SUMMARY OF FINDINGS

Assembly Human Services Committee Hearing

"Planning the Future of Social Work in California:
Dealing with the Crisis of Social Worker Shortage"

February 9, 2001
Alameda County Supervisor Chambers

I. BACKGROUND

On February 9, 2001, the Assembly Human Services Committee held the first in a small series of hearings designed to address the current and future staffing issues facing California's human service systems. The first hearing, " Planning the Future of Social Work in California: Dealing with the Crisis of Social Worker Shortage" helped to establish the size of the problem - that is, how severe is the shortage of social workers in California? This hearing was a rare opportunity to bring social work professionals and program administrators from a number of different sectors together to discuss their common problems filling social work positions.

Since the Assembly Human Services Committee is charged with the responsibility of overseeing public agencies who hire social workers to serve their clients, a staffing crisis in those agencies is certainly an issue in which the Committee is interested. Insufficient numbers of social workers, which may lead to hiring inadequately trained staff, certainly makes significant impacts on our state agencies' abilities to provide the high-quality services we expect of them. Future hearings over the coming months will also explore solutions for addressing the shortage of social workers in California; the education levels, language, and cultural competencies required to serve our population; and the adequacy of social work curricula to prepare social work students to serve our population.

II. SUMMARY OF FINDINGS

The following points were raised by witnesses before the Committee:

Social Work in the Context of the State of California

California has a very ethnically and linguistically diverse population (e.g., one in four Californians is an immigrant, one-third of all U.S. immigrants are in California, 80 languages are spoken by the students in Los Angeles unified school district alone). Social workers must reflect this diversity and be equipped to deal with complex problems. This leads to a particular need for social workers of color and those with bilingual skills.

Current Educational Preparation of Social Workers

The Commission on Accreditation meets every 10 years to reevaluate the academic social work curriculum. Social work students choose fields of specialization (e.g., gerontology, mental health, children and families) during their academic training. The standard curriculum includes research, field practicum experience, and coursework in practice methods and theory. Social work students gain a good understanding of human behavior and development in social work programs.

Obstacles to Recruiting & Retaining Social Workers

Stressful and non-supportive working conditions, poor supervision, and low salaries are significant challenges to retaining current social workers. Veteran social workers, after serving clients for ten or more years, receive no special recognition. There is also a negative public image of the social work profession, particularly of working in government social services agencies. The lack of "continuity of care" creates a negative, frustrating work environment for social workers. The lack of salary differential for licensed social workers is discouraging for those who spend extra time and effort to earn licenses. Selective recruitment and retention efforts only rob social workers from one sector for another. Social workers are increasingly burdened by clerical duties.

Strategies for Expanding the Number of Social Workers

The following strategies could help increase the pool, or improve retention, of social workers in California:

• Organize internships that include hiring incentives.

• Increase salaries and performance bonuses.

• Provide tuition reimbursement and loan forgiveness for social work students.

• Increase the flexibility of social worker schedules.

• Decrease social worker caseload sizes.

• Improve physical working conditions.

• Make free or reduced cost continuing education and training available.

• Provide mentors to incoming social workers.

• Better utilize the Title IV-E stipend program, which is currently an entitlement with no federal cap on the number of students who may participate.

• Expand training opportunities to those who are interested in the field, but have not yet attained their Bachelors or Masters in Social Work (BSW or MSW) (e.g., associates degree in social rehabilitation, human services certificate program).

• University administrators must expand their enrollment levels for social work programs.

California's Current Supply Of Social Workers From Accredited Programs

Statewide in 1998, there were just under 5,000 social work students in California (4,975), with about half in a MSW program and the other half in a BSW program. A total of 1,509 graduated from social work programs in 1998. Of those graduates, 65% earned MSWs and the other 35% earned BSWs. In 1998, social work schools received applications from 3,000 students. Of these these, approximately 1,500 were accepted into a program (some of the 3,000 could be duplicates since students may have applied to more than one school). Overall, enrollment in BSW programs has steadily increased. However, MSW enrollment has remained stable over the past decade. Seven schools in California offer both the BSW and MSW program. Thirteen offer the BSW only and 13 offer the MSW only.

The Size of the Problem: Shortage of Social Workers in California, By Sector

What follows are specific sectors' descriptions of social worker shortages and issues relevant to recruitment and retention efforts described in testimony at the hearing.

MENTAL HEALTH

The increased funding levels for mental health over the past two years have contributed to the need for more social workers specialized in mental health. The California Mental Health Planning Council is currently collecting data on all mental health occupations and the numbers of unfilled positions. The statewide public mental health system sees a vacancy rate of 22% for licensed clinical social workers (LCSWs) and MSWs combined. Among LCSWs alone, there is a vacancy rate of 25%. It would take three years time, hiring all social work graduates in California, for mental health to fill their vacancies.

Riverside County Mental Health currently has a 20% vacancy rate. Today, it takes at least 8 weeks to recruit and fill each vacant position. New mental health programs have, in fact, increased pressure to increase hiring efforts. The director, John Ryan, recently saw an advertisement for a social work position that included public safety officer retirement and a $400 hiring bonus. Mr. Ryan has seen other hiring bonuses as high as $1,000 to $2,000 for social work positions. Placing advertisements for their social work vacancies in the Los Angeles Times has been costly and not productive. Having too few workers leads to difficulties relieving incumbent staff when they must participate in training. Riverside is currently working with local universities to grow their enrollment of LCSWs. They recently started "grow our own" initiatives where bachelor's degree applicants are hired as case managers. The case managers are later hired as full-time, permanent staff if they enroll in a local social work program. Participants then complete 20 hours per week in school and 20 hours per week at work.

