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Sunset Commission HearingApril 25th, 2018Good afternoon. I would like to thank Chairman Birdwell and the rest of the esteemed members of the Sunset Commission for the opportunity to testify. I am Miriam Nisenbaum, the Executive Director for the Texas Chapter of the National Association of Social Workers (NASW/TX) and I represent around 5,300 NASW/TX members who serve Texas residents across the state. We wish to respect the committee’s time, so have chosen to have 3 members speak from our Association. Our members are very engaged in this issue and have submitted hundreds of comments to the Sunset Commission regarding their report on our licensing board.NASW/TX strongly supports the creation of the new consolidated agency: the Behavioral Health Executive Council (BHEC), as recommended by the Sunset Staff in their report released on March 25th.. There is one key caveat: we believe that rather than having an executive council made up of all public members, the council should have a 5-4 public majority with the 4 professional members retaining the right to vote. We want to see the independent Texas State Board of Social Worker Examiners (TSBSWE) that fully understands rule making, and scope of practice issues for this profession, housed at an agency that possesses the necessary public health, social work, and mental health expertise to ensure the public’s safety and trust is retained. The Association supports all the professions in the proposed BHEC to have independent boards that have sole authority over the rulemaking and scope of practice for each profession. Social workers apply a unique body of knowledge and skilled techniques to help people overcome social and health problems, such as poverty, mental illness, child abuse and neglect, emotional instability, illness, economic uncertainty, domestic violence, homelessness, and drug abuse. We work directly with individuals, couples, families, and groups to identify and overcome these problems. Some social workers work with communities, organizations, and/or systems to improve services as well as to administrate social and health programs. We practice in a wide array of settings, such as: hospitals, nursing homes, non-profits, the child welfare system, early childhood, gerontology, psychiatric facilities, and private practice to name a few.Social work in Texas, has multiple levels of licensure. Licensed Bachelor Social Workers help coordinate referrals and perform supportive work. Licensed Masters Social Workers may serve as a case manager or in many other roles and can practice clinical social work in an employment setting under clinical supervision. Licensed Clinical Social Workers may provide any clinical or non-clinical social work services. Clinical Social Work focuses on the independent practice of assessment, diagnosis, treatment, and prevention/treatment of mental illness, emotional, and other behavioral disturbances. I mention these distinctions, because while social work exists in a similar realm as the other professions recommended for the BHEC, there are differences which require the oversight and administration of an independent board aimed solely at regulating the profession. Under BHEC, the TSBSWE would retain responsibility for licensing and taking enforcement action against practitioners. TSBSWE would also make regulatory decisions, and with a social worker and a public member from the TSBSWE on the BHEC, there would be assurance that their rules were being reviewed by a group with first-hand knowledge of the profession.Lastly, I would like to assert one fact. The BHEC was not implemented last session not because of any adverse advocacy efforts against the legislation. It was killed while a larger discussion about legislation completely unrelated to the bill swept it up in its wake. The BHEC was voted unanimously out of the Sunset Commission and the House Committee on Public Health and was set to be the next bill to be heard before the clock ran out on May 11th. It was opposed by a vocal but very small group that made up less than a tenth of all the behavioral health providers in Texas. The Sunset process has found that where the board is currently housed, renders it unable to function efficiently and effectively and is actively hampering the ability of social workers in Texas to earn a living. Again we agree with the Commission about the creation of the BHEC and we advocate for professional and private voting members on the Council. The BHEC will streamline services, consolidate resources, and align the behavioral health providers in the state into one unified agency that elevates the status of mental health by signifying the importance of the providers who attend to the needs of their communities.Again, thank you for the opportunity to testify today. If you have any questions or would like more information, please do not hesitate to reach out to our association.Miriam Nisenbaum, LMSW, ACSWExecutive DirectorNational Association of Social Workers/Texas Chapter810 West 11th StreetAustin, Texas 78701Phone: 512-474-1454mnisenbaum.naswtx@Appendix I: Texas State Board of Social Worker Examiners SurveyThis survey was conducted between 11/13/2017 and 12/18/2017. It was sent out to the almost 5,200 NASW members across Texas but was open to all social workers in the state. It received 421 unique responses.