Occupational licensing regulations can undermine public health in the name of protecting it
By JULIE GRACE | March 17, 2020
For more than a year, bureaucratic delays and hurdles imposed by the Wisconsin Department of Safety and Professional Services (DSPS) deprived Meggan Thompson of a job and an income, and deprived Wisconsinites with debilitating mental health issues of the help she could have long ago provided.
A licensed clinical social worker from California, Thompson moved to Wisconsin with her family in 2018 in search of “a higher quality of life and a lower cost of living,” she says. Her goal was to carry on her many years of work on the West Coast with underserved and at-risk populations.
Her credentials are exemplary: Thompson earned a master’s degree in social work from the University of Southern California, taught classes there and continues to teach online.
By the time she moved to Wisconsin, she’d spent seven years working as a psychiatric social worker with the County of Los Angeles. She worked with the chronically homeless, people contemplating suicide, adolescents in school settings, inmates and people with complex trauma histories – all areas of need in Wisconsin.
Like all states, Wisconsin requires that social workers be licensed – a way of protecting the health and safety of those they serve. The hoops and hurdles and long periods of silence from state regulators, unfortunately, appear to have had just the opposite effect.
“There’s definitely a need when it comes to suicide and substance abuse, so to sideline someone (who can help) for over a year is disheartening,” she says.
The long and disheartening process
In February 2019, after taking a few months to settle into her new home in Mequon, Thompson applied to DSPS for her clinical social work license.
She was optimistic that her California license would transfer to Wisconsin since a DSPS employee told her that applications are evaluated on a “case-by-case basis.”
In April 2019, she took the Wisconsin law and ethics exam, which she passed.
On May 8, her application was submitted to the DSPS legal team for review – a process she was told would take about 30 working days.
Instead, it took six months. Only then – eight months after her initial application – did she get a response, and it was far from the one she expected. After numerous unanswered calls and emails to the agency, she finally heard back in October that her license was not being approved.
She then “had to bug DSPS to at least tell me why.”
“I was naive on how daunting this entire process would be,” Thompson says. “I feel powerless. You invest so much time, money and energy into a profession, and not being able to work in it is very frustrating.”
A bureaucratic nightmare
DSPS issues a wide array of licenses – over 31,000 new credentials and 167,000 renewals in 2019 alone – but says it does not keep track of the number of applications it receives or how many are denied.
The department does say, however, that the average wait time for applicants is 10 to 15 days unless an application must undergo legal review, in which case it can take up to six weeks.
In Thompson’s case, it took well over a year and, even now, that license is temporary.
In what seemed like a largely subjective interpretation of the statutes, DSPS eventually informed her that her license did not qualify for reciprocity. The agency said that while both states require 3,000 hours of post-degree training, Wisconsin demands that all of those hours be clinical training and 1,000 of the hours be face-to-face training; California requires 2,000 clinical hours and 750 face-to-face hours.
Both states require a master’s degree in social work from an accredited school, but Wisconsin also requires a mental health concentration with specific courses.
DSPS told her she’d have to reapply, pay additional fees, obtain decade-old university transcripts, provide descriptions of her internship experiences, submit course syllabi and even the resumes of former professors. She also had to have forms filled out by previous supervisors.
“Thankfully, USC archives their syllabi, and luckily I still know my old professors and had those connections, so I got the documents pretty quickly,” she says, noting that her teaching relationship with the university likely gave her an advantage over other applicants in a similar situation. In November 2019 – nine months after the initial application – she applied again and even paid an additional fee to expedite the process.
Finally, in January 2020, the Badger State’s Social Work Examining Board told her she was eligible to take a national exam that had not been required when she first received her license in California.
After signing up to take the exam, she was finally given a temporary license in March – well over a year after applying and after spending $800 in fees and study materials.
The license will be made permanent if she passes the national test next month – 14 months after she applied.
Other states, meanwhile, have found a way to process applications much more quickly. One of Thompson’s friends, another licensed clinical social worker, moved from California to Indiana and received her license in just a month, she says.
What the bureaucracy costs
After not working for the better part of a year, Thompson says she considered part-time jobs at Starbucks or Target.
“It’s been really difficult,” she says. “I hope no one else has to go through this same process.”
That appears to be a misguided hope. Thompson’s case is not unique, according to Marc Herstand, executive director of the Wisconsin chapter of the National Association of Social Workers. Herstand helps social workers from other states get licensed in Wisconsin.
“I have spoken to too many clinical social workers who have had to wait way too long to become licensed,” said Herstand in recent testimony before a legislative committee in Madison. “For many of them … it’s a real financial hardship.”
Thompson was long denied the right to earn a living in her field.
“Obviously, in addition to the fees, the biggest financial toll is that I haven’t had an income in a year,” she says. “Even with the lower cost of living in Wisconsin, we’ve been on a tight budget. We’re not where we thought we’d be when we made the choice to move here.”
But there was an even bigger cost to the Wisconsinites most in need. She notes that the teen suicide rate is rising in Wisconsin and is higher than the national average.
Not surprisingly, people with her expertise are in demand. “I’ve seen several listings looking for (social worker) positions, especially in the children’s hospitals,” says Thompson.
“It’s not just social workers either (that are needed), but healthcare and mental healthcare as a whole. Clearly there’s a need for the work that I do.”
Thompson says it would be “phenomenal” if Wisconsin could adopt full licensure recognition, in essence simple acceptance that an individual licensed in California or another state would be allowed to practice in Wisconsin, and vice versa. Very few states allow this, however, according to the Association of Social Work Boards.
Allowing individuals licensed elsewhere to work in Wisconsin under a temporary, provisional status while their applications are reviewed is another alternative.
A bill recently proposed by Sens. Dale Kooyenga (R-Brookfield) and LaTonya Johnson (D-Milwaukee) would allow DSPS to much more quickly grant temporary or provisional licenses to certain applicants while their applications are being processed.
“It’s jaw-dropping that government is getting in the way of people who are ready, willing and trained to work in our state,” Kooyenga says.
In February – a few weeks before she finally received her temporary license – the Badger Institute helped bring Thompson’s experience to the attention of lawmakers by inviting her to testify in support of temporary licenses for qualified applicants.
Under Senate Bill 747, the same standards and rules would apply to temporary license holders as to those with permanent licenses. If the temporary license is ultimately approved as permanent, the applicant would simply renew it at the appropriate time. If a permanent license is denied, the temporary license would immediately expire.
While DSPS originally supported the bill, it says it has gotten pushback from already-licensed stakeholders concerned about “unintended consequences for the specific needs of each profession.” Kooyenga calls the issue nonpartisan and says it should be met with “a sense of urgency.”
For Thompson, SB 747 comes too late. But for countless other mental health professionals like her, it could mean months or years of income and – most important – the chance to help those who are most in need.
Julie Grace is a Badger Institute policy analyst. Permission to reprint is granted as long as the author and Badger Institute are properly cited.