By Sarah Christa Butts, MSW, Director of Public Policy, NASW National Headquarters’ office in Washington, D.C.

Every Congressional session offers an opportunity to advocate and advance policies that improve access to social work services and promote the health and well-being of the clients and communities that social workers serve.

We are in the first session of the 118th Congress.  It is a new session of Congress and legislation that continues to have support will likely be reintroduced and assigned new bill numbers. It’s critical that we work to secure bipartisan co-sponsors for legislation impacting the profession and that reflect our core values.

During the pandemic period, there have been significant federal investments in mental and behavioral health, but more can and should be done to increase access to social work services and ensure policies that allow us to recruit and retain social workers across the many different practice settings where we are employed. We need investment in social work, access to student loan debt relief, increased compensation and reimbursement, improved workplace safety and the ability to practice at the top-of-license.  Further, we must continue to advocate for social justice issues such as racial equity, reproductive rights and economic justice.

This social work month, I want to remind social workers of the importance of participating in advocacy on behalf of the profession. There are roughly 700,000 social workers in the United States, and about 250,000 are licensed clinical social workers. Our collective involvement in policy advocacy and mobilization efforts is critical to ensure public policy that supports the profession and our priorities.

NASW’s policy agenda is outlined in the Blueprint of Federal Social Policy Priorities: Recommendations to the Biden-Harris Administration and Congress, which is organized using the Grand Challenges for Social Work and endorsed by the American Academy of Social Work and Social Welfare. The document includes issues that regard the social work workforce and an array of other social justice priorities. NASW has a significant set of policy goals—one of the largest of any standalone membership association in Washington, D.C. We work in coalition and with many different organizations to advance our policy agenda (see page 41 of the Blueprint document). Some of our key advocacy partners include: The Mental Health Liaison Group, The Coalition for Social Work and Health, Coalition on Human Needs, The Leadership Conference on Civil and Human Rights, Legal Action Center, Student Borrower Protection Center, PSLF coalition, the Human Rights Campaign and many more! Fully appreciating actions that NASW is taking on different policy issues requires inclusion of our efforts in coalition. We are usually not doing advocacy work alone or in isolation of specialty organizations and other expert groups. That said, NASW must advocate for the social work profession as a priority, including all social workers across different settings. Our focus on the profession is critical, especially because  other allied organizations are unlikely to prioritize advocacy for our workforce as a primary objective.

The following bills will support social work and we need to watch for re-introduction and assist in securing Congressional sponsors*:

  • Increased reimbursement and scope of practice in Medicare:
    • The Improving Access to Mental Health Act
      This bill will increase access to clinical social worker services in Medicare and increase the reimbursement rate of clinical social workers (CSWs) from 75% of the Physician Fee Schedule (PFS) to 85% of the PFS. The bill will also allow (CSWs) to provide clinical social work services to Medicare beneficiaries in Skilled Nursing Facilities and to provide Health Behavior Assessment and Intervention (HBAI) services to Medicare beneficiaries.

For additional information, you can access NASW’s issue brief here.

