MFTs Providing Therapy Across State Lines Through License Portability in the United States: An interview with Roger Smith
Curt and Katie chat with Roger Smith, Chief Advocacy Officer and General Counsel for American Association of Marriage and Family Therapists, about the challenges and progress in licensure portability for Marriage and Family Therapists (MFTs). He explains why AAMFT opted for an endorsement model over interstate compacts, the success of the Access MFTs initiative, and what’s next for portability efforts in 2025.
Click here to scroll to the podcast transcript.Transcript
(Show notes provided in collaboration with Otter.ai and ChatGPT.)
An Interview with Roger Smith, Chief Advocacy Officer and General Counsel, AAMFT
Roger Smith joined the American Association for Marriage and Family Therapy (AAMFT) in 2005. He currently serves as AAMFT’s Chief Advocacy Officer and General Counsel. Roger oversees AAMFT’s Government and Corporate Affairs team, which advocates for AAMFT’s federal and state policy initiatives, and AAMFT’s Ethics and Legal Affairs team, which handles general legal issues for AAMFT. After receiving a bachelor’s degree from Purdue University, Roger earned his law degree from the Indiana University Robert H. McKinney School of Law in Indianapolis.
In this podcast episode, we talk with Roger Smith about LMFT License Portability
As more and more therapy is happening online, therapists have an opportunity to work with clients from all over the world. In the United States, there have been efforts by social workers, mental health counselors, and psychologists to create inter-state compacts to help regulate these therapists (and provide opportunities to deliver care legally in other states). Marriage and Family Therapists have been left behind and are now seeking a different path (reciprocity or portability) due to the unique characteristics of the LMFT profession. We reached out to Roger Smith of AAMFT to help us understand why this decision was made as well as what it means for MFTs.
Why AAMFT Chose the Endorsement Model Over Compacts
“AAMFT, along with other entities within the MFT field looked at licensure compacts as a possible option, but ultimately decided not to do so, and really for a couple of main reasons. One is the cost. There’s actually a significant cost to compacts, both in developing a compact, …also the costs in getting compact licensure passed in various states…Once the Compact is in effect…you have to have a Compact Commission…We found that the existing compacts all appear to be losing money.” – Roger Smith
- Interstate compacts were considered but ultimately deemed too costly and unsustainable.
- Large states like California and New York have not adopted ANY healthcare compacts, limiting effectiveness.
- Endorsement model: Allows MFTs to practice in other states if they hold an unencumbered license—without having to meet initial requirements again.
Success of the “Access MFTs” Model
- In 2024, 7 out of 10 targeted states passed the Access MFTs model law.
- States that adopted the model include Arizona, Georgia, Illinois, Iowa, Maryland, Tennessee, and Virginia.
- Efforts continue in Kentucky and North Carolina for 2025.
Future of MFT Portability & Barriers
- California is not pursuing portability legislation but is working with CAMFT on national exam advocacy.
- Exam requirements can be a barrier to full portability.
- Expansion plans focus on pro-telehealth states and underserved regions.
Member Interest & Cost Considerations for MFTs seeking to practice across state lines
- A 2022 AAMFT survey showed strong member interest in portability, especially among younger therapists.
- Costs are a factor—both the Access MFTs model and interstate compacts involve financial considerations for therapists.
National Licensure for therapists: Why It’s Not an Option
- Licensure is a state-level issue, and federal intervention is unlikely.
- A national exam or license would face constitutional challenges and resistance from state regulatory boards.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
AAMFT Website: aamft.org
Access MFTs Initiative: networks.aamft.org/portability/home
AAMFT Advocacy Network: www.aamft.org/AAMFT/Advocacy/Advocacy.aspx
Relevant Episodes of MTSG Podcast:
Is the Counseling Compact Good for Therapists?
Addressing Racism in Clinical Licensing Exams: An Interview with Ben Caldwell and Tony Rousmaniere
Are Therapy and Coaching All That Different?
