Ever feel stuck because your license limits where you can work? The Counseling Compact is changing the game for therapists who want more freedom to practice across state lines. In this episode of The Traveling Therapist Podcast, I chat with Dr. Lynn Linde, Chief of Professional Practice for the American Counseling Association, who’s been leading the charge on this groundbreaking initiative.
Dr. Linde walks us through what the Counseling Compact is, how it started, and what it means for those of us who want to serve clients no matter where they are—or where we are! She also shares where the compact currently stands, how states are joining, and what steps you can take to get involved.
In this Episode, We Explore…
Connect with Lynn:
Website - https://counselingcompact.gov & https://compactconnect.org
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Revolutionize Your Private Practice with AI Course: www.kymtolson.kartra.com/page/ai
Signup to learn more about life as a Traveling Therapist: https://www.portablepracticemethod.com/free-training
The Traveling Therapist Facebook Group: www.facebook.com/groups/onlineandtraveling/
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Transcript:
[00:00:00] Kym: Hi, everybody. Welcome back to another episode of The Traveling Therapist Podcast. So excited to have our guest today. This is an unusual guest. Usually we just have therapists talking about traveling and how they're doing it, but we have Dr. Lynn Lindy here with us, the Chief of Professional Practice for the American Counseling Association.
[00:00:17] She oversees professional issues related to counseling and ethics and. Working on the counseling compact and the current issues in the profession around being able to have this compact in place. She's working tirelessly, is what I gained from this conversation.
[00:00:32] And I wanted to invite you in today, Dr. Lindy, just to let us know what's going on with this, your role in it, anything counselors can do to help move the process along and just, you know, some insight into where it's gonna be eventually. I keep hearing late fall, so I'm really excited to talk to you about this and let everybody else know as well.
[00:00:50] Lynn: Well, I'm delighted to be here and I'm always happy to talk about the compact. It's one of my favorite things to talk about, and I've been working on it for almost six and a half years. It is going to be a reality. I. I keep saying the end of the summer as opposed to fall, and that's a little bit of wiggle room because, for some people, the end of the summer's Labor Day, for some people it's the meteorological end of the summer, which is the end of September.
[00:01:15] So somewhere between those two, we are extremely hopeful, 95% hopeful that. The, when we say the compact will be up and running, we mean the commission will be able to issue privileges to practice . But let me backtrack a little bit about how we got here, what it is what people need to know about it. And so I don't forget, let me remind everybody.
[00:01:40] We have a ton of information on acas webpage edits. It's open to anybody. So if you're not an a CA member, not a problem. Just click on our main page and you'll see a whole link to the counseling compact. Also, the Compact has its own webpage, and that's surprise counseling co.gov,
[00:02:02] we have a government webpage now where the commission is a quasi-governmental agency and by going to that webpage you can also follow the progress that the commission is making on getting the database up and running, and that's compact connect.org. go onto that counseling compact.gov webpage and lots of information.
[00:02:24] So how did we get here? We all know if you've been a counselor for any length of time, you know that one of the biggest problems that we have in the field is practicing across state lines. And because licensure is the purview of states, everybody did it differently and it took us. 33 and a half years to go from Virginia being the first state to attain licensure in 1976 to California in 2009 when the bill got signed, I believe in 2010.
[00:02:54] So a long time to get all 50 states in the District of Columbia. We also have licensure in the territories.
[00:03:02] So 57 licensing boards, but you can't practice in more than the one where you hold a license unless you hold a license in other jurisdictions, and I'm gonna refer to them as jurisdictions rather than states just to be inclusive of the District of Columbia and and territories.
[00:03:19] So for years, everybody had lots of ideas about how to do it. The compact is not the only way To allow people to practice across state lines. It's the most efficient way. So a lot of states had reciprocity, which means I as a state am going to accept you state B'S licenses. So anybody who holds a valid license to practice independently in your state can come practice in mice state.
[00:03:44] State, and then they put various restrictions on that. You have to register, you have to let the state know you're doing it. Sometimes you don't. It depends on the state, but I did the math one day, and for every state to have reciprocity with every other state it's almost 500 reciprocal
[00:03:59] agreements that would have to exist. so you know that's never gonna happen.
[00:04:03] Kym: So complicated.
[00:04:04] Lynn: They don't exist in statue, they can go away just as easily as they were negotiated. So we were at a meeting in 2018, I think it was in January, February, of the American Association of State Counseling Boards, and there was a presentation done by these two. Professionals.
[00:04:25] Dan Logston, who's the director of the National Center of Interstate Compacts, and at that time it was Marcus Biard who was head of the Department of Defense's family unit.
[00:04:37] talked about interstate compacts, and my colleagues and I all looked at each other and said, oh my heavens, this is terrific.
[00:04:44] Why aren't we doing this instead of all the other things that everybody was trying? So the American Counseling Association signed a compact with the National Center for Interstate Compacts in January of 2019, and we began the process. So. IC is part of the Council of State Governments, so they are quasi-governmental agency headquartered in Lexington, Virginia.
[00:05:10] They service all three branches of state governments, and that is their focus is state governments, so they know all the players.
[00:05:19] They work With the legislators so you know, they know who these people are and what they're gonna sponsor. The Department of Defense has obviously been very supportive of this as well, and very helpful in identifying potential sponsors and, and helping us get bills passed.
