A Review of the Board of Examiners for Licensed Professional Counselors
Executive Summary
Introduction
PEER reviewed the Mississippi Board of Examiners for Licensed Professional Counselors (hereafter referred to as “the board”) pursuant to the authority granted by MISS. CODE ANN. Section 5-3-57 et seq. (1972). This review is a “cycle review,” which is not driven by specific complaints or allegations of misconduct.
PEER first established the public need for regulation of the counseling profession in order to reduce risks to the public, then evaluated how well the board carries out its two primary regulatory functions: licensing counselors to protect the public and handling complaints/investigations. PEER also reviewed the board’s monitoring of licensees’ fulfillment of continuing education requirements and the board’s financial management practices.
Background
The Legislature created the Board of Examiners for Licensed Professional Counselors to protect the public by regulating the practice of counseling, as well as use of the title “Licensed Professional Counselor” for those who offer services to the public for a fee. The typical regulatory functions of licensure and enforcement of applicable laws, rules, and regulations provide a safeguard, without which the likelihood of untrained or unethical counselors placing the public at risk could occur.
The board is composed of five licensed professional counselors, three of whom are primarily engaged as licensed counselors in private or institutional practice, and two who are primarily engaged in teaching, training, or research in counseling at the corporate or university level. For its staff, the board currently contracts for a full-time Executive Director and utilizes an accountant part-time. The board retains legal assistance from a representative of the Attorney General’s office.
As a special fund agency, the board’s revenues come from fees charged for licensure application, examination, and license renewal. For four of the past five fiscal years, the board’s revenues have exceeded expenditures. FY 2006 revenues were $98,695 and FY 2006 expenditures were $80,948.
Conclusions
Potential for Compromised Independence of the Process for Nominating Board Members
Because state law requires the Mississippi Counseling Association to provide nominations to the Governor for his consideration in appointing persons to fill vacancies on the Board of Examiners for Licensed Professional Counselors, the opportunity exists for the independence of the nominating process to be compromised when the association’s officers also serve as board members.
MISS. CODE ANN. Section 73-30-5 (1972) requires that the Mississippi Counseling Association (MCA) provide nominations to the Governor for his consideration in filling vacancies on the Board of Examiners for Licensed Professional Counselors. Currently, three members of the board are also officers of the MCA. The Executive Director of MCA (who is responsible for submitting nominations for board replacements) contacts members of the board, as well as other MCA officers and other interested persons, for recommendations on who should serve on the board.
When members of the current board participate in the process of nominating individuals to fill board vacancies, the independence of the board’s nominating process could be compromised and allow the opportunity for persons currently serving on the board to perpetuate their regulatory philosophies.
Needed Improvements in the Licensure Process
Educational Requirements for Licensure
The Board of Examiners for Licensed Professional Counselors has specified certain coursework that applicants must complete when meeting their educational requirements. Some uncertainty exists as to whether the board has legal authority to specify such education requirements, particularly for applicants with pertinent doctoral degrees. Also, because one of the board’s most recently added educational requirements is not based on the results of sound research such as a formal job analysis, the board cannot ensure that this requirement is necessary to ensure competence as an entry-level counselor.
For licensure as a professional counselor, MISS. CODE ANN. Section 73-30-9 (f) (1972) requires that an applicant possess:
The master’s degree or education specialist’s degree must consist of a program of not less than sixty acceptable semester hours or ninety acceptable quarter hours. Board regulations specify that a graduate program related to counselor education contain course work in ten listed areas and that each applicant for licensure must have completed course work in all ten areas.
A 1995 Attorney General’s opinion has raised questions about the board’s statutory authority to define related counseling fields, acceptable hours, or coursework that relate to the licensure applicant’s degree program and the board’s statutory authority to establish educational requirements for applicants with pertinent doctoral degrees. If the board does not have the power to define “related counseling field” or “acceptable coursework or hours,” then the board cannot ensure protection of the public health, safety and welfare through the requirement for attainment of specific knowledge needed to practice counseling competently.
