October 19, 2022--- NCPA Legislative SWAT (Strengths, Weaknesses, and Threats) Team is assembled consisting of Drs. Dale Mann, Mary Evers, Cathy Forneris, Dick Rumer, Erica Wise, Cris Saffo, and Dave Spriggs, along with Executive Director, Martha Turner-Quest and contract lobbyists, Randolph Cloud and Barden Culbreth.

October 20, 2022 --- Mary Evers, Martha Turner-Quest, and Cathy Forneris speak with NC Psychology Board member, Dr. Susan Hurt regarding two national taskforces (American Psychological Association (APA) Board of Professional Affairs and Association of State and Provincial Psychology Boards (ASPPB)) working on title, scope and regulatory issues related to master’s clinicians.

October 23, 2022 --- Dr. Robert Hill, former NC Psychology Board chair, and current consultant to NCAPP, emails Martha Turner-Quest to understand NCPA’s “current level of support for the goal of independence from supervision for LPAs.”

October 25, 2022--- Martha Turner-Quest replies to Dr. Hill via email, ensuring NCPA's support of its LPA members.

Martha Turner-Quest and Deborah Baker, Director of Legal and Regulatory Policy with APA, trade emails about model legislation for master’s level independence. Deborah Baker refers Martha to Dr. Alex Siegel, Director of Professional Affairs, ASPPB.

November 4, 2022 – Martha attends the NC Psychology Board public meeting.  There is discussion about organizing a taskforce to consider issues related to the Practice Act.

November 10, 2022 --- Legislative SWAT team convenes its first meeting to prepare for the 2023 legislative session.

November 15, 2022 --- Martha Turner-Quest meets with Dan Collins, NC Psychology Board Executive Director (monthly standing meeting), and he informs her that the Psychology Board will organize a taskforce to review the Practice Act  in light of a pathway to LPA independence.  One representative from each stakeholder organization (NCPA and NCAPP [North Carolina Association of Professional Psychologists]) may attend.  NCPA’s representative is Dr. Dick Rumer.

December 3-6, 2022 --- Martha Turner-Quest and Erica Wise work on a one-page legislative brief.  The legislative SWAT team also chimed in with edits.

December 5, 2022 --- Alex Seigel meets with Mary Evers, Dale Mann, Erica Wise, and Martha Turner-Quest and talks about the work of the national taskforces.  He advises that North Carolina wait to proceed on any legislation regarding master’s level psychologists if possible.

December 6, 2022 ---Mary Evers convenes an emergency NCPA Board meeting to approve recommendations on how to proceed forward which included:  

1. A thoughtful pathway to independence and parity with other master’s level practitioners.
2. Consistency with APA's national standards for education and training and accreditation.
3. “Grandparenting” of current LPAs with certain stipulations about successful supervised practice.
4. Implementation of a process in NC that incorporates a thorough review and adoption of the accepted national standards for current educational criteria for licensure, required supervision and scope of practice.
5. Adjustments to the Practice Act and the Rules.
6. EPPP score of 500 for LPAs who would be eligible for independent practice.

The NCPA BOD approves the recommendations.  

December 9, 2022 ---- Dick Rumer attends the NC Psychology Board taskforce and shares NCPA’s legislative brief.  In that meeting, Dr. Bob Hill conveys that NCAPP does have bill language.

December 14, 2022 --- Legislative SWAT team determines that Mary Evers should reach out to the NCAPP  President.

December 16, 2022 --- Mary Evers reaches out to NCAPP President, Janet Larsen, to see if she would be open to meeting and shared the NCPA legislative brief pertaining to a thoughtful pathway to LPA independence.

December 20, 2022 ---  NCAPP Co-Presidents Janet Larsen and Carol Williams respond stating that they were reviewing the legislative brief and welcomed a discussion on the issues.

Mary Evers responds back and proposes that a virtual meeting is scheduled that also includes Martha Turner-Quest.

January 5, 2023 --- Mary Evers sends an email to Janet Larson and Carol Williams with potential meeting dates.

January 6, 2023 --- Janet Larsen and Carol Williams respond stating that they can meet on January 16, 2023.

January 9, 2023 --- Mary Evers sends an agenda to Janet Larsen and Carol Williams for the January 16^th meeting.

January 16, 2023 --- Mary Evers, Martha Turner-Quest, Janet Larsen ,and Carol Williams meet.  A follow-up meeting is scheduled for February 6, 2023.

