Episode 14: 4 Factors To Consider Before Adding An Additional State License
Before taking the leap to get licensed in another state, there are several critical factors to consider. Learn from my journey and discover what might be best for your private practice.
In this episode we delve into a topic that many of you might be contemplating – expanding your therapy practice by adding another state license. If you’re feeling the pinch of not having enough clients or wondering whether expanding into another state is worth it, you're in the right place. Let’s dive in!
Why Consider Another State License?
First off, why might you want to get licensed in another state? This topic often comes up when therapists face challenges with referrals and practice growth. The logic seems straightforward – more states equal more potential clients. But it’s not that simple. Before making this decision, there are key factors to consider that go beyond just the number of potential clients.
Factor 1: Legal and Ethical Considerations
Every state has its own set of rules, regulations, and ethical guidelines. As a general rule, you must be licensed in the state where you're physically located and where your client is during a session. This means double the paperwork and compliance from day one!
From record keeping to informed consent, each state could have unique requirements. For example, Colorado mandates a specific consent form that isn’t required in states like Louisiana or Hawaii. You’ll also need to keep up with the changes in regulations, which can be quite a task when managing multiple licenses. Don't forget to check out CEU requirements as they can vary. For instance, while Louisiana is flexible with online courses post-COVID, they do require a certain number of synchronous CEUs.
Factor 2: Marketing Demand and Competition
Let’s talk about marketing, demand, and competition. Sure, expanding your practice to a populous state like New York might sound appealing, but what if the market is saturated? If therapists are plentiful, especially in your niche area, breaking into the market can be tough.
Consider the demographics and the unique culture of the area. For instance, marketing in Hawaii might be difficult if you’re not familiar with the local customs and community needs. It’s crucial to research how your services would be perceived and received in the specific regions you’re targeting. I’m going to dive deeper into marketing strategies for targeting specific areas within your state in a future episode, so stay tuned for that!
Factor 3: Financial Costs
Ah, financials – everyone's favorite topic. First, there are application fees, which can add up quickly. Then there are ongoing renewal fees, additional training expenses, and potentially required courses or exams for certain states.
When I considered getting licensed in Colorado, I calculated all the costs and weighed them against the potential revenue I’d gain from retaining my current clients who were moving there. In that case, it made financial sense, but it may not always be the case. Make sure to do a thorough cost-benefit analysis before committing.
Factor 4: Administrative Time and Effort
Getting licensed in another state isn't a one-time administrative hassle; it requires ongoing effort. Completing applications, gathering documentation, and potentially clearing additional exams all take time. And once you're licensed, you have to juggle different renewal periods and CEU deadlines.
To manage this, I recommend setting reminders in your calendar well in advance. For instance, my Louisiana license requires an annual renewal, so I’ve set a reminder two months ahead to start the process. It’s also smart to establish a reliable system for managing all this administrative work to avoid missing deadlines or letting a license lapse.
Final Thoughts: Do Your Homework
If you’re considering another state license, take the time to do thorough research. Reflect on your motivations – is it to expand your client base, maintain continuity with current clients, or tap into new markets? Create a pros and cons list to weigh your options and consult with legal professionals, state licensing boards, or other therapists who have gone through the process.
And remember, I’m here to help! If you’ve got questions or need someone to brainstorm with, feel free to reach out. Let’s ensure that any step you take is a calculated move towards a thriving practice.
Thanks for joining me on this deep dive. I’d love to hear your thoughts and experiences about expanding your practice. Reach out on Instagram, Facebook, or leave a comment on the podcast page. Looking forward to our next chat!
Transcript for Episode 14
[00:00:00] Ashley Comegys: You are listening to the Raised to Empower podcast. I'm your host, Ashley Comegys, a licensed clinical social worker with a multi-state online therapy practice. I have a passion for empowering women and mom therapists to break free of the fear, overwhelm, and oppressive systems that hold them back from taking action and building the private practice of their dreams.