[00:05:36] But the thing about compact, so compact does a couple of things and so we entered into this agreement. NCIC has this whole process. We put together an advisory board and, and the point that I'd like to make is that this is something counselors did for counselors. This wasn't something that was sports taught us.
[00:05:53] This isn't, you know. Government agency or somebody else saying, you have to do this. We wanted to do this a CA, paid for it. We paid for this entire process, this part of the process, and put together an advisory board, which consisted of practicing counselors, practitioners who had held licenses in more than one state and understood the pain of having to go through that process.
[00:06:16] We had counselor educators who had particular expertise had done research and licensure laws. We had licensing board members, so chairs of licensing boards, the board administrators, the lawyers for licensing boards. We had a couple of other people, A SAB was part of this group. We had a number of other people and we had some state legislators who are LPCs.
[00:06:43] And lemme tell you, that's a really tiny little group. You look at state legislators and you will find a lot of social workers a lot of other professions represented. At the time in 2019, there were six counselors who held elected office and states. So I always encourage people, go get elected to your state government.
[00:07:08] If you wanna change what happens to counseling, you need to have a voice at the table. Lobbying and advocacy is incredibly important, but it's not enough because we aren't in state legislatures. We aren't forces at the table , But that's a whole nother topic
[00:07:23] So what the group did was they wanted to look at what was going on, because we all went into this sort of thinking, well, every state did it differently.
[00:07:31] How are we ever going to agree on the core
[00:07:34] Kym: Yes. Yes.
[00:07:35] Lynn: one of our colleagues had done some seminal research and we found that there was about 85% agreement, which surprised us all actually, we all.
[00:07:44] Kym: Yeah.
[00:07:48] Lynn: Hours, 60 hours, because almost all the licensing boards required 60 hours. They all required a national exam. They all required post-degree supervision. They all required continuing professional development. and they all required either a degree in counseling or a closely related field, or enough hours to equal 60.
[00:08:12] So, for example, I live in Maryland and. counselors who got their degrees in school counseling, which is for the most part a 48 hour degree can do the 12 additional hours and the requisite courts work and get licensed as an LPC. So that's. Where we came in with some of the wiggle room for a degree and counseling, plus enough hours to equal 60 because some of the states allow that.
[00:08:35] Many of the states allow that option for people. So we had that where the differences were is how many post-degree supervised hours?
[00:08:44] Kym: Okay. I was just wondering what, what were the differences? Yeah. Okay.
[00:08:48] Lynn: from 1500. At that time it went between 1,530 500. So I'm not sure what it is now 'cause I haven't tracked that, but it, there is
[00:08:58] Kym: feel like 4,000 hours, but I don't know where I'm getting that from. Yeah.
[00:09:02] Lynn: but everybody does it differently. So that was one big differences. A lot of states feel very strongly about continuing professional development or specific courses that you have to take to get a license in their state.
[00:09:17] They had to give it up. So we came up with the draft, which was then put into a, formal bill it was basically the lawyers on the advisory group.
[00:09:25] So the board attorneys, there were a couple of executive directors who were lawyers. We had NCIS lawyers who work on compacts whose area of expertise is compact law. Put together the draft legislation, and then the next big push was getting it passed in states, and we walked out of that meeting where we had the initial draft done and the world closed down the next week for the pandemic.
[00:09:51] Kym: my gosh.
[00:09:52] Lynn: So talk about bad timing. And so everything that we had planned around publicity and outreach and legislative summits sort of, wasn't gonna happen as everybody was hunkering at home. So we continued to do some things virtually and that year, two states passed the compact and we were dumbfounded.
[00:10:15] And that was Maryland because the governor wanted it. The governor made it part of his legislative packet and Georgia, because the counselors wanted it and they pushed it up the bill through the following year. We got 15 states, and we currently have 37 states at the District of Columbia. So just to give you some idea, I mentioned 33, not a pop quiz.
[00:10:38] 33 years, 33 and a half years to get everybody to licensure.
[00:10:43] Kym: my gosh.
[00:10:44] Lynn: and a half years, 37 states and the District of Columbia. So that tells you something about how much everybody wants the compact. Our compact has moved faster than any of the other occupational licensure compacts. There are compacts that have more member states than we do,
[00:11:04] But when it comes to how quickly occupational licensure compacts are moving, we've moved very quickly and we get 10 times more hits on the webpage than any other occupational licensure compacts. So there's a huge amount of interest. So we're operating on, two fronts with this.
[00:11:22] One front is we continue to move legislatively. The other is getting the compact up and running. Within the legislation, we said you have to have 10 states to trigger a commission.
[00:11:33] What's magical about 10? Well, nothing but I mean, but that's sort of standard practice and occupational compact legislation and the reality is you want enough states to make it meaningful, but not so many states that you can't get there for years.
[00:11:49] there are some states that did, there were a couple of the compacts that set seven as their goal. Once they reached seven states, they'd established their commission. I am very happy with 10, I think, and we actually had 17 I. When we started the commission, and that was, that's a pretty representative number.
[00:12:08] And one of the things that encouraged people to pass the legislation is you get to write the rules when you're sitting at the table, but you don't get to write the rules. If you're not, then you have to come in and. Accept what's happened before you, so with the commission, so a lot of states were like, oh no, we wanna get this passed so we can be part of the initial group that decides how this is all going to work.
