Take Action - Ask Your Senators to Vote for S. 3335 on the Floor

The U.S. Senate may consider legislation to improve insurance coverage for mental health and addiction treatment as early as tomorrow, Tuesday, July 29. Please phone your Senators with the quick message below urging them to support this critical mental health and addictions treatment legislation.

Background:
The Senate leadership has added the mental health parity bill for private insurance negotiated between the House and the Senate to another bill, S. 3335, an unrelated tax extenders package. Please contact your Senators and ask them to vote yes on S. 3335 when it comes to the floor of the Senate.

Action Requested:
NASW members should telephone both of their Senators to urge they pass S. 3335, including the Mental Health Parity Act of 2008 (S. 558). Click on take action above. You will be directed to a page where you can enter your zip code into a box  to be directed to the phone numbers for your Senators. We are targeting all members of the Senate with the following message:
“I am a constituent, professional social worker and member of the National Association of Social Workers. The Mental Health Parity Act of 2008 (S. 558) will provide critical health care protection for 113 million Americans. Please vote for S. 3335, the tax extenders package, which includes this vital mental health legislation.  The Senate must pass lifesaving mental health and addiction parity legislation included in the bill before the August recess.”

Thank you for supporting this critical piece of NASW’s legislative agenda.

Colleagues,

NASW is pleased to forward this notice regarding an historic milestone for the profession.  The US House Healthy Families and Communities Sub-committee of the Health and Labor Committee will hold a hearing on Tuesday, July 29, 3:00pm EDST, Room 2175 Rayburn House Office Building.  The hearing is entitled, “Caring for the Vulnerable:  The State of Social Work in America.” 

We understand the hearing room can accommodate a large audience, so you are welcome to attend.  The hearing will also be archived on the web at:  http://edlabor.house.gov/committee/hearingsbycommittee.shtml.  You may find the committee website of interest at http://edlabor.house.gov/

We hope you can join us.

Take Action!

A crucial Senate floor vote on Medicare legislation is expected on Sunday, June 29. Email your Senators now, urging them to support “cloture” on HR. 6331. Send the message below to support passage of this important bill for clinical social workers. Simply enter your zip code and send this preformed letter.

Message: I am writing as a constituent, professional social worker, and member of the National Association of Social Workers. I urge you to support passage of the Medicare Bill (HR. 6331) on the floor. This bill includes vital improvements to ensure Medicare beneficiaries have access to high-quality mental health care.

The bill is especially important for the Medicare beneficiaries I serve, as it restores funding for clinical social work payments cut in 2007. This cut has placed the Medicare mental health benefit at risk and addressing it must be a top priority in any Medicare legislation this year. I also am pleased the bill finally treats mental health coverage equally with other medical benefits, providing Medicare coinsurance parity and halting the scheduled 10.6% cut for all outpatient provider payments. Please vote to pass H.R. 6331. It will make a real difference for the beneficiaries I serve.

Background: The Medicare bill, also known as the Medicare Improvements for Patients and Providers Act of 2008, (HR. 6331) includes important provisions for clinical social workers, including a rate increase for clinical social work services cut in 2007. Clinical social worker rates would increase for psychotherapy and related services by 5% ($45 million) for 18 months from July 1, 2008 through December 31, 2009, above the rate given to other medical services. Given strong pressure from the White House to narrow the bill, this is a huge victory for clinical social workers and psychologists who have worked to restore psychotherapy rates in Medicare. Very importantly, this compromise House and Senate bill contains a Medicare coinsurance parity provision, reducing beneficiaries’ copayments by 5% per year from 50% in 2009 to 20% in 2014 - at full parity with medical and surgical benefits. This is a crucial legislative goal long sought by NASW. This year’s Medicare package is designed primarily to halt the scheduled 10.6% cut in all Part B provider payment rates. This compromise bill would postpone the cut for 18 months, beginning July 1, 2008 and increase payments for all providers by 1.1% for 2009, including clinical social workers participating in Part B. In addition to the 1.1% increase in 2009, clinical social workers would receive an increase of 5% (effective July 1, 2008) above those of other providers, if this bill passes. Since the House has already approved HR. 6331, this bill will immediately be sent to the President for consideration. It is unclear whether he would sign it in its present form.

A Piece is Missing: Unfortunately, this compromise bill does not include language sought by NASW permitting clinical social workers to bill separately for services to Medicare Part A nursing home residents (Clinical Social Work Medicare Equity Act, S.1212). This provision was included in an earlier House Medicare package (HR. 3162) and NASW will continue fighting to get this bill enacted next year. For more background on legislative activity, see NASW’s website: NASW recent Medicare alerts.