<1: 11 <2-4: 41 <4-6: 34 >6: 24 T: 110Selected Comments:Completely disgusted with the TSBSWE's ability to process licenses. Lost my application and record that they had cashed my check. Had to resend them copies of application and copy of processed check. Never communicated with me when they needed more information. Would check in with them monthly. Each time there was something new that they would give as an excuse as to why my license could not be processed. Whole process took close to a year. Social workers and their family's livelihood are being affected by TSBSWE's incompetence, and so are the people we serve (or can't serve). I have spoken to numerous other social workers who have shared with me similar experiences and frustration. When TSBSWE was under sunset review and NASW TX was pushing to maintain a separate board (which I support), many social workers I spoke to said they wanted to see TSBSWE dismantled because of their negative experiences with the board.Very poor. In my LCSW supervision cohort we would send in 6 documents that where almost identical since we were working in the same setting and did group supervision together and we would get 6 different responses from the board. I sent forms via certified mail and the forms would get lost in their office and never make their way to my file.Very trying - had an error on my initial submission, but was not notified until months later, and only then found out because I called to check on it. The office seems very understaffed, as I have noticed poor communication, difficulty getting answers, and exceedingly long processing times.I waited and waited for my application to be processed and after a long time passed I called to follow up. I was initially told that they never received my application, but I knew for a fact they had as I hand delivered it to the office and documented who I spoke with. I then learned that my application for new license was carelessly placed into another person’s file (with the same last name) for months where it just sat. This was a very frustrating process given this caused delays, at no fault of my own, in getting my new license which resulted in lost income.<1: 172 <2-4: 61 <4-6: 3 >6: 2 T: 238Selected Comments:I log onto the website to renew my license and was unable to sign in attempted technical assistance and recording said 2-hour wait. I printed out application and sent it in the mail. It was coming down to the wire and I started calling as they had cashed my check a month ago. I waited 2 hours to talk with a live person who told me due to funding cuts she was the only person working on licensing for the state of Texas, shameful. This is ridiculous! The girl did help me as I explained I would not be permitted to work if she didn’t help.I had renewed my LMSW license through the mail and the board never received my renewal nor cashed my check. I found this out after waiting for 6 weeks and ended up having to cancel the check and renew on-line. I was disappointed that their mail-in process was flawed and if I had not been on top of the dates and checking, I would have had an expired license.Not Satisfied with State Board. In spring 2016, I mailed the required info / check, immediately, upon receipt of the renewal notice, to the requisite office. Did not receive my renewed license, until a day before my current license would have expired and I would have lost my job. I did get help from the Executive Director of the TX NASW.<1: 20 <2-4: 72 <4-6: 29 >6: 13 T: 134Selected Comments:This process took a very long time to verify which creates a lot of anxiety since I had to pay for the supervision process ahead of time and had no guarantee that it would be accepted. It was very frustrating not being able to have updates about where my paperwork was going and on top of that, there was a time when they lost my driver license picture as well.Extremely dissatisfied. It was a nightmare. My supervision plan, which was EXACTLY the same as my fellow co-supervisees, was denied while the other four was approved. There was no difference in our applications/plans whatsoever. A member of the Board, who my supervisor knew, eventually had to intervene personally to correct it. It put me way behind. Not to mention I kept being asked to submit the same paperwork over and over.I submitted mine two months ago and have not heard back. This is a frustrating process. My check was deposited almost immediately. Yet whenever I ask the board for an update they just tell me "we're behind, another 4-6 weeks". Extremely frustrating process as it delays job opportunities and salary increases.This was a very difficult process. My application was marked as questionable and it took months to have it fully reviewed and to receive feedback. There was no communication from the board, other than that it was still waiting to be reviewed. I often called weekly for status updates and would receive no explanation as to what exactly they were reviewing, who was reviewing it, why the process was taking so long, etc.