[00:12:32] And so we had 17 states that did that. So what does the compact do
[00:12:38] first of all it's a mutual recognition. Process. What that means is every state believes that they do it better than every other state And licensing boards. I have come to appreciate licensing boards so much in my work with them because they are so committed to ensuring that no one who shouldn't have a license gets a license.
[00:13:03] I mean, that's their job, and they do think a very good job of it.
[00:13:07] So it took a huge leap of faith for all of them to say, okay. We're going to accept the license of every other state that joins the compact, even if those requirements are different from ours, because we trust that our colleagues have done their due diligence in granting licenses, and that is a huge leap of faith that it took some of them a while to get there.
[00:13:33] I jokingly say I went through a few Kevlar suits. That's when I'd present the licensing board. Some of them would say, you want us to do what?
[00:13:42] You know, we are a blank, blank, blank state, you know, we don't accept, but they got there. And the ones that haven't joined yet have not joined, not because they don't support the compact, but it's legislatively they're having trouble getting it through the.
[00:13:55] Kym: Yeah, I was always wondering like, what is the reason why some wouldn't wanna join, but it's just legislative?
[00:14:00] Lynn: It's, and I can talk about that a little bit later on, but it, it just says some states are not compact friendly because nobody's against mental health. As, one senator said to us, nobody's gonna vote against mental health on the floor.
[00:14:13] Kym: Yes.
[00:14:14] Lynn: to be on record saying, I'm against making it easier for my constituents to get mental health services, particularly when we're in a mental health crisis.
[00:14:22] So that's not it. It has to do with state specific. Either they don't like compacts as a whole, usually because they don't understand them well enough. So there's a lot of education that has to go into explaining how this works or, there are a couple of other reasons. We had a couple of states, so I mentioned 60 hours.
[00:14:40] We had some states that. Didn't require 60 hours. They had to create a 60 hour pathway. So what's happened in some states is that you have a 48 hour license where you can practice within that state, but you can't go anywhere else with that
[00:14:56] And in order to practice through the compact, you have to meet that 60 hour requirement. And so it's a dual pathway. Hawaii, for example, hasn't joined. There are a 48 hour state and they need to decide if this is something they wanna do, if they wanna create that pathway. But we had at least four other states that had to create 60 hour pathways in order to join the compact.
[00:15:18] So everybody has to accept everybody else's license. And what it allows you to do is practice in any compact state. It allows you to use telehealth. So when states pass this bill, regardless of what their telehealth policies are, it permits telehealth both within the state and across state lines. It provides an expedited mechanism for counselors who move.
[00:15:41] So the compact requires that a counselor have a valid unencumbered home state license. It's where you legally reside. I always say where the IRS finds you.
[00:15:55] So I know that lots of people live in one state. They practice, they held a license in another state 'cause their office is five miles away In that other state under the compact, if you wanted to take advantage of the compact, you would have to get a license in your home state.
[00:16:11] So that is one of the requirements, but it does provide an expedited mechanism. So if you have a license in your home state and you move to another state that's a compact state, and you hold a privilege there, you will be able to swap your privilege and your home state license. So the license you currently hold in, let's say Maryland.
[00:16:33] That's where if I move to Virginia, which is another compact state, I hold a privilege in Virginia, they just swap it. Virginia becomes my new home state license. Maryland changes from my home state license to a privilege, and then even better for military spouses. It allows you to designate a license. You pick up any valid license that you hold that's unencumbered, and there's a two year lookback period and you say, this is my home state license, and for the entire duration of your spouse's active duty, you can practice on that license.
[00:17:09] So every 2, 3, 4 years, when you move, you do not have to get another license. You
[00:17:15] Kym: Ah, that's amazing.
[00:17:16] Lynn: so That's where you can see the, the military influence in all of this, because the military really, at least at the time we were working on it, was trying to make it as easy for military families as possible to go through those transitions.
[00:17:31] Kym: That's amazing. And the key about the licensing compact, my understanding anyway, so with spac, the clinician, if they have a home state designated, they actually have to be physically sitting in that home. State to be able to use the compact and the compact states, but this compact isn't like that, right?
[00:17:47] You can have a designated home state, but you don't have to physically be sitting in the home state to be able to utilize the compact. Is that correct?
[00:17:54] Lynn: That is correct, and that's because counseling doesn't care where you are.
[00:17:59] counseling cares that your license where your client is and that's the difference. one of the differences between PAC and the counseling compact because we look at licensing differently.
[00:18:10] So counseling has always said you must hold a valid license for your client is located. So under the compact you can be anywhere.
[00:18:21] Kym: Right?
[00:18:22] Lynn: As long as you have a license or a privilege to practice where your client is located, you can continue to see them. So let's say you have a large practice of college students and they go home for the summer, wherever home might be, if you wanna continue working with them, you can continue to do that.
[00:18:41] As long as you have a privilege to practice in the states where they're residing for those summer months. You can go on vacation somewhere and as long as you have internet and can do telehealth, you can continue to work with them
[00:18:55] Kym: That's amazing. And that's in all of the states licensing boards right now, that they allow you to be anywhere the, therapist to be anywhere doing telehealth or are there some states
[00:19:02] Lynn: the, in the
[00:19:04] Kym: In the compact. Okay. Gotcha.
[00:19:06] Lynn: To the 37 states in the District of Columbia who have joined the Compact, the other 13 states and the other territories still play by their own set of rules.