[00:00:23] My goal is for you to boldly believe in yourself as a clinician and business owner. If you're looking for a place to learn, practice, building, strategy and skill, while also claiming your own power as a woman and a therapist, then you are in the right place. Welcome to the show. Welcome to this week's episode of the Race and Power Podcast.
[00:00:45] I'm excited actually, to talk about today's topic, and it's gonna probably sound like a silly one, but it's one that I, I'm really passionate about and I have some feelings about, and it's a topic that I have. Frequently come up when I'm coaching other [00:01:00] women on their online therapy practices. The topic is about getting licensed in another state.
[00:01:06] A lot of times I find this comes up when I have someone who's saying, I'm just not getting enough referrals. My practice isn't growing as quickly as I want it to. Maybe I should just add another state. Maybe I should get licensed somewhere else. And so it makes sense where if you aren't filling your practice and you need more clients, the thought might be, well, let's just add another state, right?
[00:01:34] That opens up the doors for additional clients, additional referrals. Now, it's not necessarily a bad thought if you're thinking like, you know, I need more clients. I should just add an additional state. Like that makes sense. You're thinking of how can I expand my reach? But before you go and add another license, I really find that it's more important to actually [00:02:00] focus on specific locations within the state you're currently licensed.
[00:02:04] I'm going to do a whole separate episode later on about kind of how to target your ideal client when you're practicing in a whole state, and I think that that is the first place really where you should start. If you are struggling with filling your practice. The secret really is to focus on local areas within your state, but again, I'm gonna get into that in more detail.
[00:02:26] In another episode. You may be still questioning about adding. An additional state license and there may be a variety of reasons for that. If you're moving to a state, you're gonna need to be licensed there, and so that makes sense. Just as a general rule of thumb, I think it's important for us to remember is that you need to be licensed in the state where you are physically located at the time of a session, and the state that the client is located at the time of the session as well.
[00:02:56] So if you live in New Jersey, And your [00:03:00] client lives in Ohio, you need to be licensed in your state, which is New Jersey and Ohio, which is where the client is located. There are some outliers to that with Covid, some stuff was changed, but if you listen to a few episodes ago, About the changes coming with, um, the ending of the emergency declaration from the pandemic.
[00:03:27] Some of that is going to be changing, so it's definitely important at this point to double check if you've been following those rules. If you are to ask me. Where are you licensed, Ashley? Um, you're probably gonna be like, now why are you telling me not to get licensed in multiple states? Because I'm a poor example of not getting licensed in multiple states.
[00:03:50] Um, I currently hold a license in the state of Louisiana, the state of Hawaii, the state of Colorado, and Florida. Now, [00:04:00] There's a reason for that. Being a spouse of a military service member, I collect licenses, and if you're a military spouse or or a partner of somebody in the military, you understand what that means.
[00:04:14] We have to move every three to four years, which means. I am oftentimes changing states and I have to be licensed in the state where we moved to. That's why I now hold four different state licenses. The only state that I have not lived in, that I'm licensed in is Colorado, and there's a reason for that. I got licensed in Colorado because at the time that I began the process of licensure there, I had several clients who were military affiliated, who were living in Hawaii and were gonna be moving to Colorado.
[00:04:52] And so in order to continue to see them, I needed to have a license there. At the time I just [00:05:00] decided, you know, let me just look at what is the licensing process for Colorado? What are the fees, what are the requirements? Are there additional trainings I might need? I. And as I looked at all of this, it was actually a fairly easy process considering some of the other states I've had to go through and it was inexpensive compared to other states.
[00:05:21] It made sense because it was going to allow me to continue to work with a population that I'm passionate about. Um, military spouses is, is a population I focus on in my prac. This, and so it would allow me to support them during a hard time for a lot of military spouses where they're transitioning or if you know the acronyms, PCSs, permanent Change of station, and so that can be a hard, right, if you're going through this major change and you're having to move to a new state.
