What is state recognition?
State recognition is a general term that encompasses three different possibilities. As the name implies, it is the recognition of a particular profession (in this case, music therapy) by the state in its regulations. Three different options include registration, certification, and licensure.
What is licensure in Missouri?
All licensing boards are administered through the Missouri Division of Professional Registration (http://pr.mo.gov/), whose mission is:
...to serve and protect the public from incompetency, misconduct, gross negligence, fraud, misrepresentation or dishonesty by providing an accessible, responsible and accountable regulatory system that licenses only qualified professionals by examination and evaluation of minimum competency and enforces standards by implementing legislation and administrative rules.
What professions are currently licensed in MO?
The list of licensed professionals is quite long. Some health care professionals that are licensed include:
○ Counselors
○ Nurses
○ Occupational Therapists
○ Physical Therapists
○ Respiratory Care Practitioners
○ Social Workers
○ Speech Language Pathologists
What would the benefits of licensure be?
According to Judy Simpson, AMTA Director of Government Relations, and Dena Register, CBMT Regulatory Affairs Advisor (April 2010):
(There are) two primary, specific benefits for constituents in your state:
What is the difference between certification and licensure?
Certification “is a non-statutory process whereby an accrediting body grants recognition to an individual for having met predetermined qualifications”. Our accrediting body is the CBMT.
Licensure “refers to the laws which regulate a given occupation. Its purpose is essentially twofold: (1) title protection...and (2) scope of practice” (Oliver, 2003). State licensure may vary in terms of requirements from state to state.
Many private and public funding sources require that providers have a state recognized credential. The national certification (MT-BC) may not be sufficient for these sources.
The Certification Board for Music Therapists (CBMT) has additional information on this at www.cbmt.org.
What are the benefits of pursuing licensure rather than changes to the code of state regulations?
The Code of State Regulations can be thought of as the rulebook that spells out how various laws are to be enforced. For example, it defines who can be hired by school districts or hospitals, or who can be paid under a particular funding program. Other non- state entities use the state regulations as a guide; for example, insurance companies may require that a health care professional be licensed by the state in order to receive reimbursement. In some cases, simply adding information about the MT-BC to the state regulations should be enough to show that a music therapist is qualified to provide services.
The Missouri state task force has been pursuing changes to the code of state regulations but has been unable to make much headway. Based on input the task force has received from state agency officials and state legislators, it appears that creation of a music therapy license is the best way to get recognized by state agencies. We have had support from Senator Crowell in our state recognition efforts, but this year will be his last session as a senator due to term limits. If we decide to pursue licensure, having his support in the legislature may be an important opportunity that we do not want to miss.
Do we have evidence that clients are denied access to music therapy services because music therapists are not licensed in Missouri? Has reimbursement been adversely affected by not having state licensure?
Consumers who receive services through First Steps (Missouri’s Early Intervention program) have limited access to music therapy services because only state-licensed professionals are listed as service providers. Consumers may also be denied access to music therapy services through other state agencies because music therapists are not listed in current regulations that determine who is qualified to deliver health care services.
We hope that being listed will lead to both job development and will improve access to services for Missouri citizens.
Would every MT-BC have to be licensed if we decided to pursue licensure?
Yes, if a music therapy licensure law is established in Missouri, all MT-BCs would have to apply for a license to practice music therapy in the state. If MT-BCs work in more than one state, they would have to meet the licensure requirements of all the states in which they work.
What will be the requirements for obtaining a music therapy license?
We will not know what the requirements will be until legislation is written and passed. Our preference would be that holding an MT-BC would be the only requirement for obtaining a license to practice music therapy.
Will this cost me or my employer any money?
We will not know what the costs will be until legislation is written and passed. It is likely that MT-BCs will have to pay a small fee to cover the state’s costs for maintaining a licensing board.
Will I have to take an additional licensure exam? Do I have to get a master’s degree? Would there be additional continuing education or supervision requirements?
We will not know what the requirements will be until legislation is written and passed. Our preference would be that holding an MT-BC would be the only requirement for obtaining a license to practice music therapy, so additional exams, education, and supervision would not be required.
Will licensure allow the state of Missouri to regulate the competence of MT-BCs, replacing the current power of CBMT?
Our preference would be that the state of Missouri would adopt CBMT’s requirements, thus leaving only one set of requirements for MT-BCs in the state of Missouri.
Why pursue state recognition now? What if it doesn’t work out?
We know from experiences in other states that if music therapists are not involved in drafting legislation, we could end up with laws that do not accurately reflect our scope of practice and the requirements for the MT-BC. This could further restrict music therapists’ ability to practice and to receive reimbursement or funding for services. If music therapists are involved in state recognition advocacy from the beginning, it is more likely that we will be able to get legislation passed that reflects what we do and the requirements we currently have to meet to hold the MT-BC credential.
Being involved from the beginning of developing a bill increases the probability that we can request changes or ask the bill’s sponsor to remove the bill from consideration if a majority of music therapists in the state are not happy with the requirements in the legislation. Being involved from the start helps to ensure that our voices will be heard.
Has anyone spoken with music therapists in other states where licensure has been implemented to learn of the assets and liabilities for developing and maintaining licensure?
The state task force is working closely with Judy Simpson (AMTA), Kimberly Sena Moore (CBMT), and Dena Register (CBMT) regarding this topic.
In Spring 2011, both Nevada and North Dakota passed licensure bills for music therapists. Both AMTA and CBMT will continue to monitor the effects these bills have on various aspects of the profession as they are carried out in each state.
Questions?
If you have questions about licensure and the state recognition process in Missouri, please contact the state task force at missourimusictherapy@gmail.com.