The Dividing Line Between Coaching and Therapy
An Expert Witness Weighs in on Therapist Malpractice: An interview with Dr. Frederic Reamer
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm And Katie Vernoy.
Curt Widhalm 0:15
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our field, the things that affect our practices, and one of the ongoing discussions that has really taken a really prominent role in our field, especially since the beginning of the pandemic, it was going for a while before that. But with all of the wonderful opportunities to utilize telehealth to be able to meet our clients literally where they’re at, why can’t we see clients literally where they’re at? And a lot of this comes around to discussions around license portability, around interstate compacts, around having a national licensure that we’ve heard these discussions, and Katie and I have been a part of these conversations in some aspects or another, particularly here in California, and some of the legislation that goes on with it. We’ve talked about it on the podcast before, but we are also very privileged to have Roger Smith from AAMFT. He’s the chief advocacy officer, and he’s here to also help discuss a little bit around kind of where the direction of things seems to be going, AAMFTs role in all of this. So thank you very much for spending some time with us today.
Roger Smith 1:35
You’re welcome. Thank you. Glad to be here.
Katie Vernoy 1:38
So the first question that we ask all of our guests is, who are you and what are you putting out into the world?
Roger Smith 1:45
Yes, happy to be here. Again, I’m Chief advocacy Officer of AAMFT. Been with amft, the American Association of Marriage and Family Therapy, for 19 years now, and oversee as chief advocacy officer all federal and state advocacy initiatives for the association. AAMFT has several state chapters, and so help work with them on state level advocacy initiatives, including the Access MFTs portability initiative and getting MFTs into Medicare.
Curt Widhalm 2:13
So just to help our audience frame things, can we talk briefly about the history of licensure, portability and some of the compact stuff that has happened with some of the other licenses.
Roger Smith 2:27
History of licensure, portability and compacts. It’s been around for many years. When I started an AAMFT involvement advocacy 10-15, years ago, it was an issue then. Traditionally, portability under state law has been under what is known as substantially equivalent model. The idea is that if you’re licensed, you can become licensed in another state. If you came from a state that has substantially equivalent requirements to the state you want to come into. Sometimes it’s phrased a little differently. Sometimes the question is not the laws as of the time you enter, but the law at the time you actually got licensed initially. So there are variations in that. It sounds good on paper, well, you know, apples to apples, we’re going to have the same comparison. But in reality, it’s very difficult to do so. Educational requirements don’t exactly match up in terms of the coursework descriptions, even though, if they are the same thing, the silibi are different. Sometimes the supervised experience hours are different. Someone graduated from a 36 credit hour program, and now it’s 48 credit hours. They graduated from 48 credit hour program, it’s now 60 credit hour program, or they didn’t have one particular course, and yet they are not able to become licensed, and yet there has been no findings in those areas that there’s a harm to the practice of the profession, and having someone not exactly line up exactly with those particular portability requirements, and that has been sort of the traditional model. And what has happened over time is there’s been a lot of changes in that particular area.
Katie Vernoy 4:11
With portability being what it is, and then, to be clear, portability is you’re licensed in one state, and then you go about and get licensed in another state. And what I’m hearing you say is that there’s so much difference state to state on what license sure looks like, whether it’s as an MFT or a counselor or a social worker or whatever, that it’s been hard for folks to get licensed state to state. And we’ve had other organizations like the counselors, the social workers, the psychologists, get interstate compact. So there’s a Counseling Compact, the Social Workers Compact, the Psypact. And I actually, early in this conversation, saw a webinar where you and some of the folks in our California Association of Marriage and Family Therapists were talking about the decision making process of: Do we make it easier to get licensed state to state, or do we go for an interstate compact? Can you talk a little bit about what the history was there and what AAMFT and other MFT organizations decided to do?
