To read the testimony click here.

On November 5, 2009, NASW submitted testimony in collaboration with the National Child Abuse Coalition, Washington, D.C., to the Subcommittee on Healthy Families and Communities, Committee on Education and Labor, U.S. House of Representatives, regarding the reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA). Congress has not yet introduced any legislation in the House or the Senate to reauthorize CAPTA. It is speculated that a bill may not emerge until next session as health care continues to dominate the legislative agenda.

The National Child Abuse Coalition, representing a collaboration of national organizations committed to strengthening the federal response to the protection of children and the prevention of child abuse and neglect, called on Congress to reauthorize the Child Abuse Prevention and Treatment Act (CAPTA) programs to provide the core federal policy and support for:

• strengthening the child protective services (CPS) infrastructure;
• promoting community-based services to prevent child maltreatment; and
• initiating research and development of innovative programs to advance the field of prevention and treatment of child abuse and neglect.

Testimony highlighted key findings from NASW’s Workforce report, Assuring the Sufficiency of a Frontline Workforce: A National Study of Licensed Social Workers. The study warns of an impending shortage of social workers that threatens future services for all Americans, especially the most vulnerable among us, children and older adults.

House Passes Health Care Reform Legislation

In an historic vote, the House passed major health care reform legislation on November 7, with a vote of 220-215. NASW strongly supports the health care reform bill (H.R. 3962), which included a Medicare provision allowing clinical social workers to bill independently for serving certain nursing home residents. A copy of NASW’s endorsement letter highlighting provisions of great concern to social workers is linked here.

Abortion Emerges as Major Controversy in Reform

During negotiations leading up to passage, a new unsettled question arose over whether consumers who buy insurance without any government subsidy will be able to obtain insurance that covers abortion services through the federal insurance exchange established in the bill.

Abortion rights advocates and opponents agree the House language spearheaded by Bart Stupak, D-MI, would restrict access to abortion procedures for consumers who receive subsidies to buy insurance in a reconfigured health care system. Anti-abortion groups say the amendment explicitly bars private insurers from including abortion coverage in plans they sell in the exchange to consumers who pay the premiums out of pocket, but pro-choice organizations are very concerned the new language goes much further and threatens the availability of private insurance coverage for these services. NASW opposes the Stupak amendment and is working with pro-choice groups to eliminate it in the Senate and final bill. The Senate will begin consideration of health reform legislation next week, and differences between the House and Senate version will ultimately be worked out in a conference committee.

NASW Acts on New Medicare Provider Enrollment Barrier

NASW plans to join with a large coalition of medical and health care practitioner groups to urge the Centers for Medicare and Medicaid Services, (CMS) to halt implementation of a new payment policy affecting clinical social workers and other health professionals that bill independently under Medicare Part B. The new administrative barrier concerns PECOs, a database that clinical social workers will soon be required to enroll in as a condition of participation in Medicare Part B. In 2003, Medicare switched to the new PECOS database for Medicare providers.  Recently Medicare claims have been denied for any provider who is not in the PECOS system, although practitioners were not told they needed to re-enroll as Medicare providers so they could be in the PECOS system.  There are nearly 800,000 Medicare providers, but only over 500,000 have enrolled in PECOS up to the present.  The remaining 300,000 providers must re-enroll and get revalidated.  This process is similar to many insurance company processes and is long and cumbersome.  Claims by these 300,000 providers are now being denied and electronic claims are being denied immediately.  Those submitting paper claims are not being paid, but without explanation.

FTC Red Flags Rule Enforcement Delayed

The FTC has announced that it is again delaying enforcement of the “Identity Theft Red Flags” Rule” until June 1, 2010. The rules would have directly affected clinical social workers in small private and group practices. One of the controversial aspects of the Rule was its applicability to health care professionals, particularly small or solo practitioners.  The Rule has been delayed previously on two separate occasions.  NASW provided information about the identity theft regulations in the June 2009 LDF Legal Issue of the Month and the article may be accessed here.

As the regulatory situation has grown more difficult, a number of health and other professionals have approached Congress seeking a legislative solution. Congress has responded with quick movement on a bill, H.R. 3763, which would exclude licensed health practitioners with fewer than 20 people in a practice from reporting under the Fair Credit Reporting Act and from the Red Flags Rule. The bill was introduced in the House and passed the floor a brief three weeks after introduction. It is now pending before the Senate where momentum could slow down in response to the FTC’s action postponing implementation of the regulation. More information is available at an FTC website here.

