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…)

The House Education and Labor Subcommittee on Early Childhood, Elementary and Secondary Education held a hearing on March 18, 2010 titled “Elementary and Secondary Education Act Reauthorization: Addressing the Needs of Diverse Students” to examine how schools can appropriately educate low-income, minority, English Language Learners, disabled, Native American, and homeless students within the context of reauthorizing  the Elementary and Secondary Education Act (ESEA), currently known as the No Child Left Behind Act.

This goal was expressed by Subcommittee Chairman Representative Dale Kildee (D-MI) in his opening statement: “While the No Child Left Behind Act shed light on the inequalities in our education system, it unfortunately did not do enough to close the achievement gap for diverse students…This must be a top priority for future steps in education reform.”

To this end, the Subcommittee considered recommendations from a panel of educators, advocates, and a researcher working to close the achievement gap for diverse students. They included Dr. Daniel Curry, Superintendent for the Lake Forest School District in Felton, Delaware, Dr. Jack Dale, Superintendent for Fairfax County Public Schools in Falls Church, Virginia, Arelis Diaz, Assistant Superintendent for Godwin Heights Public Schools in Wyoming, Michigan, Dr. David Gipp, President of United Tribes Technical College (UTTC), Jacqui Farmer Kearns, Principal Investigator for the National Alternate Assessment Center, and Michael Wotorson, Executive Director of Campaign for High School Equity.

To read the transcript go tohttp://edlabor.house.gov/hearings/ecese/

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On March 17, the House of Representatives passed the Professional Social Work Month and World Social Work Day Resolution honoring social workers by a vote of 419-0.  Social worker and Congresswoman Carol Shea-Porter managed the bill during the debate.  To view the debate and final passage, please go to:

Video of Reps. Shea-Porter and Guthrie managing the social work month resolution:
http://www.c-spanvideo.org/program/292544-2 (Once on the site, go to: transcript on the left and scroll down to 5:47:17 (Shea-Porter) to begin the video.  End at 5:51:3).

Video of the actual vote:  http://www.c-spanvideo.org/program/292567-1 (Once on the site, go to: transcript on the left and scroll down and begin at 1:23:49 and end at 1:31:55).

On March 10, 2010 NASW attended a fundraiser for the Honorable Chaka Fattah (D-PA) seeking his support for the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act (H.R.795).  Representative Fattah is a Member of the powerful House Appropriations Committee and without fail, embraces the mission of social work especially social service administration to underserved populations.  During the event, Representative Fattah spoke with conviction about the importance of social work to his congressional district (2^nd) and the measureable outcomes due to intervention that have dramatically improved the lives of many.  The Congressman also discussed his commitment to NASW’S education agenda.

Earlier this week the White House released a summary of its $950 billion plan to reconcile the House and Senate versions of comprehensive health reform legislation. Release of the plan marks a new phase of more direct presidential involvement in the legislative negotiations. The President’s plan largely favors the Senate’s bill and clarifies use of a legislative strategy known as budget reconciliation, which could pass the bill through Congress with 51 votes. Democrats on Capitol Hill reacted in a receptive manner to the proposal, although leaders are expected to flesh out many important details as the plan is worked into legislative language.

On Thursday, February 25, the President will meet with Democratic and Republican congressional leaders at Blair House in an attempt to reach compromises on comprehensive legislation. However, Republicans have not accepted the President’s premise for the meeting, which is to bring forward their own plans to address comprehensively the major coverage and costs problems that plague the U.S. health system. Absent a breakthrough at the talks this week, Democratic leaders are expected to attempt to pass final legislation without Republican votes. The President’s proposal generally follows NASW principles for health reform, and we expect to support the compromise legislation as it moves toward House and Senate consideration.\

The Kaiser Family Foundation created a side-by-side chart comparing the health care proposal unveiled by President Obama on February 22 and the previously passed House and Senate health care bills.  To view the full chart, please go here.

Urgency for State Medicaid Relief Grows

A new report by Families USA, an NASW coalition partner, documents a large number of states facing Medicaid cutbacks unless Congress quickly increases temporary funding for state Medicaid programs. Families USA reports that States are dealing with unprecedented budget shortfalls as a result of declining tax revenues, high levels of unemployment, increasing poverty and declining wages.  They concluded that at least 30 state legislatures are contemplating cutbacks to Medicaid, beginning this July.

In addition to protecting funding for current services to Medicaid recipients, the report shows that increased federal funding will improve state economies while expanding and protecting jobs. The Families USA report is available here: States in Need: Congress Should Extend Temporary Increase in Medicaid Funding.

President Obama’s federal budget proposal released earlier this month called for maintaining current Medicaid services during the economic downturn with an additional $25 billion in federal fiscal relief for state Medicaid programs. NASW has joined with Families USA and other advocacy groups in pushing for the funds in new legislation. The proposal would include a 6.2 percent increase in the amount of money states receive for Medicaid, and those with higher unemployment rates would receive more. Our coalition urges passage at the earliest opportunity as most state legislatures are already well along in the development of their budgets for their new fiscal year.

Essential Medicare Legislation Still Delayed

Partisan gridlock is continuing to stall legislation extending expiring Medicare provisions that establish provider payment rates. Congress had hoped to use the comprehensive health reform bill as a vehicle to address Medicare provider payment extensions, but the cost of the Medicare provisions and confusion on the health reform bill led to their being temporarily set aside for another legislative vehicle. Earlier this month the Senate Finance Committee attempted to again pass the Medicare “extenders package,” but the vehicle, a large jobs bill, was rejected by party leaders before coming to the floor. Currently, leaders know the Medicare package is urgent to pass now, but they have not found an acceptable vehicle for the multi-billion dollar package.

