National Health Service Corps (NHSC) New Awardees convened in Washington, DC last week for a conference of networking, orientation and education.  NASW members were among the attendees and reported enthusiastically about the conference and about their work as part of the Corps.  The Corps helps Health Professional Shortage Areas (HPSAs) in the U.S. get the medical, dental, and mental health providers they need to meet their tremendous need for health care.  Social workers with clinical licenses are eligible to participate in the Loan Repayment Program. 

A major site of employment for members of the NHSC are Federally Qualified Health Centers (FQHC).  Their  mission is to improve the health of underserved communities and vulnerable populations by providing comprehensive, culturally competent, quality primary health care services.  President Obama has proclaimed this week “National Health Center Week,” encouraging people to celebrate by visiting the centers and learning more about their providers and their services. In addition to working as NHSC employees, social workers can serve as volunteers in the clinics. 

This week, NASW especially acknowledges the work of clinical social workers in these vital and important clinics. If you are not familiar with the FQHCs, visit a center in your community this week.  Learn more about the ways social workers are contributing to the health of the nation.

The Affordable Care Act contains many provisions that strengthen the Medicare program. However, polling data recently released by the National Council on Aging (NCOA), a nonprofit service and advocacy organization whose mission is to improve the lives of older Americans, especially those who are vulnerable and disadvantaged, reveal that many seniors are still confused by the new law, including the provisions that directly relate to Medicare and senior health.

To provide further information about the benefits of the health care law and seniors, the NCOA launched a new educational campaign to help seniors understand what is in the new law and how it will affect them. The Straight Talk for Seniors on Health Reform campaign provides fact sheets and other resources about seniors and health reform.  The campaign can be found at:

http://www.ncoa.org/public-policy/health-care-reform/straight-talk-for-seniors-on.html

 Every couple of days, the Obama administration highlights provisions of the new health care laws.  The latest information concerned the requirements for plans to include preventive services.  Chronic disease accounts for 75% of health care spending and many chronic diseases can be prevented.  So it makes sense to provide preventive services to not only help people lead healthier lives, but also to lower overall healthcare spending. 

The Affordable Care Act will require health plans to cover preventive services and to eliminate cost-sharing. According to a new regulation released by the Department of Health and Human Services, the Department of Treasury and the Department of Labor, people who enroll in a new health plan on or after September 23, 2010, will have insurance coverage for recommended preventive services without  a copay, co-insurance or deductible.

The current list of services was recommended by the U.S. Preventive Services Task Force (USPSTF).  For more information on services that will be provided, go to:  http://www.healthcare.gov/law/about/provisions/services/index.html

NASW’s focus on veteran’s affairs has taken on heightened importance over the last few years.  The long and still ongoing conflicts in Iraq and Afghanistan have led to an increasing number of returning veterans who require care.

To this end, we have pushed for increased construction of VA hospitals.  For many years, resources were not provided for the maintenance and construction of VA medical facilities.  With more and more veterans returning from overseas, the need to alleviate this problem became more pressing.  This message has been heard loud and clear by Congress, which has provided funding for a new state of the art facility under construction in Southern Nevada.

It is important to note the separate Mental Health Building in this complex.  We have long sought to educate public officials about the importance of holistic care for veterans that meets their physical, emotional, and psychological needs.  With this new and advanced facility, Congress and the Department of Veterans Affairs have taken a decisive step in the right direction.

Political Climate

The primary season began in earnest on Tuesday, May 18 and we learned several important lessons that night.  For one, voter turnout was not particularly high, defying the expectations of many observers who believed voter anger would voice itself loudly at the first opportunity.  Second, the night clearly went better for Democrats than it did for Republicans.  The hard fought special election in PA-12 was decisively won by Democrat Mark Critz over Republican Tim Burns.  Rep. Joe Sestak, who polling has shown to be the stronger candidate in a November general election matchup, toppled longtime Sen. Arlen Specter.  In Kentucky, we saw progressive state Attorney General Jack Conway advance to take on staunch conservative Rand Paul in the race to succeed retiring Sen. Jim Bunning (R).  Moderate Sen. Blanche Lincoln (D) will have to confront progressive challenger Lt. Gov. Bill Halter in a runoff, since Lincoln was unable to cross the 50% threshold necessary to win the primary outright.

