At the beginning of 2023, test exam fees for anyone seeking a social worker license were temporarily waived with funds allocated by the Oregon Legislature. The Oregon Health Authority told KLCC this was meant to address the number of social workers who left the industry during the pandemic and increased demand. The funds have also allowed fees for some license renewals and new applications to be waived as well.
But with technology, communication and backlog issues facing the Oregon Board of Licensed Social Workers, some applicants have been waiting months to get their license to practice in the state. Currently, the board estimates that process and approval time for a license can take upwards of three months. Nathan Smith is a licensed clinical social worker who waited five months for his application to be approved. He joins us to share his experience. Lou Savage is the interim director of the Oregon Board of Licensed Social Workers, the state agency that processes and approves social worker licenses. He also joins us to share what the demand has been like the past few years, why wait times are so long and what the agency is doing to address delays.
Note: The following transcript was created by a computer and edited by a volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Everyone seems to acknowledge that Oregon is facing a shortage of mental health professionals, but many people who are actively seeking to fill those roles are stuck in limbo. They’re waiting many months to become licensed clinical social workers or clinical social work associates. The Oregon Board of Licensed Social Workers is responsible for these certifications. They say they’re working to reduce the backlog and to streamline this process. For more on all of this, I’m joined now by Lou Savage, the interim director of that board. Nathan Smith joins us as well. He is a licensed clinical social worker who moved to Oregon from Indiana and waited five months for his application to be approved. Welcome to you both.
Lou Savage: Thank you.
Nathan Smith: Thank you for having me.
Miller: So Lou Savage first, my guess is that a lot of our listeners have never heard of the Board of Licensed Social Workers before. What does it do?
Savage: The Board of Licensed Social Workers is the regulatory body for the state. It is a board-governed agency and there are two clinical licenses that the board authorizes and I will kind of briefly talk about those. The clinical social work associate and the licensed clinical social worker are the two licenses that are for clinical work. The CSWA which is the clinical social work associate is really the first step to becoming a licensed clinical social worker. These folks are graduates with a master’s degree in social work and they need a certain number of hours of supervised clinical experience, hours of direct client service and hours of supervision as well. They ultimately will get their licensed clinical social work license after they complete the requirements for CSWA.
And LCSW (licensed clinical social workers) really have specialized clinical knowledge and advanced clinical skills for assessment, diagnosis, treatment of mental/emotional behavioral disorders. So they are often employed by hospitals and health clinics to really focus on mental illness, emotional and behavioral disturbances and they perform a lot of functions in hospitals, medical clinics and other other clinics that serve this really needy population.
We also have two nonmedical license types, registered baccalaureate social worker and license master of social work. But I think the focus really in terms of the backlog is on the CSWA, the clinical Social work associate and the licensed clinical social worker, the LCSW.
Miller: Nathan Smith, my understanding is that you moved to Oregon from Indiana. When did you first apply to get your license transfer to get an Oregon license?
Smith: It was actually at the beginning of May. We had started to kind of have a conversation about coming out here and I’m currently licensed in the state of Indiana as well as the state of Tennessee at that point. So I know as far as licensing goes, there is a need to go ahead and try to get that done as soon as possible, get the ball rolling because you never really know how long it’s going to take. I think for Indiana, it took me about a week to turn around from the time I passed the clinical exam until I was granted my license. Tennessee is a state of reciprocity. They looked at all of my credentialing and I had to do a background check, which is pretty standard, but they had me credentialed as an independently-practicing licensed clinical social worker within a month’s time. So I started the process at the beginning of May knowing that I was going to be coming out here.
Miller: OK. But your previous experience in two different states was first just one week in Indiana and then with reciprocity and the paperwork took about a month. What’s the process that you had to go through for Oregon?
Smith: Oh goodness. Well in June, when I decided that I was coming out for sure, I called the licensing board and just was checking in to make sure if there was anything that needed to be done. And I spoke to a young lady who informed me that she was the only person that was in charge of processing all the clinical licensure applications. And I said, well, I’m getting ready to come out there for a job and I want to be able to know that I can work. She told me very matter of factly and I understood, oh, I just can’t pull your application out of the pile and put you ahead of everyone because that wouldn’t be fair. And I’m thinking, no, that’s correct, but I never got an application number. I never was notified about where my application was in the process.
And then in July, after I had moved out here, I had spoken with a woman at the Oregon Licensure Board who answered the phone and said that the person who normally did the applications was on vacation. So no application materials were being done. And I’m a solution-focused kind of person in therapy and in life. And if I come to a situation or problem, I’m going to try to find a solution and present that with it to be like I thought about this and I had mentioned, why not– just harebrained idea–get social workers that are clinically licensed in Oregon that have been 10 plus years, get them to volunteer and give them some continuing education credits that were all required to have our license, get them to come in on a Saturday and help you sort through just the licensure of the people that were licensed in other states. If you need to go specifically through the ones that are newly granted for just passing their clinical exam, they need to be licensed. That’s a different thing. But for those of us that are already licensed and have been practicing for several years, it just seemed like that would streamline the process. And she told me that unfortunately that that wasn’t something that would be able to be done because the process of hand grading the test that goes with the application causes the process to be longer and that the training process for that role would take about three months.
