Thursday, July 10, 2014

Explanation of Clinical Chaplaincy given at the UGST Symposium 2013

Personally, I have completed four units of CPE and, after working for over 5 years full-time as a chaplain, I am now a board certifiable chaplain.  A Board Certified Chaplain (BCC) is very expensive and requires a minimum of four units of CPE (two must be Level Two CPE), 2000 clinical hours of work after completing CPE, a Master’s of Divinity, a lengthy application process, and then sitting for a consultation/review by other BCCs.  After being hired by UGST, I walked them through the year-long process of becoming a Member School of ACPE.  I then was the natural and only potential candidate for the cluster board to appoint to the St. Louis Cluster Board that governs CPE training in the St. Louis, MO, and the Springfield, IL, area.  The St. Louis Cluster is the only remaining Cluster board in the ACPE; at one time such cluster governance dominated the ACPE.  This Cluster has survived because it is dedicated to unity, tolerance, and a commitment to be inclusive to a wide variety of faith backgrounds.  In this Cluster, United Pentecostal Church (UPCI) chaplains have found a warm welcome and mentoring by CPE supervisors who are dedicated to making a place at the table for them.
It would be helpful to start with an overview of clinical chaplaincy and how chaplaincy training takes place.  CPE training is given in a succession of levels, and the level you complete will determine the job opportunities.  It is also worth noting that the requirements for employment are different from state to state, and even from county to county, depending on the strength of enforcement by state and local officials.  For example, Missouri law states that no one can work in any clinical chaplaincy position without at least one unit of CPE.  However, in rural areas state regulators ignore this requirement because there is no CPE training available (although someone with CPE would be preferred in a hiring process).  On the other hand, in population centers like St. Louis and Kansas City you would probably not even be considered for an entry-level position without two units of CPE. 
As a final note on employment, it is the expectation of ACPE, most educators, and even state regulators that the Federal Government will likely establish rules on the education requirement of chaplains, because both Medicaid and Medicare are now billed for and reimburse for chaplains’ visits in a hospice setting.  In 2010 the Medicare Hospice Guidelines made the chaplain and/or a counselor a mandatory part of the Hospice Team. As in the case of other medical providers that are part of the Hospice Team, a minimum standard will probably be set in the near future.  When this happens it is the hope of ACPE that this will be set high (M. Div. and four units of CPE) (which is in keeping with social worker requirements) to improve the quality of care that chaplains are providing.  When this happens present day chaplains will be given a time span to come into compliance before being allowed to work for a company that accepts Medicaid and/or Medicare.
While I have no official data, there are only a handful of licensed or ordained ministers in the UPCI that have any CPE at all.  As far as I know, there are only a couple of people who are board certifiable (I am the only one I know of for certain).  Further, there are no Oneness Pentecostal supervisors or any Oneness Pentecostal students in supervisory training.  Crystal, if she gets a supervisory training slot, will be the very first to have been accepted into such a training program.
After a lengthy application is filled out ($50 fee) and the student is selected, all CPE students start with Level One training at a hospital that is licensed by ACPE to provide the training.  The cost for a unit of CPE varies between locations, but is usually around $600.  ACPE gives priority to people with an M. Div. and students in a similar program.  However, if slots are available, supervisors will fill the slots with anyone interested in chaplaincy.  The clinical method of training in CPE units require between five and eight students to be effective.  Each unit of Level One or Level Two CPE require 300 hours of clinical time, 100 hours of didactic and group supervision, and sometimes a variety of other responsibilities such as on-call work.  Each unit is usually made up of students at a variety of levels, and the cohort supports each other through the process.  Units can be done over different periods of time (10 weeks @ 40 hours a week and often called an ‘Intensive Unit’, 20 weeks @ 20 hours a week and is often referred to as an ‘Extended Unit’, etc).
Anytime after a single unit is completed and either the student or the supervisor feels that the student has completed all of the Level One objectives (objectives are listed in the ACPE Handbook), the student can apply to sit for a Level One Consultation.  A Level One Consultation is a written and verbal examination by supervisors and other important hospital employees or Cluster board members to determine if they are ready to begin working on Level Two objectives.  Many students will work for many units on Level One and never sit for a Level Two Consultation.  One reason for this is that supervisors will rarely tell students what is clearly written in the ACPE Handbook (students are required to sign that they have read the handbook), and I have known students who have completed six units of CPE and, when asked, had never heard of Level Two CPE.
Another opportunity for those seeking training is to be hired by a medical facility as a ‘resident’.  It is required that residents have at least one unit of CPE before becoming a resident.  As a resident they will do four Intensive Units back-to-back over the course of a year.  During that time the resident is expected to devote their entire attention to CPE learning and working at the medical facility that hired them.  While resident students are still required to pay for their CPE units, they are paid a stipend that again varies between location (between $23,000 and $32,000 a year).  Occasionally hospitals will hire a Second-Year Resident that will serve as a resident and mentor to other residents.
The next level of training would be a supervisory candidate training.  Because of the number of clinical hours one accumulates doing CPE, it is not required (as in other programs) that those seeking supervisory training have a clinical period (or become BCC) between finishing Level Two training and starting supervisory candidate training.  Supervisory training is provided by a supervisor who is qualified to do so and a medical center that is licensed to provide the training.  Supervisory training takes between three and five years after completing Levels One and Two CPE.  Therefore it would not be considered unusual if the entire process (Level One to Full Supervisor qualified) took about ten years to complete.  Currently in the United States, chaplain supervisors have been ageing and retiring at a faster rate than new supervisors have been trained.  There is therefore an increasing shortage of supervisors available.  Currently in the St. Louis area there have been two supervisor positions and a supervisor trainee position open for almost a year.  The before-mentioned shortage, coupled with ACPE’s dedication to inclusion of under-represented groups (especially Pentecostals, who now make up 1/12 of the world’s population), opens a space for a golden age of opportunity for Pentecostal chaplains.

My vision when I started out in chaplaincy was to have an influence on chaplaincy education throughout the Oneness movement.  By being appointed to the St. Louis Cluster Board as a representative of UGST (and by extension representing all Pentecostal chaplains), I have in some ways jumped over the need to have supervisory training in order to have this influence. I envisioned that this would only be possible by becoming the first UPCI supervisor and training UPCI’s future chaplains.  However, by sitting on the Cluster Board, I can influence the decisions of the Cluster as it determines who gets the scarce training slots in the St. Louis area.  Further, because of this position, I am sought out to consult on matters that affect or include Pentecostals in general.  I am also asked to sit on Level One Consultation Boards, Supervisory Candidate Mock Boards, meet with and/or interview potential job applicants around the city and give feedback, give presentations at chaplaincy training events and conferences, provide hospital training for chaplains and social workers, and only God knows the influence I can have over CPE and chaplaincy training in the remaining years of my life.  My chaplaincy journey has been one of faith, and God has surely opened the doors so that, as His vessel, I might be used to bring glory to His Kingdom.

No comments: