Licensure and Certification: A Comparison of Requirements and Features

Introduction

In Massachusetts, both Licensure (LADC) and Certification (CADC) are available to recognize specialty training in addiction.

Employers often prefer to hire people with specialty training; third-party reimbursement is increasingly available for people who hold licenses or certifications; and the preparation required will increase your ability to provide quality services to clients.

The following tables provide a general overview of the similarities and differences between the Licensure and Certification:

• Licensure of Alcohol and Drug Counselors is provided by the Bureau of Substance Addiction Services (BSAS). There are three levels of licensure: LADC Assistant, LADC II, and LADC I.
• Certification of Alcohol and Drug Counselors is provided by the Massachusetts Board of Substance Abuse Counselor Certification (MBSACC), the MA chapter of IC&RC (International Certification and Reciprocity Consortium). There are three levels of certification: CAC, CADC, CADC II.

Contact Information

Licensure (LADC) – Bureau of Substance Addiction Services (BSAS)

• Ian Bain (BSAS), ian.bain@state.ma.us / 781-774-6627

Certification (CADC) – Massachusetts Board of Substance Abuse Counselor Certification (MBSACC)

• Jackie Cummins (MBSACC), mbsacc@aol.com / 508-842-8707

Details on Licensure and Certification

Different Levels of Licensure / Certification can Enable the Holder to:
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Get Reimbursed by a 3rd party	No	Yes, possibly. This is determined by insurance companies and payers.		No	No	Yes, LADC I's should contact insurance companies and payers to determine what credentialing process is.
Work independently, without supervision (see note 3) Supervision is highly recomended for all levels of licensure and certification	No	No - may work under the supervision of a Master's level, Certified clinician	Yes – with a Master’s degree in counseling and an established private practice	No	No - may work under the supervision of an LADC I or Master's Level Clinician in private practice or other licensed health care facility	Yes - in private practice or licensed program or other health care facility.

Application Process
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Steps required to apply for Certification or Licensure	Download the application from MBSACC.com. Obtain and document all required education and field experience. Complete and submit application. Verify acceptance of application. Take and pass exam (see section on examination for more information).			Complete the appropriate LADC self-assessment form which can be downloaded from the LADC Requirements web page. Email the Self-Assessment form to Ian.Bain@state.ma.us  Applicants who appear to meet licensing requirements will be granted access to BSAS eLicensing for LADC. Complete the eLicensing application and provide supporting documents as directed in the application to show evidence of work experience and education; submit one letter of evaluation from most recent supervisor, and two letters from individuals familiar with applicant’s related work). Note: Application processing takes a minimum of 30 days.

Education Requirements. Documentation (course descriptions, syllabi, instructor information) may be requested for review by BSAS or MBSACC.
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Minimum Degree	High School / Equivalent	High School / Equivalent	Master's in Counseling or closely related field	High School / Equivalent	High School / Equivalent	Master's in Behavior Science (see note 2) with 18 Graduate Semester Hours in Counseling
Alcohol and Drug Education Hours (see note 1)	174 with specific category requirements	264 with specific category requirements	174	50 with specific category requirements	260	260
Ethics Education Hours specific to A&D Counseling	6	6	6	Included in Alcohol and Drug Education Hours	10	10

Supervised Practical Experience*
	CAC	CADC*	CADC-II*	LADC Assistant	LADC II*	LADC I*
Work, Internship, or Practicum (must be supervised) (see note 3)	4000 hours	6000 hours with High School / Equivalent 5000 hours with Associate's Degree in Behavioral Science 4000 hours with Bachelor's Degree in Behavioral Science 2000 hours with Master's Degree in Counseling	2000 hours with Master's Degree and no CADC. No additional hours if the relevant hours were documented for CADC.	2000 hours	6000 hours with High School / Equivalent 4000 hours with Bachelor's Degree	6000 hours with Master's Degree and no LADC II 2000 hours if 4000 were documented  with Bachelor's for LADC II No additional hours if 6000 were documented for LADC II
Supervision of Work, Internship, or Practicum (see note 4)	120 hours related to the Four Essential Domains and DSM 5 Diagnostic Criteria (see note 5)	300 hours related to the Four Essential Domains and DSM 5 Diagnostic Criteria, with at least 10 in each domain (included in the Supervised Hours above) For individuals with a related Master's Degree, this must be a Counseling Practicum		0 hours	300 hours in an appropriate setting (see note 3) with at least 10 hours in each of the 12 Core Functions (in addition to the Supervised Hours above)

*When you want to upgrade an existing license or certification to a higher level, contact the relevant office to determine which qualifications from the existing level will count. In particular, there are multiple considerations when upgrading from CAC to CADC or CADC-II, or from LADC Assistant to LADC II or LADC I.

