Licensing delays keep social workers, counselors out of WA workforce

For Hawaii resident Maryn Stevens, Washington state looked like a land of opportunity. When she discovered she could earn more in Washington than Hawaii as an early career mental health counselor, she began laying plans to find a job here.

Stevens, 26, was living with her parents in Honolulu and carrying about $50,000 in graduate school loans. She was ready to launch her next, more financially secure chapter. So one day in late April this year, she gathered her transcript, filled out a personal information form and took her first step: applying to Washington’s health department to begin seeing clients as a trainee.

A month and a half of silence went by before she started getting nervous.

Stevens had unknowingly joined a queue of thousands of applicants hoping to enter Washington’s workforce as mental health counselors and social workers, data obtained by The Seattle Times shows.

As of Aug. 8, nearly 3,600 potential mental health professionals — including recent graduates like Stevens, trainee “associates” ready to pursue full licensure, and professionals licensed in other states — were awaiting final approval or to hear back about applications they’d submitted to Washington’s Department of Health.

Backlogs are mounting as the state grapples with staff vacancies, a rise in applications and major technology snags. In recent months, overloaded phone lines and moves to modernize the state’s digital licensing system have scuttled many applicants’ abilities to submit required forms or get in touch with licensing staff about basic application questions.

Officials say the department’s goal is to process at least 90% of complete applications within three to six weeks. But regulators are taking an average of four months and three weeks to issue applicants’ credentials, the data shows; in 2024, DOH recorded similar wait times.

Stevens read on the health department’s website that application reviews typically take “a few days to a few weeks.”

In 2024 she’d earned a graduate degree from a program recognized by the leading mental health counseling accrediting body, which, at least in some states, should have expedited her application. Knowing this, she accepted an associate mental health counselor job that offered decent pay and she resigned from her current workplace. She gave them two months’ notice — a big buffer, she thought — before her official last day.

By the time her last day of work arrived in late June, she hadn’t heard back and was panicking.

She woke up early the next day to call the health department as soon as it opened.

“I was on hold for eight hours,” she said. “From the beginning of the day ‘til they closed.”

She kept calling until the middle of July when one day she was met with a recorded message alerting her that the department wasn’t currently accepting calls.

“I just stopped calling,” she said.

Software struggles

Washington has long faced a mental health worker shortage: The state has just one provider for every 360 residents, according to the Washington State Health Care Authority, which considered the issue so serious that in 2021 it decided to launch a still-ongoing campaign to recruit people into the state’s behavioral health workforce.

Amid the licensing holdup, more than 50% of the state’s DOH-certified behavioral health agencies report that it’s taking an “exceptionally long” time to fill vacant mental health counselor positions, according to Washington’s Health Workforce Sentinel Network, which monitors employment trends across the state’s health care professions. A quarter say open social worker positions have been vacant for a long time.

Stevens had visited Washington several times and, given the state’s demand for providers, its lower cost of living and opportunity for higher pay, was considering a move.

Because of Hawaii’s system for licensing new mental health counselors, Stevens’ only option there was to take a job as a “pre-licensed graduate” — a title that allowed her to see clients but came with extremely low pay. Before taxes, she earned about $2,000 a month, hardly enough to rent a studio apartment in Honolulu.

She still needed to complete more clinical hours and pass a national exam before she could work with Washington clients without supervision. But she was on her way: She had a job offer here at a group practice where she could see patients through a telehealth platform and get paid $65-$85 per client session, roughly double what she was making in Hawaii.

Stevens specializes in working with people who have chronic illness or experienced childhood trauma, and was eager to begin building her caseload. Without a credential, though, she feared losing out on the job offer.

She had no way of knowing a software transition was stalling applications like hers for months.

After several months-long delays and tens of millions of dollars in state investments, DOH in April rolled out the second phase of a new health care professional licensing platform intended to simplify how applicants upload required documents and check their application status. But that transition has “temporarily slowed processing times,” said Frank Ameduri, a DOH spokesperson.

Washington has budgeted more than $63 million and spent about $51 million on the upgrades so far. The agency is launching the new platform in phases; some features went live in 2024 and others are expected to go online later this year.

But the transition has been far from smooth. Problems with contractors, including “high staff turnover” and “underestimation of the complexity of the work” that led the state to switch technology vendors in 2021, stalled the project for about 10 months, according to DOH documents. Data storage and software upgrades were more expensive than expected. And this month, DOH has planned a credentialing freeze Aug. 22-26 to update the system, Ameduri said; the agency urged people whose licenses were expiring to “renew early.”

“There have been some challenges,” said Ameduri. “But the department is working through them, and the outcome will be a significantly improved experience for applicants.”

The new licensing platform “cost a lot of money, and it took a long time to implement,” said Shannon Thompson, executive director of the Washington Mental Health Counselors Association, which represents a little more than 2,600 Washington mental health professionals. “I’m hoping this is just that as an issue, not something bigger.”