Yesterday we asked you to contact your Members of Congress about H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008. Thanks to those of you who responded, we won the vote 355-59. We only needed 290 votes to win.  [Click here for more information on the Victory]

Background

The Centers for Medicare and Medicaid Services (CMS) has issued seven Medicaid regulations that will significantly cut Medicaid payments for social work and other services to vulnerable Medicaid clients. The regulations are an attempt to implement Medicaid cuts proposed in the Bush Administration’s Fiscal Year 2008 Budget.

Recently, Representatives John Dingell (D-MI) and Timothy Murphy (R-PA) introduced “Protecting the Medicaid Safety Net Act of 2008” (H.R. 5613) to delay until April 9, 2009 implementation of these seven cost-cutting Medicaid regulations. The bill has been referred to the House Energy and Commerce Committee, which may consider it as early as April 1. Similar legislation will be introduced shortly in the Senate.

The seven rules reduce Medicaid recipients’ access to rehabilitative services, targeted case management, school-based transportation and outreach services, and hospital clinic services. The regulations have drawn strong criticism from social workers across the country and a range of other stakeholders, including organizations representing people with disabilities, children and families, hospitals, educators, providers and state Medicaid directors. H.R. 5613 would impose a moratorium on all seven of the detrimental rules.

How much will the Medicaid regulations cost your state? Congressional staff have prepared an estimate of the impact of these rules for your state at: http://oversight.house.gov/features/medicaid08/ Fortunately, Congress has the authority to delay the implementation of these regulations through a legally authorized postponement known as a moratorium. A moratorium gives Congress time to review the regulations closely and propose needed revisions through legislation.

Status

House Energy and Commerce Committee Chairman John Dingell (D-MI) and Rep. Tim Murphy (R-PA) introduced the Protecting Medicaid Safety Net Act of 2008 (HR 5613) on March 13. The bill would provide a 1 year moratorium on the regulations, prohibiting CMS from taking action to implement them until April of 2009. A Senate companion bill is expected to be introduced soon.

Take Action

Please contact your Representative and him/her to pass HR 5613. NASW members may use our website to send a sample message electronically to their Representative, by visiting
http://capwiz.com/socialworkers/issues/alert/?alertid=11190396&PROCESS=Take+Action

For background information, see the comments NASW submitted with its coalition partners to CMS (Rehab option comments to CMS; School-based transportation and administration comments to CMS; and Targeted case management comments to CMS)

Thanks for your help! Your advocacy efforts worked to pass the College Opportunity and Affordability Act (H.R. 4137), also known as the Higher Education Act or “HEA”, out of the House in an overwhelming vote (354 to 58) on February 7. The bill would fully reauthorize the Higher Education Act (HEA) for the first time since 1998 and includes loan forgiveness for national need occupations, clarifies appropriate financial aid professional/lender relationships, simplifies the financial aid application process, attempts to slow rising college costs, and creates a host of reporting requirements for higher education institutions.The loan forgiveness provisions in the House bill would directly benefit social workers by allowing a person with a degree in social work or a related field, and who is employed by a public or private child welfare agency, to have part of his or her college loans forgiven. For each year of work, $2,000 would be forgiven, up to a maximum of $10,000 over five years. The loan forgiveness covers 13 areas of national need, including qualified Head Start, child care and preschool teachers; some teachers in high-need fields; and some mental health professionals. The loan provisions would apply only after the law is passed, not for previous years worked, and would be provided on a first-come, first-served basis.

For HEA to ultimately pass into law, the House and Senate must approve a negotiated version of the bill and send it to the president to be signed. While the House version includes the loan forgiveness language, the Senate version (S. 1642), passed during the summer, does not. We need your help in getting the loan forgiveness provisions into the final bill.

Important note: We want to emphasize that the College Opportunity and Affordability Act is not the same as the College Cost Reduction Act of 2007 (H.R. 2669) which provides loan forgiveness for social workers in public child or family service agencies, nonprofit, military, and other areas for eligible120 loan payments made after Oct 1, 2007.
http://www.socialworkers.org/advocacy/updates/2007/092107.asp
That legislation was signed into law by the President in September. While similar in focus, the College Opportunity and Affordability Act is broader in scope,

Action Needed: The House and Senate will negotiate their versions of HEA in the near future so please call your Senator at (202) 224-3121 or write them and urge them to retain the House’s loan forgiveness provisions in the final version of the College Opportunity and Affordability Act (H.R. 4137).Let your Senator know that you are a constituent and social worker and you appreciate their support. Thanks again for your advocacy.