<1: 11 <1-2: 6 <3-4: 9 >4: 1 T: 27Selected Comments:Highly unsatisfied. This complaint hung over my head for more than 3 years. RIDICULOUS. At least triage the complaints. The complaint was examined by your representative. At that time, it could have been reviewed and a determination be made as to whether or not I needed to go before the board. I had to have an attorney involved who I requested be there with me because I had no idea what would happen. And the case was dismissed as unfounded! Are you just checking to see if your board is being paid attention to? Do you need this process to make people believe it is important? If that is the case, then it needs to be handled in a much more professional manner. Criminals don't have to wait that long for a verdict. Your current system needs to be revamped to be more proactive for the client's sake as well as the therapist. The way it operates now indicates poor organization which makes it appear that it is just "going through the motions" instead of holding to the purpose of maintaining the highest level of ethics in the profession.I received a complaint a year ago and have not received any information from the Board about it. My attorney says he expects it will take 3 years to resolve the complaint, based on his current experiences with the Board.I currently have a complaint against me before the licensing board. This is the beginning of the 3rd year with no action...VH: 42 MH: 53 A: 63 MU: 45 VU: 28 SC: 26SD: 70 3D: 45 W: 28 OW: 37 OM: 52 T: 232Y: 51 N: 214 T: 265Selected Comments:No one knew how to help me transfer my out of state license- each different person I spoke with (in Texas and Indiana) had different answers. I ended up taking the exam again because I was not finding answers in the year + long process.I would more describe the information as incomplete or unavailable. When I call with a question, most recently regarding policies of the Board stated on the website, staff will simply read back the content from the website verbatim. I then am encouraged to contact other sources for information. Staff has not been able to respond to request for clarification. I generally do not contact them anymore with questions, and I utilize NASW, my liability insurance company, and consultation, in addition to on-line research for information.I had an issue with my license and received three different answers. One for each time I called for clarification. I finally had to get my State Senator's office involved - not to speed anything up - but just to get a straight answer.Y: 67 N: 213 T: 280E: 169 P: 247 LR: 96 LC: 83 F: 36 O: 33 T: 289Additional Selected Comments:Please note that TSBSWE needs to (always) have the adequate resources to perform its functions on behalf of the thousands of licensees in the state, who expect professionalism and consistency in context of its rules and regulations. Assuring that the transitions the board has experienced are realized with the greatest degree of professionalism, timeliness, and maintenance is crucial for its standing among social work licensees.Please make it a streamlined/easily accessible online process with updates regarding applications. It would decrease the number of calls they receive. I think that there needs to be more organization and the timeline for applying and acceptance should be significantly shorter.Frustrating and unorganized... The application process should be converted to an online system where documents can be uploaded and email correspondences can take place for faster turnaround. When working in a high demand environment as most social workers do, it is not feasible to spend hours/months trying to contact someone for guidance, or wait 6+ months for an application to be processed... For most positions the job depends on the licensure... it shouldn’t be this hard.I am a Social Work faculty and assist our graduating students with application for licensure. The process takes much longer than in prior years, packets are lost and have to be resubmitted, and the board is not readily accessible to assist. They are underfunded and understaffed to handle the workload.The people I have called at the board have clearly been doing the best that they can in a system not set up for their success or ours. The best advice I received regarding the board was, if you are applying for a license, to call as much as you can to make sure it's moving along through the process, otherwise it will take months and months.The board cannot keep up with the demand of the social workers. The amount of time spent waiting for forms to be approved stops Social Workers from properly being licensed and pursuing/obtaining professional jobs. My questions could not be answered. Luckily, I was informed of an open records request ability and was the only way I got any answers.The Board used to be run by a social worker years ago and it was more professionally geared to our needs. Now it seems like unless there is an ethical concern it is non-professionals who just address the requests/needs. Sure, would be nice to have a social worker heading our profession.Just that every SW I know lives in terror of even a false, retaliatory board complaint because the board takes so long to investigate and resolve even the most overtly false complaints. Meanwhile our professional and often, as a result, personal lives are put on hold, sometimes for years. It creates a dynamic where we become fearful of and potentially overly accommodating to clients who manipulate with threats of reporting.Colleagues in other states are shocked when I explain our licensure (LCSW/LMSW-AP) process to them, and how long it takes. I have met people who refuse to come to Texas to practice or obtain a TX license because it is so complicated and time consuming. It makes personal and professional lives exceedingly difficult to plan and keeps qualified practitioners out of the state. It is also nerve wracking to be in limbo all the time, wondering what will happen next and when. ................
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