[00:19:16] Kym: And they might, they might allow it, but they might not allow it. So you have
[00:19:19] Lynn: Right. You the licensing board,
[00:19:22] Kym: right. That's a question that comes up all the time. And you know, can I, or can I, and it's like, well you gotta go check with your licensing board to find out. But that's interesting to hear. Yeah. So the compact states, all of 'em are in on board with that.
[00:19:33] Lynn: the other thing that you have to do, states have to there's some state requirements and obviously all the states that have joined the compact meet those requirements. And then what do counselors have to do? I keep saying you have to have the degree, you have to be able to practice independently, and it only applies to those people who were licensed.
[00:19:53] And I'm going to use the term LPCs licensed. Professional counselors. The reason for that is years ago with the 2020 initiative, all of the counseling organizations decided, agreed that that's the term we would use. So that's why we wrote that term into the legislation. Of course, nobody uses that term.
[00:20:10] There are about 22 different terms that all the licensing boards use. So what you have to look at is, what does that mean? It means you are licensed to practice independently and you have the ability to assess, diagnose, and treat behavioral conditions.
[00:20:26] Because at the time this was being written, Counselors didn't have the ability to bill for Medicare yet, but we knew once we got Medicare, we knew that was gonna be close. And once we got it, that integrated healthcare was going integrated practice was going to become much larger. And so we wanted to use terminology that would account for that.
[00:20:47] Kym: It's amazing. Gosh. And it's so, it just sounds so complicated. This whole process
[00:20:51] Lynn: it has been. So every year we get a few more states. This year, unfortunately, we haven't had any states. The District of Columbia came on board this year. They actually passed it last summer. But the district has a provision where Congress has to review all, everything that passes and approve it, and so they didn't do it until the fall.
[00:21:11] So I still claim the District of Columbia as part of last year. We have pending legislation in Pennsylvania. It passed the house. It is now in the. This week, it passed the house Tuesday and is in the other chamber, so there's an outside chance it could still pass in Pennsylvania. Massachusetts has legislation, but I can't tell if it's actually going anywhere this year.
[00:21:36] New York isn't going anywhere this year. New York State.
[00:21:39] They're just not a, real compact, friendly state, but we're, we're still hopeful. So going down, I sort of do it geographically in my mind. down the
[00:21:48] Kym: I'm like, I would love to know which states aren't, fully on board, because then we can advocate, you know, people can go and advocate with their state
[00:21:54] Lynn: has had legislation, but it doesn't seem to be moving. Illinois isn't doing much of anything. Nevada and New Mexico tried very hard this year and were not successful. Although in Nevada there's still something going on, but I'm not quite sure how they're working sort of behind the scenes because their session has ended.
[00:22:15] Oregon decided they lost by one vote last year. They decide not to put a bill in this year, but they'll put what in next year, i'm sorry Idaho. Oregon didn't go anywhere this year. California, I thought was going to work on it this year, but hasn't. As far, we haven't seen any pending legislation, but they're still very interested.
[00:22:37] Hawaii hasn't shown a lot of interest. Alaska's just beginning to show some interest. So I think that's most of the 13. I've probably missed some. Oh, Texas. Texas has a bill and their problem was that the chair of the committee that heard compacts didn't like compacts last year, so the bill didn't go anywhere.
[00:22:59] So the lieutenant governor moved the bill to a different committee. So we're hopeful that that will pass, and I think that's. That should be most of the 13 states.
[00:23:09] Kym: Okay. That's amazing that you could name those. So why, why wouldn't the states want the compact? I mean, I know you said legislative holdups and that sort of thing, but there's a theory like in the therapist world, right?
[00:23:19] That it's like, oh, they wanna keep all the money to themselves. They don't wanna have to like, but I'm just curious like, what would be the negatives to it that they see?
[00:23:26] Lynn: I hear the issue of reimbursements and our rates are so much higher than everybody else's. If we, if we had the compact, everybody would come to, I've not heard that from state legislators. I only hear that from counselors, so I'm not quite sure where they're getting that. the reality is it's that some states are just not compact friendly.
[00:23:46] The ones that have legislation in, for the most part are Pennsylvania really wants the compact. They're a unique situation because you have to have an FBI background check, and only a handful of states require FBI background checks to get an initial license. So as part of joining the compact, every state had to agree to implement an FBI background check.
[00:24:10] There was a. Disagreement in Pennsylvania about whether the FBI could do background checks for occupational licenses. So Pennsylvania passed a bill that resolved that issue, so now they can put compacts through. And now a number of compacts, including the counseling compact are moving through.
[00:24:28] They have a very active counselors group who have been lobbying for years. For this and have done an outstanding job. So I'm very hopeful. In some other states, there's a lack of understanding about compacts and some states think that they're giving up their state sovereignty. When they join a compact, they don't understand the role of the commission.
[00:24:51] The commission doesn't establish new law. the way a compact works is there is one lit piece of legislation and states have to pass that identical piece of legislation. There's a little bit of wiggle room. If the state says, well, we use the word may not shall, then they can change all the shalls to May, but they can't substantially change any of the language in the compact legislation.
[00:25:16] That's what makes it uniform. But what some legislators think is that I'm giving up my ability to make decisions. The compact has nothing to do with initial licensure.
[00:25:29] That is the purview of states. States have all the control over deciding. What the requirements are for initial licensure. To whom are they going to give a license?
