensed Licensed Licensed Licensed
Ind. Clinical Social Worker Certified Social Worker Graduate Social Worker Social Worker
LICSW LCSW LGSW LSW
DSW/MSW DSW/MSW MSW BSW
2 yrs POST 2 yrs POST 0 0
Clinical Advanced Intermediate Basic
YES
Wisconsin
Certified Certified Certified Certified
Ind. Clinical Social Worker Ind. Social Worker Adv. Practice Social Worker Social Worker
CICSW CISW CAPSW CSW
DSW/MSW DSW/MSW DSW/MSW MSW/BSW
2 yrs POST 2 yrs POST 0 0
Clinical Advanced Intermediate Basic
YES
Wyoming
Licensed Clinical Social Worker
LCSW
DSW/MSW
2 yrs POST
Clin/Adv
YES
LMSW-AP
LMSW LSW SWA
Source: American Association of State Social Work Boards
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Social worker
Practice Area 172
Positions of other interested parties Beverly (MA) Hospital
According to Blair Smith, social work coordinator and senior clinician at Beverly (MA) Hospital, an acute-care facility that is part of the Beverly-based Northeast Health Systems, the hospital looks for social worker applicants who have a master’s degree in social work and hold the highest level of licensure in Massachusetts, an LICSW. “That’s what the majority of our staff are, although depending on the need, we occasionally hire people who have an undergraduate degree in social work.” The primary functions of the social workers at Beverly Hospital are: • Psychosocial assessments • Crisis intervention • Supportive counseling • Advocacy and protective work—whenever there are issues of abuse, neglect, or violence • Community outreach—referral and coordinating services • Discharge planning—arranging transfers for individuals, either home with services or to other hospitals or rehab facilities • Consulting physicians—general practitioners and specialists “It’s difficult to define the inpatient caseload of individual social workers at our facility because they do not just work in the hospital,” Smith says. “They also work in the community and do outreach as well.” Smith’s best estimate is that each social worker on staff is assigned to approximately 15 inpatient cases at any given time. There is no formal reappointment procedure at Beverly Hospital. “As long as the social workers maintain their licenses and meet an annual performance review and evaluation, they stay here until they choose to leave,” Smith says.
JCAHO
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has no formal position concerning the delineation of privi-
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Practice Area 172
Social worker
leges for social workers. But according to a JCAHO spokesperson, there are two things that a health care organization has to do in regard to social workers. The first is to verify that there is evidence that the social worker has a current license to be an independent practitioner. The second is to grant initial, renewed, or revised privileges to that independent practitioner based on relevant training and/or experience, current competence, and the ability to perform the privileges requested. While the JCAHO does not require hospitals to use any specific method in delineating clinical privileges, its 1997 Comprehensive Accreditation Manual for Hospitals does require that such privileges be hospital-specific and based on an individual’s demonstrated current competence (MS.5.15). It further requires (MS.5.15.1– MS.5.15.1.3) that “privileges are related to an individual’s documented experience in categories of treatment areas or procedures, the results of treatment, and the conclusions drawn from quality assessment and improvement activities when available.”
For more information
For more information regarding this practice area, contact: American Association of State Social Work Boards 400 South Ridge Parkway, Suite B Culpeper, VA 22701 Telephone: 540/829-6880 Fax: 540/829-0142 National Association of Social Workers 750 First Street, NE, Suite 700 Washington, DC 20002-4241 Telephone: 202/408-8600 Fax: 202/336-8311
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Social worker
Practice Area 172
The information contained in this document is general. It has been designed and is intended for use by hospitals and their credentials committees in developing their own local approaches and policies for various credentialing issues. This information, including the materials, opinions, and draft criteria set forth herein, should not be adopted for use without careful consideration, discussion, additional research by physicians and counsel in local settings, and adaptation to local needs. The Credentialing Resource Center does not provide legal or clinical advice; for such advice, the counsel of competent individuals in these fields must be obtained. Reproduction in any form outside the recipient’s institution is forbidden without prior written permission. Opus Communications retains the copyright to the Clinical Privilege White Papers.
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A supplement to Briefings on Credentialing 781/639-1872
Criteria reviewed 2006