A. Application
Packet
Upon reading the requirements for professional credentialing
in Chapter 3, Section 4, pp. 11-12 and making a decision to upgrade to Licensed
Clinical Mental Retardation Therapist (LCMRT), an individual shall submit to
the Division an upgrade application packet containing the forms/materials
listed below. These forms verify the provisional certification requirements
listed in Chapter 3, Section 4, pp.11-12.
(1) Application: A completed, notarized
Upgrade Application Form;
(2)
Employment: A completed Upgrade Verification of Employment Form from the
applicant's current place of employment meeting the employment requirement
listed in Chapter 3, Section 4, B., (1), p. 11;
(3) Education: An Official Transcript(s)
meeting the educational requirements listed in Chapter 3, Section 4, B., (2),
p. 11.
However, if the educational requirement for LCMRT is met by
the Official Transcript already on file with the individual's initial
application for PCMRT or upgrade application for CMRT, then no further
documentation is necessary.
(4) Experience: A completed Upgrade
Verification of Experience Form(s) meeting the experience requirements listed
in Chapter 3, Section 4, B., (3), p. 11.
However, if any of the experience requirement for LCMRT is
met by the Verification of Experience Form(s) already submitted with the
individual's initial application for PCMRT or upgrade application for CMRT,
then only the balance necessary to meet LCMRT experience requirements should be
submitted.
(5) Ongoing
Inservice/Training:
If upgrading from PCMRT to LCMRT, a completed Verification of
Inservice/Training Form(s) verifying required inservice/training obtained
during the individual's Provisional Certification Period as indicated in
Chapter 3, Section 2, E., (2), pp. 9-10; and,
If upgrading from CMRT to LCMRT, a completed Verification of
Inservice/Training Form(s) verifying required inservice/training obtained
during the current two-year Certification/Licensure Period as indicated in
Chapter 3, Section 4, B., (4), pp. 11-12.
(6) MR-CTP: While successful completion of
the MR-CTP is required for a provisional certificant to upgrade, there is no
reporting requirement for the upgrade applicant. See Chapter 4, Section 1, I.,
p. 23 for more information on documenting participation in the
MR-CTP.
(7) Application Fee: A
nonrefundable $75.00 check or money order made payable to the Mississippi
Department of Mental Health. See Chapter 6, Section 1, A., p. 36 for more
information on the Application Fee.
B. Directions
(1) When preparing to submit an upgrade
application for clinical licensure (LCMRT), be sure to follow the General
Guidelines found in Chapter 4, Section 1, pp. 19-23 as well as the directions
found at the top of each form. Directions are also located in Chapter 9 on p.
58 and in a checklist format found on pp. 59-60.
(2) If questions arise which are not
addressed in this document, please contact the Division for
assistance.
C.
Submission Timelines
When upgrading from PCMRT to LCMRT, individuals are expected
to follow these timelines:
(1) Upon
conclusion of the Provisional Certification Period (24 consecutive month
maximum), a provisional certificant is expected to submit an upgrade
application packet so that it is received by the Division no later than the
last working day of the 25th month (one month past the 24 consecutive month
maximum).
(2) Provisional
certificants who have completed all Provisional Certification Period
requirements prior to reaching the maximum number of months allowed (24 months)
and who wish to submit an upgrade application packet prior to the
25th month deadline may do so.
(3) A provisional certificant who has been
unable to complete all requirements during the Provisional Certification Period
due to extenuating circumstances may submit a written request to the Review
Board for Extended status. This written request must be received by the
Division no later than the last working day of the
25th month. See Chapter 3, Section 7, B., (2), p. 15
for more information on Extended status.
(4) If neither the upgrade application packet
nor the written request for Extended status is received by the last working day
of the 25th month, the provisional certificant is considered to have Defaulted.
See Chapter 3, Section 7, B., (3), pp. 15-16 for more information on Defaulted
status.