Roger Smith 5:13
Yeah, a compact is a type of portability model. It’s one type of portability model. There are several others. Interstate compacts have been around for many years. They go back 200 years or more, and have found in many, wide variety of areas. In healthcare, compacts have been around for about 10-12, years or so. The most common compact is the Nursing Compact. Been around in 39 states now 39-40 states. There are now compacts for recently, as you mentioned, mental health counseling that got off the ground about 2018, 2020, psychology psypact, it’s been around for over 10 years. And social work compact, it’s newer. And they do have a process where you try to, you have to develop a compact, a profession has to develop one and then have a review process and submit it to various states. And there’s also an organization called the Council on State Governments that oversees the compact process. And these laws have to be identical in every state. AAMFT, along with other entities within the MFT field looked at licensure compacts as a possible option, but ultimately decided not to do so, and really for a couple of main reasons. One is the cost. There’s actually a significant cost to compacts, both in developing a compact, in other words, just getting people together, and the costs of developing and coming together with that, but also the costs in getting compact licensure passed in various states. But then the real costs take a head once the Compact is in effect, because you have to have a Compact Commission that includes representatives of all from all the state licensure boards in the states that are part of the compact, they have to meet regularly, they have to have staff involved, and they also have to have a data set so you can do more instantaneous comparisons. And if someone applies, they can get licensed quickly through the privilege to practice in these other states. And that computer program costs well over a million dollars, from what I’ve heard, it costs could have gone they may go down over time if people work together, which there’s been some efforts to reduce those costs. But then you have costs of maintaining the systems. You have the cost in running the compact boards. And those costs themselves, we looked AAMFT, had looked at all the other compacts, we found that the existing compacts all appear to be losing money. In other words, the revenue obtained from compact certificate holders, those who licensees, who have decided to join the compact and pay money to practice in various states, does not exceed the cost to maintain the compact. And so typically, in that case, the ones who are left holding the bag, either state licensure boards or professional associations are representing the professions, and since state licensure boards, for a variety of reasons, will not be holding the bag in that and the governing authorities and legislatures in those states won’t allow that. It’s up to the professional associations, usually, to backstop, if you will, or support that. And even in professions like nursing, that are large numbers of people who’ve availed themselves and joined the compact or part of the compact process, the costs still exceed the revenue coming in. The MFT profession is quite large, at 81,000 lmfts or so. However, it is the smallest of the mental health the non-medical mental health professions, and even the ones that are larger, like nursing, I said, occupational therapy and others that have gone forward have a lot more members and are able to generate more money. And so there’s not enough money to support the compact, or it would be a huge strain on the entire profession. Also, not all people join compacts. So you could have a compact that, let’s say, in the MFT field, you might have 10,000 people, or 15,000 or 20,000 who, by 81,000 are supporting the 20,000 for instance. Secondly, the other factor is the MFT field is not uniformly distributed across the country A; and B, not all states have adopted compacts. In particular, the states of California and New York have not adopted any healthcare compacts to date, not even the nursing compact that’s been adopted by 39-40 states, not the counseling compact. And from what we have heard from various sources, those states so far are unwilling to adopt compacts. There are other states that have adopted few compacts, like Oregon or Alaska, and there are some that have adopted, on the other side, a lot of compacts. Then the MFT profession. A little over half of all licensees are in California, and if California does not adopt the compact, California licensees residing in the state of California cannot join the compact. You can’t, as a California resident, go and join a compact your state is not part of unless you actually move out of California to another state and reside there as your permanent residence.
Katie Vernoy 10:26
And I think a lot of people thought that that would be the way around. I’m licensed in Arizona. Arizona is potentially likely to join a compact, but you actually have to reside there. So that doesn’t help me. Even though I’m licensed in Arizona as well, it does not help me get into a compact?
Roger Smith 10:41
Correct. You’d have to have a privilege of practice in a state under these compacts, and that would be their state of primary residence, where you’d be working.
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Curt Widhalm 10:52
What have you heard as the reasons for states like New York and California not adopting any of the compacts?