The Honorable Edolphus Towns
Date: 11/6/2009

Dear Colleague:

I wanted to call your attention to an article on cnn.com highlighting the top 15 “stressful jobs that pay badly.” The number 1 job listed — social work. This article highlights one  of the key problems in recruiting and retaining qualified individuals who will “step in when others step aside.”

My bill, HR 795, the Dorothy I. Height and Whitney M. Young Social Work Reinvestment Act, aims to solve this problem by establishing a commission to study the policies needed to recruit and retain qualified social workers in a time when they are needed the most. Social workers focus their practice on those who are most vulnerable in society. With the economic downturn, their caseloads are only increasing, while salaries and positions are being cut.

For more information, here is the article from cnn.com:

Social worker

Median pay: $43,200
% who say their job is stressful: 72%

Social workers step in when everyone else steps aside to help people and families in vulnerable situations. They provide patients with education and counseling, advise care givers and make referrals for other services. And with social workers in short supply and programs underfunded, few must juggle the work of many, while reaping little reward.

Just ask Heather Griffith, a social worker who works with children in intensive foster care in Boston: “You’re getting paid $12 an hour and kids are screaming at you, telling you that you are just in it for the money and you’re just like, really?”

http://money.cnn.com/galleries/2009/pf/0910/gallery.stressful_jobs/index.html

Regards,

Edolphus “Ed” Towns
Member of Congress

NASW Calls for Increased Mental Health Funding

The National Association of Social Workers has joined with the Mental Health Liaison Group (MHLG), a coalition of national organizations representing the diverse mental health advocacy community, in calling for higher federal funding levels for mental health services, supports and research.  The coalition argues that higher federal funding levels are essential to meet the extraordinary mental health needs of communities throughout the nation, which are especially strained by the extraordinary economic crisis. NASW and MHLG called on the Congress to go above the Administration’s proposed increases for the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institutes of Health (NIH), which includes funding for the National Institute of Mental Health (NIMH).

In a coalition letter signed by NASW, the group called for funding increases in overlooked federal mental health programs, including increases for the mental health block grant and consumer-centered programs, among others, whose funding levels have remained stagnant for nearly a decade.  NASW and the coalition are pursuing a comprehensive funding approach, advocating for a broad array of services and supports to address the needs of all communities with many residents who have been affected by the crisis, and because of the likelihood that every state will be forced to reduce services. For a copy of NASW’s coalition letter to Congress, see here. 

Congress Negotiates Health Reform Details

Democratic leaders continue to convene in high level meetings to work out the details of comprehensive health reform bills headed soon to the House and Senate floor. With critical decisions being worked out behind closed doors, advocacy organizations are scrambling to learn how their top priority concerns are faring in the ongoing negotiations. NASW continues to press for a variety of priorities including expanding coverage of the uninsured and ensuring that health disparities are addressed. NASW members interested in learning the details of the various bills may access two new resources to compare the various bills on a wide range of variables.  Follow this link to a new Kaiser Family Foundation’s side by side document comparing the major health care reform bills and also this one of a new Commonwealth Fund analysis of the major health care reform bills.

Social Work Medicare Equity Act Language Included in House Bill

Section 1307 of the House Bill (H.R. 3200) includes language that removes clinical social work services from the Skilled Nursing Facility (SNF) per diem rate and alternatively authorizes independent practitioners to bill for them independently. With this provision, licensed clinical social workers that participate in Medicare will be able to bill Medicare directly. This is a long-sought change by NASW and a critical parity provision for clinical social workers that will expand the availability of services to certain Medicare SNF residents. 

 Political Climate

Senate Majority Leader Harry Reid has sent a health care reform bill containing a “state opt out” to the Congressional Budget Office (CBO) for scoring, or a determination of how much the bill would cost.  The “opt out” would permit individual states to remove themselves from the federal insurance program if they wish.  Sending the bill to the CBO is a strong indication that Reid believes he can pass a “state opt out” bill through the Senate with at least 60 votes (and exactly 60 votes, in all likelihood).  Speaker Pelosi has expressed a strong preference for a bill containing some kind of public option, but has indicated that a “state opt out” would accomplish many of the same goals and does not believe it would hinder the progress of a final bill.  If Sen. Reid can secure 60 votes for this bill, the process of reconciliation with the House bill would then commence, before a final version is sent to the White House.