[00:05:52] And maybe you've been working with a therapist for a long time and it's not that you are making this choice to, to leave that state. The [00:06:00] military is telling you you have to go. Being able to have that continuity with a therapist can be a really positive thing. When I was looking at the plans to add that additional state I was looking at, What is the cost going to be to have this license?
[00:06:19] Um, what are the renewal fees and what does that look like compared to the clients that I'm going to be having moving from Hawaii to Colorado? And it's actually, uh, In my experience has not been an uncommon thing, and I've had multiple clients make that move, and so to be able to have that continuity of care has been huge.
[00:06:38] It made financial sense for me and where I was in my practice at the time, financially things were, were gonna be with these clients that have continued to work with me. I hold these four licenses. And I have to say, I don't know that I will always hold licenses in each of these [00:07:00] states because we are a military family and we will have additional moves, at least a couple more before my husband retires from the Coast Guard.
[00:07:11] There's always a possibility we could end up in one of those states Again, it's happened before, so I've made the decision that until we know where we're gonna, you know, eventually retire to that, I'm not going to drop any of those licenses. Eventually I will probably drop one or two of them, but for now, it just makes sense for me personally to continue to hold them until.
[00:07:34] We know, um, you know, where we're gonna be because it is the process to go through getting a state license. If I don't have to go through that whole process again in the midst of a move, I'm not gonna do that. That's kinda been my journey to collecting these licenses and adding an additional one, um, an additional license and a state that I do not live in and I have not lived in, and most likely will not live in.
[00:07:59] As [00:08:00] you are thinking about adding an additional state license, there's four factors that I want you to consider if you're deciding to get license in another state that you're not moving to. There's lots of considerations and factors that will help you to make this decision. If you're moving to a state, that's one thing, right?
[00:08:22] You know for sure you're gonna have to be licensed there, but if you're not moving there and you're just thinking about adding an additional. State. Maybe it's because you have a client that's moving there, or maybe you travel to that state a lot to visit family, or you spend your summers there or something like that.
[00:08:41] We're gonna go through these four different factors for you to, to look at and examine and to consider as you're making that decision. The first factor is the legal and ethical considerations. You know, you're gonna have to follow. And be up on that. [00:09:00] State's regulations, there are rules for things like record keeping or informed consent, um, reporting obligations.
[00:09:07] For example, Colorado has a requirement of a specific form that has to be filled out, that has to do with, um, consent and record keeping, I believe. And that that is not required of any of the other states I'm licensed in, but it's something that is unique to them. So you're gonna have to, you know, really look at, okay, so what does each state now require of me and how does that change things in my practice?
[00:09:34] Does it change things for other states now because this is what I have to follow? Is it just something additional that I have to add? But it's something that absolutely is important to look at For you to know these things ahead of time and to really stay up on them. Each state changes their laws and their regulations, their boards all are always updating things or changing things, and so it's really important that you look [00:10:00] ahead of time of what does this board require of me?
[00:10:04] Are there unique ethics to that state or unique legal considerations that I don't have to worry about with other states? I'm already licensed in? And then you also wanna look at, you know, again, as part of kinda like these legal and ethical considerations, what are the C E U requirements of that state?
[00:10:23] It may be that you have to have a certain type of C E U, the number of CEUs you have to collect each year. It also may be that you have to obtain them a specific way. So like for example, in Louisiana with Covid, they dropped this requirement and you could really obtain your CEUs anyway. But they are gonna be eventually going back to where at least half of your CEUs have to be live and in person.
[00:10:51] Well, I should. Backup, they're gonna actually make it so you could do it synchronous, so like a live Zoom training, but you couldn't do like recorded [00:11:00] trainings more than 10 hours. So these are things that you absolutely want to stay on top of and just have an awareness of a lot of states. Will accept CEUs that are approved by other states.
