MFT Portability

Our bill is about license portability which is the ability to take an individual’s qualifications for licensure in one state and apply them for licensure in another state.

For Licensed Marriage and Family Therapists, LMFTs, the process and purpose of license portability has been disjointed across the states, mainly due to a widespread policy started in older days that of only approving applicants that prove their qualifications are “substantially equivalent” to the requirements of the state they are applying.

In theory, substantially equivalent sounds logical but practice has shown that this policy creates additional barriers to LMFTs, even those that may have been licensed for years in another state. There are many cases where subjectivity in applying the “substantially equivalent” policy has resulted in LMFTs having to take the same classes over again, complete additional hours of supervision, and more.

Our national Association for Marriage and Family Therapy AAMFT has developed a model of MFT license portability to promote more objectivity in assessing qualifications and standardization between states in our increasingly mobile society.

The model NAMFT proposed bill espouses is a “full endorsement” model.

The licensure board shall issue a full and unrestricted license to an applicant to practice in Nebraska as a marriage and family therapist if the applicant:

• Has a valid and unrestricted license to practice as a licensed marriage and family therapist in another state or territory, and

• Has completed an application for licensure and paid any required fees.

Important pointers:
As used in this model, the term “state” means any state or territory in the United States, and the District of Columbia.

This model applies only to full licensure as an LMFT, not associate or provisional licensure.

This model would not apply to those applicants with a restricted license due to an ethics violation or other reason, or those who had their MFT licenses terminated.

The requirement of completing an application also includes complying with any related requirements that apply to all applicants for licensure in a state such as passing a background check or passing Nebraska jurisprudence test (an exam pertaining to state law or ethics). The model is not meant to supersede any of these general requirements that apply to all healthcare licensees in Nebraska.

Nebraska Mental Health Practice Board Structure
In Nebraska, the MFTs, the social workers and the professional counselors, at the certification level, are all loaded on the same Board, Mental Health Practice Board under the umbrella of Licensed Mental Health Practitioners LMHP or Licensed Independent Mental Health Practitioners LIMHP.

What does Nebraska currently have pertaining to portability?
Our current Reciprocity statutes were created July 19, 2018. (172 NAC 94-003.02 Reciprocity-Mental Health Practitioner based on a license issued in another jurisdiction).

It requires applicant:

• Meets the licensure requirements of the Mental Health Practice Act or substantially equivalent requirements as determined by the department with recommendation of the Board.

• Has to be in active MFT practice one out of three years immediately preceding their application.

• And in good standing and having passed the Nebraska jurisprudence exam.

NAMFT proposes legislative changes that remove the “1 out of 3 – years immediately preceding the application” and clauses such as “providing documentation that the standards regulating the practice of mental health in the other jurisdiction are equivalent to those maintained in Nebraska” for out-of-state licensure applicants.

Instead, portability applicants must be fully licensed in another state, be in good standing (unrestricted license), complete the application and pay the required fees to be eligible.

In other words, we are now seeking to create a streamlined licensure process, decrease barriers, and attract additional therapeutic talent to Nebraska to assist in the mental health professional workforce shortage.

In 2023 and 2024 there are states which have already adopted the model portability law or modified their portability/reciprocity laws.
To date, AAMFT reported the following states have introduced AAMFT model full endorsement portability laws or modified their own:

• Alaska

• Delaware

• Idaho

• Indiana

• Kansas

• Utah

• Illinois

• Georgia

• Arizona

• Iowa

• Tennessee

• Maryland

• Virginia

Of the bills introduced, none of the bills are identical to each other, and all have some different language from the AAMFT endorsement model. They all moved away from the “substantially equivalent standards model.” Virginia is considered closest to following the endorsement model. It was signed into law at April, 2024.

States which are poised to introduce legislation on portability as prepared by AAMFT at 2025:

• Michigan

• Pennsylvania

• Connecticut

• Nevada

• Texas

• Washington DC

Interstate Compact
In Nebraska the professional counselors (2023) and the social workers (2024) have already adopted laws to join an Interstate Compact of their disciplines, respectively.

An interstate compact is a formal agreement between two or more states that bind them to the provisions of the compact. Healthcare licensure compacts are set up to allow a person licensed to practice in a profession on one state to be able to practice in any other state that has adopted the compact. States that join the compact adopt the same standards for licensure. E.g. the Interstate compact of nurses, which is the most successful in USA (34 states), and of the physicians, etc.

We NAMFT and AAMFT would have used the interstate compact approach had we the numbers like the social workers and the professional counselors in the nation. Compacts are very expensive to establish and expensive to maintain. NAMFT, therefore, adopts the route of “full endorsement model of portability” in alignment with all the other states which are advocated and facilitated by AAMFT to do the same.

Anne Buettner, M.A.
Legislative Chair
NAMFT