Survey results from the Ohio Music Therapists Survey
Music Therapy Registration and Licensure in Ohio
Summary of Questions by Survey Respondents
Ohio State Task Force: February 2013
Overview
In 2005, the American Music Therapy Association (AMTA) and the Certification Board for Music Therapists (CBMT) developed the state Recognition Operational Plan in order to pursue recognition of music therapy and the Music Therapist-Board Certified (MT-BC) credential throughout all 50 states. Judy Simpson, Director of Government Relations for AMTA, Dr. Dena Register, Regulatory Affairs Advisor for CBMT, and Kimberly Sena Moore, Regulatory Affairs Associate for CBMT provide leadership for each of the state task forces. There are currently 38 states involved in the recognition process.
1. How would state licensure or registration differ from and/or enhance our national certification through CBMT? What exactly are title, practice, and public protection?
The shift in responsibility for setting basic occupational regulations from federal to state agencies has created a need for state recognition in addition to our national certification. The national MT-BC credential is present in Ohio state regulations, but inconsistently so. This, in turn, creates inconsistent access to services and funding options for our consumers. The goal is to have the state accept our existing national criteria for certification, with the aim of ensuring state level access to and funding for quality music therapy services.
The main benefits of increased state level legislative recognition are:
• Increased access to services for clients and families in need
• Public protection from misrepresentation and harm by those who claim to be practicing 'music therapy' when they are not, potentially turning a client away from a beneficial evidence-based treatment option
• Title protection of the title of ‘music therapist’, and recognition of the MT-BC credential
• Practice protection of the profession's existing structure of criteria for competent practice including the AMTA Code of Ethics and Standards of Clinical Practice, and the CBMT Code of Professional Practice and Scope of Practice
• Increased recognition among other professionals
2. What is the difference between registration and licensure?
"Registration is the least restrictive form of state regulation, usually consisting of requiring individuals to file their name, address and qualifications with a government agency before practicing the profession. Registration is an appropriate form of regulation when the threat to life, health, safety, and economic well-being is relatively small and other forms of legal redress are available to the public." (Shimberg, Benjamin and Roederer, Doug. Questions a Legislator Should Ask, The Council on Licensure, Enforcement and Regulation, 1994.)
In some states there is no legislative structure for registries, which makes a registry for music therapists (MTs) unfeasible. The task force has found two professions that operate within a registry in Ohio. Ohio professions that are registered include:
• Acupuncture
• Nurses aide
"Licensure is the most restrictive form of state regulation. Under licensure laws, it is illegal for a person to practice a profession without first meeting the standards imposed by the state. It is illegal for unlicensed individuals to perform acts within the statutorily defined scope of practice. Licensing is a process by which a government agency grants individuals permission to engage in a specified profession or occupation upon finding that individual applicants have attained the minimal degree of competency required to ensure that the public's health, safety and welfare will be reasonably well protected." (Shimberg,
Benjamin and Roederer, Doug. Questions a Legislator Should Ask, The Council on Licensure, Enforcement and Regulation, 1994.)
Ohio professions that are licensed include but are not limited to:
• Speech-Language Pathology
• Occupational Therapy
• Occupational Therapy Assistant
• Physical Therapy
• Physical Therapy Assistant
• Dietician
• Social Worker
• Registered Nurse (RN), Licensed Practical Nurse (LPN)
• Audiology
• Teacher
3. Would this be an additional cost to certification? How much would the fee be?
Yes, this would be an additional cost. Our national certification dues are paid to CBMT, whereas the cost for licensure or registration would provide for state level oversight and compliance of the new regulations. Increased cost to the individual
MT has been the most frequently expressed concern, and every effort will be made to lessen the financial impact as much as possible. The task force is researching fees in comparable professions in Ohio so that we may better predict the additional cost. We will continue to update Ohio MTs as we progress through this process and more information becomes available.
