Social worker. The hospital social worker recognizes groups at high psychosocial risk. These groups include:

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1 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). 1

2 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. 2

3 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. 3

4 LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE TITLE INITIALS EDUCATION EXPERIENCE EXAM REQUIRED BOARD APPROVAL Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Private Independent Practice PIP DSW/MSW 2 yrs POST Advanced YES Licensed Certified Social Worker LCSW DSW/MSW 2 yrs POST Advanced Licensed Graduate Social Worker LGSW MSW 0 Intermediate Licensed Bachelor Social Worker LBSW BSW 0 Basic Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clinical YES Certified Independent Social Worker CISW DSW/MSW 2 yrs POST Clin/Adv YES Certified Master Social Worker CMSW DSW/MSW 0 Intermediate Certified Baccalaureate Social Worker CBSW BSW 0 Basic Licensed Certified Social Worker LCSW MSW 2 yrs POST Clin/Adv YES Licensed Master Social Worker LMSW MSW 0 Intermediate Licensed Clinical Social Worker LCSW MSW 2 yrs POST Clinical YES Associate Clinical Social Worker ASW MSW 0 N/R Licensed Clinical Social Worker LCSW DSW or 1 yr POST Clin/Adv NO MSW 2 yrs POST Clin/Adv Licensed Clinical Social Worker LCSW DSW/MSW 3,000 hrs POST Clin/Adv YES Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clinical YES Licensed Ind. Clinical Social Worker LICSW MSW 3,000 hrs POST Clinical YES Licensed Independent Social Worker LISW MSW 3,000 hrs POST Advanced Licensed Graduate Social Worker LGSW MSW 0 Intermediate Licensed Social Work Associate LSWA BSW 0 Basic Licensed Clinical Social Worker LCSW DSW/MSW 3 yrs (2 yrs POST) Clinical YES Certified Master Social Worker CMSW MSW 3 yrs (2 yrs POST) Intermediate Licensed Clinical Social Worker LCSW MSW 3 yrs POST Advanced YES Licensed Master Social Worker LMSW MSW 0 Intermediate Licensed Social Worker LSW DSW/MSW 0 Intermediate N/S Independent Practice CSW DSW/MSW 2 yrs POST Intermediate YES Certified Social Worker CSW DSW/MSW 0 Intermediate Social Worker SW BSW 0 Basic Licensed Clinical Social Worker LCSW DSW or 2,000 hrs POST Clinical YES MSW 3,000 hrs POST Clinical Licensed Social Worker LSW MSW or 0 Intermediate BSW 3 yrs POST Intermediate Clinical Social Worker CSW MSW 2,000 hrs POST Clinical YES Social Worker SW MSW or 0 Intermediate BSW 2 yrs POST Intermediate Licensed Social Worker LSW DSW/MSW 2 yrs POST Clinical YES 4

5 LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE TITLE INITIALS EDUCATION EXPERIENCE EXAM REQUIRED BOARD APPROVAL Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada Specialist Clinical Social Worker LSCSW DSW/MSW 2 yrs POST Clinical YES Master Social Worker MSW MSW 0 Intermediate Baccalaureate Social Worker BSW BSW 0 Basic Licensed Independent Practice LCSW DSW/MSW 2 yrs POST Clinical YES Certified Social Worker CSW DSW/MSW 0 Intermediate Licensed Social Worker LSW BSW or 0 Basic BA 2 yrs Basic Board Certified Social Worker BCSW MSW 2 yrs POST Clin/Adv YES Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clinical YES Licensed Master Social Worker LMSW DSW/MSW 0 Intermediate Certified Social Worker Clinical LCSW DSW/MSW 2 yrs POST Clinical YES Certified Social Worker LCSW DSW/MSW 2 yrs POST Advanced Graduate Social Worker LGSW DSW/MSW 0 Intermediate Social Work Associate LSW BSW 0 Basic Licensed Independent Clinical Social Worker LICSW DSW/MSW 3 yrs Clinical NO Licensed Certified Social Worker LCSW DSW/MSW 0 Intermediate Licensed Social Worker LSW BSW or 0 Basic BA or 2 yrs Basic 1 yr college 1 yr Basic or HS 8 yrs Basic Licensed Social Work Associate LSWA AA/BA 0 Basic Certified Social Worker CSW MSW 2 yrs POST N/R NO Social Worker SW MSW or 4,000 hrs POST N/R BA 2 yrs POST N/R Social Work Technician SWT 2 yrs college 1 yr POST N/R or 1 yr exp. 0 N/R Licensed Independent Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clinical YES Licensed Independent Social Worker LISW DSW/MSW 2 yrs POST Advanced Licensed Graduate Social Worker LGSW MSW 0 Intermediate Licensed Certified Social Worker LCSW DSW/MSW 2 yrs POST Clin/Adv YES Licensed Master Social Worker LMSW DSW/MSW 0 Intermediate Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clin/Adv NO Licensed Social Worker LSW DSW/MSW 2 yrs POST Advanced YES Certified Master Social Worker CMSW DSW/MSW 3,000 hrs POST Clin/Adv YES Certified Social Worker CSW MSW/BSW 0 N/R Licensed Clinical Social Worker LCSW DSW/MSW 3,000 hrs POST Clinical YES Licensed Independent Social Worker LISW DSW/MSW 3,000 hrs POST Adv/Int 5

