Understanding How Healthcare and Social Work Can Vary from State to State

Social work and healthcare are both in high demand. If you’ve watched the news at all over the last few years, you’ve likely heard reports about hospitals experiencing major personal shortages. The issue has become so pronounced that an ER nurse in Washington had to call 911 to get additional paramedic support in their emergency room.

The cause? Not a bus crash or a collapsed building. They just didn’t have the staff to cover a normal Saturday night shift.

While the demand for social workers is quieter, it’s also very prominent. The need for social workers is expected to increase by around thirty percent over the next ten years, creating around 64,000 vacancies by 2034.

Both career paths are rewarding ways to protect and serve your community. However, they are also both heavily influenced by local law and population demographics. In this article, we take a look at some of the ways healthcare and social work can vary from state to state.

Licensing Requirements

There are core requirements for both health and social work that remain basically the same no matter where you are. If you want to become a nurse, you will need to go through nursing school and pass the NCLEX.

If you want to become a licensed social worker, you will need to get your MSW and go through all of the required clinical work.

While these requirements won’t change, you may need to jump through additional hoops depending on where you live. For example, California requires internationally educated nurses to go through an equivalency exam to make sure their training matches the requirements of the state.

Many states may also have minor but tedious hoops you will need to jump through if you received your certifications from a different state.

Insurance and Medicaid Requirements

Variations in insurance coverage could be its own article. Here’s a (relatively) simple example. The Affordable Care Act expanded Medicaid eligibility, allowing more adults to file for coverage. However, a 2012 Supreme Court ruling made this aspect of the ACA optional. States could expand coverage, but they were no longer required to do so.

This qualification means that the depth and scope of care can vary significantly from state to state. Variations of this kind can have a very direct impact both on social and healthcare workers. Doctors and nurses might pursue different treatment strategies for insured patients than they would with the uninsured.

Social workers, on the other hand, serve as community advocates. The people that they work with typically consist of society’s most vulnerable individuals. Communities that have less healthcare coverage are significantly more vulnerable than those who can access comprehensive care.

Demographic Needs

While healthcare and social work deal with objective metrics there are also softer more subjective considerations that can play a significant role in the outcomes of the people receiving care. Some of these are cultural. For example, people belonging to certain religions may have spiritual restrictions in how they accept care.

Perhaps even more commonly, however, you will deal with people who have their own culturally influenced way of speaking about and interpreting the world. Diversity is everywhere but by that same token, a nurse who grew up in rural Nebraska might be out of their element in urban New York.

That certainly does not mean that nurses and social workers need to stick to treating people who share their backgrounds. It does mean they should remain willing to constantly expand their horizons.

It’s also important to keep in mind that there are regionally specific concerns that go beyond simple demographics. For example, a nurse working in rural America might have a lower volume of patients than a nurse working in a city, but they will also typically have fewer resources at their disposal.

Understanding these differences can help future nurses and social workers refine their approach to care and better advocate for the people they are serving.

Politics

Local politics can also have a major influence on how health or social services are administered. For example, Idaho recently experienced a mass exodus of Obstetricians who were concerned that the language in a recent abortion bill would make fundamental aspects of the care they provide effectively criminal in the eyes of the state.

Florida, on the other hand, has had an influx of people moving into the state because they appreciate new rulings that allow for enhanced patient freedom. Florida’s stance on “medical freedom,” gives citizens the option to decline vaccines and other forms of care that have historically been mandated for entry into schools, businesses, and other public gathering spaces.

The point is not the rightness or wrongness of state-induced health or social work interventions. The point is that a single law can have a significant impact on what options are available to health and social workers.

It’s a good idea for health and social workers to research local laws before taking a job.

Is There a “Best Place” to Be a Social/Healthcare Worker?

It’s not very productive to look for an objective answer to such a subjective consideration. And the truth is that most people going into health or social work don’t pull out a map of the United States and start scrutinizing their options.

Most health and social workers choose their career paths because they want to serve their communities.

You definitely should look into local regulations, policies, and other variables that might impact your working experience. Maybe you live within comfortable driving distance of a state with better policies for social workers or healthcare employees.

However, it’s important to keep in mind that there’s no way to “crack the code.” Health and social work jobs are difficult. They will always be difficult. Figure out what conditions are most suitable for you, and then get ready. The road ahead will be full of rewarding challenges.