    • Improving Access to Advanced Care Planning Act
      This bill provides statutory authority for Medicare coverage of advance care planning services. It also (1) allows such services to be provided by clinical social workers, and (2) waives the coinsurance and deductible for such services (regardless of whether the services are provided as part of an annual wellness visit).The Centers for Medicare & Medicaid Services must conduct outreach about Medicare coverage of advance care planning services; the Medicare Payment Advisory Commission must study and report on the provision and utilization of such services.
  •  Integrated care:
    • Collaborate in an Orderly and Cohesive Manner Act
      This bill requires the Department of Health and Human Services (HHS) to award grants for implementing and evaluating specified models of care that integrate the delivery of behavioral health and primary care services.Specifically, HHS must award grants to primary care providers for the initial costs (e.g., hiring staff) of implementing such models. In awarding the grants, HHS must prioritize recipients that provide care to medically underserved populations and in areas where the prevalence of behavioral health conditions exceeds the national average. HHS must also provide additional incentive payments to recipients who use appropriate billing codes and quality measures for behavioral health services.In addition, HHS must award grants to national and regional organizations for providing technical assistance to healthcare providers and systems to improve implementation of integrated behavioral health and primary care models. Furthermore, HHS may direct its agencies to expand efforts to evaluate current and emerging integrated behavioral health and primary care models.
  • Funding for social work positions:
    • School Social Workers Improving Student Success Act
      This bill provides certain resources to increase the number of social workers in elementary and secondary schools.Specifically, the bill directs the Department of Education to award grants to high-need local educational agencies to retain or hire school social workers.The bill also establishes a national technical assistance center for school social work to, among other duties, develop strategies for improving the effectiveness of the school social work workforce.
    • The Community-Based Response Act
      This bill establishes a program to assist communities with implementing alternative emergency response models in vulnerable populations to resolve crisis situations that may not require a law enforcement response or situations in which a law enforcement response may increase the risk of harm.Specifically, the Administration for Community Living, in consultation with the Department of Housing and Urban Development and the Department of Justice, must award grants to eligible partnerships to establish or expand these models. The partnerships must consist of a unit of local or tribal government that is independent of law enforcement agencies and a nonprofit, community-based organization or consortium of such organizations. The partnerships may also include other entities, such as nonprofit or public institutions of higher education and behavioral health organizations.A partnership may use grant funds for a variety of purposes, such as triaging 9-1-1 calls to refer certain emergencies to entities other than law enforcement. In awarding these grants, the administration must prioritize partnerships that include community-based organizations that have a record of effectively serving, and are led by members of, vulnerable populations.
    • More Social Workers (MSWs) in Libraries Act
      The MSWs Act seeks to further strengthen public libraries as community hubs by facilitating aspiring social workers into library facilities across our country.The bill will help reinforce America’s social work talent pipeline by creating a paid social work internship program at public libraries across our nation. Specifically, under the MSWs Act, the Department of Education would develop a program to provide competitive grants to institutions of higher education that would be used to fund an internship for social work university students in a regional public library and employ qualified social workers in regional public libraries to oversee social work of student interns.
  • Safety:
    • Protecting Social Workers and Health Professionals from Workplace Violence Act
      This bill directs HHS to award grants to states, Indian tribes and tribal organizations for providing safety measures to social workers, health workers and human services professionals who perform services in high-risk and potentially dangerous situations.
  • Emerging areas of practice: Addressing climate change:
    • Community Mental Wellness and Resilience Act
      This bill requires the Centers for Disease Control and Prevention to award competitive grants to consortia that represent various community entities (e.g., schools, businesses, and health and human services providers) for carrying out community mental wellness and resilience programs that use a public health approach. This innovative legislation will empower communities to craft their own locally specific responses to the mental health problems caused by disasters, other adversities and toxic stress.

The above proposals are not an exhaustive list of the Congressional bills that will be assistive in facilitating improved access to social work services and improved mental and behavioral health. These are just a subset of important proposals that we need to try to advance this Congress. Sometimes, moving Congressional legislation takes years, even decades.

It’s important to understand that lawmakers in Congress want to hear from constituent social workers, our clients and patients, in their states, regarding the problems and potential policy solutions that impact the communities they represent.

How can you get involved? Start by joining NASW’s Advocacy Listserv and respond to our legislative alerts. We will issue alerts when priority bills are re-introduced or being considered for advancement in some way. Help us to get the Congressional delegation in your state to co-sponsor these bills and others, this Congress.

We need the full strength of the profession for collective impact in policy at the federal and state levels. We ask you to please join us and advocate for the policy and practice changes necessary for improved health and wellbeing of our society.


* Definitions of Congressional bills were pulled from or the associated Congressional press releases for each bill.

Bio: Sarah Christa Butts, MSW, is Director of Public Policy at the National Association of Social Workers (NASW), headquarters office in Washington, DC. Butts is responsible for leading the association’s public policy, political and legislative affairs agenda, overseeing field organizing, working at both the national level and with 55 NASW state chapters, political candidates’ fundraising and endorsement efforts, as well as developing and advancing the association’s strategic goals and objectives related to influencing the legislative and executive branches of government. Prior to joining NASW, she served as the executive director of the Grand Challenges for Social Work, and she is the founding administrator of the American Academy of Social Work and Social Welfare. Sarah started her career in public child welfare and has held direct service and administrative roles at Maryland’s Department of Human Services and the Family League of Baltimore. She is a graduate of the Title IVE-E education for public child welfare program. She is co-chair of NASW’s Licensure Task Force, a member of the board of directors of the Congressional Research Institute for Social Work and Policy and the Mental Health Liaison Group. She is a member of the leadership board of the Grand Challenges for Social Work and a member of the national steering committee and advisor to the International Transformational Resilience Coalition. She earned her BSW degree at University of Maryland, Baltimore County and MSW degree from University of Maryland, Baltimore.

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