[00:11:16] So that's something else to consider because you don't have to be like doing specific CEUs that are approved by Louisiana and then separate ones that are approved by Hawaii. And then separate ones that are approved by Florida. You can usually count those for each state. Um, again, it's good to verify with the board usually and offs will accept, um, a C U that has been approved by another state.
[00:11:41] Even if it's not been approved by that specific state, We've all been told we need to network in our private practice, but no one actually tells us how to do it or what to say. Enter comprehensive connecting effective scripts that expand your networking community and actually [00:12:00] fill your online practice.
[00:12:01] This free guide will give you effective scripts to connect with fellow clinicians, medical professionals, and community stakeholders. To build strong networking relationships that will help fill your practice. In this guide, you will get tips and tricks for building relationships that will lead to referrals in your practice.
[00:12:19] Real life examples of messages used to connect with referral sources and customizable plug and send scripts for your specific practice needs. So download your free script guide today by going to bitly slash comp Connecting. Hey, hey, bang. So the second factor that you need to consider is the marketing demand and competition.
[00:12:44] You absolutely can get licensed in a state that has a high number of therapists, and you absolutely can still fill your practice from that state, but you have to be marketing to the right ideal client in areas that your specialty is needed. But you do want to [00:13:00] look at what is the demand there for my type of niche.
[00:13:03] For example, let's say you decide, you know what? I wanna get licensed in New York State so that I can do online therapy with clients in New York City because I can charge a higher rate with a lot lower overhead. I don't have to live there and I can make all this money. But you may have a really hard time breaking into that area if it's highly saturated with therapists already, especially if you don't have a very specific niche.
[00:13:32] If you are looking to break into an area of a state that you're not already there and you do not have a specialty or specific niche, That may be something to really consider. Am I going to make my money back and the time back by investing in this license if I have a really hard time filling my practice there?
[00:13:58] Again, it doesn't mean that if you [00:14:00] wanted to get licensed in New York that you still couldn't fill your practice even outside of New York City. There are a lot of other areas that you could market to, but you have to really do your research. You have to look at how many therapists are already in that.
[00:14:13] State, especially in the areas that you're thinking of marketing to, because again, I will go into this in more detail in another episode. You're not truly marketing to the whole state. You're going to be marketing to a specific area, specific neighborhood, specific parts of the state, and you really wanna look at, again, not just how many therapists are already there, but that also specialize in your niche.
[00:14:38] Let's say you specialize in addiction treatment. And you are looking to market, um, in one specific area of that state, and there are a lot of therapists already with that specialty. You may not necessarily need to say no to that state, but it may be that that may not be the area in that [00:15:00] state that you wanna market to.
[00:15:01] So again, really do your research and then also consider the demographics of the state, specifically the areas that you're wanting to target. You definitely need to consider the culture of the area and how your services may be received in the community or state. If you are, for example, trying to get licensed in Hawaii and you've never been there, you've never lived in the community.
[00:15:26] You know, you may have a harder time connecting with somebody if you're wanting to maybe, um, target, uh, a specific area of that state. And maybe you're wanting to work with people who are native to the, to the area, native to the land. And if you've never lived there, and if you're not native there, you may have a really hard time.
[00:15:47] Breaking into that area and being received, um, in that community or even in the state. So again, these are the types of things that you really need to look at and examine how your specialties, how [00:16:00] your services will be received and perceived in the areas of the state that you're wanting to specifically market to and, and work with.
[00:16:10] The third factor that you definitely need to consider when adding an additional license is additional costs. So financial considerations. It's not gonna just be the renewal fees. You're gonna also have to look at, okay, what are the fees to simply apply for this additional application? What are the ongoing renewal fees?
[00:16:33] Are there any additional trainings or exams or courses that you're gonna have to complete just to be able to obtain that license? Each state is so different. Each license is so different. I know of people who have moved to an area, and so again, they didn't really have a choice to not get licensed there, and they had to do additional supervision because the state that they were licensed in prior said you needed to have X number of [00:17:00] hours of supervision and.