Fee amounts and renewal frequency vary state by state. AMTA and CBMT are suggesting that fees be set at $50/year. Although we would prefer a 5-year renewal cycle to match the CBMT recertification cycle, most states already have a 2-year renewal cycle in place and we may need to follow that model. Nevada is on a 3-year renewal cycle; the initial application fee is $200 and it drops to $150 for the renewal (which aligns with AMTA and CBMT’s $50/year proposal). Nevada’s license application process is public record: http://health.nv.gov/HCQC_MusicTherapist.htm
4. Would a license require a Master’s Degree?
No, these are two separate issues. Any proposed legislation would apply to all MT-BCs regardless of their educational level.
5. What legislative/legal advice have we received? What is AMTA’s advice?
AMTA and CBMT are guiding us in every step of this process by collaborating with the task force to determine the best path to increase recognition in Ohio. They have drafted legislation templates for both licensure and registration as a guide for each state. Every piece of music therapy legislation is vetted by CBMT's legal counsel to verify that our scope of practice is protected and accurately defined.
6. How many other states recognize a music therapy license? What have been the results?
• In 2011, North Dakota and Nevada passed the first-ever legislation creating music therapy licenses in both states. Nevada’s regulations have been written and approved by the state and the license is in effect. There is anecdotal evidence that the music therapy license has allowed access to a funding stream reviously denied due to lack of state recognition. North Dakota’s regulations have been drafted and are awaiting final legislative approval.
• In 2012, Georgia also passed legislation creating a license. The state is awaiting appointments of an Advisory Board that will draft the regulations (anticipated summer 2013).
• Wisconsin has established a registry and offers the WMTR, or Wisconsin Music Therapist-Registered.
• The New York Licensed Creative Arts Therapist (LCAT) is a mental health license that requires a master's degree. This is not the recognition model we are seeking, as it does not recognize music therapy as a separate profession, and it does not adopt our national certification standards.
• We anticipate that up to 9 states will file recognition legislation in 2013, including Indiana, which filed a title protection bill, South Carolina, and Arizona, which both filed licensure bills.
7. Would those of us already practicing be grandfathered? What about RMTs?
If Ohio creates a music therapy registry or license and you provide music therapy services in the state, you will need to complete the appropriate application process. Language would be put into any bill that allows those currently listed on
the National Music Therapy Registry (RMTs) to be listed on the state registry or apply for the license.
8. Will there be reciprocity for those MT-BCs who work in multiple states, or who move from state to state?
It is possible that a music therapist will need to meet the requirements of each individual state including any fees involved. However, the application and renewal requirements may remain consistent state to state, as we are using the national standards developed by AMTA and CBMT. Unlike other professions that may encounter this issue, our unified national MT-BC credential may make it easier to address the problem through language in the regulations.
9. What does oversight by the state involve?
After legislation is passed and signed into law, the state would appoint a board or advisory committee. The board will first be charged with writing the regulations that describe the details of how music therapy will be licensed or registered. Details about how the license or registry will be enforced and who can report complaints will also be decided.
10. What effect will our efforts have on Certified Music Practitioners, music volunteers, thanatologists, vibroacoustic therapists and other professionals that use music?
We are not seeking to limit the use of music by other professionals; our aim is to protect the title and practice of music therapy and our national standards for competent practice. As we move forward, we will continue to educate on the differences in training, education, and scope of practice between MTs and other music healing professionals. In addition, AMTA and CBMT are working with the national Board for Therapeutic Musicians to ensure that exemption language is included so that all music healing professions are able to practice in accordance with their clinical training scope of practice as we seek state recognition.
11. How would an MT-BC apply for licensure or be listed on a registry? What would the process entail?
The process would involve submitting an application and fee to be listed on the registry or to obtain a state license. This process would be defined and outlined as part of writing the regulations.
12. Which way is the task force leaning?
The task force's job is to act in the best interest of the music therapy profession, the MTs working in the state, and the clients we serve. We will move forward only when we have consensus of MTs in Ohio, and necessary legislative support of our efforts.