[00:25:41] You know, all of those things about licensure still remain with the state. None of that's changed. What they're saying is, but okay, for people who can practice independently, if they wanna be part of the compact, then we're going to abide by. These regulations for those folks, but it doesn't change everything else that goes on within the states.
[00:26:03] The states aren't giving up anything. One state was very concerned about the opposite that from, we pay so much, everybody's gonna wanna come here. Their concern was, well, if our counselors can practice someplace else without leaving the state, then who's gonna be providing services to our residents if they practice someplace else. So other compacts that have been operational for a while have not seen that happen,
[00:26:34] but we haven't been operational yet. It's hard to dispute concerns like that. 'cause we can't say, well, in these three states, that didn't happen because there aren't any privileges that have been granted yet.
[00:26:44] So we have to look to other compacts to say, well, in the in CPAC or in the EMS compact, that wasn't true in the nursing compact. That wasn't true.
[00:26:56] Kym: interesting. And I wonder, I mean, I don't know, if this is part of it, but. Disciplinary in action. if you're not in your home state, if you're like seeing the clients physically in one of the compact states is not your home state, who disciplines the clinician if there's a complaint against them, I feel like that would be really complicated
[00:27:12] Lynn: it's not as complicated as it sounds. NHA Kalis is the lawyer. We use for both the commission and she works part-time. She's a contractor for NCIC, so she's the one who reviews all the legislation, answers all of our legal questions. the way N Holly frames it is the state can only take away what the state gives you.
[00:27:33] So if you think about it that way, it makes a lot of sense. So I have a privilege to practice in Virginia. I do something. That goes against a law, a regulation, or scope of practice in Virginia, and I'm sanctioned by the Virginia Board because it happened in Virginia.
[00:27:52] Kym: Right.
[00:27:53] Lynn: They granted me a privilege. The only thing they can do is take away that privilege to practice.
[00:27:58] They can't touch my home state license,
[00:28:01] Kym: okay.
[00:28:02] Lynn: but through the database, they report the sanction against my privilege. To the database, which means every state where I hold a license and or a privilege is notified of this sanction. And then every licensing board decides whether they wanna take action or not.
[00:28:22] for example, recreational marijuana is legal in this state, it's not legal in a lot of other states. So I use recreational marijuana that's not legal in a state where I hold a privilege. They revoke. My privilege is Maryland to revoke my privilege. Probably not 'cause it's legal here and I wasn't using it while I was seeing a client.
[00:28:46] I, it has nothing to do with my practice. So the board will look at it and they will probably say, Nope, we're not gonna take any action. Your license is fine, but you know, sleeping with your client, you're gonna lose your license and your privileged to practice in every state.
[00:29:00] Kym: Right.
[00:29:00] Lynn: depends what it is.
[00:29:02] Kym: Yes. That's so interesting. Now you'd mentioned like Hawaii, for example. If Hawaii comes on board and they only require 48, but the compact says 60. Does that mean a clinician that's, you know, already licensed and working in Hawaii that had the 48 hours now has to come up? The remaining 12 to meet the 60 to be able to be in the compact
[00:29:21] Lynn: Oh, great question. So let me talk about legacy licenses. So when the bill was created, we wanted to be respectful of all of those people who have been practicing for years. Now, first of all, if Hawaii wants to join the Compact, they have to create a 60 hour pathway.
[00:29:40] So anybody who's going to moving forward at the time, they become part of the compact.
[00:29:47] Anybody who's granted a license would have to have 60 hours in order to participate in the compact. But what about all those people who've been practicing for 20 years? We have counselors who were practicing before the National Counselor Exam even existed.
[00:30:03] I mean a handful, but we do have some. And we have a lot of people who graduated from 36 hour programs, and then we have a lot of people who graduated from 48 hour programs and they are fully licensed in the state where they practice.
[00:30:18] They met all of the requirements for licensure at the time they were granted their license to practice independently. They'll not have to do anything else to. Obtain a privilege to practice, except if a state requires a jurisprudence exam, they'll have to take a jurisprudence. Everybody will have to take a jurisprudence exam in a state where they wanna hold a privilege if the state requires it.
[00:30:44] And about half the state's require jurisprudence exams.
[00:30:47] because jurisprudence exam is, this is our licensing law. If you're gonna practice in another state, it's incumbent on the counselor to understand what is the scope of practice of that state, what are the laws, what are the regulations?
[00:31:00] And one of the ways of ascertaining that the counselor does understand that is to require the jurisprudence exam, which is an exam on their law.
[00:31:09] Kym: Wow. That's incredible. yeah, ' cause there's different ages of consent in different states. There's, all kinds of different rules and regulations that are probably different state to state, I would think that you'd have
[00:31:19] Lynn: Very different but if I have a 48 hour degree and I, my license is in good standing and I've been practicing for 20 years, I'm not gonna have to go back and take 12 more hours.
[00:31:30] because I'm going to get what's called a legacy license. Now, there may be a few cases, and it's up to the individual board where somebody won't be granted a legacy license.
[00:31:42] There are a couple of states that have licensed people whose degrees are not in counseling. And this is a counseling compact, so I'm surprised you haven't asked me, but no, I'm sorry. Marriage and family therapists, you don't qualify
[00:31:55] Kym: Well, I was gonna ask that actually. 'cause when you said earlier, they have different names in every state, so I was thinking that, is that Lm hcs And does l MFTs does it,
[00:32:03] Lynn: Well, some are clinical mental health counselors. Some are licensed professional clinical. I mean, every state a little bit different, but they're all counselors, so they all met the requirements for a counseling license. But if the state licenses marriage and family therapists separately,
[00:32:20] Kym: Mm.