California's licensing requirements for LCSWs are a barrier for social workers who try to attain licenses after moving to California from another state. California should explore other state's licensing requirements, whose loosened standards do not lead to more malpractice lawsuits.

DEVELOPMENTAL DISABILITIES

Regional centers, the community system of care for the developmentally disabled, currently serves 170,000 clients. Regional centers see a 5% annual growth in the size of the population they serve. The centers need 2005 service coordinator social workers immediately. There is a lack of parity between the MSW salaries in regional centers and those with government entities who serve the disabled. However, regional center requests for parity have been ignored. Additionally, regional center employees do not benefit from the cost of living adjustment given to state employees.

Regional centers have a more difficult keeping social workers than they do initially hiring them. Hardly anyone stays with the regional centers for more than three years. Many social workers use the centers as a "training ground," turning to more lucrative public positions once they receive a few years experience at a regional center. Very few applicants possess MSW degrees. Most applicants are quite young with minimum experience and use the job as a stepping-stone to a better-paid position. For example, Marin, San Francisco, and San Mateo regional centers experienced a 19% turnover in social workers last year. At Golden Gate Regional Center, there are 10.5 vacancies this month and Regional Center of the East Bay has 23 vacancies. These vacancy rates mean that 651 severely disabled clients at Golden Gate will go without services and 1400 to 1500 clients at East Bay will go without services.

Social workers in developmental and regional centers currently carry high caseloads, between 50 to 100 clients. State developmental centers currently have a 25% vacancy rate. Agnews Center actually lost its license to operate for a period due to inadequate staffing. Some state developmental centers have begun to hire retirees to fill positions. In Metropolitan State Hospital, there is a 50% turnover rate. Four years ago, 90% of the hospital's employees were licensed social workers and today, only half are.

Social worker turnover leads to cases getting randomly assigned to staff who may not possess specialization in the client's population (e.g., age group, severity of needs). This turnover is a real hardship because families of the regional center clients really rely on the relationships they develop with social workers. Today's disabled clients have more serious problems than those of four years ago. Patton State Hospital's clients have continued to become more dangerous. Additionally, schools of social work curricula lack sufficient preparation in developmental disabilities.

CHILD WELFARE

This month in the ten largest county child welfare agencies, there are 7,500 social workers, 790 vacancies (10.5% vacancy rate), and county general fund dollars are used in "over match" to pay for additional social work positions. It is estimated that 3,400 new social workers are needed among the largest 10 counties, 50% more than the number they currently have. Among the 15 smallest county child welfare agencies, turnover is as high as 50%. Small counties have particular staffing difficulties due to their lower wages and distance from continuing education. Additionally, the need for social workers in the Adult Protective Services system has drained workers out of child welfare services.

The child welfare workforce is largely an inexperienced one. Two years ago, 40% of agency staff were MSW-level social workers. During the past year, that number has decreased to 25%. And today's child welfare social worker has a different job than historically. Just during the past two years, the numbers of child abuse or neglect allegations, the number of juvenile court contests, and the numbers of appeals have increased significantly. More social workers are needed at the "front end" to prevent children and families from entering the child welfare system.

The duties of a child welfare social worker can be broken down into the following types: assessment, evaluation and diagnosis, planning and linking, monitoring, administration and clerical, advocacy, and treatment. The question was posed, "which could be performed by someone other than an MSW social worker (e.g., public health nurses)?"

AGING AND LONG-TERM CARE

Social workers are described as "the glue" that integrates the fragmented care and services for the elderly. There is a growing number of elders, particularly those who are 85 years of age or older. Aging and long-term care facilities have vacancy rates of 20 to 30%. For example, one agency with nine social worker positions has three that continue to go unfilled. There has been success in using "community health workers" who do not have social work degrees. However, these paraprofessionals need educational paths that allow them to attain social work degrees while working.

In a survey of 53 licensed adult care agencies: 75% reported that it is hard to recruit MSWs; 36% said it is hard to recruit BSWs and LCSWs; and 62% said it impacts the quality of their services and their abilities to meet regulatory requirements. The biggest barriers to recruiting more social workers in this sector is the lack of candidates who are willing to work for the sector's low wages and the lack of ethnically diverse candidates.

Senate Bill 2199, passed in 1999, requires Adult Protective Services (APS) to operate 24 hours per day. This has resulted in an increased need for social workers and is difficult to fulfill.
In Los Angeles County APS, cases have increased significantly over the past few years. APS workers carry 50 to 100 cases each. While APS used to solely perform crisis intervention, its role has expanded to "care management," which increases their staffing needs. Each enhancement to services results in an increased need for social workers. Los Angeles County APS has recently brought an MSW tuition reimbursement proposal to their county supervisors to help recruit more social workers.

SCHOOL SOCIAL WORK

Of 7,000 schools in California, there are 400 to 500 school social workers. The shortage of school social workers is partly due to the following cycle: universities are hesitant to train more school social workers unless there are a number of open positions, but schools will not advertise positions when they think there are not enough school social work graduates. Only some MSW programs offer the Pupil Personnel Services Credential, a requirement of school social work positions. MSW students specializing in children and families should receive training on linking their services with their clients' schools.