Best Practices and Lessons Learned: Shaping National Health Care Reform

Kyrsten Sinema, MSW, JD is a social worker, NASW member and a member of the Arizona legislature, serving as Arizona’s Assistant House Democratic Leader. She led a Lunch Time Series teleconference to discuss federal health care reform. Sinema is one of 32 state legislators nationwide — the only state lawmaker from Arizona — selected for President Obama’s White House Health Reform Task Force. She provided an overview of the various health reform proposals being considered. NASW members can read the transcript online.

Benjamin Confirmed as U.S. Surgeon GeneralOn October 29, the full senate unanimously approved Regina Benjamin, MD as U.S. Surgeon General.  The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps (PHSCC) and thus the leading spokesperson on matters of public health in the federal government.

First announced as the U.S. Surgeon General nominee on July 13, 2009, Dr. Regina Benjamin was the founder and chief executive officer of the Bayou La Batre Rural Health Clinic in La Batre, LA, the immediate past chair of the Federation of State Medical Boards of the United States and previously served as associate dean for rural health at the University of South Alabama College of Medicine. In 2002, as the president of the Medical Association of the State of Alabama, she became the first black woman to be president of a U.S. state medical society. 

NASW supported Dr. Benjamin’s confirmation.

Congress is working to pass major health care reform legislation, and the full House will consider a bill over the next several days that will meet many of the needs of the American populace. “The Affordable Health Care for America Act of 2009,” (H.R. 3692) provides more affordable quality coverage for millions, calls for shared responsibility by individuals, employers and government, and expands health insurance coverage choices, including being able to retain one’s current coverage, having additional private plan options and offering a public health insurance option designed to lower costs and keep insurance companies accountable. NASW strongly supports this compromise legislation and has called on Congress to pass comprehensive health care reform now. See NASW’s letter of support here.

The National Association of Social Workers has steadfastly been involved with hate crimes legislation for over a decade. On October 22, 2009 NASW’S tireless efforts came to fruition with the passage, by the Senate, of the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act by a 68-29 vote. The hate crimes initiative was included in the Fiscal Year 2010 Department of Defense Authorization Report passed previously by the House of Representatives. The historic enactment of hate crimes legislation represents a vital victory for social justice advocates and all Americans who affirm that inequality and intolerance corrupt Democratic principles and ideals.

Consistently, many Americans are victims of violent crimes due to their race, religion, sexual orientation, gender, gender identity and disability. The Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act will realign significant federal resources to aide local law enforcement efforts in the fight against hate crimes, racism and intolerance against those who exercise their right to alternative lifestyles. Further, the bill acknowledges that gender identity must be protected under federal law. The Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act is our nation’s sincerest attempt statutorily at protecting the civil rights of the lesbian, gay, bisexual and transgender communities. NASW strongly believes that the enactment of this legislation affirms America’s commitment and moral imperative that all of its citizens are one. Today, Social Workers should be proud that lawmakers have reaffirmed the intrinsic values of our profession and its unwavering pursuit of equality for all.

In an effort to keep you informed of the work NASW is doing on health care reform, we will periodically send out a roundup of activities. For ongoing information, please visit our health care reform page.

Congress Advances Health Care Reform

Congress made major progress last week on health reform legislation. House leaders continued to negotiate merging three somewhat different committee versions of their bill into H.R. 3200. The final House language for H.R. 3200 could be released this week and Democratic leaders plan to begin floor votes within three days of release.  The design of a public insurance option remains a sticking point in the bill, along with payment rates for providers that participate in the public plan. NASW has supported this House effort, including the public option.

In the Senate, the Finance Committee has largely completed their version of reform legislation and received a favorable cost estimate from the Congressional Budget Office, which has boosted its political prospects. NASW has important reservations with the Senate Finance Committee bill, including the number of people excluded from coverage after full implementation, the omission of direct billing privileges for clinical social workers serving nursing home residents covered by Medicare, the failure to boost payment rates for psychotherapy services under Medicare, and the omission of a strong public option. NASW will await receipt of final Senate language before taking a position on floor consideration, which could begin next week. Senate floor consideration will continue for perhaps several weeks, and a number of amendments and key votes are expected during the debate. For more details on NASW activities, visit our webpage here.