Nancy McFall Jean, NASW Lobbyist, Government Relations Department

Leaders of the House Education and Labor Committee announced that they expect the House to vote on the College Opportunity and Affordability Act (H.R. 4137) on Thursday, Feb. 7. The legislation reauthorizes the Higher Education Act (HEA), which sets financial aid policy for students for the next five years. The bill provides loan forgiveness for national need occupations, clarifies appropriate financial aid professional/lender relationships, simplifies the financial aid application process, attempts to slow rising college costs, and creates a host of reporting requirements for higher education institutions. The loan forgiveness provisions would directly benefit social workers by allowing a person with a degree in social work or a related field, and who is employed by a public or private child welfare agency, to have part of his or her college loans forgiven. For each year of work, $2,000 would be forgiven, up to a maximum of $10,000 over five years.

The loan forgiveness covers 13 areas of national need, including qualified Head Start, child care and preschool teachers; some teachers in high-need fields; and some mental health professionals. The loan provisions would apply only after the law is passed, not for previous years worked, and would be provided on a first-come, first-served basis. If approved by the House, negotiators from the House and Senate would then reconcile the differences between the two chambers’ versions of the bill. The House and Senate must then approve the negotiated version of the bill and send it to the president to be signed into law. Currently the House version includes the loan forgiveness language while the Senate version (S. 1642) does not.

Important note: We want to emphasize that the College Opportunity and Affordability Act is not the same as the College Cost Reduction Act of 2007 (H.R. 2669) which provides loan forgiveness for social workers in public child or family service agencies, nonprofit, military, and other areas for eligible 120 loan payments made after Oct 1, 2007 http://www.socialworkers.org/advocacy/updates/2007/092107.asp The legislation was signed into law by the President in September. While similar in focus, H.R. 4137 is broader in scope and we need your help in getting this important legislation passed.

Action Needed

H.R. 4137 is slated for a House floor vote tomorrow. Two important actions by you can make the difference in moving things forward. First, please call your House Representative at (202) 224-3121 and urge them to support H.R. 4137 with the loan forgiveness provisions. Second, contact your Senator at the same number and encourage them to include the House loan forgiveness provision in S.1642, the Senate’s current version of HEA. In both cases let your member know that you are a constituent and social worker requesting their support for passage of these important bills with the loan forgiveness provisions for social workers. Thanks for your advocacy.

Nancy McFall Jean, NASW Lobbyist, Government Relations Department

ACTION NEEDED

The Senate Finance Committee is scheduled to begin consideration of Medicare legislation on Wednesday, December 5th.  It is very important that Finance Committee members hear now from social workers supporting three changes in Medicare law:

• Remove clinical social work (CSW) services from the Medicare skilled nursing facilities (SNF) consolidated payment system, permitting CSWs to bill Medicare separately, the same as psychiatrists and psychologists, for services to Medicare Part A beneficiaries provided in SNFs.
• Increase Medicare Part B payments to CSWs and psychologists by 5% starting on January 1, 2008. This increase will partially restore a Medicare cut for these clinical services that occurred on the first of this year.
• Correct Medicare’s current discriminatory co-payment on outpatient mental health services from 50/50 beneficiary cost sharing to the standard 80/20 coverage for other Part B services. This “Medicare parity” provision should go into effect on January 1, 2008.

Please email your two Senators immediately and ask them to support clinical social work services in Medicare. Our suggested message is located on NASW’s website at: Medicare Support Letter.

THE ISSUE AT HAND

The Senate Finance Committee will soon consider crucial legislation for clinical social workers within broader Medicare legislation correcting physician and other outpatient (Part B) payment problems.  NASW hopes to score a major early victory for its Social Work Reinvestment Initiative (SWRI) by attaching provisions that will increase Medicare payment rates for all clinical social workers billing Part B independently as well as restore clinical social workers’ ability to bill independently for services provided to Medicare nursing home residents. One key SWRI component, known as the Clinical Social Work Medicare Equity Act (S.1212) has long been sought by NASW. Recently, NASW has sought relief for CSW payments under Part B, which were cut by 9% late last year by federal administrative action. NASW advocates that the Senate legislation increase CSW payments by 5% above their current level beginning on January 1, 2008. This special payment increase would apply only to psychotherapy and behavioral services that were cut on January 1, 2007 by 9 percent. In addition to the 5 percent increase in 2008, CSWs would receive the same percent payment change that Congress will authorize for all physician services in the program, currently a .5% positive payment update under the House version, HR 3162.