January 25, 2023 --- Martha Turner-Quest contacts Deborah Baker and several colleagues about the omnibus board movement around the country.  Martha organizes and compiles all the information from the various states.

The Legislative SWAT Team meets, and Randolph Cloud shares his concerns about omnibus healthcare boards and states that he does not recommend opening the Practice Act. Rep. Sarah Stevens attended an NC Bar Association Administrative Law Council meeting (October 2022) and outlined that the Administrative Procedure Oversight Committee will be focused on looking at if occupational licensing boards need to have license requirements, need to be merged together, and if they are acting within their statutory authority.

Martha Turner-Quest has a phone call with Dan Collins.

January 26, 2023 --- Dick Rumer attends the 2^nd Psychology Board taskforce meeting. Dr. Bob Hill confirms that NCAPP will be moving forward on a  bill.  Language was not shared.  Several taskforce members expressed reservations about moving forward with opening the Practice Act.  Mary shared the motion passed by the NCPA BOD.

Mary Evers sends a follow-up email to Janet Larsen and Carol Williams and informs them that while NCPA leaders fully support NCPA and NCAPP working together to create a pathway for independent licensure for LPAs, the realities of the current legislative environment would preclude NCPA moving forward in opening the Practice Act during the 2023 legislative session. Mary’s letter also shared NCPA’s willingness to collaborate on a Memorandum of Understanding (MOU) between NCPA and NCAPP that states NCPA’s support of the pathway to parity with other master’s level clinicians and independent practice and NCPA’s intention to work toward those goals in the not-too-distant future.

January 27, 2023 --- Mary Evers calls an emergency NCPA BOD meeting.  The BOD discussed and considered omnibus boards, NCAPP’s potential legislation, and the Psychology Board taskforce meeting.

January 28, 2023 --- Mary Evers emails Dr. Helen Brantley, NC Psychology Board Chair, to inform her of NCPA’s position regarding opening the Practice Act and creating a pathway for independence for LPAs.

January 29, 2023 ---- Helen Brantley responds to Mary Evers’ letter. She informed Mary that the NC Psychology Board will meet on February 9^th and 10^th and will discuss the issues at hand.

January 31, 2023 --- Janet Larsen and Carol Williams respond to Mary Evers thanking her for the comprehensive email, for the offer of the MOU and that they were interested in seeing the position statement. They also convey that the legislature make-up will not be substantially different in future years and that they wish to work around these issues. Further, they do not offer any language for the potential MOU between NCPA and NCAPP.

February 1, 2023 ---Mary Evers emails Janet Larsen and Carol Williams asking for a written statement of NCAPP’s position regarding moving forward with parity with other master’s level mental health providers and a pathway to independence for LPAs in preparation for the February 6 meeting.  Mary’s letter also asked for bill language.

February 3, 2023 --- Janet Larsen and Carol Williams stated that since the two boards only began working together, they must “respectfully” defer on the questions and matters of interest to NCPA. They also indicated that they have no prepared official document or bill language.

February 4, 2023 --- Mary Evers emails Janet Larsen and Carol Williams and recommends postponing the joint meeting between NCPA and NCAPP until after the Psychology Board meets February 9^th and 10^th.

February 9-10, 2023 --- The NC Psychology Board meets.  NCPA Immediate Past President and NC Psychology Board liaison, Dr. Susan Hill, attends the public meeting in Greensboro, NC.  Alex Siegel of ASPPB joins via Zoom to discuss national movement on master’s level licensure and regulations.

February 12, 2023 --- Helen Brantley emails Mary Evers regarding the Psychology Board’s position on opening the Practice Act.
“The Board supports a pathway to independent practice for Licensed Psychological Associates (LPAs) in North Carolina. Given the work currently being done by the APA and ASPPB on the issues of master’s level program accreditation, licensure, supervision, scope of practice, and title, which may necessitate changes to the Psychology Practice Act, the Board believes it is premature and counterproductive at this time to make any changes to the Psychology Practice Act regarding LPA supervision, as such changes may be inconsistent with recommendations and guidance anticipated to be issued by APA and ASPPB in the Fall of 2023. If the Psychology Practice Act requirements related to LPA supervision remain unchanged, the Board, with input from stakeholders, plans to seek a rule change this year allowing for a pathway to independent practice by LPAs.”

