Application for Professional Social Work Continuing Education Credit

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Continuing Education

Approval Program

Packet

Contents:

Program Application Criteria

Letter of Instructions and Application Costs

Application (Newly revised November 2012)

Please Note: Effective Jan. 1, 2013 only the newly revised

November 2012 CE application will be accepted.

NASW Oregon Chapter

2929 SW Multnomah Blvd., Suite 204

Portland, OR 97219

Tele: 503-452-8420

Toll free in Oregon 888-842-8420

Email: jk@nasworegon.org

http://nasworegon.org

P

ROGRAM

A

PPLICATION

C

RITERIA

Continuing Education Committee

Oregon Chapter, NASW

OVERVIEW

The NASW Continuing Education Program certifies workshops, conferences or seminars that contribute substantially to social work knowledge in all areas of practice (mental health, health, child/family services, administration, etc.). Since inception, the goal of the program has been to encourage the continuing education of all social workers throughout the State (and beyond) and to establish a professional standard of excellence in those continuing education offerings.

To maximize consistency in quality among those granted CE credit, all proposals must center upon a didactic presentation, although portions may be allocated to group response, discussion, breakout sessions, etc.

Applications are expected to include subject matter, content outline, goals of the presentation, credentials of presenters and timetables.

Ongoing seminars, workshops, staff development series, etc. may be included for CE credit if the sponsors submit the aforementioned information and criteria.

Applicability of NASW CE credits by conference attendees for Oregon social work licensure use can and should only be determined by the State Board of Clinical Social Work . Continuing education must relate to the licensee’s work practice and the field of social work.

EVALUATION CRITERIA FOR PROGRAM APPLICATIONS

1) Topic Information

The topic must be relevant to social work practice. The implications to social work and/or program operations are to be clear, logical and defensible.

Applications must contain sufficient information to identify goals/objectives, conference intent, topic content and speaker qualifications. If the submitted information is insufficient, additional information is solicited from the conference sponsor before rendering a final decision.

Topics solely based on religious or political dimensions as the predominant theme will not be considered for continuing education credit. Religious or political content may be acceptable, however, if the program’s focus is on social work and if the program is consonant with social work values, including client self-determination and social action. See, for example, sections 1.02 and 6.04 of the NASW Code of Ethics.1.

For clinical/LCSW applications, note that the statutory definition of clinical social work includes

“Modifying … external conditions that affect a client’s behavior, emotions, thinking, or intrapersonal processes” (ORS 675.510 (2)(d)).2

1. Section 1.02 states, in part, that “Social workers respect and promote the right of clients to selfdetermination and assist clients in their efforts to identify and clarify their goals.” Section 6.04 states, in part that “Social workers should be aware of the impact of the political arena on practice and should advocate for changes in policy and legislation to improve social conditions in order to meet basic human needs and promote social l justice.” It also says that social workers should act to expand choice and opportunity, promote conditions that encourage respect for cultural and social diversity, and act to prevent and eliminate discrimination.

2. “Clinical social work’ means the professional practice of applying principles and methods with individuals, couples, families, children and groups, which include, but are not restricted to: (a) Providing diagnostic, preventive and treatment services of a psychosocial nature pertaining to personality adjustment, behavior problems, interpersonal dysfunctioning and deinstutionalization; (b) Developing a psychotherapeutic relationship to employ a series of problem solving techniques for the purpose of removing, modifying, or retarding disrupted patterns of behavior, and for promoting positive personality growth and development;

(c) Counseling and the use of psychotherapeutic techniques such as disciplined interviewing which is supportive, directive or insight oriented depending on diagnosed problems, observation and feedback, systematic analysis and recommendation; (d) Modifying internal and external conditions that affect a client’s behavior, emotions, thinking, or interpersonal processes; (e) Explaining and interpreting the psychosocial dynamics of human behavior o to facilitate problem solving; and (f) Supervising, administering or teaching clinical social work practice.

Topics must have substance and value and reflect contemporary issues and social work practice.

Topics must be well within the Code of Ethics of NASW. Applicants are strongly encouraged to address diversity, cultural competence, social justice, and/or anti-oppressive practice.