Roger Smith 11:01
We haven’t really gotten, I guess, what you would say is an official answer from those states. From what we’ve heard, there may be concerns in those states, A with maybe a perception of different or lower standards from other states. Those states are California and New York or the first and third largest state, actually New York maybe the fourth largest state now in the country, and they’ve traditionally also had, probably, compared to other states, more regulation or requirements, more bureaucracy or administrativeness on that. And so that may be a hindrance as well. We’ve also heard that some, particularly with some of the other, not mental health compacts, of some of the others, that there have been concerns by other groups, particularly unions, or those vested, maybe interests within those states that are afraid that some businesses may, you know, someone may abuse a compact and have a bunch of people flood into a state, I think maybe could be overblown perception, perhaps, where we’ve heard informally of those ideas as well. I think that there may be other concerns, too. Also larger states, and we’ve seen this in many other cases, tend to operate more as on their own or solo, as an island, if you will. We don’t care what those states say. Whereas maybe if you’re a smaller state, you might be more concerned with, well, 30 states are on board and our neighbors, we’d better do it too. But if you’re a larger state of Texas or Florida, you know, New York, California, you might be able to say, well, we don’t, we don’t need to do that. You know, it doesn’t matter what the other states are doing. So those all could be factors. But again, I don’t think there’s been any, as far as I know, any statement by a legislative committee or governor’s office articulating the views.
Katie Vernoy 12:57
We talked a bit when the counseling compact came out. We’ll put a link to that episode in our show notes over at mtsgpodcast.com, but we talked a little bit about some of the concerns around compacts with there are different regulations. It isn’t a licensure, so it’s very easy to get your privilege to practice rescinded. There’s not a whole process around it. And so we’ll, we’ll leave that conversation on that episode, but it’s clear from what you’ve been talking about, and what we’ve seen is MFTs are going for parity, and they’re going for a portability of making it easier to get licensed in other states. Can you talk about the efforts to date and what the goal is?
Roger Smith 13:35
The goal itself, essentially, is probably the best way to describe it as maybe a full endorsement model. Endorsement is sort of the idea that one state will recognize another state’s licensee and have through more of a streamlined process of licensure. You do not have to comply with the initial requirements for licensure, but it’s more abbreviated, so sort of an expedited licensure process that we would have here. And AAMFT, over the last couple of years, looked at this situation closely, even before the pandemic, during the pandemic, and decided in late 2022 to pursue a full endorsement model. Or basically, AAMFT developed a model law, and it states that if you are licensed in one state, you can be licensed in another state without having to have certain years of experience or meet substantially equivalent requirements that are nebulous we talked about earlier. And so someone who has been licensed for one or two or three or 10 or 20 years is an LMFT in one state licensing another state. Of course, that person would need to have an unencumbered license, and a state could, under our model, say, Well, we think you’ve had too many ethics investigations, etc, and screen you out that way. Also, you would be required to comply with the state specific requirements, fill out an application, take a fingerprint, if that’s required. You would also in states that have jurisprudence exams, which many do, including California and other states, you would be required to comply with that requirement and take the jurisprudence exam in the state. Also, our model does indicate that you do not need to take a particular clinical exam, or you could either pass the AMFTRB National Exam for the California clinical exam. The key is, do you have a full LMFT license in one state? It’s unencumbered if you do, and you can come in through this pathway without having to prove years of experience or substantial equivalent.
Curt Widhalm 14:34
What has been the response so far to where you’re coming from. I know I’ve been participant in some of the California discussions around temporary practicing decisions, and California seems to have this model of, okay, we understand, if you have clients moving into the state and 30 days, seems about right for them to be able to find somebody local. California being maybe off on its own a little bit here, what’s the response that you’ve seen, as far as introducing this to some of the other states.
