Overview

The joint AMTA/CBMT State Recognition Operational Plan (SROP) is a national initiative designed to achieve state recognition of the music therapy profession and the MT-BC credential required for competent practice. There are currently 35 active state task forces at various stages in the process from initial regulatory research to building relationships with state legislators to filing legislation.
The purpose of the SROP is to protect our clients by ensuring competent practice and to increase their access to our services. AMTA and CBMT staff provide guidance and support to the local task forces and music therapists in the state. CBMT legal counsel reviews all legislative language before it is introduced in any state. AMTA, CBMT, and the state task forces only move forward at any stage in the process when the proposed action serves the best interests of the music therapy profession, the MTs working in the state, and music therapy clients.
The SROP has been in effect since 2005 and the amount of activity has almost doubled every year. A significant accomplishment in Arizona was the passage of SB 1376 in 2010, which added a definition of music therapy and a requirement for the MT-BC for providers of music therapy services for persons with disabilities.
In August 2012 the AZ task force with the support of AMTA and CBMT submitted a Sunrise Review. The Sunrise and recent SB 1437, currently in process, were introduced to address special state licensure under the Department of Health Services (DHS). (view the complete SB 1437 at http://www.azleg.gov).
Questions

Q: The MT-BC is a national certification. Isn’t that enough?
Answer: In most states, a national certification is not enough. This has been a shift over the past 10-15 years as the federal government moved towards deregulation and allocated more regulatory control to state governments. In addition, many existing state regulations require that education and health care providers hold a state license. Having a license, as opposed to a registry, is a signal to the public that the state government recognizes that music therapists have met and maintained certain criteria to practice, just as they do in comparable healthcare and education professions. For music therapists, this criteria will be the AMTA clinical and education training standards and the CBMT board certification and recertification –familiar to us in the profession, but important for those in the public to know about. It also signifies that music therapists have oversight and regulation by a license board.

Q: Is there a difference between licensure, certification and registration?
A: Yes. A registry is a list of professionals who have met predetermined education, clinical training, and certification requirements and this program provides title protection. A license outlines specific education, clinical training, and continuing education requirements and provides title protection, practice protection, and public protection.

Q: What would the benefits of licensure be?
A: According to Judy Simpson, AMTA Director of Government Relations, and Dena Register, CBMT Regulatory Affairs Advisor (April 2010): “State recognition has two primary, specific benefits for constituents in your state:
• Protects clients or patients in the state from potential harm or mis-representation from
individuals that are not board-certified music therapists and are not practicing under the MT-BC Scope of Practice (i.e., non-music therapy musicians in healthcare)
• Allows patients or clients and their families to access services provided by a board certified music therapist as determined by various state agencies such as Department of Education, Department of Health and Human Services, Department of Disabilities and Special Needs, etc., that require state recognized service providers.”
Judy Simpson and Dena Register also state:
This state recognition has many additional, ancillary benefits for constituents in your state:
• Increases awareness of music therapy as a profession resulting in increased service referrals, increased jobs, increased enrollment in educational training programs
• Increases access to private and public funding streams as most of these programs require that providers have a state recognized credential
• Additional validation of what music therapists do as part of the educational or healthcare treatment team and alignment with professional practices in comparable professions.

Q: Who will be administering the license?
A: The Arizona Department of Health Services, Division of Licensing Services/Office of Special Licensing.

Q: How long is the license valid?
A: As stated in SB 1437 the license will be good for 2 years.

Q: Is any additional training or education required for this license?
A: No. As written in SB1437 initial application for license requires proof of education, internship, and proof of passing the examination for board certification. If the applicant is licensed in another state proof must be given of good standing within that state. To renew the license the licensee must provide proof of completing 40 continuing education hours for the 24 month period. This aligns with the requirement for CBMT renewal of 100 hours for 5 years.

Q: Would every MT-BC have to be licensed?
A: Yes, if a MT licensure law is established in AZ, all music therapists (part time or full time) who wish to practice in the state will have to apply for licensure in order to legally practice music therapy.

Q: What if your job title does not include music therapy?
A: If you are providing music therapy services, then you would need to apply for a music therapy license.

Q: Does this license prohibit other professions from using music?
A: No, this does not prohibit a person regulated in another profession from performing work that includes the use of music as long as they do not claim to be a music therapist. This also does not prohibit a student or intern in an accredited music therapy program from working under the supervision of a music therapist as long as the student does not claim to be a music therapist. Finally, this does not prohibit the practice of music therapy techniques under the supervision of a licensed music therapist so long as the person does not claim to be a music therapist (i.e. the family of a client following the directions identified in a licensed music therapist’s individualized home program specified for the client).

Q: Will there be a difference between Bachelor’s or Master’s levels of education?
A: No, these are two separate issues. This legislation will license music therapists working in the state who hold the MT-BC credential, regardless of the educational level.

Q: Would federal employees be under the same requirements?
A: Yes. Federal employees would be under the same requirements unless covered elsewhere in Title 32. There is an exception related to license renewal and expiration for military members.