Case consultation or peer supervision provided as a part of regular on-the-job activities are not considered appropriate for CE credit.

Workshops which focus on self-help or personal growth will be considered if the application clearly shows the social work relevance of the material being presented. The applicant should show how the material presented will be tied to use in social work practice.

Conferences which are open to 'consumers' and the public as well as professionals will be considered for approval if the application clearly shows how the subject matter will be tied to social work practice.

Conferences which include break-out sessions or portions which do not meet the criteria for CE credit will be reviewed and partial credit will be approved for the relevant portions.

Courses which include language study: These courses will be reviewed and CE credit given for the portions which include content relevant in a social work setting such as information about cultural values, considerations in treatment decisions, understanding from a cultural context in making clinical assessments. CE credit will not be given for the study of vocabulary.

2) Presenter Information

Speakers are regarded as qualified to present the topic based on the following factors . A brief paragraph covering the following biographical information will be required with each application: a) Credentials (academic/professional) and/or; b) Publishing history (on the proposed topic) and/or; c) Public speaking history (on the proposed topic) and/or; d) Professional practice experience that reflects knowledge and/or use of the proposed topic and/or; e) Demonstrated expertise in the topic to be presented.

3) Organizational Base/Conference Arrangements

The application must reflect that sufficient planning has been made for the forthcoming conference.

This is reflected in completion of as many of the following items as possible: a) Selection of the site; b) Completion of speaker selection (as opposed to “proposed”); c) A detailed agenda with time frames for each topic.

4) Record Keeping

The applicant must keep and maintain records of the names of individuals receiving NASW

Continuing Education certificates. Certificates are to be distributed at the conclusion of the educational program

5) Video Tapes, Audio Tapes, Internet, and Home Study Courses a) The video/audio tape or home study course meets the content requirements established for other forms (e.g. workshops, seminars and conferences) of continuing education established by the committee. b) An appropriate monitoring mechanism exists to assure the home study materials are actually reviewed and learned, or that the tapes are actually viewed or listened to by those receiving continuing education certificates. This may be accomplished by: i) Having a proctor present to take attendance and issue NASW continuing education certificates at the conclusion of the program, or ii) Have a post test (of at least 5 questions, 80% of which must be answered correctly) submitted to the granting authority prior to the granting of the NASW continuing education certificates. c) In the case of a home study course, the applicant must describe how the number of continuing education credit hours to be granted will be calculated, and the method used to calculate these credit hours must be approved by the committee. The number of continuing education hours for a home study course will not exceed the number of hours granted for a one day workshop. d) All other record keeping requirements for other forms of continuing education are met. e) No credit will be given for time spent taking the post test in home study audio, video, and internet courses. f) No credit will be given for time spent watching 'Hollywood' type movies when included in a conference.

6) Study Groups and Case Consultation a) Applications for CE credit for study groups and case consultation groups will be reviewed using the above criteria (completeness of application, topic relevance, monitoring of participation). b) The group must contain a minimum of 5 and a maximum of 10 licensed mental health professionals who meet for a minimum of an hour on a scheduled basis to discuss topics directly related to the field of social work. c) The focus of the group meeting must be a presentation or discussion of a book or article published by a professional body. d) The topics of the group discussion must be directly related to established and relevant good social work practice. e) A maximum of two hours may be credited for a group meeting.

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7) Fees, Retroactive Credit, and Refunds a) Fee schedule attached b) No retroactive credit will be given for conferences when applications are received after the date of the conference. c) If requested applicants may receive a refund of 50% of their application fee in the event of cancellation of a training.

Effective Jan. 1, 2013 only the newly revised

November 2012 CE Application will be accepted.

November 2012

Thank you for your interest in obtaining continuing education credit for your event/workshop from the Oregon

Chapter, NASW. Please refer to the Program Application Criteria in this packet to assist you in understanding the level of conference content and relevant social work topics if needed.