Roger Smith 16:07
It’s been very good. We introduced the Access MFTs plan late 2022 and 2023 to our membership. And membership has been excited about this particular model, and moving forward with portability. Licensure portability concerns has been one of the major issues that MFTs in our profession have been coming about and wanting AAMFT to tackle as well. In 2024 we came up with the first year of legislation. So we came up with the plan. The idea 2023 was putting together fact sheets, identifying lobbyists and states to target. In 2024 we targeted 10 states for our first Access MFTs initiative. And the results, we can happy to report that in nine of those 10 states we pursued legislation, and of those nine states, we have an MFT licensure law. And a couple states there were amendments that passed in seven states, and they were Arizona, Georgia, Illinois, Iowa, Maryland, Tennessee and Virginia. And all those states passed our Access MFTs model. They’re a couple of the exceptions. Arizona added one year, so you have to be licensed one year in a state. So I guess the two of you, if you want to get like you’ve been licensed more in a year, you’re fine, but you had that one year speed bump. Illinois, it’s two and a half years. Illinois has a little more difficult portability laws overall, not just the MFT profession. So it’s now two and a half years instead of five, and it’s been streamlined that way. The remaining states, you can get licensed, you have an LMFT license, you can get licensed right now in those states, and we’ve heard from members some of those states are the laws are now in effect. We’ve heard from folks who were able to get licensed in Virginia, but you can effective July 1. If you license another state, get licensed there prior to then, it took five years and meeting certain requirements. So it’s vastly improved. The other two states, we did induce bills they didn’t pass. Where we’re going to be working next year will be Kentucky and North Carolina. The 10th state I mentioned is California. California, we are not pursuing legislation. As the two of you may know, there was a portability change a few years ago that reduced it to two years of experience. So probably to see how that law works out. Instead, AAMFT is working closely with CAMFT on an initiative to advocate that the national exam be adopted as a national exam in California. And happy to report in May, the Board of Behavioral Sciences agreed to go forward with adopting the AMFTRB National Exam is exam for all licensees in California. Again, don’t go out and take in California national exam today and think it’s the exam will take a few years, probably two or three more years, before it’s fully affected.
Katie Vernoy 16:34
So it sounds like for California anyway, there’s, there’s work on both sides, but trying to come in and do a portability law is not on the books yet for California.
Roger Smith 19:06
Correct, but I think the exam issue is actually and probably for California MFTs, who want to practice in other states, the number one barrier is the exam issue. There are several states that have that. For instance, the law in Georgia, until this year, required that anyone coming from any state had the through portability, had to take the AMFTRB National Exam, which is a significant barrier for California MFT particularly practicing for several years, who wants to move to Georgia. And there were just one of the states that there’s a lot of people moving to now under the access MFTs initiative, that goes away. What matters is you have a California unencumbered license as an LMFT in California. Now you’ll be able to practice in Georgia without having to meet that requirement. So for portability, in terms of California, MFTs moving out of state, that exam has been a big one, and I think we’ll have to see how the two year law and goes in terms of people coming into California from other states.
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Curt Widhalm 20:12
In some of this legislation, I hear you saying, this is just about unencumbered licensure. I know some states that have amongst their licensure requirements, like COAMFTE accreditation. Is that something that you’re running into in any of these discussions or in kind of planning out which states that you’re looking forward to going in the future?
Roger Smith 20:36
Yeah, it’s a good question, and we have, on the latter we are not looking at that or considering that as a barrier, even as a factor in looking at states to target for next year. On the former issue, there had been a couple of, we’ve had a couple of questions from members, and I think at least in one state, where maybe our state leaders would say, What about COAMFTE versus non COAMFTE? That has come up in one or two states, but that has not been a barrier to passing the law or moving forward the Access MFTs initiative. Most states actually do allow non COAMFTE graduates from non COMAFTE credited programs to become licensed in the state. Sometimes it’s a little more difficult, because state law will say if you came from a COAMFTE accredited program, you’re good to go. You can meet and now you go on to the experience requirements, and then if you came from a non COAMFTE accredited program, then you have to meet the laundry list of requirements and state regulations in the education requirements. But portability, I think at this point, after probably, if this had been 10 or 20 years ago, that would have been a significant barrier. But I think right now that COAMFTE versus non COAMFTE accreditation in terms of portability, is not a barrier anymore.
