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Can Social Workers Fill a Care Gap in Innovative Community Health Programs?

Analysis  |  By Eric Wicklund  
   December 04, 2023

New Jersey lawmakers are considering a bill that would expand Medicaid reimbursement to include licensed independent social workers, addressing a care gap that many states are struggling to fill.

New Jersey lawmakers are considering expanding the state’s Medicaid program to enable licensed social workers to be reimbursed for behavioral healthcare services.

The proposed bill, S2716, is one of many innovative ideas being considered across the country as healthcare organizations grapple with a surge in behavioral healthcare needs, especially among underserved populations. If passed, it would help systems reduce the traffic in their Emergency Departments and enable executives to include social care workers in group-based care management programs.

“Granting these highly trained professionals and counselors the ability to bill Medicaid directly will greatly improve our mental health treatment capacity and provide long-needed flexibility,” New Jersey State Senator Joe Vitale, who introduced the bill in May 2022, recently told NJ Spotlight News. “This bill could provide a real breakthrough in access to treatment, making sure all patients receive the care they need when they need it.”

The Garden State is one of many that restricts Medicaid reimbursement for social workers to those who are employed by a health system, leaving out independent social workers, as well as those working with programs that focus on underserved communities but aren’t affiliated with a health system. Without that funding, these programs are hampered in treating people who need help but can’t access or afford that care.

Allowing Medicare reimbursement would give health systems more leeway to design new programs and services for their most vulnerable populations, enabling partnerships with community health programs and designing innovative telehealth, remote patient monitoring, acute care at home, and other remote care programs that include social workers.

“This policy can and must change,” Kate Shamszad, policy director for the New Jersey Health Care Quality Institute, said in a recent op-ed piece posted in NJ Spotlight News. “There are simply not enough mental health clinicians to meet the current burgeoning need. We need to expand, not limit, the number of clinicians who can treat people insured by Medicaid.” 

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.


Many states are struggling with a surge in behavioral health needs in underserved populations and a shortage of care providers.

Licensed social workers are often not allowed to collect Medicaid reimbursement unless they are part of a health system, leaving out independent social workers and those working with small community health programs.

New Jersey legislators are considering a bill that would expand Medicare reimbursement to include those social workers, enabling health systems to forge partnerships with innovative programs and include more social workers in telehealth, RPM, acute care at home, and other programs.

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