The state of Oregon requires social workers practicing at the bachelors, masters and clinical/LCSW social work levels to seek licensure and continuing education. The NASW of Oregon certifies conferences and workshops in the continuing education categories of non-clinical, clinical, ethics and supervision. Please see the State Board of

Licensed Social Workers Oregon Administrative Rules Chapter 877 at http://www.oregon.gov/BLSW/pdfs/OAR_2011.pdf?ga=t .

Please complete the following Application for Professional Social Work Continuing Education Credit, including

Attachment A: CEU Application Worksheet in its entirety.

The CE application fee is different for “profit” and “non-profit” sponsors and is graduated according to the number of hours approved. Please call the office to discuss this non-profit rate or with questions. NASW will send an invoice to you. The CE application fee for a “profit” sponsor is: $190 for 1-7.5 CE hours; $280 for 8-16 CE hours, $400 for

17-25 CE hours, $450 for 26-55 CE hours, $500 for 56-99 CE hours, $630 for 100-150 hours and $790 for 151-200 CE hours.

For a “non-profit” sponsor who is not charging for the conference, the CE application fee is: $95 for 1-7.5 CE hours,

$140 for 8-16 CE hours, $200 for 17-25 CE hours, $225 for 26-55 CE hours, $250 for 56-99 CE hours, $315 for 100-

150 and $345 for 151-200 CE hours.

We request that applications be sent by e-mail to Janet Kusyk at JK@nasworegon.org

at least three to four weeks prior to the training. Completed applications received two weeks (10 business days or less) before the date of the

workshop will be assessed a late fee of $25.

The Chapter will review your application and contact you by e-mail with its determination. If your conference is approved, you will need to have attendees requesting CE credit complete an NASW conference evaluation form and sign a conference roster indicating their completion of the conference. Your approval letter, CE certificates, evaluation forms and conference roster will be e-mailed to you approximately two weeks prior to your event, time permitting. Your forthcoming approved conference/workshop will be posted on the NASW Oregon Web site if you request it on your application. If you wish to repeat this workshop (same speaker, content, etc.) within 12

months, there is a per repeated workshop fee of $50 for nonprofits and $80 for profit sponsors. Email

JK@nasworegon.org

with your request.

It is the responsibility of the event/workshop sponsor to mail (please, do not e-mail or fax) attendance rosters and evaluations to the NASW office (2929 SW Multnomah Blvd., Ste. 204, Portland, OR, 97219) upon completion of the training. NASW will maintain these documents in its chapter files.

Again, we appreciate your interest in the NASW Oregon Chapter’s Continuing Education Program. Please contact our office at (503) 452-8420 if you have further questions.

Sincerely,

Janet D. Kusyk

Janet D. Kusyk. Continuing Education Coordinator, jk@nasworegon.org

Application for Professional

Social Work Continuing

Education Credit

Revised November 2012

For office use only:

No.__________________ Fee $____________

Date Rec. _______/________/________

PDF_______/_______/_______or E-mail ______/______/______

Data Entry_____ _/______/_______

Date Paid ______/______/_______

Please save this as a Microsoft Word document or PDF and send via e-mail to JK@nasworegon.org

.

Please type or print legibly.

Date of Application _________________Prepared by ______________________________________________

Title of Event ______________________________________________________________________________

Sponsor(s)________________________________________________________________________________

Event Date(s) _____________________________________________________________________________

Event Locations(s) ___________________________________ City _______________________ State _____

Target Audience ___________________________________________________________________________

Will there be a registration fee(s)?  Yes  No

Registration Fee(s) $________________________________________________________________________

Registration Telephone (____) ________________________________________________________________

Web site _________________________________________________________________________________

E-mail for registration inquiries ________________________________________________________________

Estimated number of attendees ___________

Total estimated number of CE hours requested for approval. ________

Is this an "in service" (open to other social workers) event?  Yes  No

Do you request this event be listed on the NASW Website?  Yes  No

1. If diversity, cultural competence, social justice and/or anti-oppressive practice will be addressed, please describe how.

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

________________________________________________________________________________________

2. Attach a brief agenda (including breaks and lunch) that includes dates and time frames for each agenda item or send a training flyer/brochure that carries this required information.

