Current through Register Vol. 39, No. 6, September 16, 2024
(a) Pursuant to
G.S.
90B-8(b), any nonresident
clinical social worker certified, registered, or licensed in another
jurisdiction desiring to obtain a temporary license from the Board shall make
application to the Board. Applications not completed within two years of
submission to the Board shall be denied. Application forms and instructions may
be found on the Board's website at https://www.ncswboard.org.A temporary
license shall expire six months following the date of issuance and is not
eligible for renewal. No individual shall hold more than one temporary license
within a five-year period.
(b) An
applicant pursuant to this Rule shall provide the following information on the
application set forth in Paragraph (a) of this Rule:
(1) the applicant's name, contact
information, signature, and date of signature;
(2) the social security number of the
applicant;
(3) the requested
designation of licensure type;
(4)
the applicant's place of employment, the name of the applicant's supervisor,
and the license number of the applicant's supervisor, if the supervisor holds a
license to practice clinical social work;
(5) educational history and degree
attainment;
(6) whether the
applicant has ever been certified, licensed, or registered to practice social
work by the Board, by another occupational board or agency, or in another
state/jurisdiction and, if so:
(A) what
credential was held;
(B) in what
state/jurisdiction;
(C) the
issuance date and expiration date; and
(D) what examinations were taken to obtain
said certification, licensure, or registration;
(7) whether the applicant ever has had a
credential denied, limited, reprimanded, suspended, or revoked;
(8) whether the applicant ever has been
convicted of a felony or misdemeanor under any laws;
(9) whether any criminal charges are pending
against the applicant;
(10) whether
any court, board, agency, or professional organization has found the applicant
guilty of misconduct, unprofessional conduct, dishonest or fraudulent practice,
or incompetent practice;
(11)
whether any charges are pending against the applicant before any court, board,
agency, or professional organization for unprofessional conduct, dishonest or
fraudulent practice, or incompetent practice;
(12) the applicant's certification that:
(A) the applicant has read the North Carolina
General Statute 90B Social Worker Certification and Licensure Act, and the
Board's rules, ethical guidelines, and disciplinary procedures, which are
available on the Board's website at
https://www.ncswboard.org,and agrees to
comply with them;
(B) the
information provided by the applicant in the application is true;
(C) the applicant consents to a criminal
history record check;
(D) the
applicant's consent for the jurisdiction in which the applicant is licensed to
release information to the Board related to the applicant's licensure status
and practice of social work;
(E)
the applicant has read and understands the public notice statement on employee
misclassification that is set forth in the application and has disclosed any
investigations for employee misclassification, and its results, over the
preceding 12-month period, as prescribed by
G.S.
143-789; and
(13) an application fee of twenty-five
($25.00) dollars.
(c) An
applicant pursuant to this Rule shall provide a copy of the completed
application set forth in Paragraph (b) of this Rule to the occupational board
or agency in which the applicant is certified, licensed, or registered to
practice social work. The applicant shall request that the occupational board
or agency in which the applicant is certified, licensed, or registered to
practice social work submit a form to the Board that contains the following:
(1) confirmation that the applicant's
completed application as set forth in Paragraph (b) of this Rule is accurate,
if known;
(2) whether the applicant
obtained original licensure from the responding board or agency and, if not,
the jurisdiction from which the applicant obtained original
licensure;
(3) whether the
responding board or agency has official transcripts, as prescribed in
21 NCAC
63 .0203, in its records for the
applicant;
(4) whether the
applicant graduated from an education program that is accredited by the Council
on Social Work Education (CSWE), for which accreditation standards are
available at
www.cswe.org;
(5) whether the applicant was exempt from the
jurisdiction's licensure requirements at the time the applicant received his or
her certification, licensure, or registration to practice social
work;
(6) whether the applicant
took an ASWB examination to obtain licensure in the responding board or
agency's jurisdiction and, if so, which examination;
(7) whether the applicant's licensure in the
responding board or agency's jurisdiction is in good standing and, if not, the
reason for which the licensure in not;
(8) whether the responding board or agency,
any state agency, or any professional organization ever has found the applicant
guilty of misconduct, unprofessional conduct, dishonest or fraudulent practice,
or incompetent practice and, if so, a copy of the documents adjudicating the
applicant;
(9) whether any charges
are pending against the applicant before the responding board or agency, any
state agency, or any professional organization for unprofessional conduct,
dishonest or fraudulent practice, or incompetent practice;
(10) whether the applicant completed any
supervision of clinical practice that was approved by the responding board or
agency and, if so:
(A) the dates of
supervision;
(B) the total number
of supervision hours recorded;
(C)
the total number of practice hours recorded; and
(D) the name and license number of the
applicant's supervisor;
(11) whether the responding agency or board
has any additional comments regarding the applicant's fitness to practice
clinical social work or licensure status; and
(12) the name, signature, date of signature,
and contact information of the representative completing the information set
forth in Paragraph (c) of this Rule, with the responding board or agency's seal
affixed.
Authority
G.S.
90B-6;
90B-6.2;
90B-8;
Temporary
Adoption Eff. October 1, 1999;
Eff. July 1, 2000;
Amended Eff. January 1, 2009;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. September 19, 2015;
Amended Eff.
October 1, 2021.