13. What has happened so far?
There are 38 states with active task forces involved in the State Recognition Operational Plan, and Ohio was one of the very first to begin collaborating with AMTA and CBMT in 2006. In the past 7 years the task force has:
• Done periodic surveys to collect information about the makeup of MTs in Ohio.
• Examined the Ohio Administrative Code to see how other professions such as OT, PT, SLP, counselors, and therapists
organize themselves.
• Identified where music therapy is already recognized in the Administrative Code Statutes and Regulations.
• Made contact with legislators in an effort to gauge outcome and support.
• Used data from previous surveys to put together informational brochures and fact sheets specific to music therapy in Ohio to
be used when speaking with our state representatives and senators.
• Developed a plan to begin to reach out to other state therapy organizations to seek support for our efforts of state
recognition.
• Held regular conference calls with AMTA and CBMT to gain guidance in our advocacy efforts.
14. What will happen next and what is the time frame?
This is a process that requires many steps and careful consideration as well as adjustments as we progress through the plan. Our current targets are:
• Hill Day at GLR in April, 2013 with corresponding advocacy CMTE
• Decide on best direction to move forward based on legislator response
• Secure a bill sponsor
• File legislation in the House and Senate
• Testify at committee hearings. We will need not only testimony from MTs, but also from the public including positive stories
from consumers, administrators, and other health professionals. We will also seek out those consumers who have been
harmed by the inaccessibility of services, funds, or by unqualified professionals.
• Advocate for support of the bill by making phone calls and sending emails to state legislators asking them to support the bill.
• The bill would have to pass both the state house and senate and be signed by the governor to become law.
15. How can I get involved?
There are many ways to get involved in this process and they vary regarding time commitment:
• Read and respond to emails from your state task force
• Make sure you are a member of AMTA
• Read AMTA’s and CBMT’s newsletters
• Act on calls to action from your state task force, which can include filling out surveys, making phone calls, or sending emails\
• Participate in the Advocacy CMTE and Hill Day event at the GLR conference in
April 2013
In 2005, the American Music Therapy Association (AMTA) and the Certification Board for Music Therapists (CBMT) developed the state Recognition Operational Plan in order to pursue recognition of music therapy and the Music Therapist-Board Certified (MT-BC) credential throughout all 50 states. Judy Simpson, Director of Government Relations for AMTA, Dr. Dena Register, Regulatory Affairs Advisor for CBMT, and Kimberly Sena Moore, Regulatory Affairs Associate for CBMT provide leadership for each of the state task forces. There are currently 38 states involved in the recognition process.
1. How would state licensure or registration differ from and/or enhance our national certification through CBMT? What exactly are title, practice, and public protection?
The shift in responsibility for setting basic occupational regulations from federal to state agencies has created a need for state recognition in addition to our national certification. The national MT-BC credential is present in Ohio state regulations, but inconsistently so. This, in turn, creates inconsistent access to services and funding options for our consumers. The goal is to have the state accept our existing national criteria for certification, with the aim of ensuring state level access to and funding for quality music therapy services.
The main benefits of increased state level legislative recognition are:
• Increased access to services for clients and families in need
• Public protection from misrepresentation and harm by those who claim to be practicing 'music therapy' when they are not, potentially turning a client away from a beneficial evidence-based treatment option
• Title protection of the title of ‘music therapist’, and recognition of the MT-BC credential
• Practice protection of the profession's existing structure of criteria for competent practice including the AMTA Code of Ethics and Standards of Clinical Practice, and the CBMT Code of Professional Practice and Scope of Practice
• Increased recognition among other professionals
2. What is the difference between registration and licensure?
"Registration is the least restrictive form of state regulation, usually consisting of requiring individuals to file their name, address and qualifications with a government agency before practicing the profession. Registration is an appropriate form of regulation when the threat to life, health, safety, and economic well-being is relatively small and other forms of legal redress are available to the public." (Shimberg, Benjamin and Roederer, Doug. Questions a Legislator Should Ask, The Council on Licensure, Enforcement and Regulation, 1994.)
