PURPOSE: This rule outlines the require - ments for provisional licensed clinical social workers.

1. (1) Application for provisional clinical social work licensure shall be made on the forms provided by the committee. Application forms shall be obtained from the State Committee for Social Workers, PO Box 1335, Jefferson City, MO 65102.
2. (2) An application for licensure as a provisional licensed clinical social worker is not considered officially filed with the committee until it has been determined by the committee or division staff to be complete and the application is submitted on the form(s) provided by the committee. The application must be typewritten or printed legibly in black ink, signed, notarized and accompanied by the application fee as set forth in the rules promulgated by the committee.

3. (3) The following documents must be on file for an application for provisional clinical social work licensure to be considered complete and officially filed:

   1. (A) Completed application;
   2. (B) Official transcript(s) sent directly from the educational institution(s);
   3. (C) Completed Registration of Supervision form provided by the committee; FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION
   4. (D) Verification of a passing score, as determined by the committee, on the clinical examination administered by the Association of Social Work Boards (ASWB). Verification of score(s) must be sent directly to the committee office by the ASWB; and

   5. (E) An applicant for provisional clinical social work licensure who answers “yes” to any question in the application which relates to possible grounds for denial of licensure under section 337.630, RSMo, shall submit a sworn affidavit setting forth in detail the facts that explain the answer and shall submit copies of appropriate documents related to that answer, if requested by the committee, which shall include but is not limited to the following:

      1. 1. Certified copies of final orders/judg-

ments;

1. 2. If no final order—A certified copy of

clerk’s docket sheet and copy of complaint; and

1. 3. If criminal conviction—A certified

copy of final order and sentence or commutation of sentence.

1. (4) Following the committee’s review process, the applicant will be informed by letter of licensure approval or denial. The denial letter will identify the reasons for denial and the appeal process.
2. (5) The term of a provisional clinical social worker license shall be no more than fortyeight (48) consecutive calendar months except under extenuating circumstances as determined by the committee. The provisional clinical social work license shall be valid only while the licensee is under active supervision as defined by rule. The provisional clinical social work license will terminate with the issuance of a clinical social work license.
3. (6) The applicant for provisional clinical social work licensure shall provide clinical social work as defined in section 337.600(1), RSMo, under the order, control, oversight, guidance, and full professional responsibility of the approved registered supervisor at the setting(s) approved by the committee.
4. (7) A provisional licensed clinical social worker may be employed in the supervisor’s private practice setting or in the private practice of another. In those instances, the supervisor may bill clients for services rendered by the provisional licensed clinical social worker but under no circumstances shall the provisional licensed clinical social worker bill the clients directly for services rendered. The only exception to this section shall be when reimbursement for services is provided under Title XIX (Medicaid) through the Missouri Department of Social Services Medicaid Services Division. A provisional licensed clinical social worker may accept a Medicaid reimbursement number and services may be billed through that number, provided such reimbursement is administered through the professional setting employing the provisional licensed clinical social worker, and not directly paid to the provisional licensed clinical social worker. The professional setting shall not include private practice in which the provisional licensed clinical social worker operates, manages or has an ownership interest in the private practice.
5. (8) Provisional licensed clinical social workers shall report any change of supervisor, setting, or both in writing on a Change of Status form provided by the committee. There is no fee for updating a change of supervision and/or setting. The committee shall notify both the provisional licensed clinical social worker and registered supervisor, in writing, of the committee’s approval or refusal of the registration of supervision.

AUTHORITY: sections 337.600, 337.612 and 337.615, RSMo Supp. 2004 and 337.627 and 337.630, RSMo 2000.* This rule originally filed as 4 CSR 263-2.045. Original rule filed Dec. 30, 1998, effective July 30, 1999. Amended: Filed Oct. 30, 2002, effective June 30, 2003. Amended: Filed March 15, 2004, effective Sept. 30, 2004. Amended: Filed March 28, 2005, effective Sept. 30, 2005. Moved to 20 CSR 2263-2.045, effective Aug. 28, 2006.

*Original authority: 337.600, RSMo 1989, amended 1995, 2003; 337.612, RSMo 1989, amended 1997, 2001; 337.615, RSMo 1989, amended 1995, 1997, 2001, 2004; 337.627, RSMo 1989, amended 1993, 1995, 1997; and 337.630, RSMo 1989, amended 1997.