Lawmakers in over 20 states want to pass legislation in the current year in order to establish a common, multistate license for social workers and help alleviate the workforce shortages and deficiencies in mental health-care access nationally.
The Social Work Licensure Compact has garnered significant momentum in 2024, with states like Colorado, Nebraska, and Virginia introducing bills this month to implement the professional agreement. In total, 22 states have presented such legislation, with Missouri being the sole state that has adopted the compact. At least six more states need to follow suit to officially establish a single license allowing social workers with a college degree or clinical license to serve clients in each compact state.
Advocates behind the effort assert that the compact will enable social workers to help patients across state lines, including through telehealth platforms, without the need to obtain additional state-specific licenses.
This initiative comes as the Covid-19 pandemic has exacerbated gaps in access to mental health services and workforce shortages across the healthcare system. The US Bureau of Labor Statistics has projected a shortfall of 74,000 social workers annually for the next ten years, with rural areas being particularly affected.
“State policymakers are interested in the social work compact as they’re looking for solutions for shortages of mental health providers and recognizing the mental health crisis that’s in the country right now,” said Matt Shafer, deputy program director at the Council of State Governments National Center for Interstate Compacts, which has helped develop the social work compact.
Despite the potential of the compact to address workforce and mental health accessibility issues, organizers and policy analysts express doubts about states such as California and New York, which have resisted joining the 13 other professional licensure compacts in the country and are less likely to participate in the effort. Trade groups also highlight the need to address the racial and ethnic disparities among those entering the social work profession.
Path to Enactment
In July 2023, Missouri Gov. Mike Parson (R) signed legislation making the state the first to adopt the social worker compact. Shafer and professional social work groups that helped develop the model legislation see 2024 as the year a wave of other states will follow suit.
“We’re going to have those seven states this year,” said Laura W. Groshong, director of policy and practice for the Clinical Social Work Association. After this, the states will create a commission to oversee implementation of the compact, made up of representatives from each member state and social work stakeholder groups, Groshong said.
Development of the social work compact began in 2021 as part of a US Department of Defense initiative to improve the license portability of military spouses serving as social workers. With funding from the federal government, the Council of State Governments, and Association of Social Work Boards developed the model legislation with help from the National Association of Social Workers and the Clinical Social Work Association.
South Dakota’s Senate voted Wednesday on a bill (HB 1015) to accept the compact that passed in the House earlier this month. The legislation now goes to the governor’s office for signature.
In Ohio, a bill (SB 90) to adopt the compact is awaiting a final vote in the House before heading to the governor’s desk.
Tackling Shortages, Access Barriers
Professional trade groups and policy analysts predict the primary benefits of the social work compact will be greater flexibility and access—both for social workers themselves, and the patients they serve.
“We’ve heard of social workers who hold licenses in all 50 states,” Shafer said. “It’s really eliminating a lot of that burden on the licensee, and they’re able to practice using the compact rather than having to have licenses in all those states.”
Maintaining a stable supply of social workers can be particularly difficult for some employers, said Patricia Pittman, director of the Fitzhugh Mullan Institute for Health Workforce Equity at the George Washington University.
Pittman cited the institute’s Behavioral Health Workforce Employer Survey published in October 2023, which found employers most frequently cited licensed clinical or certified social workers as the most difficult roles to recruit and maintain.
The social work compact can make “it easier for job seekers that may wish to change states based on wages or other job, or family considerations, without having to pay again and wait for a new license in states that are not already part of a compact,” Pittman said.
The compact would also allow social workers to “provide counseling via telehealth across state lines, and in so doing potentially expand access for patients that may not otherwise be able to find a counselor,” Pittman said.
This can be especially helpful for rural territories hit hardest by mental health workforce shortages. States with the largest number of nonmetro health professional shortage areas include Montana, South Dakota, and Texas, according to data from the US Department of Health and Human Services.
Obstacles Linger
The full reach of the compact could be limited, groups behind the effort note, as not all US states are expected to enter the agreement. Racial and ethnic disparities in the clinical social work exam passage rates have also unveiled a need to reevaluate entry requirements, policy analysts say.
Alaska, California, Massachusetts and New York haven’t joined any of the professional licensure compacts thus far. California, for example, has considered joining the nursing compact multiple times, but proposals have faced concerns from the state’s nursing board on a potential decline in work standards and a loss of oversight on nurses in the state.
Another point of concern in the clinical social work profession is the disparity between passing rates on social work licensing exams. A 2022 report from the Association of Social Work Boards found a difference of more than 30 percentage points between the eventual clinical exam pass rate of White and Black test takers.
In response to these concerns, the social work licensure compact bill allows states to have an alternative way to prove competency, Groshong said. But so far, only Illinois has done so—now allowing 6,000 hours of documented, supervised experience to serve as an alternative to passing the licensing exam.
While policymakers and professional groups aim to make progress in this area, the social work compact will still be “beneficial to everyone who needs mental health treatment,” Groshong said.
“There’s a lot of unserved people and we hope that this will make it improve so that many more people can get the help they need,” she said.