Q: If we have state licensure, will a standardized assessment be required? (As OTs, PTs, etc. utilize standardized assessments)?
A: No. Seeking state recognition involves seeking recognition of the profession’s existing structure. The profession is well established in its education and clinical requirements, exam and continuing education requirements, Standards of Clinical Practice, Professional Competencies, Code of Ethics, Scope of Practice, and Code of Professional Practice.
Fees

Q: What are the fees and how often do we pay? Why do we have to pay for both BC and license?
A: The fees are being determined at this time and would be required every 2 years. There will not be a redundancy associated with the MT-BC, because the state license would create formal recognition and acknowledgement of the MT-BC within AZ, so both would still be required.

Q: What is the advisory committee?
A: The purpose of the music therapy advisory committee is to write the regulations (e.g. rules) that uphold the music therapy licensure once it is passed, process potential consumer complaints and oversee the disciplinary process, issue a license to each applicant who meets the requirements, and ensure the public’s health and safety by enforcing qualification standards for licensees and applicants.

Q: Who will serve on the advisory council?
A: Although the advisory council has not been specifically outlined in this bill it will likely be addressed in regulations. To reduce costs, these will be volunteer positions, appointed by the DHS Director.

Q: Where do the fees go?
A: Licensure fees will be used for costs related to the administrative processing expenses and to reimburse Advisory Council expenses. 10% of the fees will go into the state general fund. The other 90% of the fees will go into a music therapist fund. The benefit of our proposal is that it provides a cost-neutral option to the state, since they will not need to outline the education and clinical training requirements, nor create a certification exam, since this structure is already in place through AMTA and CBMT.

Q: Would CBMT be interested in a single fee for the MT-BC and the state license (CBMT would pay the states)?
A: It is highly unlikely that a state will consider receiving payment for an individual’s license from a private, national credentialing body. The point of state licensure is for the state to protect the public and to officially recognize a profession through a state established system and to not rely on a national entity.
Reimbursement

Q: How will this affect reimbursement?
A: The waiver program funds music therapy services, regardless of whether music therapy is licensed by the state or not. There is no connection between licensure and waiver funding. In fact, having a music therapy license in all likelihood will create access to additional funding streams. Although state licensure is not an automatic guarantee of third party reimbursement, it removes a significant barrier that many payers currently use as a reason to not reimburse for music therapy. State licensure will allow more reimbursement options for state funding and private insurance coverage that have never before been available to AZ residents. In other states where state recognition is moving forward, we have experienced an increase in reimbursement benefits from both state funding and private insurance companies. We have not experienced any negative payment outcomes from obtaining licensure in other states.

Q: Will our paperwork/documentation change due to licensure?
A: The legislation and regulations will not outline specific documentation requirements. However, certain facilities and employers may require different document requirements as needed. For example, if the license allows music therapists to bill through new revenue sources, your employer may ask you to fill out and submit different billing-related paperwork.
Legal Process

Q: What is the process? Was there a lawyer involved?
A: The legislative process is often a long one that involves securing a bill sponsor, filing the legislation in the House and the Senate, testifying at committee hearings, and advocating for support of the bill. Once legislation is filed, it becomes law after it passes both sides of the state legislature (House and Senate) and is signed by the governor.
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. Once the bill is passed, the regulations, which serve as the “rules” that lay out how the new law will be upheld, are written. AMTA and CBMT are involved in every step of this process to make sure that everyone’s best interests, the music therapists in the state and our clients, are considered and upheld.
It is not unusual for the process of passing legislation to take several years. Much advocacy is needed to educate legislators about the profession and the need for state recognition.

Q: How does a bill become a law?
A: A bill becomes law after it has passed both sides of the state legislature and has been signed by the governor. The legislative process is often a multi-year process. It starts with securing a sponsor and drafting legislation. The legislation is then introduced in the house or senate and is assigned to a committee (the Health and Human Services Committee for our bill). At least one committee hearing will take place, during which people who support the bill and people who oppose the bill testify based on their interests. Legislation has to pass out of committee before the entire floor hears it again and votes on it. If passed on that side, the legislation will move to the other side and the committee and voting processes will occur again on that side. If any amendments are made during the process, the legislation will have to be re-reviewed and there will be a re-vote on the original side. Once legislation has passed both sides, it is sent to the governor, who either signs the bill into law or vetoes the bill.

Q: Who is sponsoring/supporting SB 1437?
A: Senate Bill 1437 is sponsored by Senator Kelli Ward, R- District 5 with co-sponsors Senator Adam Driggs, R- District 28 and Senator Steve Pierce, R- District 1.

Q: What can I do now to support /further this process? How can I get involved?
A: Read the proposed SB 1437 at http://www.azleg.gov. Stay connected through AZMTA membership/website and the WRAMTA website. If you have any questions or know of any instances of harm caused by misrepresentation of music therapy or “music therapy” provided by a non-music therapist in the state of Arizona contact the Arizona Music Therapy State Task Force at AZmuictherapyTF@gmail.com.
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Music Therapy Advocacy in Action: Hill Day CMTE
The AMTA Director of Government Relations Judy Simpson and the Arizona State Music Therapy Task Force will be presenting a 6-hour CMTE before the upcoming WRAMTA conference in Tempe in April. The CMTE starts on Wednesday evening from 6:00-9:00pm where you’ll learn the necessary skills to communicate effectively with your state legislators. Gain insight about state recognition efforts and updates about current health and education issues related to music therapy practice. On Thursday morning, attendees will join Arizona Task Force members in meeting with Arizona legislators and promoting music therapy. For more information, please consult the conference program at http://www.wramta.org
We hope to see you there to be a voice advocating for music therapy in Arizona!

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