Legislators in the 118th Congress reintroduced the Improving Access to Mental Health Act (S. 838/ H.R. 1638) this March during National Social Work Month, marking a significant first step in the bill’s legislative process.
The legislation would increase the reimbursement rate for clinical social workers in Medicare, allow clinical social workers to provide Health and Behavior Assessment and Intervention (HBAI) services, and provide clinical social work services to Medicare beneficiaries who are residents of skilled nursing facilities.
U.S. Senate sponsors of the bill are Sens. Debbie Stabenow, D-Mich., a social worker; and John Barrasso, R-Wyo., a physician. In the U.S. House, Reps. Barbara Lee, D-Calif., also a social worker; Brian Fitzpatrick, R-Pa.; and 17 co-sponsors introduced the legislation. Eighteen organizations endorsed the bill upon introduction, and NASW is working in coalition with these groups and others to advance the legislation—and will continue to advocate for its progress.
In the last session of Congress, the bill had 54 co-sponsors in the House and nine in the Senate—the highest number of co-sponsors the bill has received since it was first introduced in 2015. During that session, two provisions of the Improving Access to Mental Health Act were included in the Senate Finance Committee’s discussion draft. All three provisions of the bill were included in the Health Equity and Accountability Act (H.R. 7585/S. 4486). Having the bill provisions added to other legislation or legislative vehicles is evidence of progress. It generally takes a large number of congressional sponsors for bills to advance. The skilled nursing facility provision was initially introduced under a different title—the Clinical Social Work Medicare Equity Act—between 2001 and 2011.
The legislation’s reintroduction is a positive first step, and NASW is encouraging social workers to continue to advocate for this and other bills important to social workers and the people they serve.
“Passage of this bill is one of our most important advocacy goals,” said NASW CEO Anthony Estreet, PhD, MBA, LCSW-C.
Sarah Butts, MSW, NASW’s director of public policy, said NASW needs all social workers to get involved “to help us advance the Improving Access to Mental Health Act in the 118th Congress.”
“We need the entire profession to get involved, to contact their members of Congress and ask them to co-sponsor the bill,” Butts said. “Lawmakers want to hear from their constituents.”
One example of exemplary outreach came from NASW’s Connecticut Chapter, which “took multiple steps to get co-sponsors,” said Chapter Executive Director Stephen A. Wanczyk-Karp, LMSW. “First, we wrote an official request to our congressional delegation. Then we sent out three legislative alerts over several months and phone banked enough members to assure at least 20 constituent contacts.”
“We also communicated with congressional office staff, in collaboration with (NASW) national staff, at the same time that we were mobilizing members,” Wanczyk-Karp said. “Persistent lobbying over a four-month period succeeded in having both U.S. senators and three U.S. House members become co-sponsors.”
NASW will engage with Congress and media at every level to increase support for this important legislation. The association recently provided input to the Senate Health, Education, Labor, and Pensions (HELP) Committee to provide its point of view on workforce concerns. NASW highlighted the need to pass the Improving Access to Mental Health Act as a top priority for Congress. NASW also signed on to the Mental Health Liaison Group’s Workforce Working Group letter to Senate HELP, which included this request.
“The scope of practice and reimbursement rate for clinical social workers practicing in Medicare has not been re-evaluated since 1989 when clinical social workers first became Medicare providers,” Butts said. “We need to address low reimbursement and unresolved gender pay disparities for social workers. This important work includes addressing low Medicare reimbursement rates and limited scope of practice, especially during a mental health crisis period.”
During Social Work Month in March, Butts wrote an article for the Case Management Society of America, outlining key legislative advocacy areas for social workers, and the importance of becoming involved. The article includes details about congressional legislation that needs ongoing social work support and action, including:
The Improving Access to Mental Health Act
Improving Access to Advanced Care Planning Act
Collaborate in an Orderly and Cohesive Manner Act
School Social Workers Improving Student Success Act
The Community-Based Response Act
More Social Workers (MSWs) in Libraries Act
Protecting Social Workers and Health Professionals from Workplace Violence Act
Community Mental Wellness and Resilience Act
Read more about these bills and NASW’s policy agenda
How NASW Advocates
NASW speaks on behalf of its 110,000 members and the approximately 700,000 social workers in the U.S. The NASW national office leads on federal policy, while its 55 chapters lead at their local and state levels. NASW advocates for social workers on workforce issues—including compensation, scope of practice, licensing, telehealth and workplace safety—and on behalf of clients, communities and society on social justice issues—like climate change, human rights, economic justice and ending racism. NASW also encourages social workers to be advocates at every level.
NASW leaders meet with members of Congress, federal agencies, and the administration on behalf of the profession and social work clients. The association also crafts responses during public comment periods and advocates in coalition with other organizations. This work paid off when some of NASW’s priorities were included in the end-of-year 2022 federal spending bill. These include:
Securing a two-year telehealth expansion in Medicare
Averting some of the Medicare reimbursement cut for FY 2023
Expansion of scholarships and loan repayment for mental health providers
The Behavioral Health Workforce Education and Training (BHWET) program received a total of $153 million, representing a $30 million increase
$20 million to help communities create mobile behavioral health crisis response teams, representing a $10 million increase
$10 million for grants to states to support mental health parity enforcement.
Social Work Engagement
Charles E. Lewis Jr., PhD, MSW, director of the Congressional Research Institute for Social Work and Policy (CRISP), offers advice on getting involved.
“I tell social workers, support the candidates of your choice,” he said. “Whether or not we have a problem with the current system, you still have to support your candidate. Getting your points across requires advocacy.”
To help with that, CRISP provides trainings so students can improve their advocacy skills. That starts with knowing what they are advocating for so they can talk about the issues.
“If you want to be a successful advocate in legislation, you’ve got to have an idea of what you want to be in that legislation,” Lewis said. “You have to do your homework and you have to know who you’re lobbying to, what the committees are, and what issues are in those committees at that time. That lets the legislator know you are aware of what you are doing.”
Lewis said it requires being an effective listener, and “that’s something we get training on as social workers.”
“If you’re operating in the political arena, you have to have some sense of what will go forward,” he said. “You may not get everything you want, and you have to accept that.”
Butts adds: “NASW encourages social workers to get to know their members of Congress and their staff and to serve as a resource for their offices. Social workers can attend town hall meetings, visit members of Congress in their state or district offices, and when in Washington, D.C., meet with their members of Congress or their staff. They should get to know the key legislative staff and the committees on which their members of Congress sit.”
To help in this effort, NASW mobilizes social workers throughout the year and is hosting a Capitol Hill Advocacy Day in June, where association leaders will advocate for NASW’s priority legislation. NASW also hosts “Hill Days” during its biannual national conference and in states through many NASW Chapter Legislative Advocacy Days.
There is always work to be done at the local, state and federal levels to help advance priorities for social work and for society. Social workers can check with their state chapter to find out what the priorities are and how to get involved. Find your chapter’s contact information.
For federal policy, the NASW has resources that can help. Visit NASW's Advocacy page to learn more about the association’s policy and social justice priorities, sign-on letters and statements, Political Action for Candidate Election (PACE), policy updates, and legislative alerts.
Social workers are encouraged to join NASW’s Advocacy Listserv to stay up to date on legislative developments and respond to action alerts.