[00:32:21] Lynn: not as part of the counseling license, but has a separate marriage and family therapy license, then no.
[00:32:26] Those folks don't qualify unless they meet the requirements for counselor license. Social workers don't qualify. They have their own compact. Well, they're working on their own compact.
[00:32:37] Kym: Right. I am a social worker, by the way, and I'm, I'm curious about that one, too. I'd love to get somebody to talk about that.
[00:32:42] Lynn: Oh, I'll give you the name of somebody. offline. My counterpart for social work she will be more than happy to talk about the social work compact.
[00:32:49] Kym: Oh, that's amazing. Thank you.
[00:32:50] Lynn: So social work is working on its own compact. Psychology has had one forever. So the people who are really left out are art therapists, music therapists, dance therapists unless they're licensed as counselors or social workers, and have a specialty in that area that they aren't qualified for the compound.
[00:33:12] Kym: Gotcha.
[00:33:13] Lynn: So marriage and family, as far as I know, is not working on a compact. I know they were approached, but they've had some obstacles to doing it, so I haven't really kept up with it. I don't speak for them. They're a separate profession, a separate organization. I just sort of watched the progress of all the compacts 'cause we do meet as a group.
[00:33:33] The project leaders meet as a group
[00:33:35] Kym: Oh, that's amazing. Yeah.
[00:33:37] Lynn: get to sort of follow each other's progress and share stories and successes and, you know, this person was really helpful in this state. You might wanna talk to them. So it's, it's a very supportive group.
[00:33:49] So what else do we need to know? Okay, so the commission, who is the committee? Who's this commission?
[00:33:54] The commission is one representative from the licensing board for every member state, and the state gets to decide who that person is. However it happens within the state. In some cases it's a governor's appointment. In some cases, the board decides for itself in some cases it's the Secretary of State who does that. So, however appointments are made, that's how somebody is appointed. And for counseling, it's about half board administrators and half counselors who serve on boards.
[00:34:25] some of the other compacts have done it differently. They've decided to have only board administrators because they have a little bit more time and they don't revolve as frequently as board members do.
[00:34:37] They have to meet at least once a year. And that meeting is usually has been for the last couple of years attached to the American Association of State Counseling Board's Annual Conference because most of the commissioners are there. They also have, four active subcommittees.
[00:34:54] Finance, obviously the executive committee, the rules committee, and nominations and elections. they will have a compliance committee pretty soon. and the compliance committee would deal with any issues of states not being in compliance.
[00:35:10] Kym: Um,
[00:35:10] is there a commissioner from every state, regardless if they're in the compact or not? Or only if they're in the compact, do they get a
[00:35:16] Lynn: if they're in the compact.
[00:35:17] Kym: Okay. Gotcha.
[00:35:18] Lynn: no, the 13 states and the other territories are not represented. They cannot have a seat until they do become part of the compact. But because we are a quasi-governmental, we being the commission, as a quasi-governmental agency, I need to watch my world. We. I just feel such ownership.
[00:35:36] But the commission is a quasi-governmental agency and it applies. The open meeting rules apply. So when you go on the counseling compact.gov webpage, all of the meetings are listed. The agendas, the minutes from previous minutes, the Zoom links for the meetings. Anybody can attend. And they leave at least five minutes at the end of every meeting, whether it's a committee meeting or the full commission meeting to entertain questions or comments from the public.
[00:36:06] And when it started and the rules were being written, and there was a lot of contentiousness around, some of the people thought there would be contentiousness around some of the rules. we would get a hundred people, 150 people on these calls. Now, if we get a handful of interested counselors, people who've been working with this thing.
[00:36:26] So what kinds of rules have they written? The rules committee writes a rule. It goes to the executive committee. They review it. It then goes to the full commission for acceptance. They wrote the rule about legacy licenses. They define home state. they wrote the rule around fees,
[00:36:40] how much is this going to cost me? The commission decided that it's going to be $30 per privilege.
[00:36:46] Why $30? right now, the commission has been largely paid for by the American Counseling Association, a CA. Two sets of funding. Our first set of funding, which was about $600,000, is our contract with the Council of State Governments to get this whole process in place to work with them, to get the legislation passed, to do the, the lobbying, the legislative work, and to get the commission up and running.
[00:37:14] So. We've been working with them for a little over six years now, six and a half years. On that, we will probably extend our contract with them for another year to really make one last concerted effort on those laps 13 or however many states are left at the end of this year. The second contract we have is for up to $1.2 million, and that is with the commission.
[00:37:37] So yeah, a CA has put almost $2 million into this. And well it says, speaks to our commitment to counseling. I mean, this is the biggest change to practice in 30
[00:37:48] Kym: Oh my God. it'll be so important to have these
[00:37:51] Lynn: incredibly important for our counselors, regardless of whether an a, a member, I mean, everybody benefits. And for those whom we serve, it's incredibly important .
[00:38:01] it brings very needed changes to the way we practice, that has paid largely for the commission. The commission, once it got up and running, hired an executive director. That's Greg Sears and his information can be found on the webpage. And Greg runs the day-to-day operations of the commission.
