September 2019 CLEAR Conference Information and Thoughts.

1. Pamela Rollins, PhD, LMFT, AMFTRB Past President Debunking the Continuing Competency Myth

• The best competency model relies on engagement and striving for constant improvement.
• The continuing competency program being presented hoped to facilitate professional’s self-reflective learning in a way that enhanced practice while maintaining accountability for the professional.

If I Was Going There, I Wouldn’t Start from Here: Learning Outcomes of Punitive versus Non-Punitive CPD Enforcement Processes with a Multi-Profession Health and Social Care Regulator

• This workshop emphasized the importance of engaging in intentional planning and problem solving before implementation of a continuing professional development program by discussing the difficulties of their initial efforts.
• The presenters indicated that their focus was not on what their licensees had done in terms of continuing education, but in what they learned, how they used it, and how it impacted patient/client care.

Trust But Verify, Compliance Monitoring as Risk Mitigation

• When determining a sanction for impaired clinicians, regulators need to determine if it is in the public’s interest to remove the clinician from practice, particularly in underserved areas
• One determinant is the idea of ungovernability in which a licensee has demonstrated an inability or unwillingness to abide by the profession’s directions and rules – in which case, the clinician should be removed
• If it is determined that the risk of keeping a clinician practicing is acceptable, the public’s expectation is that compliance will be monitored by the regulatory board.

Entry to Practice Competencies: Excellent or Expired?

• Speakers presented evidence that current competencies required for entry level positions are no longer relevant
  • Citizenship, specified work experience (can you justify that work experience is needed) and traditional modes of assessment
• Competencies such as social skills, tech literacy, abstract thinking, active listening, critical thinking, creativity and professionalism are valued more now and will be in the future
• Presenters recommended operationalizing the construct of “good moral character” and finding ways to assess

Occupational Licensing Policy Learning Consortium: State-Based Solutions to Licensing Reforms

• Council of State Government is emphasizing portability and assert that certain populations are disproportionately affected, i.e. veterans and military spouses, individuals with criminal records, immigrants, and low income, unemployed and dislocated workers.
• Reviewed recent laws, such as Arizona and Pennsylvania’s Universal Recognition bills just passed that allows individuals licensed in other states to be licensed in their states.

The Balance Between Public Protection and the Right to Earn a Living

• Licensure limits opportunities to enter professions, limits the tasks that workers can perform, limits the number of consumer choices, and increases prices while reducing fluidity of labor market.
• When determining the need for an occupation to be regulated, identify the problem that the legislators need to address and then choose the least restrictive credential.

2. Scott Cohen, AMFTRB Treasurer Two takeaways from each of the CLEAR workshops I attended.

Effective Governance (opening keynote)

• Setting up agenda where most important items happen first and mundane reports are last
• On effective boards the whole is greater than the sum of individuals and that once a decision is made expectation is that there is a 100% support of decision, even when there was disagreement getting there.

Debunking the Continuing Competency Myth

• Self-reflection/assessment as a model for assessing continuing competency
• Asking licensees for feedback about CE programs and if they are meeting their needs

Competency Modeling in Credentialing

• Looking at competency modeling vs. job analysis
• Knowledge/skills vs. competencies

Occupational Licensing Policy (Friday’s breakfast Plenary)

• Compacts make a lot of sense (we already knew that)
• Thinking abt barriers to disproportional affected populations:
  • Veterans/Military spouses
  • Those with criminal records
  • Immigrants w/work authorization
  • Low income/unemployed/dislocated

Regulation thru punishment or remediation

• What is the ability of the licensing board to target specific deficits and create specific remediation vehicles
• Using practice advisors for at risk licensees
• Looking at technical skills (clinical practice skills) vs. professional behavior

Too Much information (social media)

• Having a policy and publish it about how investigators might use social media as part of their investigation
• 60% of med schools report unprofessional behavior as a result of discovery on social media

Assessing MH concerns in investigative process

• Awareness of Human Rights Law in investigative process
• Use of a support person for the complainants

Setting precedents: top 10 cases (closing session)

• Court ruling that discipline can be enforced even a civil/criminal trial returns a not guilty verdict

So these are my takeaways from the CLEAR workshops I attended. I am very glad I went. Scott also recommends the following articles:

• Excessive Occupational Licensing Hurts State Economy, Reduces Tax Revenue
• The counterproductive cruelties of occupational licensing

3. Jennifer Smothermon, AMFTRB President-Elect Regarding CLEAR insights/learnings…

I thought that the information on Effective Boards from the first keynote speaker was very helpful. The ideas about board meeting structure, strategic planning, and successful board composition were affirming and beneficial.

I also think the presentation by the Institute for Justice was helpful to give us insight about what we’re up against. I’m grateful that CLEAR continues to invite them to the conversation for that reason. The CLEAR webinar that I sent you after the conference provided an excellent rebuttal to the IJ arguments, which I had not heard before. I would love to see them in a Lincoln-Douglas style debate at CLEAR. I think both the presentation and the webinar can serve to continue to inform and direct us as we work on regulatory issues in an anti-regulatory climate. Not surprisingly, we received a letter from our Governor soon after the conference, directing boards to be mindful of many of these issues as we draft rules and make licensing decisions. I was able to provide context to that letter for my colleagues since I had familiarity with the information and arguments through CLEAR conferences and webinars and through our work together in AMFTRB.

I also appreciated being able to hear about the top 10 cases regulators should know about. That PowerPoint was good.

“What Explains Occupational Licensing.”

A CLEAR webinar: This is excellent and very important research in rebuttal to the Institute for Justice deregulation argument. The information would be very beneficial for our members to hear.

What is CLEAR?

CLEAR promotes regulatory excellence through conferences, educational programs, webinars, seminars, and symposia. The organization provides networking opportunities, publications, and research services for those involved with, or affected by, professional and occupational regulation. As a neutral forum to encourage and provide for the sharing of best practices, CLEAR serves and supports the international regulatory community and it’s vital contribution to public protection