Katie Vernoy 21:55
Which so helps California therapists. And I think the decision to go to the national exam will further help future therapists, but the fact that we’re being kind of pulled into the, you know, kind of sample law with being able to say, Hey, we got licensed over here, it doesn’t matter we didn’t take the same exam, but we got licensed over here, because the story I’ve heard is that California, we have, I guess, about half, or more than half of the MFTs we’re pretty long, and the tooth over here, we’ve been around a long time. COAMFTE accreditation for schools is newer. There’s no real impetus for schools in California to become COAMFTE accredited. And so the fact that we’re just all different over here in California, I think, does indeed get helped by this, you know, Access MFTs law. How are you deciding which states to pursue at this point?
Roger Smith 22:47
Yeah, the States to pursue we typically have have looked at initially when our Phase One states, one of the considerations were the states that were most active in passing compacts, because if a state was passing a lot of compacts, that was a signal that they were very pro portability or pro mortability states. So a lot of our initial states, like Georgia and Tennessee, were two of the top states on licensure compacts. And so we looked at that as a factor. We also looked at the level of interest within a state among state leaders. Is one of the things that we do is talk to state leaders before even making a decision whether to go forward. Which are doing right now on Phase Two states for 2025 but in terms of what we’ve done in the past and what we’re currently doing is we look at that so we look at interest by state volunteers. We look very closely at the state law. How bad is it? We’ve had some states where they made changes. Kansas and Utah, for instance, come to mind, where the last couple of years, they’ve moved to one year practice instead of four or five years. And so are we going to go into maybe a Kansas this year when they only have that one year barrier, versus maybe a state that has five years plus you have to come from a 60 credit hour program, and you have to take this exam and stand on your head, and you have all these other requirements you would go for the latter, all things being equal. So that was a key consideration. Then also, we try to, in some ways, have states a little bit grouped together. We had a heavy presence in the southeast, which is a very active and more friendly to portability overall. We did have one state in the West, Arizona. We’re hoping to have more states, maybe in 2025 where we had no states in New England. New England’s another area that has not been as friendly to portability. We hope to have planning to have some states up there next year, but we concentrate a lot on the southeast, Mid Atlantic, Virginia, Maryland area, and have some commonality there among those states, and also states in the middle of the country. There are also some states we didn’t pursue as much because they have pro telehealth laws. There are laws in some states, Florida, Idaho, Delaware, for instance, that allow you to register and provide telehealth services, as long as you don’t practice in person services in those states. So if they have those laws that when you mean when someone means portability, half the time or more, they mean telehealth only portability, and then part of the time they mean in person, and then other times they mean both. But for those who are telehealth only, that sort of checks the box for those states, if you will, largely. And so we’ve looked at those factors, and that’s sort of the lens we’re looking at going forward as well those factors.
Katie Vernoy 25:42
So you’re going to tackle the most challenging ones first or next in the second phase, get the ones that are super messed up, super opposed to portability, and see if you can whip them into shape and get them into an Access MFT mindset.
Roger Smith 25:56
We are, we are, I think we’re going to get a progressively harder so there are some states we will not tackle or practice. We’re planning another nine or 10 states, the ones that the two states, Kentucky and North Carolina, plus several other states. We will be having some announcements very shortly. There will be some large states on the list, one or two. There’ll be states in different parts of the country, other than the southeast and Midwest. So we’ll have more geographic variation as well. We are working our way. We passed, the laws passed in the Access MFTs initiative in Seven of Nine states, which is very good. So that’s a very high percentage for passing it. We’ll be getting in the states where maybe we hope to have seven of nine, eight of nine, nine of nine next time. But can guarantee every year we have that will get a little harder as we go on, but we plan to go through this, and the idea is to eventually have these enhanced portability Access MFTs Model law passed in all states, or essentially all states.
Katie Vernoy 26:56
I know that as an AAMFT member myself, there were different surveys that went out to membership as you were making these decisions. And I’m curious, because that one of the, one of the things about getting licensed in multiple states is that there’s a lot of cost involved. And it sounds like there’s also a cost involved in joining a compact state. So there’s, there’s differential costs, I think, but there’s still both have costs associated. Are members wanting to have licensure or portability to a ton of states? Or what did it look like when you said, Hey, do you want portability? What did people say? What were they looking for, and what generally do you think is needed for increasing access for mental health services?