Also, when asked for research to support the addition of one of its recently added coursework requirements, the board was unable to produce sufficient evidence to validate that this requirement is necessary to ensure competence as an entry-level counselor. If the board cannot ensure that its educational requirements are actually necessary to ensure entry-level competence, the requirements might actually limit entry to the profession unnecessarily, thereby restricting qualified counselors from practicing.
Experience Requirements for Licensure
The board requires supervisors of applicants’ post-master’s clinical experience to submit verification of supervision, including a recommendation to the board that the applicant be considered for licensure. However, the board’s current process for utilizing supervisors’ recommendations does not ensure that applicants possess the minimum competencies needed to practice counseling.
MISS. CODE ANN. Section 73-30-9 (h) (1972) requires the applicant for licensure to have two years of supervised experience in professional counseling, or its equivalent, acceptable to the board, one year of which may be obtained during pursuit of the master’s degree program.
A board regulation (Chapter 4, Section 3) specifies that the applicant’s experience must consist of 3,500 supervised hours of counseling in a clinical setting post-bachelor’s degree, with certain stipulations regarding the type and number of supervised hours.
Prior to granting a license to applicants, the board requires verification of an applicant’s post-master’s supervised clinical experience. However, the board does not provide supervisors of post-master’s clinical experience with objective criteria by which to make their recommendations, thus allowing for subjective judgments of applicants’ competence. Also, the board does not require any documentation from supervisors of internships or post-master’s clinical experience that the applicants they recommend without reservations have demonstrated competencies necessary to perform as a competent, entry-level counselor.
The board relies on the self-reporting of hours by the applicant and the supervisor and on supervisors’ brief descriptions of supervised practice without specifically requesting information related to actual content of the supervised experience. This places the public at risk of receiving counseling services from an unqualified individual.
Examination Requirements for Licensure
Although the board requires that licensure applicants pass an examination that measures academic knowledge of counseling information and skills, it does not employ the most rigorous process available (i.e., a validated exam, published by a nationally recognized organization, that was designed to measure clinical expertise) to help ensure that an applicant is fully prepared for unsupervised practice.
The board requires that licensure applicants pass the National Counselor Examination for Licensure and Certification (NCE). The National Board for Certified Counselors (NBCC) publishes this exam, as well as the National Clinical Mental Health Counseling Examination (NCMHCE).
The NCE consists of 200 multiple-choice questions that measure academic knowledge in each of the five relevant content domains. The NCMHCE consists of ten clinical mental health counseling cases and assesses clinical problem solving ability, which includes identifying, analyzing, diagnosing, and treating clinical problems.
The only exam that the board requires, the NCE, is intended to measure only academic knowledge, as opposed to clinical skills. Individuals who take and pass only the NCE have demonstrated academic knowledge but have not demonstrated through taking and passing the appropriate validated examination that they have the needed clinical skills to practice in an unsupervised setting, which could ultimately place the public at increased risk.
Exemptions from Licensure
Because the board’s enabling legislation exempts thirteen professional categories from licensure and several of the categories encompass multiple professions, the number of individuals practicing counseling without a license could potentially be much higher than the number of those practicing counseling who actually hold a license as a professional counselor. Due to the nature of these exemptions, the board is not able to protect large numbers of Mississippians from receiving counseling services from individuals who might not be qualified.
The board’s enabling legislation allows individuals employed in any of numerous professions and occupations to engage in the practice of counseling without holding a license as a professional counselor. The number of individuals whose employment or credentials are represented by the exempted categories could be quite large. Because the board cannot regulate the individuals in the exempt occupations and professions, the board cannot protect the public from these individuals within these occupations or professions who practice counseling but might not have the necessary knowledge and skills.
Applications for Licensure
Because state law does not specifically authorize the Board of Examiners for Licensed Professional Counselors to perform background checks on applicants for licensure, the board accepts applicants’ self-reporting of criminal history rather than initially utilizing background check resources available to it. As a result, the board may not be able to protect the public from applicants who do not disclose criminal histories and subsequently obtain counseling licenses.