3. Attach a short paragraph ( DO NOT send resumes ) on each presenter describing the presenter's qualifications to present on his or her topic. Please include name, title, degrees, current and former work experience in topic area, etc.

4. Complete all information requested on Attachment A: CEU Application Worksheet

5. Please feel free to send additional information as a Microsoft Word document or PDF.

Have you determined that the physical facilities for this event are ADA compatible for participants?

 Facilities are ADA compatible  Not ADA compatible or undetermined as of this date

Please add any further information that would be valuable to the CE Committee.

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Name/address of person to whom the CE certificates should be emailed:

Name __________________________________________________________________________________

Organization_____________________________________________________________________________

Address ________________________________________________________________________________

City _______________________________________________ State _________ Zip __________________

E-mail ______________________________ Phone (___) ________________Fax (___) _______________

Name/address of person to whom the invoice should be emailed:

Name __________________________________________________________________________________

Organization_____________________________________________________________________________

Address ________________________________________________________________________________

City _______________________________________________ State _________ Zip __________________

E-mail ______________________________ Phone (___) ________________Fax (___)________________

After completing this form, including Attachment A, the CEU Application Worksheet, please e-mail both and any additional information to Janet Kusyk, jk@nasworegon.org

. An invoice will be e-mailed.

Late Fee Notice: Completed applications received two weeks (10 business days or less) before the training date will be assessed a late fee of $25, which will be added to the application fee invoice sent by NASW.

Application fees and payment information on next page.

Application Fees and Payment Information:

Profit Sponsor Fees

For a “profit” sponsor: $190 for 1-7.5 CE hours; $280 for 8-16 CE hours, $400 for 17-25 CE hours,

$450 for 26-55 CE hours, $500 for 56-99 CE hours, $630 for 100-150 hours and $790 for 151-200 CE hours.

Non-Profit Sponsor Fees

For a “non-profit” sponsor who is not charging for the conference the CE application fee: $95 for 1-7.5

CE hours, $140 for 8-16 CE hours, $200 for 17-25 CE hours, $225 for 26-55 CE hours, $250 for 56-

99 CE hours, $315 for 100-150 and $345 for 151-200 CE hours.

Payment

The chapter will send you an invoice for the application fee. Checks or money orders should be made payable to: Oregon Chapter, NASW and mailed to the chapter office, 2929 SW Multnomah Blvd.,

Suite 204, Portland, OR 97219.

When sending additional material or a payment to NASW, the workshop’s title and date should be clearly visible.

Repeat Fee

If you wish to hold this workshop again within 12 months of the workshop date, there is a per repeated workshop fee of $50 for nonprofits and $80 for profit sponsors.

Please call the chapter office at (503) 452-8420 for questions or information.

Incomplete applications will not be processed until all information is received.

Revised November 2012

Attachment A: CEU Application Worksheet

Training Title: ____________________________________________________

_________________________________________________________________

Training Date(s): ___________________________________________________

Worksheet Completed by: ____________________________________________

Tele._____________________________________________________________

Email_____________________________________________________________

Time frame for each workshop 1 (Do not include time for introduction, breaks or lunch break)

Speaker/Credentials/

Licensure

Workshop Title & Brief

Description

Non-Clinical

Social Work

Practice

# of CEUs 2

Page 1 of _____

1.

Provide the start and end time for each workshop.

2.

Non-Clinical Social Work Practice CEUs—Number of hours with content pertaining to the practice of social work in general .

3.

Clinical Social Work Practice CEUs—Number of hours with content pertaining to the prevention, assessment, treatment or diagnosis of mental disorders. See page 2 of the Program Application Criteria for more information.

4.

Social Work Ethics CEUs—Number of hours with content pertaining to ethics, laws and administrative rules of practicing social work.

5.

Social Work Supervision CEUs—Number of hours with content pertaining to supervising the practice of social work.

6.

Learning Objectives—State how each workshop meets the objectives of each workshop’s content.