PROSPECTS

The House version of Medicare legislation, which contains the physician fee updates, already contains the three clinical social work service improvements described above. These benefit improvements are expected to be offset by cuts in managed care payments for Medicare. Early indications are that we are within reaching our legislative goals in the Senate since the House bill has already adopted them. It is vital that all Senators here the message to support clinical social work services now.

THANKS FOR YOUR ADVOCACY!

For further information, contact Jim Finley at NASW: jfinley@naswdc.org.

BackgroundCongress is currently considering legislation to extend Medicaid coverage for youth who age out of foster care. The  Medicaid Foster Care Coverage Act of 2007 (H.R. 1376) will address ways to provide Medicaid coverage for youth who exit the foster care system without a permanent family unit. There are currently 25,000 youth aging out of the foster care system every year who have a variety of unaddressed medical conditions and other challenges because of inadequate health insurance. These include mental and physical disabilities that may result in a lack of educational achievement and financial instability; some youth become homeless.

Beyond funding the direct provision of basic physical health care services, Medicaid currently allows states to provide critical rehabilitative, therapeutic, psychiatric, and targeted case management (TCM) services to children in foster care. Such programs and funding are essential to ensure children in foster care receive the necessary physical and mental health supports while in protective custody.

The Medicaid Foster Care Coverage Act of 2007, introduced by Representative Dennis Cardoza (D-CA) on March 7, 2007, will assist foster care youth in accessing much needed health care.  It is in the House Committee on Energy and Commerce and has been referred to the House Subcommittee on Health with 15 cosponsors.  Congress has an opportunity to make significant progress in improving the lives and outcomes for youth in foster care.

Action Needed

Please contact your Representative and urge them to support The  Medicaid Foster Care Coverage Act of 2007 (H.R. 1376) and let them know that you are a constituent and a social worker who is committed to this issue. Let them know that this legislation is necessary to provide youth in foster care with appropriate access to medical care.

Contact Nancy McFall Jean, Lobbyist, Government Relations Department at 202-408-8600 x 440 for more information.

Background

On October 18th 2007, the House Committee on Education and Labor, by a vote of 27-21 passed the Employment Non Discrimination Act (H.R.3685). This historic legislation providing workplace protections on the basis of sexual orientation has left committee and will likely face a floor vote this week. HR.3685 is identical to the long supported H.R.2015, with the notable exception of protections based on gender identity. Representative Tammy Baldwin (D-WI) has proposed an Amendment, with the full support of the House Democratic leadership that would restore ENDA to its original language and intent. Without this Amendment, H.R.3685 would deny protections to transgender people, as well as fail to protect lesbian, gay and bisexual people who do not conform to society’s gender expectations. Baldwin’s effort would be our best opportunity to override the prior bias and ensure that these protections are a critical element within the comprehensive ENDA legislation. Unlike the Senate, where any Senator can offer an amendment at almost any time to any bill, the House is tightly controlled. Leadership has to approve what amendments will be offered-and they have to be cleared by the House Rules Committee. In particular, including language which protects victims of discrimination based on gender identity is arduous and for some Members of Congress, politically divisive. Language of this magnitude will affirm the relevance of abating employment discrimination for all. Therefore, the reinstatement of gender identity protections back into ENDA will insulate a vulnerable population from further discriminatory practices, in addition to entrenched inequities.

The Baldwin Amendment would ensure that ENDA is wholly inclusive of the entire LGBT community. Further, it would help to erode discrimination against LGBT citizens and promote a national identity that is dedicated to fundamental fairness and equity for all. For years, social workers, activists and advocates for civil rights and gay equality have fought to eradicate discrimination on behalf of marginalized communities. NASW will not waver from its conviction that intolerance and personal prejudice predicated upon one’s sexual orientation is unconscionable. We will steadfastly proceed with our efforts to protect the rights of all Americans and seek passage of an ENDA bill that is inclusive and reflective of America’s diversity. The Association believes that this represents Democracy at its best-advocating for full equality and nondiscriminatory practices.

Action Needed

Representative Baldwin’s Amendment will likely be considered on the House floor the week of October 22, 2007. Please call your Representatives at 202-224-3121 and urge them to support the BaldwinAmendment, and vote yes on gender identity protections in ENDA. Let your Representatives know that you are a constituent and a social worker requesting their support for the alleviation of intolerance and the protection of civil liberties.

Contact: Lawrence Moore, III at (202) 336-8289