[00:38:21] that money also pays for the creation of a database Now some of the compacts had databases side pack. For example, their licensing board group had a database that they were able to use. The same thing for nursing. And counseling. That's not true. So we would enter partnership with occupational therapy and speech language pathology and audiology create a database.
[00:38:47] But no one had ever done this before. So use, it's been a quite the process. So when we say, well, I've been saying for two years, well, we're about to grant privileges. Well guess not another six months. That's why, because when we started this process two years ago, we didn't know what we didn't know, and we all learned the hard way.
[00:39:05] And then the council of State governments through their Department of Defense grant, have put money into this because the database costs about a million and a half dollars to create. But through this partnership we've each been able to put in, it'll be a total of about half a million dollars which is very different than what we thought it was gonna cost us initially.
[00:39:24] And then it's open source, which means Any compact coming after, such as social work, take advantage of the database and use that database. So when social work comes through, you'll be about two years ahead of us. Just because you won't have to create a database. All you have to do is adapt it for the social work needs and The Department of Defense has funded about 12 occupational licensure compacts, and so that's part. Their investment is that any of those compacts can use this database, but it has been quite a process. Inspiring Apps is the vendor who was working on this and the owner or CEO of Inspiring Apps wife is a counselor,
[00:40:06] Kym: Oh wow.
[00:40:06] Lynn: been major impetus to get this done but that's what has taken so long. It's the development of the.
[00:40:12] Kym: Okay. Okay.
[00:40:14] Lynn: I can ask the question, if we had gone that route by ourselves, could we have done it faster? The answer is, I think maybe only by a month or two.
[00:40:23] It's not the partnership that has slowed it down.
[00:40:26] It's the actual work and getting it right making sure that it has the functionality. Because if you think about it, the way it's gonna work is that the form is gonna sit on the compacts.
[00:40:39] Kym: Okay.
[00:40:40] Lynn: And I want a privilege in another state. So my state has uploaded all of my information into this database and I wanna privilege in another compact state.
[00:40:50] And I go in and I say, okay, this is who I am. I wanna privilege in this state. Here's my credit card. I'm paying my $30. And the database runs through all. Okay, I'm good to go. They send it to the state, they can grant my privilege. So. If you have to take a jurisprudence exam, it's not going to be immediate, but then you'll know that you're eligible for privilege and you have to jump through those last hoops.
[00:41:14] Why $30? Because that's an equitable amount of money. And right now the National Board for Certified Counselors has, given some money to the commission and the database development. A CA has paid the bulk of it. And we would all like the commission to be self-sufficient. Because you can't depend on grants forever.
[00:41:35] To pay for the expenses of the commission and the salaries and the secretariat, which is the organization that actually hosts the commission. So, they felt that within three years, they could be self-sufficient charging that. Then there's an additional fee, which is what the state is going to charge to give you a practice.
[00:41:56] Every state gets to set that amount themselves. So the states that are members of the compact have been asked to go ahead and establish their fees. Some of them have already done it, some of them are still in the process, and it varies between nothing, and $400.
[00:42:12] Kym: Okay.
[00:42:13] Lynn: How the state finances or funds the licensing board. There are some states that have to be totally sufficient with their licensing. Boards have to cover all of their costs, and so their fees are much higher than boards that have more resources and other money or it, it's just so state specific.
[00:42:35] Kym: Now, will these be recurring fees? Like the $30 and then the, estate fee? Okay, so every year, like annually kind of
[00:42:42] Lynn: Well, most of the licenses are biannual, so every two years.
[00:42:46] Most of the states license for two years. So the way it works is I have a license, I. Ask for three privileges to practice and I pay my money. I get these three privileges to practice, but everything is synced with my home state license.
[00:43:00] So if I only have another year of my license and I pay my money to get privileges, those privileges are only good for a year
[00:43:07] because my license is only good for one more year because I've already been practicing for a year. at the end of that year, I will have to renew my home state license and all of the privileges that I wanna keep.
[00:43:19] So why does it work that way instead of staggering? Well, because nobody wants you practicing on an expired license
[00:43:28] So that way we know that when you apply for a privilege, you have a valid home state license.
[00:43:34] Otherwise, you could technically practice for a year in another state when your home state license has not been renewed.
[00:43:42] So that solves that problem.
[00:43:45] Kym: That's amazing. Can I ask you about another topic that always comes up and that is insurance billing across state lines. I don't know if you're in touch with that at all but that's a huge question even for. LPCs and LCSW that are just licensed in two states, they run into that problem with, can I bill insurance if I'm not physically sitting in this state?
[00:44:05] Or, you know, how, how will that work with a compact? Will that even be taken into consideration or, what's happening with that?
[00:44:12] Lynn: I always have to punt a little bit on that answer because insurance is not a compact issue. By the way, supervision isn't a compact issue
[00:44:20] Kym: Oh, interesting. Okay.
[00:44:21] Lynn: can you supervise across state lines? Because it, it only deals with practice issues. Maybe the commission will get around to supervision later on, but not immediately.
[00:44:31] CMS, the Center for Medicare Medicaid Services has said that they will recognize compacts.
[00:44:38] for all, compacts. So PAC counseling Compact, that'll be social work. I mean, we're not the only folks who bill occupational therapy, speech therapy, physical therapy all bill insurance companies.