Examination
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Exam Date	For all License and Certification Levels, testing is available at sites across the Commonwealth. To flearn more, contact: MBSACC, 508-842-8707, or visit www.mbsacc.com
Exam Type	IC&RC	IC&RC	IC&RC Advanced	IC&RC	IC&RC	IC&RC
Steps required to register for exam	CADC application must be complete before registering for Exam. Request application from MBSACC. Obtain and document all required education and field experience. Complete application. Submit completed application along with documentation. Contact MBSACC to learn about exam testing sites and schedules. Take exam. MBSACC will distribute results to applicants 5 - 7 weeks following exam.			Exam may be taken at any point in the application process. To learn more about the licensing process, contact Ian.Bain@state.ma.us or visit the LADC requirements web page. Visit www.mbsacc.com and click on Mass Update to download the test reservation. Mail the exam reservation form and exam fee to MBSACC per the instructions on the form. Take Exam. Exam results are available immediately after the exam to applicants and official score will be sent to BSAS directly.

Alternatives to full Application and Exam Processes (for those holding current Certification or Licensure in another state or jurisdiction)
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Certification / Licensure can be available as follows	Not available	If credentialed by another IC&RC Board at the equivalent Reciprocity Level		If requirements are similar to MA licensing requirements (see note 6) This is determined via consultation with Licensing staff at BSAS, and review of relevant factors (e.g. other state/ jurisdiction’s requirements, education, and experience of the applicant, whether the credential is in good standing, etc.) Contact Ian.Bain@state.ma.us.
Exam is waived as follows	Not available	Via Reciprocity with another IC&RC Board and if credentialed with equivalent level certificate.		The exam is not required for applicants who hold a current, valid certification from a recognized certifying body (see note 7) including: MBSACC, CEAP, CAC, NAADAC, ICRC.

Recognition of License or Certification in other States / Jurisdictions (for those who hold current Certification or Licensure in MA)
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Certification / Licensure may be available as follows	Not available	IC&RC reciprocity is available in 47 states and territories; 24 countries; 5 Native American regions; all branches of the military. There may be additional requirements in some states / jurisdictions. Visit IC&RC web page to determine reciprocity possibilities.	IC&RC reciprocity is available in 47 states and territories; 24 countries; 5 Native American regions; all branches of the military that offer the IC&RC Advanced reciprocal credential. There may be additional requirements in some states / jurisdictions. Visit IC&RC web page to determine reciprocity possibilities.	Check with the local certifying board or state licensing authority.

Maintaining Licensure or Certification
	CAC	CADC	CADC-II	LADC Assistant	LADC II	LADC I
Continuing Education topics and hours	40 hours of Continuing Education in Addictions, Counseling Techniques, and/or Behavioral Science are required every 2 years. Up to 50% (20 CEUs) can be completed via online / distance learning.			40 hours of Continuing Education in Addictions, Counseling, and related topics are required every 2 years. Up to 50% (20 CEUs) can be completed via online / distance learning. See the BSAS CE Policy web page.

Definitions and references

In the past, IC&RC documents referred to 8 domains, based upon TAP 21: The federal Substance Abuse and Mental Health Administration (SAMHSA)’s Technical Assistance Publication #21 - Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice and 12 Core Functions: screening, intake, orientation, assessment, treatment planning, counseling, case management, crisis intervention, client education, referrals, reports and record keeping, and consultation with other professionals. The original content is incorporated into the current Four Essential Domains. Some additional changes were made on content for advanced cerification.