Desperate for advice, Stevens wrote a post about her licensing delays on a therapist subreddit. Sympathetic replies — stories from people who’d run into gummed-up phone lines or waited months for their criminal background check to go through — poured in.

To avoid background-check related delays, Stevens got in touch with DOH’s fingerprinting department and found out she could get a fingerprinting kit on her own and overnight it. She signed up for the national exam, and passed.

She also began emailing state lawmakers.

“Urgent” she wrote in the subject line.

“I wouldn’t reach out if it wasn’t an urgent situation … I’m excited to start seeing clients in Washington and worry I will lose my job opportunity, housing, and livelihood due to the delay,” she typed.

“I’m willing to do whatever I can to get this worked out.”

“I gave up”

When Lavender Marlowe and Wyatt George moved from Colorado to Washington, the couple hoped to begin seeing Washingtonians through their respective therapy practices.

Both are licensed mental health professionals in Colorado; George is also licensed in Ohio. They both take clients with public insurance — a rarity among mental health professionals, since government insurance programs often pay significantly less than commercial insurers. And they work with marginalized groups that struggle more than most to find timely and culturally competent care, like trans and queer people, those with low incomes and people with severe mental illnesses and chronic health conditions.

Marlowe, who is 29 and uses they/them pronouns, discovered they met guidelines for a “reciprocal license,” which meant their educational background, exam scores and professional supervision hours fulfilled Washington’s requirements. But when they were ready to apply last summer, they struggled to find the relevant application form as they clicked through the state’s licensing website.

Three times they emailed customer service. Three times they received the same autoreply.

“This notification confirms receipt of your email. Our goal is to respond to all incoming messages within two business days.”

When, weeks later Marlowe received a personal response, it was from a customer service representative who directed them back to the general licensing page.

“Thanks for sending that over. I am still very unclear on the process, unfortunately,” Marlowe responded. “How and where do I apply?”

About a month later, a different representative replied with an excerpt from the DOH licensing website and another link.

“At this point, I gave up and didn’t try again until June of this year,” said Marlowe, who noted that the state’s website has since improved and they applied for licensure this summer. “I’m just kind of aghast that it’s A. impossible to reach or contact anybody, and B. that they’re processing things months and months and months behind.”

Reviewing applications is complex work, Ameduri said, and more people are applying for certain credentials than in years past. The current backlog, he said, is due in part to the fact that more people apply for associate level credentials in the summertime following spring graduation season. The agency will often receive incomplete applications, Ameduri said, which can add to wait times.

As more and more applications stream in, DOH’s credentialing department continues to be short-staffed: three of the state’s 12 staff positions charged with reviewing applications are sitting unfilled. Insufficient staffing and technical problems have in recent years slowed other mental health professionals’ path into the workforce. In 2023, for instance, a majority of clinical psychologist applicants were waiting months or years to get licensed.

In response to questions about its email system and phone tree, Ameduri said the agency has “at times sent autoreply emails directing applicants to its website” and has shut down the call center “on very rare occasions” like during an all-staff meeting or training. The last time this happened was in August 2024, he said.

If more than 20 people are in the phone queue, the system will give the next caller a recorded message and then hang up on them.

Marlowe is technically still missing at least one required document: They said the state’s credentialing department wanted a physical license verification form for their out-of-state license. But Colorado regulators won’t fill out paper forms and only provide an online verification tool. (While not commenting on Marlowe’s case, Ameduri said the state is able to use online verification tools for some applicants and relies on paper forms when it can’t verify someone’s credential online.)

Feeling stuck, Marlowe emailed DOH for direction.

“Please note that submitting multiple emails and/or phone inquiries slows down processing time,” read the agency’s autoreply. “We encourage using our online services for health care providers wishing to obtain a new license in Washington or renew their existing license.”

When George, 32, applied for a reciprocal license in Ohio it was “shockingly easy” and took two or three weeks to process, he said. George, who is currently seeing clients living in Colorado and Ohio via telehealth, is saving five to 10 spots in his caseload for Washingtonians.

But like Marlowe, he’s still waiting to hear back about his license application.

Stevens’ persistence eventually paid off.

When Rep. Clyde Shavers received Stevens’ email in June he decided to take up her cause and contacted DOH.

“As delays persist, you have these professionals that want to serve their community continue to be more and more discouraged,” said Shavers, a Democrat who represents Island County and parts of Skagit and Snohomish counties. “This is a crisis for sure in terms of trying to ensure that we maintain an increasingly robust behavioral health workforce.”

On July 21, three months to the day after submitting her application, Stevens opened her inbox to an unceremonious notice of approval. She’s sure, she said, that Shavers “played a part in me getting my license.”

“We’re all trying to do something about (the mental health crisis), but there are barriers in place that prevent us from doing that,” she said. “The more you pick at the thread, the more it just comes undone, and you end up in this big pool of yarn.”