Because I work for a nonprofit, I go through, I believe CAHQ, but it’s a credentialing. So to make sure my license is current and that I’m able to, they’re able to build Medicare and Medicaid for my services. And I was getting notifications from them that I was not in compliance because I didn’t have my license in Oregon to practice and trying to communicate that with them and say I’m doing everything I can, I promise you, I’m making the phone calls, but I have made my supervisors aware. There’s nothing I can do. So there was a period of time..
Miller: So could you be hired legally in Oregon to do the job that you had accepted without the license having been approved?
Smith: Oregon is a state where–I’ve done my research on this–they do QHMPs (qualified mental health professionals) and that kind of covers a lot of people that are either on the track for licensure or have maybe the associate the licensure and they’re getting clinically licensed to practice independently, so there’s a QMHP component. For me, it affected my pay greatly. As soon as I got licensed, that was another thing I was looking at–a very substantial increase in my pay–and there was nothing that I could do about that. So I went about four months before I got my pay upgraded. And I had said to my supervisor at the job that I have that if I waited to take the position until I was clinically licensed, I wouldn’t have started until September. So I applied in May and then in September, my license was granted.
I came out here in July thinking that I was just going to roll with the punches and see where it went, not thinking that it would ever have taken as long as it did for me. And when I got it, it was kind of anticlimactic because I thought about it and I was like, there’s so many other people that just try and give up and don’t pursue it. I did because I was already out here, me and my three dogs were here, we’d already made the move and invested the money. So we were here. So we just kind of had to grin and bear it for a bit.
Miller: Lou Savage, what is the current wait time? What’s your estimate in terms of applications to be processed as we just heard from Nathan, it was five months for him.
Savage: Yeah. Well, let me give you a little bit more background as well. So there are currently over 8,000 social workers in Oregon. Actually, the exact number is 8,255.
Miller: That’s 8,000 of the two licensed versions of being a social worker in Oregon? There are others.
Savage: No, no. This is all.
Miller: Every single one. OK.
Savage: Yeah. But most of them are either the CSWAs (the clinical social work associates) or the LCSWs. That’s the bulk of those folks. So it’s a large number of folks. We currently have a staff on the licensing side of three and a half people. It has not taken much to kind of get the licensing backlog underwater.
And I will tell you kind of what happened back in 2022 because I think it’s useful to know this. So back in 2022 when the legislature recognized that there was a real problem with the number of social workers available in Oregon, the number of folks in the workforce, the legislature authorized a fee waiver for licensure. The result of that was a large number of applicants and particularly a large number of applicants from out of state. So last year at this time, there were 292 out of state license applications. This year, 2023 there are 886. So that’s almost three times the number. And so that has helped to overwhelm the system.
Miller: Let me make sure I understand that correctly. You’re saying that many more people came to Oregon or decided to move here just because of the reduction or the elimination of the fee?
Savage: Well, no…
Miller: It’s such a big life decision and we’re talking about a couple of $100.
Savage: They didn’t have to move here. They could do telework.
Miller: That makes a lot more sense.
Savage: Yeah. No, no, no, they didn’t all move here. They were able to do telehealth and so this increased dramatically as a result of House Bill 4071. It was a good thing to do, but it increased the applications dramatically.
The other thing that happened internally was that we had a staff of three doing licensure. One of those folks left in August 2022 and that position didn’t get filled for five months. So the combination of the increase in out of state licensure and the decrease in staff really overwhelmed the system.
Miller: If I could just speed things up because we have a minute and a half left for the show for this week. What is the backlog right now? And what are your plans going forward to actually streamline the entire process?
Savage: Absolutely. So we have done triage, particularly for the CSWA applications because those are the folks who have come out of school and need employment right away and the health system really needs those folks in the system. We have gone from a 219 backlog in August to 111 as of today. We’ve reduced the wait time from 115 in August to 56 today. We are also working with our provider on systems upgrade so that the application process is quicker and we’ve brought in new staff. We’ve brought in additional staff, which is helping to reduce that backlog. And we’re really confident that by the end of the year, we will be significantly caught up with that backlog.
It’s just taken a while, but I think the combination of increased resources, doing some triage and working on our system upgrades is really going to improve the process.
Miller: Lou Savage and Nathan Smith, thanks very much for joining us today. I really appreciate it.
Savage: You bet.
Smith: Thank you.
Miller: Nathan Smith is a licensed clinical social worker who now lives in Oregon. Lou Savage is interim director of the Oregon Board of Licensed Social Workers.
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