1. Alcohol & Drug: related to all forms of drugs, including alcohol and all forms of prescription and other drugs. Also related to addiction to alcohol, drugs, or activities such as gambling. Includes multiple physiological, legal, psychological, social and other perspectives as described in category requirements.

   For the LADC Assistant, the 50 hours must be 10 hours in each of the following areas, as defined in Section 168.006 – Eligibility Requirements found in the Licensure of Alcohol and Drug Counselors Regulations: Assessment; Counseling; Case Management; Client, Family and Community Education; and Professional Responsibility (which includes Ethics).

2. Behavioral Sciences, as defined in Massachusetts regulations, means

   anthropology	music therapy
   art/dance therapy	nursing / medicine
   child development / family relations	occupational therapy
   community mental health	pastoral counseling
   chemical dependence	physical therapy
   counseling / guidance	psychology
   criminal justice	recreational therapy
   divinity / religion / theology	rehabilitation counseling
   drama therapy	social work
   education	sociology
   gerontology	special education
   health administration	speech pathology
   health education	vocational counseling
   human services

   If the coursework for the Behavioral Science degree submitted by an applicant does not provide sufficient substance use and addiction education to meet the requirements, additional course work may be necessary.

3. Work, Internship or Practicum: practice in diagnostic assessment, intervention, and alcoholism and/or drug counseling to establish and maintain recovery and prevent relapse; regular on-site, documented clinical supervision required by the license or certification.

   • For LADC I or II, BSAS considers work experience from a variety of settings which are licensed or approved to provide substance use/addictions services. Settings can be treatment programs, mental health and primary care settings, or private practices. The applicant needs to document that the work experience included diagnostic assessment, intervention, and substance use/addictions counseling.

4. Supervision of Work, Internship, or Practicum: Supervision is a formal, systematic process of staff development that focuses on integrating knowledge and enhancing clinical skills and other competencies in counseling.

   • For LADC applicants, supervision must be documented on forms provided by BSAS in the application, and include the signature of an approved supervisor for the work or academic setting, as well as:

     Supervisors must be:

     • For each work position held: a description of the substance use and addictions work, the number of hours, the number of hours of individual and group supervision the person received.

     • For each practicum: the number of hours in each of the 12 Core functions, and where the practicum was done.

     • A Clinician who has:

       1. a master’s degree in one of the following disciplines or a closely related field: clinical psychology, education-counseling, medicine, psychology, psychiatric nursing, rehabilitative counseling, social work, and who has a minimum of one year of supervised substance abuse counseling experience; or

       2. a bachelor’s degree in any of the listed disciplines and a minimum of two years of supervised substance abuse counseling experience; or

       3. a recognized certification or licensure including 4,000 hours of clinically supervised counseling of individuals with substance use disorders including at least 220 documented hours of supervision.

   • For CADC applicants, supervision must be documented on forms provided by MBSACC in the application, and

     • MBSACC requires workplaces to provide clinical supervisors, preferring that they hold CADC or CADC-II Certification.

     • For practicum or internships, MBSACC accepts supervisors selected by the academic institutio

5. Four Domains and DSM5 Diagnostic Criteria: The Four Domains are:

   • Domain I: Screening, Assessment, and Engagement
   • Domain II: Treatment Planning, Collaboration, and Referral
   • Domain III: Counseling (Counseling & Education for CADC-II)
   • Domain IV: Professional and Ethical Responsibilities.

6. MA Licensing Requirements: Per 105 CMR 168.014: The Department will issue a license without requiring written or oral examination to any applicant who is deemed eligible for reciprocity based on the following:

   • the applicant holds a current, valid licensed as an alcohol and drug counselor or a comparable field in other state wherein the requirements for licensure are deemed by the Department to be equivalent to or in excess of those requirements of the Department; and,

   • the Department receives written verification from the other state licensing authority that the applicant is in good standing.

7. Recognized Certifying Bodies: International Certification and Reciprocity Consortium, Massachusetts Board of Substance Abuse Counselor Certification, National Association of Alcohol and Drug Counselors, Certified Employee Assistance Professionals.

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Developed by the MA DPH Bureau of Substance Addiction Services (BSAS) with input from the BSAS Addiction Education Provider Advisory Group and the Massachusetts Board of Substance Abuse Counselor Certification.