Dear Honorable Members of the House Committee on Human Services:
On behalf of the people living with cystic fibrosis in North Dakota, we write to express our support for HB 1035, which would add North Dakota as a member of the Social Work Licensure Compact (SW Compact). Through the SW Compact, North Dakota will be able to extend the reach of its social workers and improve access to telehealth services for patients with CF who get care across state lines.
About Cystic Fibrosis, the Cystic Fibrosis Foundation, and the CF Care Model
Cystic fibrosis is a progressive, genetic disease that affects the lungs, pancreas, and other organs. There are close to 40,000 children and adults living with cystic fibrosis in the United States, including approximately 80 people in North Dakota, and CF can affect people of every racial and ethnic group. CF causes the body to produce thick, sticky mucus that clogs the lungs and digestive system, which can lead to life-threatening infections. While great strides have been made in the treatment of the disease, the lives of young people with cystic fibrosis are still cut far too short; half of all CF deaths occur before the age of 37.
The Cystic Fibrosis Foundation accredits the more than 130 care centers in the United States — including one in North Dakota — and supports the development of systematically reviewed, data-driven CF clinical practice guidelines. Because cystic fibrosis requires highly specialized care and treatment, most people with CF receive care at one of these accredited CF care centers — which provide multidisciplinary care in accordance with the clinical practice guidelines.
Social workers play a crucial role in the CF care model and are one of six core team members at accredited care centers. In CF care, social workers support people with CF and their family members in coping with their disease and navigating life challenges, including identifying and enrolling in health insurance, and assessing supports for social risk factors that can impact health outcomes such as housing and food insecurity, employment accommodations, and school accommodations. CF social workers also provide mental health services, including anxiety and depression screening, crisis counseling, and therapy. These services are particularly important in CF, as depression and anxiety are two to four times more prevalent in people with CF than the general population.
SW Compact Supports Access to Telehealth for People Living with CF
The SW Compact provides a permanent solution to help facilitate care between in-person appointments for people with CF who rely on out-of-state care centers. People living with cystic fibrosis may seek care across state lines for a variety of reasons, including geographic proximity or access to specialists with expertise in their particular comorbidities or disease state. For example, those who culture certain bacteria or are post-transplant may need to travel out-of-state to get appropriate care. In these cases, extending the reach of social workers through licensure is an important tool to make remote care more accessible. On average, people with CF receive 20% of their care through telehealth.
The SW Compact will improve access to telemedicine services for CF patients who get care across state lines by streamlining administrative requirements for obtaining additional social worker licenses. The compact would allow social workers licensed in a participating state to apply for a multistate license that allows them to practice in all other compact member states. Social workers would no longer need to fill out separate paperwork or provide additional fingerprints in each state they wish to practice in, easing administrative burdens to help social workers reach more patients, while also maintaining state licensing boards’ authority to regulate the practice of social work and take disciplinary action as needed in their state. Such flexibilities are particularly important given the shortage of mental health professionals in the US and will help people with CF more easily access care from their regular care team.
We urge you to support HB 1035. Joining the SW Compact will remove administrative barriers for CF social workers licensed in North Dakota and support the delivery of remote care to CF patients living across state lines. The Cystic Fibrosis Foundation appreciates your attention to this important issue for the CF community.