[00:44:51] So Any provider who bills an insurance company, CMS will recognize the compacts. they're hoping that that will sort of set the stage for the private insurance companies. I know PAC has had a number of conversations with insurance companies as have other groups right now. I think it's still pretty individualistic.
[00:45:12] we think that it's going to be where your client is located and yes, you can, but there are a few insurance companies that are pushing back and saying, Nope, we're not gonna let you. which brings me to another issue about the compact, and that's, it's voluntary.
[00:45:30] Kym: Yes.
[00:45:30] Lynn: You know, because just because you have a privilege to practice or you can get a privilege to practice, doesn't mean you have to follow your clients around the country. So.
[00:45:40] Kym: Good point.
[00:45:41] Lynn: You move a client moves, whichever that's a discussion between the two of you. You know, you as a counselor have to make a decision. Do I wanna continue working with my clients? I'm moving halfway across the country. Do I want to terminate and refer, which under our code of ethics, you can. That's perfectly acceptable.
[00:46:03] Or you could apply for privileges to practice in those. States where your clients are located. If you work with clients in more than one state if you don't hold those already and, you know, you swap your privilege to practice with your with your light home state license, and so you can continue to work with them, but nothing requires you to do that.
[00:46:24] So that is a, a discussion you have to have with your client. You know, I've made the decision that I'm not going to. Practice via telehealth. I'm not gonna apply for privilege to practice here. Whatever, or, yes I am. Do you wanna continue with me? So that's It is voluntary. If you hold four licenses in four different states and you wanna hold onto those licenses and not convert the non-home state licenses to privileges, that's up to you.
[00:46:53] You're welcome to do that. The advantage of a privilege. Is that you don't have to do the continuing education for any state except your home state. within the compact, when we were writing the legislation, there were some things that we punted. I said the two things that were the most different across state is continuing professional development, the number of supervised post-degree hours.
[00:47:18] So we hunted that and said basically the commission's gonna make that decision.
[00:47:22] And what the commission decided was. We're going to allow the home state. To make that decision. So everybody's going to accept the home state. So if your home state license is in a state that requires 3,500 hours of post-degree supervision, then you have to have 3,500 hours of post-degree supervision to be licensed independently.
[00:47:43] That's not really a compact issue, it's just that whatever the state requires, what. Is the compact issue is continued professional development. Whatever your home state requires, that's what we will accept. And you don't have to do any continuing education hours for any other state,
[00:47:59] which is terrific because I've seen counselors show me spreadsheets uh, all the licenses they hold, the number of continuing education hours they have to do for each day, the due dates, I mean, it's a nightmare for so many.
[00:48:14] Kym: I've heard it too. It is a nightmare. Oh my
[00:48:16] Lynn: This simplifies all of that.
[00:48:19] Kym: That's
[00:48:19] Lynn: So that's another big advantage of a privilege. And why do we call it a privilege instead of a license? because license for laws are very specific in what you have to do to get a license in that state. And this isn't it.
[00:48:33] Kym: Yeah.
[00:48:34] Lynn: You're not doing any of those things. This is mutual recognition.
[00:48:37] We're accepting your license, so therefore we can't call it a license because you didn't jump through all those hoops that the state says you have to jump through to get a license in this state. So we call it a privilege, but it holds all the same rights and responsibilities as a license. So it's a license by another name.
[00:48:56] Most of the mental health professions, most of the occupational licensure professions use the privilege model and not the model.
[00:49:06] Kym: Okay, so we're saying like maybe late summer, early fall for this thing to be, come to fruition completely. Is it, just we're waiting on the database to be completely built out for that to be able to start or What would make it just be finalized? Like when, what would make it just happen in that timeframe? Okay.
[00:49:24] Lynn: I hesitate to use the word beta testing, but they're going to have some states upload their data to make sure that it's smooth. There aren't any glitches, once that goes smoothly, then all the states can upload their data, assuming they're all supposed to be getting ready. They've already decided what.
[00:49:38] What data they're going to upload and whose data within states. There's been discussions about are we going to upload everybody's data or just the data of people who indicate they want privileges. So that's an individual state decision. so as soon as all the data's uploaded, and it may be, I'm not sure, it may be that if a state isn't ready to upload their data when the.
[00:50:00] The database goes live and the commission's ready to start e issuing privileges that that state just can't issue privileges until they get online. So it may not be a 100 per, you know, all 37 states and the District of Columbia start on the same day. I think that's what we're hoping for, but that may not be the reality 'cause we are dealing with state government
[00:50:21] Kym: Right, right.
[00:50:22] Lynn: you know, so there.
[00:50:23] Kym: and it, yeah.
[00:50:24] Lynn: Yeah, there're always some, some glitches, but it's basically waiting for the database and all of the data to be uploaded because everything else is pretty much in place. And when that's ready, then every group that's involved will be sending out via all of their social media platforms, you know, emails, whatever.
[00:50:48] There will be lots of information going out saying, okay, it's up.
[00:50:52] Kym: Let's do this.
[00:50:54] Lynn: feel free to apply. So, you know, we'll make sure all of us in the profession will make sure that everybody knows. 'cause this is, this is huge.
[00:51:04] Kym: It's huge. and it's amazing that you took the time today to come and talk to us about it. 'cause I know so many people have these questions, so I really appreciate it.
[00:51:12] Lynn: Oh, my pleasure. Thank you for asking.