[00:17:01] For whatever reason, the state that they were moving to would not just accept that information and accept some reciprocity there. So you really want to look at that and consider, what is this gonna cost me upfront? What is this gonna cost me ongoing? And you should consider whether the potential increase in in your client base will justify the financial investment of adding that additional license.
[00:17:29] For me, when I was looking at adding Colorado as a state, I looked at. What was the application cost and then what was going to be that ongoing renewal fee? There was a jurisprudence exam that I had to take to get that license, but when I looked at everything that I had to spend to get licensed there and then how much it was going to add additional income or continued income to [00:18:00] my practice, it made sense for me at the time.
[00:18:03] I am full in my practice now and I can afford if a client is moving and, um, to not fill my caseload ongoing with them because I have a wait list at this point. And at the time I didn't. So that was definitely something that I was factoring in. I was still relatively full, but I also knew the needs that this client or these clients that were, that were gonna be moving had.
[00:18:29] And again, it was just something that I really wanted to do to be able to continue to work with them. And when I looked at the, the costs and all that went into it, it did make sense for me. I have had compliance moving to other states that, you know, they'll say, well, can I continue to work with them? And I always do just take a peek at what is the process of getting licensed there.
[00:18:52] My, my gut at this point is always to be like, no, I'm not adding an additional license. But I always do just look, just so that way [00:19:00] I can also come back to them and say, Yeah, it's not gonna happen. Maybe not quite that, that forcefully, but I have had other clients move to other states and it does not make sense for me to add additional costs of the application and the fees and the renewals and all of that stuff.
[00:19:19] So again, you really do wanna look at what is the upfront cost and then what is the ongoing income that would come from either the clients that you're. Going to be able to continue working with, or if you're looking at marketing to that area, um, what's the potential income from there? And then the fourth factor you definitely want to consider if you are looking to add an additional state license is some of the administrative pieces, the administrative considerations.
[00:19:51] It takes time to complete applications. And then if you have ever moved to another state or obtained a uh, [00:20:00] license from another state, you have to stay on top of the boards, right? You have to be on top of them of what's going on with my application? Where am I in the process? Sometimes that can be as simple as an email.
[00:20:11] Sometimes it's a matter of playing phone tag with people for weeks on n. And that takes time. And so you really need to look at the time and the effort of just kind of completing the application process. That can include gathering documentation. Sometimes you have to obtain and submit transcripts if there's specific continuing education requirements.
[00:20:35] Or exams that you're gonna have to complete before you can apply or be approved. These are things that you need to be doing kind of at the beginning of this process. And so do you have the time for that right now? Do you have the time to, to add an additional task to your schedule? You may, um, but you may also be really overwhelmed right now with whatever life has going on for you.
[00:20:58] And so it's [00:21:00] something to definitely keep in mind when considering adding. An additional license. And then as far as ongoing administrative piece, you do also have to stay on top of when is each state's renewal period and as well as when is their C E U collection period. For some states, it's different than when the renewal period is, and so you do have to stay on top of that.
[00:21:25] I have in my ICO annually, it will tell me when my Louisiana license is. Is up for renewal. I think I have it set for maybe like two months before and then maybe a month before it'll remind me. My Hawaii license renews every three years and so I have a reminder for that. Um, Colorado is every two years, so I'm not having to keep track of it.
[00:21:47] I can testify that when I didn't keep track of it, there may have been a time when I had a license renew late. So you do need to make sure, um, if you're someone who does struggle with [00:22:00] organization, Or kind of administrative pieces, if you are gonna add an additional licensing, use some kind of system for you to be able to stay on top of this.
