In order to ensure that “music therapy” is provided by individuals who meet established education, clinical training, and credential qualifications, each state must officially recognize the music therapy profession and the MT-BC credential required for competent practice. Official state recognition is the first step towards successful inclusion within health and education regulations, which allows improved access to employment opportunities and increased access to reimbursement and state funding streams, such as private insurance, Medicaid waivers and special education.

Since 2005, the American Music Therapy Association and CBMT have collaborated on the State Recognition Operational Plan. Judy Simpson (AMTA’s Director of Government Relations), Dena Register (CBMT’s Regulatory Affairs Advisor), and Kimberly Sena Moore (CBMT’s Regulatory Affairs Associate) work collaboratively to implement the plan, providing guidance to state task force groups as they seek professional recognition in their state.

WHY STATE RECOGNITION?

There have been questions about the difference between board certification and state recognition. The strength of our national credential and the importance of the credential as a quality assurance measure for competent music therapy practice establishes a platform for pursuing state recognition. Other nationally certified professions include our colleagues in physical therapy, occupational therapy, and speech-language therapy. It is the strength of our national MT-BC credential that provides us the opportunity to be recognized and supported by the state as a profession.

State recognition is designed to officially recognize the MT-BC as the credential required to practice music therapy. It has two primary, specific benefits for constituents. It:

1. protects clients or patients from potential harm or misrepresentation from individuals that are not board certified music therapists and are not practicing under the CBMT Scope of Practice (i.e., non-music therapy musicians in healthcare)
2. 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 the Department of Education, Department of Health and Human Services, Department of Disabilities and Special Needs, etc., that require service providers be state-recognized.

State recognition has additional, ancillary benefits for constituents in your state. It:

• increases awareness of music therapy as a profession, resulting in increased service referrals, increased jobs, and 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.
• provides additional validation of the contributions music therapists make as members of an educational or healthcare treatment team.
• aligns us with professional practice in comparable professions.

Additional Rationale for the AMTA and CBMT State Recognition Operational Plan

1) Shift in governance

Over the past 15 years, there has been a change in how professional qualifications are established, with movement away from state reliance on federal regulations and guidelines. There is a nationwide trend toward the expansion of states rights, which translates into states outlining qualifications for employment and inclusion in funding sources for certain professions.

This shift in responsibility from federal agencies to state agencies for setting basic occupational regulation has created problems for consumers attempting to access music therapy services. In programs with state oversight, such as special education, Medicaid funding, and even private insurance, regulations often require some form of official "state recognition” of the profession and its credential.

With a few exceptions, the profession of music therapy and the MT-BC credential are not universally included in these state regulations or on these state-maintained lists.

2) Avoid confusion for healthcare organizations

National accrediting organizations, such as the Joint Commission and the Commission for Accreditation of Rehabilitation Facilities (CARF), outline within their standards the qualifications and professional requirements of staff that are permitted to practice within accredited healthcare facilities. These standards often reiterate that professionals hold the credential that is required or recognized by the state.

Official state recognition of the MT-BC credential will help healthcare facilities that rely upon state regulations to address the confusion regarding the difference between music therapists, music practitioners, music thanatologists, and other non-music therapy musicians in healthcare.

3) Distinguish between music therapy and related professions

Official state recognition of the MT-BC credential will help distinguish the difference between music therapy and other creative arts therapies and related professions (e.g., counseling), proactively addressing the potential for legislative exemption language.

ABOUT THE STATE TASK FORCES

The state task forces, with guidance and support from AMTA and CBMT, work to identify how to achieve professional recognition in their state. There are generally 2 types of recognition:

1. Music therapy becomes regulated by the state through legislation. There are up to four options for occupational regulation: title protection, registration, state certification, or licensure.
2. Music therapy is added to lists of state agency-recognized providers by being included in state regulations and codes.

Specific tasks and action items vary, but may include:

• Identifying where music therapy is currently listed in state regulations
• Building a grassroots network of supporters (e.g. parents, colleagues, administrators)
• Developing a relationship of trust with legislators, agency officials, and other key stakeholders
• Educating legislators and state agency officials about music therapy and the MT-BC credential

Interested in helping? Click here to connect with your state task force and learn how you can assist in your state’s recognition efforts.

LICENSURE FAQ

The MT-BC is a national certification. Isn’t that enough? Why might we need a separate state credential?

A national certification is not enough in most states. This is the result of a policy 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 healthcare providers hold a state license. As a result, many current and potential clients have difficulty accessing music therapy services within educational and healthcare facilities. Communication with most state education and healthcare agencies emphasize that service provision procedures require official state recognition—often in the form of a state license—in order for state citizens to access music therapy services.

What is the difference between a title protection, registration, state certification, and licensure?

Title protection prohibits an individual from saying he or she is providing music therapy services or is a music therapist unless he or she is a board certified music therapist. A registry is a list of professionals who have met predetermined education, clinical training, and certification requirements. It offers the same benefits of title protection plus a mechanism through which consumers can search for a qualified professional. State certification functions like a registry in that it offers a state maintained list of professionals who have met certain education, clinical training, and certification requirements. However, this program is often voluntary and, depending on the state, may or may not offer title protection. A license outlines specific education, clinical training, and continuing education requirements and provides title protection, practice protection (also called scope of practice protection), and public protection.

What fees are associated with state licensure?

Fee structures vary significantly state by state. They can range from $50 every two years to $200 every year.

Would every MT-BC have to be licensed if a state decides to pursue licensure?

Yes. If a state passes music therapy licensure legislation, then any MT-BC who practices in that state (part-time or full-time) will have to apply for the license in order to legally practice music therapy.

Will there be additional coursework?

We are asking states to pass legislation that recognizes the current MT-BC credentialing process as the measure of competent practice and continuing education requirements. As a result, there are no additional training requirements at this time. Sometimes states require a background check; if so it is often required for all professions registered or licensed in that state. This background check may be required only with the initial application or maybe with every renewal of license. There is usually a fee of $25-$50 for this background check. Some states may also require a short ethics course, which as of 2010 is also a requirement to renew your MT-BC credential.

I have heard that we are about 30 years behind the occupational therapy (OT) profession? Will official state recognition put us more in line with OTs and other related professions?

We are not behind, but are in line with our OT, physical therapy (PT), speech, and mental health colleagues. The last counseling license was created in California about 3 years ago and the last PT license was created in Kansas in 2002/2003. In addition, there are still states who do not license OTs and SLPs. Given this, music therapy is doing quite well and we have made significant progress since the launch of the state recognition plan in 2005.

Would federal employees be under the same requirements?

No. It is customary for state licensing laws to exempt federal employees from the license requirements as long as they are employed by the federal government.