Less than 24 hours after the conclusion of these primaries, we saw general election foes confronting one another with negative attacks.  Republicans are trying to contain any impression that Tuesday’s results don’t bode well for their long term prospects this year, while Democrats are basing their narrative on the idea that voters evidently still support them.

While we certainly can’t speculate on what this all means for the remaining 5+ months of this year’s election cycle, we can say one thing for sure: this year’s midterm elections will continue to be spirited, intense, and hard fought, right through to November 2.

President Obama Unveils the 2010 National Drug Control Strategy

On May 11, President Obama unveiled the 2010 National Drug Control Strategy.  The strategy was developed by the White House Office of National Drug Control Policy (ONDCP) with input from Federal, State and local partners.  Highlights of the strategy include:

• Strengthen efforts to prevent drug use in communities including a focus on inhalants, pain killers, “study drugs” and steroids and curtailing drugged driving.
• Seek early intervention opportunities in health care especially by increasing the knowledge of healthcare providers in screening and brief intervention techniques.
• Integrate treatment for substance use disorders into health care, and expand support for recovery.
• Break the cycle of drug use, crime, delinquency and incarceration, including supporting alternatives to incarceration such as drug- and problem-solving courts.
• Disrupt Domestic Drug Trafficking and production with attention to domestic methamphetamine production and criminal distribution of prescription medications for nonmedicinal purposes
• Strengthen international partnerships.
• Improve information systems for analysis, assessment and local management.

For more information on the Strategy, go to http://www.whitehousedrugpolicy.gov/strategy/

DC Voting Rights Act Stalled

The D.C. Voting Rights Act attempts to enfranchise over 550,000 District of Columbia residents through the addition of one House seat for our Nation’s Capitol and another for the Republican-leaning state of Utah, which is the next state scheduled to pick up a seat according to the census count.  However, despite the efforts of NASW as well as its coalition partners, H.R.175 was stalled due to significant alterations to the controversial gun amendment orchestrated by Reps. Childers (D-Miss.) and Souder (R-Ind.).  NASW will continue to pursue enactment of the D.C. Voting Rights Act since social workers seek equality for all.

Congress Struggles over Medicare Rate Legislation

This legislation is active and we will post a blog about any developments later today, May 28, 2010. (more…)

Political Climate

With the health care debate now behind us, Capitol Hill and the Obama Administration have moved on to other things.  Issues of great significance include a pending Supreme Court nomination, fluctuating news on employment, and several Congressional primary races that will give shape to the November general election.  At this point in the year, many Members of Congress are focused on both a wide range of policy issues as well as their reelection prospects.

While Democrats are expected to suffer losses this year, experts widely disagree on the number (House seat estimates have ranged from 25 all the way to 60).  That said, it’s important to remember one thing about any election in which the minority party is trying to overwhelm the majority party: only in the summer and fall are the challengers truly tested, in both fundraising and campaigning.  Those Republican candidates trying to defeat entrenched Democrats will have to maintain a significant fundraising pace and avoid gaffes on the campaign trail.  Any error in either category could cost the GOP potential seats.

These remarks are not meant to be partisan in nature because the Democrats were in a similar position in 2006 as well as 2008.  In each of those years some Democratic challengers were unable to defeat Republican incumbents due to either lackluster fundraising, a disappointing campaign, or both.  At the same time, the Democrats won a significant number of seats in the House and the Senate, eventually taking over the majority.  The GOP is likely to repeat that pattern this year, enjoying a sizeable number of wins, but not necessarily as many as their most optimistic supporters would like.