[00:22:08] Something to help you remember something, um, to help you just stay on top of this so that you don't end up in a bind with then additional work for you to have to do because the license lapsed or you didn't complete something that was needed. If you are thinking about adding another license, and if you're thinking about doing this simply because you're just not getting full in the state that you're currently licensed in, you're thinking, I just need to expand my reach.
[00:22:39] I'll just open up to another, another state. I definitely do not recommend collecting another license to do that. If you need to fill your practice, getting another license is not necessarily the way to do that, and I will go into that in another episode, so stay tuned for that. But if you are considering adding another license, [00:23:00] not simply just about filling your practice, you need to make sure to look at these different things that we've talked about in this episode, the legal and ethical differences of the state from where you're already licensed.
[00:23:13] You definitely need to look at the demand. That is in the state that you're considering getting licensed, how easily will it be for you to attract that ideal client? How saturated is the market where you are looking to to market your practice? What is the demand for what you are offering? And then also, again, the additional financial costs that will be there for you in adding this license.
[00:23:39] Whether that is in renewal fees, whether that is in additional CEUs that you don't have to have necessarily for the state you're currently licensed in, or just even the upfront application fees. You need to look at the financial costs and how does that weigh with the potential income that you may have from adding [00:24:00] that license.
[00:24:01] And then also look at the additional administrative tasks that you have to take on, not only to obtain the license, but then to continue to maintain it. Things like CEUs, renewals, all of that, that goes into continuing to maintain your license. I really encourage you, if you are considering adding this other license, do your research, really look at a variety of things.
[00:24:27] Maybe first start with a little bit of a self-assessment. Why am I adding another state? Is it because I'm worried that what if my practice dips or because I, I'm worried that I don't have enough clients. Is it because I have somebody that is gonna be moving somewhere else and I wanna be able to continue to work with them?
[00:24:47] Looking at does it make financial sense to continue to work with them? And what is the likelihood of having additional clients in that state? Really looking at, I, I, I always love to make a pros and cons list. [00:25:00] Make that list and, and weigh the pros and cons of expanding your practice into another state.
[00:25:05] What are the positives of doing that? What are some of the negatives of doing that? And again, some of the things we aren't going to fully be able to know, but to have a sense of what would this look like? How could this play out? And then I really do encourage you if you are thinking about expanding into another state to seek some consultation from, from someone, whether it's from a legal professional, from the licensing board of that state, from another therapist who has worked in that state or has gone through the process of adding additional licenses.
[00:25:43] Talk to somebody else about what was that process like? What was it like to have to go through the application process if they had to have. An examination taken. What was it like for them? Do they have any recommendations? Would they recommend that you [00:26:00] do this? It's always good to have another perspective and to just learn from somebody else who has already gone through that.
[00:26:07] I do a lot of consultation with other therapists who are looking to expand their practice, so if you do need, you know, somebody to, to bounce some ideas off of. Or to help you kind of think through this, you can always reach out to me and we can try to find a time to, to look at this together and does it make sense for you?
[00:26:24] But I really do encourage you to really look at the pros and cons and, you know, consider these different pieces when you are looking to expand your practice into another state. I would love to know what your thoughts are on this. If you have found it easy to add additional state licenses, if you've gone through that process, if you are scared of it, if you're on the fence, let me know.
[00:26:49] You can leave a comment in the comment section on the podcast. You can send me a message through Instagram or through [00:27:00] Facebook, but I'd love to know your thoughts on this. I truly appreciate you joining me here today for this episode, and I look forward to chatting with you more next week. Thank you so much for listening to the Raise to Empower podcast.
[00:27:13] Check the show notes for all links and resources mentioned in the show. If you found today's episode helpful or inspiring, be sure to share it with your therapist friends, and don't forget to subscribe to the show and leave your five star rating and review. It truly means so much to me and will help us get our message of empowerment out to other women and mom clinicians, and I'd love to connect with you in our Facebook community.
[00:27:36] So check out the show notes for the link or head to Bitly slash raise to empower to join us. I'll see you back here next week.