6 LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE TITLE INITIALS EDUCATION EXPERIENCE EXAM REQUIRED BOARD APPROVAL Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Licensed Social Worker LSW MSW/BSW 0 Basic or MA/BA 3,000 hrs POST Basic Licensed Associate in Social Work LSWA Emp. in SW 0 N/R Certified Clinical Social Worker CCSW DSW/MSW 2 yrs POST Clinical YES Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs Clinical YES Licensed Social Worker LSW DSW/MSW 0 Intermediate Certified Social Worker CSW BSW or 0 N/R BA 1 yr N/R Licensed Independent Social Worker LISW MSW 2 yrs POST Clin/Adv YES Licensed Master Social Worker LMSW MSW 0 Intermediate Licensed Baccalaureate Social Worker LBSW BSW 0 Basic Certified Social Worker CSW MSW 0 Clin/Adv/Int NO Certified Clinical Social Worker CCSW DSW/MSW 2 yrs POST Clinical YES Certified Social Work Manager CSWM DSW/MSW 2 yrs POST Clinical Certified Master Social Worker CMSW DSW/MSW 0 Intermediate Certified Social Worker CSW BSW 0 Basic Private Practice LCSW DSW/MSW 3 yrs POST Clin/Adv/Int YES Licensed Certified Social Worker LCSW DSW/MSW 0 Intermediate Licensed Independent Social Worker LISW DSW/MSW 2 yrs POST Clin/Adv NO Licensed Social Worker LSW DSW/MSW/BSW 0 Basic Registered Social Work Assistant RSWA AA 0 N/R License for Private Practice LSW DSW/MSW 2 yrs POST Clinical YES Licensed Social Worker LSW DSW/MSW 2 yrs POST Advanced Licensed Social Work Associate LSWA BSW 2 yrs POST Int/Basic Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clinical YES Clinical Social Work Associate CSWA DSW/MSW 0 N/R Licensed Social Worker LSW DSW/MSW 0 Intermediate NO Licensed Social Worker LSW BSW 2 yrs POST N/R NO Licensed Ind. Clinical Social Worker LICSW DSW/MSW 2 yrs POST Clinical YES Licensed Clinical Social Worker LCSW MSW/BSW 0 Intermediate Licensed Independent Social Worker LISW DSW/MSW 2 yrs POST Clin/Adv YES Licensed Master Social Worker LMSW DSW/MSW 0 Intermediate Licensed Baccalaureate Social Worker LBSW BSW 0 Basic Independent Practice CSW-PIP DSW/MSW 2 yrs Advanced YES Certified Social Worker CSW DSW/MSW 0 Intermediate Social Worker SW BSW or 0 Basic BA 2 yrs Basic 6

7 LEVELS OF SOCIAL WORK PRACTICE REGULATED STATE TITLE INITIALS EDUCATION EXPERIENCE EXAM REQUIRED BOARD APPROVAL South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Social Work Associate SWA AA/BA 0 Basic Independent Practitioner LCSW DSW/MSW 2 yrs Clinical YES Certified Master Social Worker CMSW DSW/MSW 0 N/R Advanced Clinical Practitioner LMSW-ACP DSW/MSW 3 yrs POST Clinical YES Advanced Practice LMSW-AP DSW/MSW 3 yrs POST Advanced Licensed Master Social Worker LMSW DSW/MSW 0 Intermediate Social Work Associate SWA BA/AA 1 yr/3 yrs Basic (Associate) Clinical Social Worker CSW DSW/MSW 2 yrs POST Clinical NO Certified Social Worker CSW DSW/MSW 0 Intermediate Social Service Worker SSW MSW/BSW 0 Basic or BA 1 yr POST Basic Licensed Clinical Social Worker CSW DSW/MSW 2 yrs POST Clinical YES Licensed Clinical Social Worker LCSW MSW 2 yrs POST Clinical YES Licensed Social Worker LSW MSW or 0 Basic BSW 2 yrs POST Basic Certified Independent Social Worker CISW DSW/MSW 2 yrs POST Clin/Adv YES Certified Social Worker CSW DSW/MSW 0 Intermediate Social Worker SW BSW or 0 Basic BA 2 yrs POST Basic Social Work Associate SWA AA/BA 0 Basic Certified Social Worker CSW DSW/MSW 2 yrs POST Clin/Adv YES Licensed Ind. Clinical Social Worker LICSW DSW/MSW 2 yrs POST Clinical YES Licensed Certified Social Worker LCSW DSW/MSW 2 yrs POST Advanced Licensed Graduate Social Worker LGSW MSW 0 Intermediate Certified Ind. Clinical Social Worker CICSW DSW/MSW 2 yrs POST Clinical YES Certified Ind. Social Worker CISW DSW/MSW 2 yrs POST Advanced Certified Adv. Practice Social Worker CAPSW DSW/MSW 0 Intermediate Certified Social Worker CSW MSW/BSW 0 Basic Licensed Clinical Social Worker LCSW DSW/MSW 2 yrs POST Clin/Adv YES Source: American Association of State Social Work Boards 7

8 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- 8

9 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 MS ) 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 Telephone: 540/ Fax: 540/ National Association of Social Workers 750 First Street, NE, Suite 700 Washington, DC Telephone: 202/ Fax: 202/

10 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. 10