Remembering Dr. Dorothy I. Height

NASW and the social work community were devastated by the loss of Dr. Dorothy I. Height on April 20, 2010. One of the world’s most important social workers, Dr. Height was a civil rights legend who spent a lifetime advocating for the rights of women and people of color. Dr. Height worked on five continents for four major national organizations during her lifetime. Dr. Height was the only female team member in the United Civil Rights Leadership which included Dr. Martin Luther King, Jr.,  Whitney Young, A. Philip Randolph, James Farmer, Roy Wilkins and John Lewis. She received the Presidential Medal of Freedom in 1997, the Congressional Gold Medal in 2004, and was inducted into the Democracy Hall of Fame International. NASW was honored to award Dr. Height with the 2009 Lifetime Achievement Award.

The most comprehensive piece of federal legislation ever introduced to address social work workforce challenges was named after Dr. Height and fellow social worker Whitney Young. NASW Executive Director Dr. Elizabeth Clark penned a tribute to Dr. Height and discussed her support of the legislation bearing her name. Honor the legacy of Dr. Height today by contacting your Representative and Senators in support of this critical legislation.

NASW Joins Young Invincibles In Support of Early Dependent Coverage

NASW joined 65 state and national groups on a letter asking insurance companies to start dependent coverage early.  The letter was generated by Young Invincibles, a national youth advocacy group focused on health reform.  (more…)

Take Action Today!

Action Requested

Contact your Representative today about signing on as a cosponsor to H.R. 5040, the “HIT Extension for Behavioral Health Services Act.”

Background

Rep. Patrick Kennedy (D-RI) has introduced bi-partisan legislation along with Rep. Tim Murphy (R-PA), a clinical psychologist, called the Health Information Technology Extension for Behavioral Health Services Act of 2010 (H.R. 5040). The bill, introduced on April 15, 2010, would extend the new Medicare and Medicaid “meaningful use” incentive payments established under the HITECH Act within the American Recovery and Reinvestment Act (ARRA) to clinical social workers and other mental health and substance abuse providers and facilities.

ARRA provides $20 billion in incentives and grants to health care providers and hospitals to establish interoperable electronic health record (EHR) systems throughout the nation. Medicare and Medicaid ARRA payment incentives are available to most physicians, chiropractors, dentists, optometrists, podiatrists and hospitals.  However, Congress excluded from eligibility behavioral health providers, as well as most non-physician practitioners, because of cost concerns when the law was enacted in 2009. Among those providers who would be eligible for the payments under Rep. Kennedy’s H.R. 5040 are clinical social workers, clinical psychologists, psychiatric hospitals, substance use treatment facilities and mental health treatment facilities.

As enacted, ARRA establishes a vast national EHR system that excludes the electronic patient records of clinical social workers’ and other behavioral health providers. If the current law’s deficiency is not corrected, the behavioral health records of many consumers will likely remain in paper form and therefore less accessible to other health care providers. Nevertheless, there is a high risk that excluded providers would be compelled to use electronic health records systems to participate within commercial provider networks and to obtain EHR information from covered physicians and facilities. NASW is a supporter of strong patient privacy protections established within ARRA, and also believes that quality of care will likely be seriously compromised if the records of clinical social workers and other behavioral health providers remain excluded from developing EHR systems.

Details on H.R. 5040

NASW believes it is essential to integrate care delivered by clinical social workers with other behavioral health and medical providers, and this legislation will be an important priority for enactment. The Health Information Technology Extension for Behavioral Health Services Act would:

• Clarify the definition “health care provider” throughout the HITECH/ARRA Act to include clinical social workers and psychologists, substance abuse professionals, psychiatric hospital, behavioral and mental health clinics, and substance use treatment facilities.
• Establish grants for those mental health treatment facilities not eligible for meaningful use incentives through the HITECH/ARRA Act. The grants allow for purchasing certified EHRs, training medical staff in the use of EHRs, and improving the exchange of health information between mental health providers and other health care providers.

