Access to Care

Reducing Professional Social Work Barriers and Increasing Mental Health Access: Interstate Social Work Compact

Ali Myers

Executive Summary

Background Summary

Policy Options

Sources and Further Reading

Enact Interstate Social Work Compact

Current social work licensing structures pose significant problems for the 500,000 licensed social workers within the United States and U.S. territories. The requirement for social workers to become licensed separately in each state disproportionately affects individuals in rural areas gaining access to safe and adequate mental health treatment. Additionally, employment opportunities for military families are negatively impacted by the strict requirement to be individually licensed in each state or area that the family is relocated. To combat employment concerns and increase access to safe mental health treatment, I propose local policy makers enact the Interstate Social Worker Compact into legislation.

During COVID19, poor licensure portability limited access to safe treatment and adequately trained mental health providers via telehealth (Apgar, 2022). Mental health risks are increased for children (Musburger et al., 2023) and individuals living in Rural area due to limitations in access to adequately trained providers. In Iowa, providers from 6 bordering states had to get licensed in multiple states to provide needed mental health services to rural towns (Landsman and Rathman, 2023). Further, some states do not have legislation enacted for licensed clinical social workers, removing the ability for individuals to receive psychotherapeutic services from these providers (Cooper-Bolinskey, 2019).

One-third of military spouses have a professional license or need to obtain one. Each time a military family must relocate for the enlisted individuals’ services, the spouse is required to obtain a new licensed. This requires the individual to pay fees for each move, complete additional applications, and potentially complete additional testing. Additional issues may arise creating further professional barriers for military families if the states have differing regulatory requirements for social worker licensure (Kersey, 2013).

Limited licensure mobility and portability is a multifaceted issue. Regulatory bodies should consider alternative policy in addition to the Interstate Social Work Compact.

• Standardized Scope of Practice

• Narrow gaps between CSWE and ASWB standards

• Require transparency in ASWB examination pass/fail demographics

  (Cooper-Bolinskey, 2019; Morrow, 2023)

• Improve licensure preparation within education programs

• Nationwide consistency in licensing titles

• Develop inclusive pathways to licensure

• Increase empirical research on licensure outcomes

The Department of Defense awarded a $500,000 grant to begin the development of an Interstate Social Work Compact. The Interstate Social Work Compact would streamline licensing for social workers, only requiring providers to complete testing, pay fees, and complete applications in their home state. However, social workers would be able to provide services within other states that have joined the compact agreement (National Center for Interstate Compacts, 2024).

The enactment of legislation to join the compact would enable more social workers to provide services to individuals and families in West Virginia and allow clients more flexibility with choosing a provider. Additionally, access to more providers can reduce the likelihood of dual or multiple relationships occurring. If a dual or multiple relationship arises, increased access to providers in our rural state would make it easier for services to be transferred to another adequately trained provider (National Center for Interstate Compacts, 2024).

• Increased access to treatment

• Continuity of Care

• Expand Employment Opportunities

• Reduce Administrative Burdens

• Enhance Public Safety

• Preserve State Sovereignty

  These states have already acted on legislation for the Interstate Social Work Compact.

• 22 states have passed legislation to enact the agreement: ME, VT, CT, NH, RI, TN, GA, KY, OH, VA, LA, AL, MI, MN, IA, SD, KS, NE, CO, AZ, UT, WA

• 5 states have pending legislation to enact the agreement: IN, PA, NJ, ND, NV

(National Center for Interstate Compacts, 2024;

Dehart et al., 2022; Landsman and Rathman, 2023;

Apgar, 2022; Apgar and Nienow, 2023;

Cooper-Bolinksey, 2019; Kersey, 2023)

Benefits

• Apgar, D. (2022). Social work licensure portability: A necessity in a post-COVID-19 world. Social Work, 67(4), 381-390.

• Apgar, D., & Nienow, M. (2023). Critical time in regulation of social work practice: Forging a path forward. Research on Social Work Practice, 33(1), 3-4.

• Cooper-Bolinskey, D. (2019). An emerging theory to guide clinical social workers seeking change in regulation of clinical social work. Advances in Social Work, 19(1), 239-255.

• DeHart, D., Iachini, A., King, L. B., LeCleir, E., Reitmeier, M., & Browne, T. (2022). Benefits and Challenges of Telehealth Use during COVID-19: Perspectives of Patients and Providers in the Rural South. Advances in Social Work, 22(3), 953-975.

• Kersey, A. W. (2013). Ticket to ride: Standardizing licensure portability for military spouses. Mil. L. Rev., 218, 115.

• Kim, J. J., Joo, M. M., & Curran, L. (2023). Social Work Licensure Compact: Rationales, expected effects, and a future research agenda. Clinical Social Work Journal, 51(3), 316-327.

• Landsman, M. J., & Rathman, D. (2023). Rural Challenges in Social Work Regulation. Research on social work practice, 33(1), 121-131.

• Morrow, D. F. (2023). Social work licensure and regulation in the United States: Current trends and recommendations for the future. Research on Social Work Practice, 33(1), 8-14.

• Musburger, P., Olson, E., Etow, A., Camilleri, C., Wong, H., Witten, M. H., & Kaminski, J. W. (2024). Examining State Licensing Requirements for Select Master’s-Level Behavioral Health Providers for Children. Psychiatric Services, appi-ps.

• National Center for Interstate Compacts. (2024). Social Work Licensure Compact. https://swcompact.org/