MISS. CODE ANN. Section 73-30-9 (1972) does not require the board to conduct background checks on licensure applicants, but it does state that applicants be “of good moral character” in order to be licensed as a counselor. The board utilizes self-reporting of criminal history on its licensing application as the sole determinant of whether an applicant is of “good moral character.”
Due to the nature of the counseling profession, use of criminal background checks and offender registry checks would be justified. The board’s attorney has advised that the board lacks specific statutory authority to conduct or obtain criminal background checks on applicants.
Relying on self-reporting of criminal history potentially allows unethical applicants with serious criminal histories to be licensed. These licensees would be obvious threats to public safety, particularly to the counseling profession, as they could take advantage of a vulnerable population.
Inadequate Monitoring of Continuing Education of Licensees
The Legislature has recently amended the board’s enabling legislation to require continuing education hours for all licensed professional counselors. However, the board’s continuing education policies do not ensure that licensees remain current in professional knowledge, skills, and issues in counseling.
MISS. CODE ANN. Section 73-30-29 (2) (1972) states that as of January 1, 2004, licensed professional counselors must complete twelve hours of continuing education each year before their licenses are renewed. These hours must be in the field in which the counselor practices.
Rather than requiring annual verification of continuing education for all licensees, the board’s policy requires that only ten percent of licensees’ continuing education hours be audited each year. Also, the board conducts these audits after licenses have been renewed, rather than prior to renewal. Thus the board does not ensure that all licensees receive the necessary continuing education to remain professionally competent prior to having their licenses renewed.
Also, even though state law requires that a licensee’s continuing education hours be taken in the field in which the licensee practices, because the board does not require licensees to demonstrate how continuing education relates to their particular fields of practice, the board does not ensure that licensees further the knowledge and skills needed to remain current in those fields of practice.
Inadequacy of Complaints Process
The board’s management of complaints against licensed professional counselors is inadequate because it does not track or maintain complete, confidential records of complaints that have been filed, investigated, or resolved. Also, the board has insufficient standards for investigating complaints.
The enforcement of the licensed professional counseling law and regulations is greatly dependent on how well the regulatory body administers processes for receiving and handling complaints against counselors and the expediency and uniformity with which it takes disciplinary action against violators. PEER examined the complaint and disciplinary processes of the board and found the following:
PEER also found that the board’s minutes do not contain sufficient record of the disposition of complaints.
Failure to Publicize Disciplinary Actions
The board’s current practice of not publicizing information on disciplinary sanctions limits the public’s and licensed counselors’ awareness of rules infractions and their consequences.
The board should provide information that is easily accessible to the public regarding sanctions against licensees so that the public can make informed choices when obtaining counseling services. However, the only method currently used is responding to requests from the public. As noted in the previous section, because the board does not maintain general information on complaints and/or resolutions of complaints, it cannot ensure that an accurate response is given.
Problems with Financial Management
The board has not established a proper internal control environment and, as a result, does not have assurance that any of its financial information is accurate or complete.
The management of an organization is responsible for establishing proper internal controls for financial management. During its review, PEER found deficiencies in four areas of the board’s financial management: separation of accounting duties, cash management, financial reporting, and service contracts.
The board’s lack of separation of accounting duties violates state agency accounting policies and procedures set forth by the Department of Finance and Administration and compromises the accuracy and completeness of the board’s accounting records. Because of this condition, the board cannot ensure the public that its operations are reasonably free from fraud.
Also, contrary to MISS. CODE ANN. Section 7-9-21 (1972) and state agency accounting policies and procedures, the board does not immediately account for collections received or deposit such collections in the State Treasury in a timely manner.
Rather than requiring its staff to submit reports regarding the agency’s financial condition for each of its quarterly meetings, the board requires only an annual financial report that is limited because of its method of presenting expenditures. Because the board has a fiduciary responsibility regarding receipt and disbursement of public funds, prudent financial management principles require that the board stay abreast of the agency’s financial condition.
Additionally, the board has not formalized its relationship with its part-time accountant through a written contract. Without a written contract, the board could be exposed to a future liability without documentation of that liability. A written contract would also serve guide future board members in the expectations for service providers.
Recommendations