Extend Medicare and Medicaid payment incentives for meaningful use of EHRs to clinical social workers and psychologists, psychiatric hospitals, mental health treatment facilities, and substance abuse treatment facilities.

The policies of NASW have clearly and consistently stated the profession’s commitment towards ensuring that all local, state, federal, and international policies and/or legislation ban all forms of discrimination, including those based on race, ethnicity, sexual orientation, gender or gender identity, age, disability, and/or relationship or familial status.

Therefore, NASW was pleased when President Obama issued a memorandumthat outlines new rules for hospital visitation on April 15.  The memorandum bars publically funded hospitals from denying visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability, which directly speaks to the practice standards of the social work profession.

The memorandum states that the Department of Health and Human Services (HHS) will disseminate rules for hospitals that receive Medicaid or Medicare funds to require them to respect the rights of patients to designate visitors.  In addition, the President directed HHS to report back to him in 180 days with additional recommendations about actions it can take to address hospital visitation, medical decision-making and other health care issues that affect LGBT patients and their families.  To read the entire memorandum, go to:

http://www.whitehouse.gov/the-press-office/presidential-memorandum-hospital-visitation

To learn more about human rights and lesbian, gay, bisexual, and transgender issues, go to:  http://www.socialworkers.org/practice/intl/issues/gender.asp#rights

Last evening, April 15, 2010, President Obama signed into law the “Continuing Extension Act of 2010.”  The new law extends through May 31, 2010 the zero percent update to the Medicare “Physician” Fee Schedule (MPFS) which was in effect for claims with dates of service from Jan. 1, 2010, through March 31, 2010. The new law is retroactive to April 1, 2010 and will remain in force until the end of May. Without this new stopgap measure, physicians, clinical social workers and other health professionals that bill Medicare Part B independently faced a scheduled rate cut of 21 percent on claims for service delivered after April 1.

The Centers for Medicare & Medicaid Services (CMS) has instructed Medicare contractors to immediately resume processing claims under the new law for services provided by physicians, and non-physician practitioners (NPPs) such as clinical social workers, who are paid under the MPFS. Most claims with dates of service April 1 and later were held by Medicare in anticipation of yesterday’s congressional action. If Congress had not acted, payment rates for claims occurring after April 1, by practitioners who are paid under the MPFS would have been reduced by 21 percent, as required by a formula specified in the Medicare law.

The Medicare MPFS cut was originally scheduled to go into effect for claims paid on or after Jan. 1, 2010, but it was first postponed until March 1 by a provision in the Defense Appropriations Act of 2009, and again until April 1, in the Temporary Extenders Act of 2010. This latest Act extends last year’s payment levels until the end of next month, May 31, at which time Congress plans to again have reached agreement on a longer-term formula solution. For background information on this matter, please see NASW’s website here.

To join the Advocacy listerv, go here.

For more information on Practice, go here.

For more information on Specialty Practice Sections, go here.

For more information on Credentialing, go here.

For information from the NASW Press, go here.

The Department of Health and Human Services (HHS)  is hosting another program in their webchat series on health insurance reform. Nancy-Ann DeParle, Director of the White House Office of Health Reform will join Secretary Kathleen Sebelius for a discussion on how the new Affordable Care Act will impact you.  Questions addressed will include information about Medicare Part D and the doughnut hole; obtaining affordable health care coverage for young adults and children under age 26; and affordable health care options for people with pre-existing conditions.

Join the conversation at 4 p.m. EDT on Thursday, April 15^th at http://www.hhs.gov/live.

Send your questions today to Healthreform@hhs.gov. HHS will also take questions live via Twitter during the webchat.  You can find them on Twitter at @HHSGov.

HHS will answer as many questions as they can during the webchat and will answer more on the “Your Questions Answered” section of our website, Healthreform.gov.