Roger Smith 27:38
Yeah, the we did have actually a survey, like you said in 2022. I, it’s been a while, unfortunately, since I’ve read the results fully, but what we found is a strong interest in portability. We had a survey, an earlier survey to that, that showed that a majority of people favored portability, and particularly our Access MFTs model we adopted was favored and was favored by the younger members, even more than the more experienced ones, who are probably the ones who are more interested in mobility. But our current survey from 2022 found that there was interest in a lot of states like Colorado and Florida, California practicing it didn’t ask questions like drilled down, necessarily on Well, if it costs $100 a year, would you do there $200 a year or $300 a year? And those are key questions. And there may be individuals who view maybe compacts as cost free, and the Access MFTs model. Well, if you get licensed in this state, in this state, in this state, and there are costs to getting license in various states through the Access MFTs initiative and states that pass those laws. But there’s also an issue cost to compacts as well, in terms of joining the compact. And several compacts, depending on the compact, do charge a cost per state that’s set by the state licensure boards in those states. So it’s not you pay one fee in joining 20 states or 30. You might have to pay individual fees in each state.
Katie Vernoy 29:09
So it’s not free. Portability is not free. So why not a national exam, a national license?
Roger Smith 29:15
Yeah, we get that all the time. That’s a favorite question. Traditionally, licensure is in a state issue. It’s something that the federal government has not been involved with. The federal government does not license any healthcare entity. They’re involved in the drug industry, obviously regulating that, but that’s not closely related to being a licensed individual practitioner, and also they’re unlikely to do so. There are some constitutional reasons, but more importantly, members of Congress are very knowledgeable and attuned to some of these boundaries in the state’s roles that came from the States, in many cases, the state legislatures, they’re very unlikely to overturn that. It doesn’t matter which party it is. So it’s not going to occur that way. And, and you, you throw all your cards in one all, all of your apples in one basket, which, for MFTs, are familiar with Medicare, where it took passing a federal law, it was the last major plan to recognize MFTs. And and partly because of that barrier. It’s just what you’re you’re either in or out. So there are some, many disadvantages, but the main reason it’s just not going to occur for the reason I mentioned earlier.
Curt Widhalm 30:31
Where can people find out more about am ft and all of the wonderful things that you do over there?
Roger Smith 30:40
They can find out various areas. aamft.org. AAMFT’s website has a lot of materials. We do have a Access MFTs website. You just Google: Access MFTs, or whatever browser you choose to use, and you’ll find a wide variety of information on it. It gives information on our model law. We have a nice, colorful map that lists all the states we are doing phase one Access MFTs initiative, soon to be updated with the states to be working in 2025. We also have other information on some other licensure laws and even some states we’re not working in. We do have a updated news article that has news releases that we have information all the time. You can even donate. You can also join AAMFTs family team, which is AAMFTSs advocacy network. It’s free to join. You do not have to be member of AAMFT to join this network, and you’ll receive, again, additional communications about advocacy initiatives, including the Access MFTs initiative.
Katie Vernoy 31:37
And that would include when you should reach out to your legislators and put in a good word in your own state about Access MFT or other initiatives for MFTs?
Roger Smith 31:47
Correct. And during the access MFTs initiative in these states we’ve worked in, we did send out grassroots alerts and several, not too many emails, hopefully, but email the communications to all members in those states and grassroots alerts when needed to ask them to contact their members of the state legislature and advocate for this legislation.
Curt Widhalm 32:06
And we will include links to all of that wonderful stuff in our show notes over at mtsgpodcast.com. And make sure you follow us on our social media where we pass along sometimes those timely sorts of announcements as well. Join our Facebook group, the Modern Therapist’s Group, and until next time, I’m Curt Widhalm with Katie Vernoy and Roger Smith.
… 32:28
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