Learning Objectives 6 Clinical Social

Work Practice

# of CEUs 3

Social Work

Ethics

# of CEUs 4

Social Work

Supervision

# of CEUs 5

Attachment A: CEU Application Worksheet

Training Title: ____________________________________________________

_________________________________________________________________

Training Date(s): ___________________________________________________

Worksheet Completed by: ____________________________________________

Tele._____________________________________________________________

Email_____________________________________________________________

Time frame for each workshop 1 (Do not include time for introduction, breaks or lunch break)

Speaker/Credentials/

Licensure

Workshop Title & Brief

Description

Non-Clinical

Social Work

Practice

# of CEUs 2

Page 2 of _____

1.

Provide the start and end time for each workshop.

2.

Non-Clinical Social Work Practice CEUs—Number of hours with content pertaining to the practice of social work in general .

3.

Clinical Social Work Practice CEUs—Number of hours with content pertaining to the prevention, assessment, treatment or diagnosis of mental disorders. See page 2 of the Program Application Criteria for more information.

4.

Social Work Ethics CEUs—Number of hours with content pertaining to ethics, laws and administrative rules of practicing social work.

5.

Social Work Supervision CEUs—Number of hours with content pertaining to supervising the practice of social work.

6.

Learning Objectives—State how each workshop meets the objectives of each workshop’s content.

Learning Objectives 6 Clinical Social

Work Practice

# of CEUs 3

Social Work

Ethics

# of CEUs 4

Social Work

Supervision

# of CEUs 5

Attachment A: CEU Application Worksheet

Training Title: ____________________________________________________

_________________________________________________________________

Training Date(s): ___________________________________________________

Worksheet Completed by: ____________________________________________

Tele._____________________________________________________________

Email_____________________________________________________________

Time frame for each workshop 1 (Do not include time for introduction, breaks or lunch break)

Speaker/Credentials/

Licensure

Workshop Title & Brief

Description

Non-Clinical

Social Work

Practice

# of CEUs 2

Page 3 of _____

1.

Provide the start and end time for each workshop.

2.

Non-Clinical Social Work Practice CEUs—Number of hours with content pertaining to the practice of social work in general .

3.

Clinical Social Work Practice CEUs—Number of hours with content pertaining to the prevention, assessment, treatment or diagnosis of mental disorders. See page 2 of the Program Application Criteria for more information.

4.

Social Work Ethics CEUs—Number of hours with content pertaining to ethics, laws and administrative rules of practicing social work.

5.

Social Work Supervision CEUs—Number of hours with content pertaining to supervising the practice of social work.

6.

Learning Objectives—State how each workshop meets the objectives of each workshop’s content.

Learning Objectives 6 Clinical Social

Work Practice

# of CEUs 3

Social Work

Ethics

# of CEUs 4

Social Work

Supervision

# of CEUs 5

Attachment A: CEU Application Worksheet

Training Title: ____________________________________________________

_________________________________________________________________

Training Date(s): ___________________________________________________

Worksheet Completed by: ____________________________________________

Tele._____________________________________________________________

Email_____________________________________________________________

Time frame for each workshop 1 (Do not include time for introduction, breaks or lunch break)

Speaker/Credentials/

Licensure

Workshop Title & Brief

Description

Non-Clinical

Social Work

Practice

# of CEUs 2

Page 4 of _____

1.

Provide the start and end time for each workshop.

2.

Non-Clinical Social Work Practice CEUs—Number of hours with content pertaining to the practice of social work in general .

3.

Clinical Social Work Practice CEUs—Number of hours with content pertaining to the prevention, assessment, treatment or diagnosis of mental disorders. See page 2 of the Program Application Criteria for more information.

4.

Social Work Ethics CEUs—Number of hours with content pertaining to ethics, laws and administrative rules of practicing social work.

5.

Social Work Supervision CEUs—Number of hours with content pertaining to supervising the practice of social work.

6.

Learning Objectives—State how each workshop meets the objectives of each workshop’s content.

Learning Objectives 6 Clinical Social

Work Practice

# of CEUs 3

Social Work

Ethics

# of CEUs 4

Social Work

Supervision

# of CEUs 5

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