In some states there is no legislative structure for registries, which makes a registry for music therapists (MTs) unfeasible. The task force has found two professions that operate within a registry in Ohio. Ohio professions that are registered include:
• Acupuncture
• Nurses aide
"Licensure is the most restrictive form of state regulation. Under licensure laws, it is illegal for a person to practice a profession without first meeting the standards imposed by the state. It is illegal for unlicensed individuals to perform acts within the statutorily defined scope of practice. Licensing is a process by which a government agency grants individuals permission to engage in a specified profession or occupation upon finding that individual applicants have attained the minimal degree of competency required to ensure that the public's health, safety and welfare will be reasonably well protected." (Shimberg,
Benjamin and Roederer, Doug. Questions a Legislator Should Ask, The Council on Licensure, Enforcement and Regulation, 1994.)
Ohio professions that are licensed include but are not limited to:
• Speech-Language Pathology
• Occupational Therapy
• Occupational Therapy Assistant
• Physical Therapy
• Physical Therapy Assistant
• Dietician
• Social Worker
• Registered Nurse (RN), Licensed Practical Nurse (LPN)
• Audiology
• Teacher
3. Would this be an additional cost to certification? How much would the fee be?
Yes, this would be an additional cost. Our national certification dues are paid to CBMT, whereas the cost for licensure or registration would provide for state level oversight and compliance of the new regulations. Increased cost to the individual
MT has been the most frequently expressed concern, and every effort will be made to lessen the financial impact as much as possible. The task force is researching fees in comparable professions in Ohio so that we may better predict the additional cost. We will continue to update Ohio MTs as we progress through this process and more information becomes available.
Fee amounts and renewal frequency vary state by state. AMTA and CBMT are suggesting that fees be set at $50/year. Although we would prefer a 5-year renewal cycle to match the CBMT recertification cycle, most states already have a 2-year renewal cycle in place and we may need to follow that model. Nevada is on a 3-year renewal cycle; the initial application fee is $200 and it drops to $150 for the renewal (which aligns with AMTA and CBMT’s $50/year proposal). Nevada’s license application process is public record: http://health.nv.gov/HCQC_MusicTherapist.htm
4. Would a license require a Master’s Degree?
No, these are two separate issues. Any proposed legislation would apply to all MT-BCs regardless of their educational level.
5. What legislative/legal advice have we received? What is AMTA’s advice?
AMTA and CBMT are guiding us in every step of this process by collaborating with the task force to determine the best path to increase recognition in Ohio. They have drafted legislation templates for both licensure and registration as a guide for each state. Every piece of music therapy legislation is vetted by CBMT's legal counsel to verify that our scope of practice is protected and accurately defined.
6. How many other states recognize a music therapy license? What have been the results?
• In 2011, North Dakota and Nevada passed the first-ever legislation creating music therapy licenses in both states. Nevada’s regulations have been written and approved by the state and the license is in effect. There is anecdotal evidence that the music therapy license has allowed access to a funding stream reviously denied due to lack of state recognition. North Dakota’s regulations have been drafted and are awaiting final legislative approval.
• In 2012, Georgia also passed legislation creating a license. The state is awaiting appointments of an Advisory Board that will draft the regulations (anticipated summer 2013).
• Wisconsin has established a registry and offers the WMTR, or Wisconsin Music Therapist-Registered.
• The New York Licensed Creative Arts Therapist (LCAT) is a mental health license that requires a master's degree. This is not the recognition model we are seeking, as it does not recognize music therapy as a separate profession, and it does not adopt our national certification standards.
• We anticipate that up to 9 states will file recognition legislation in 2013, including Indiana, which filed a title protection bill, South Carolina, and Arizona, which both filed licensure bills.