The Psychology Board’s statement is also shared with NCAPP, per Dr. Brantley.

February 13, 2023 --- Martha Turner-Quest, Randolph Cloud, and Erica Wise have a Zoom meeting regarding Randolph’s meeting with NCAPP’s lobbyist, Cassidy Whitley. Ms. Whitley expressed no reservations about opening the Practice Act or the threat of Board consolidation.  NCAPP’s lobbyist did not confirm that they have a bill or sponsor.

February 17, 2023 --- Dick Rumer and Erica Wise create a comparison document of LPs and LPAs based on minimum education, course content, internship and related field experience, and EPP score requirement.

February 21, 2023 --- Randolph Cloud forwards an email from Alex Miller (NCAPP’s lobbyist) to Martha Turner-Quest with the following points.

1. What authority does the Psychology Board believes it has to make a change like this without legislative direction? Only the Board can answer the question posed in Ms. Turner-Quest’s email regarding “possible methods/workarounds to avoid opening the Practice Act”.
2. How do the ongoing discussions at the national level impact this discussion? My understanding is those discussions are centered around accreditation, not supervision.

Martha Turner-Quest and Randolph Cloud address Mr. Miller's questions about accreditation and supervision via email.  Martha Turner-Quest has a conference call with Dan Collins (NC Psychology Board Executive Director) and Sondra Panico (NC Psychology Board Attorney) to discuss the Board’s authority to make changes to the Rules. 

Based on the conference call, Dan Collins, and Sondra Panico email Martha Turner Quest the following statement:

The issue of supervision in the Psychology Practice Act comes under N.C. Gen. Stat. § 90-270.139(e), which reads:

A licensed psychological associate shall be supervised by a qualified licensed psychologist, or other qualified professionals, in accordance with Board rules specifying the format, setting, content, time frame, amounts of supervision, qualifications of supervisors, disclosure of supervisory relationships, the organization of the supervised experience, and the nature of the responsibility assumed by the supervisor.

As the highlighted portion above indicates, this provision of the Psychology Practice Act grants the Board the authority through its rules to set the specific terms of supervision. 

 In 2021, the Board amended its rules to allow for one hour of supervision of LPAs every three months, after a period of 3 years or 5 years of supervision (depending on the LPA’s score on the national licensing exam). This language is included in Board Rule 21 NCAC 54 .2008(h)(3).  At that time, the Board sought independent practice for LPAs after the passage of a period of time, but the N.C. Rules Review Commission (RRC) decided that the Board did not have the statutory authority to do so.  The Commission reasoned that because N.C. Gen. Stat. § 90-270.139(e) included the phrase “amounts of supervision” some amount of supervision was required and that the amount could not be zero. 

 The Board believes that it can meet LPAs’ need for independent practice through amending its rules, while taking into consideration the RRC’s previous decision, by allowing independent practice for some LPA activities, such as therapy, but still require continuing supervision for other activities, such as forensic evaluations (Please note that the Board has not yet determined which activities would or would not require supervision.  The previous two cited activities are just for illustrative purposes).  The Board’s position is that since some of LPAs’ activities will require continuous supervision, it will meet the language in the statute for “amount of supervision” and will likely be approved by the RRC.

Martha Turner-Quest shares the statement from the NC Psychology Board with Randolph Cloud who then forwards it to Alex Miller.

Dick Rumer creates a document comparing the scopes of practice in North Carolina between licensed psychological associates (LPAs), licensed clinical social workers (LCSWs), licensed clinical mental health counselors (LCMHCs), licensed marriage and family therapists (LMFTs), and licensed clinical addiction specialists (LCASs).

February 22, 2023 ---  Mary Evers pens a letter to NCAPP Co-Presidents, Dr. Carol Williams, and Ms. Janet Larsen and NCAPP Board Consultant, Dr. Robert Hill sharing the NC Psychology Board’s statement regarding a pathway to independence by working with the Rules as opposed to opening the NC Psychology Practice Act.  Dr. Evers also offers to arrange a meeting between NCPA, the NC Psychology Board, and NCAPP to discuss this approach.

As of March 2023, there has been no response from NCAPP leaders to Dr. Evers' email from February 22nd.

April 4, 2023 --- SB 570-Modernize Regulations/Master’s Level Psychologists was filed independently of NCPA.