African-American and Latino Organizations Join Forces to Push for Health Care Reform

On October 5, the country’s largest African-American and Latino organizations announced they are joining forces with other major national civil rights and grassroots organizations to mobilize the nation’s 100 million people of color for a final push in support of universal health care reform.  NASW attended this press conference, works with these groups, and is a member of the Leadership Council on Civil Rights. The organizations included the NAACP National Voter Fund, the National Council of La Raza, the Leadership Council on Civil Rights, the Campaign for Community Change, and the United States Student Association and PowerPAC.org.

The groups released television and print ads in English and Spanish that will run in four states with sizable African-American and Latino populations, part of a grassroots effort to ensure that members of Congress appreciate the importance of reform to the people of color they represent.  Those four states are Florida, North Carolina, Louisiana and Arkansas.

The ads can be viewed at www.healthequityforall.org.

Administration Announces Parity Regulation Delay

The new federal mental health and addiction services parity law, P.L. 110-343, passed in October 2008, requires that regulations be issued by Oct. 3, 2009; however, HHS Secretary Sebelius announced on October 2 the new rules will arrive late. Said Sebelius in her letter to Capitol Hill offices, “We (Dept. of Labor/DHHS) are committed to ensuring access to these critical services, and it is our goal to issue regulations by January 2010 that will address the key issues…”  According to Sebelius, the Department received over 400 public comments in response to a regulatory notice published this spring. NASW submitted comments at that time.

The effective date of the new law is for health plans with renewal dates beginning on or after January 1, 2010. Employer groups of fewer than 50 employees are exempt from the new requirements, but all other private insurance plans, including those covered by ERISA, are subject to the new federal requirements. According to the law, health insurance plans that offer any level of mental health or substance abuse treatment benefits must offer them at parity level with other health care benefits available under the plan. With the delay in the new regulations, health plan administrators will lack guidance on technical issues in the law, although they will still be required to follow the law or risk administrative and legal action by employees or state regulators for non-compliance. For more information about the law, see NASW’s Legal Issue of the Month for January 2009

• $40 billion to expand the Pell grant program that aids low income students
• $10 billion to help community colleges increase enrollment and enable students to obtain a higher education
• $8 billion to help states improve early learning programs for children from birth to age 5
• $2 billion for historically black colleges and universities and other minority serving institutions

Betsy Clark, PhD, ACSW, MPH
Executive Director

Yesterday I had the nice opportunity to meet informally with Congressman Ed Towns (D-NY) and three of his staff members. Congressman Towns is the lead sponsor of the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act. He is also a staunch advocate for our profession, as he began his career as a social worker. I was joined by fellow social workers Jeane Anastas, the Chair of the Action Network for Social Work Education and Research and  Freddie Avant, President of the Baccalaureate Program Directors of Schools of Social Work. The first thing Rep. Towns said was that he felt social workers were more needed now than ever.  We couldn’t agree more. That led us to further discussion of why our Social Work Reinvestment bill (H. R. 795/ S. 686) is so essential to ensuring a sufficient workforce to care for the ever increasing need for our services. It is wonderful having a social worker in Congress who understands and fully supports our profession.

Find out more about the Social Work Reinvestment Initiative including the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act! Take action today by contacting your Representative and Senators in support of the legislation!

NASW participated in two White House conference calls this week on health care reform.

• Conference call with Health and Human Services (HHS) Secretary Kathleen Sibelius and Mary Wakefield, Administrator of the Health Resources and Services Administration (HRSA) regarding new funding for health care professions training.  See http://www.hhs.gov/news/press/2009pres/07/20090728c.html for the press release. For information about the National Health Services Corps Loan Repayment Program for clinical social workers, visit our loan forgiveness page.
• Conference call with Tina Tchen, White House Office of Public Engagement and with Christina Romer, Chair, Council of Economic Advisors (CEA) regarding small business and health care reform.  Romer was online yesterday holding a live chat to answer questions on small business and health insurance reform. If you are a member of the social network LinkedIn, go take part in the discussion she has initiated there. Click here for a video by President Obama on this topic.  He discusses a key factor that has been considered in the development of the health insurance reform proposals that are being considered: the impact of reform on small business.