7. Would those of us already practicing be grandfathered? What about RMTs?
If Ohio creates a music therapy registry or license and you provide music therapy services in the state, you will need to complete the appropriate application process. Language would be put into any bill that allows those currently listed on
the National Music Therapy Registry (RMTs) to be listed on the state registry or apply for the license.
8. Will there be reciprocity for those MT-BCs who work in multiple states, or who move from state to state?
It is possible that a music therapist will need to meet the requirements of each individual state including any fees involved. However, the application and renewal requirements may remain consistent state to state, as we are using the national standards developed by AMTA and CBMT. Unlike other professions that may encounter this issue, our unified national MT-BC credential may make it easier to address the problem through language in the regulations.
9. What does oversight by the state involve?
After legislation is passed and signed into law, the state would appoint a board or advisory committee. The board will first be charged with writing the regulations that describe the details of how music therapy will be licensed or registered. Details about how the license or registry will be enforced and who can report complaints will also be decided.
10. What effect will our efforts have on Certified Music Practitioners, music volunteers, thanatologists, vibroacoustic therapists and other professionals that use music?
We are not seeking to limit the use of music by other professionals; our aim is to protect the title and practice of music therapy and our national standards for competent practice. As we move forward, we will continue to educate on the differences in training, education, and scope of practice between MTs and other music healing professionals. In addition, AMTA and CBMT are working with the national Board for Therapeutic Musicians to ensure that exemption language is included so that all music healing professions are able to practice in accordance with their clinical training scope of practice as we seek state recognition.
11. How would an MT-BC apply for licensure or be listed on a registry? What would the process entail?
The process would involve submitting an application and fee to be listed on the registry or to obtain a state license. This process would be defined and outlined as part of writing the regulations.
12. Which way is the task force leaning?
The task force's job is to act in the best interest of the music therapy profession, the MTs working in the state, and the clients we serve. We will move forward only when we have consensus of MTs in Ohio, and necessary legislative support of our efforts.
13. What has happened so far?
There are 38 states with active task forces involved in the State Recognition Operational Plan, and Ohio was one of the very first to begin collaborating with AMTA and CBMT in 2006. In the past 7 years the task force has:
• Done periodic surveys to collect information about the makeup of MTs in Ohio.
• Examined the Ohio Administrative Code to see how other professions such as OT, PT, SLP, counselors, and therapists
organize themselves.
• Identified where music therapy is already recognized in the Administrative Code Statutes and Regulations.
• Made contact with legislators in an effort to gauge outcome and support.
• Used data from previous surveys to put together informational brochures and fact sheets specific to music therapy in Ohio to
be used when speaking with our state representatives and senators.
• Developed a plan to begin to reach out to other state therapy organizations to seek support for our efforts of state
recognition.
• Held regular conference calls with AMTA and CBMT to gain guidance in our advocacy efforts.
14. What will happen next and what is the time frame?
This is a process that requires many steps and careful consideration as well as adjustments as we progress through the plan. Our current targets are:
• Hill Day at GLR in April, 2013 with corresponding advocacy CMTE
• Decide on best direction to move forward based on legislator response
• Secure a bill sponsor
• File legislation in the House and Senate
• Testify at committee hearings. We will need not only testimony from MTs, but also from the public including positive stories
from consumers, administrators, and other health professionals. We will also seek out those consumers who have been
harmed by the inaccessibility of services, funds, or by unqualified professionals.
• Advocate for support of the bill by making phone calls and sending emails to state legislators asking them to support the bill.
• The bill would have to pass both the state house and senate and be signed by the governor to become law.
15. How can I get involved?
There are many ways to get involved in this process and they vary regarding time commitment:
• Read and respond to emails from your state task force
• Make sure you are a member of AMTA
• Read AMTA’s and CBMT’s newsletters
• Act on calls to action from your state task force, which can include filling out surveys, making phone calls, or sending emails\
• Participate in the Advocacy CMTE and Hill Day event at the GLR conference in
April 2013