The expiring Medicare provisions include large rate cuts that directly impact payments to clinical social workers billing Medicare independently under Part B. Clinical social workers face two large rate cuts under expiring law. These include the physician payment provision in Medicare law that leads to a 21 percent cut in all Medicare Part B rates due to the Sustainable Growth Rate (SGR) formula that affects all practitioners. For more than a decade, all Medicare Part B payment rates have been set by the SGR formula, which by statute annually expire, cutting payments to providers. Each year Congress has intervened to postpone the SGR cut, but due to the costs of a permanent repeal, Congress has not agreed to a solution to the underlying flaws in the formula. NASW supports a permanent change in the Medicare formula (see our letter HYPERLINK “http://capwiz.com/socialworkers/utr/1/AURAMBWPUD/FHCOMBWQIV/4723954896“here). In late December Congress agreed to postpone the SGR cut for two months, but on March 1, 2010, the SGR cut will again go into effect. That agreement leaves Congress only a few days to enact another extension to correct the SGR formula.

In addition to the SGR reduction, Medicare psychotherapy rates already received a five percent cut on January 1st due to a CMS five-year rate review implemented in 2008. Clinical social workers and psychologists are working together to ensure the psychotherapy rate cut is restored in any bill delaying the larger SGR cut.  An increase for psychotherapy billing codes was included in the House version of health care reform (H.R. 3590), but not the Senate version (S. 3962). Again, with the delay in enacting comprehensive reform, a new legislative vehicle must be found to delay this cut. NASW is working very aggressively with a coalition of health practitioner groups to pressure Congress to attach the psychotherapy rate provision in the larger SGR legislation.

County of Residence Impacts Personal Health

A new project undertaken by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute ranks county health status in every state in the nation. The project found that the health of a community depends on many different factors – ranging from individual health behaviors, education and jobs, to quality of health care, to the environment. The project has recently released a collection of 50 state reports designed to help community leaders demonstrate that where people live influences how healthy they are and how long they live. For information on health by county in any state, see HYPERLINK “http://capwiz.com/socialworkers/utr/1/AURAMBWPUD/GCWDMBWQIW/4723954896“here.

Take Action Now! – Social Work Reinvestment

On February 3, Ed Towns (NY-10) introduced H.R. 795, the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act. To date there are 38 cosponsors. The act establishes a Social Work Reinvestment Commission to address the future of the profession. It also establishes demonstration programs that address the current state of the social work profession. You can contact your member of Congress and ask them to become a cosponsor of the legislation.

Pay discrimination denounced

The first 6 weeks of the 111^th Congress have been exciting. Congress passed and the President signed the Lilly Ledbetter Fair Pay Act (Public Law No. 111-2). The law reverses a Supreme Court decision that acutely limits women workers’ capacity to sue for wage discrimination. It changes the law to declare that an unlawful practice occurs when a discriminatory compensation decision or other practice is adopted, when a person becomes subject to the decision or other practice, or when a person is affected by the decision or practice, including each time wages, benefits, or other compensation is paid. Therefore, a person can file a complaint about wage discrimination after any pay check that includes the pay discrimination. NASW Executive Director, Betsy Clark, was invited to the bill signing ceremony at the White House. You can view the video of the signing on our Web site.

Children’s Health Care passed

Another big win was passage of SCHIP legislation (Public Law No. 111-3). This legislation includes a mandate that mental health treatment be on par with medical health services. More specifically, the new law prohibits SCHIP plans from setting lower treatment limitations or higher financial requirements on coverage of mental health or substance use services than they set for other health services. It will cover around 4 million additional uninsured children. It is paid for, primarily with a 62-cent increase in the federal tobacco tax. It will extend federal support of CHIP through 2013. It encourages states to enroll children who are already eligible but not yet covered, and gives states new tools to reach uninsured children. It removes the five-year waiting period for legal immigrant children and pregnant women who enroll in Medicaid or CHIP. See the final vote. (more…)

In November, groups hoping for the repeal of the “Don’t Ask, Don’t Tell” policy were disappointed when the Senate Armed Services indefinitely postponed a long awaited hearing on the matter.

However, the issue was moved to the forefront during the State of the Union speech, when President Obama uttered the words, “This year, I will work with Congress and our military to finally repeal the law that denies gay Americans the right to serve the country they love because of who they are.”  (The full text of the speech is available here.)

“Don’t Ask, Don’t Tell” may be on the agenda for the Senate Budget Committee hearing on Tuesday, Feb. 2 at 10:00.  NASW will continue to keep you updated as this issue moves through Congress.

In October, Representative Barbara Lee (CA-9) introduced H.R. 3699, a bill to prohibit any funds being expended to increase the number of members of the United States armed forces serving in Afghanistan. The bill currently has 27 cosponsors and has been referred to the House Committee on Armed Forces. Rep. Lee, a social worker, was the only opponent to George W. Bush’s War Resolution in 2002 by introducing House Concurrent Resolution 473 into the 107th Congress, which urged the United States to re-engage the diplomatic process and stressed the government’s commitment to the United Nations’ inspections process. NASW applauds the efforts of Representative Lee to restore peace.

Democrats Regroup on Strategy for Health Care Reform

Democratic congressional leaders are currently developing a new strategy to pass health care reform after the stunning loss of a Senate seat in Massachusetts. Although their new strategy will be finalized after some days have elapsed and is not yet final, several conclusions are apparent from their public comments. First, Democrats fear that failing to enact the health care bill now could increase voter anger later in this election year. Second, many legislative strategists prefer what is described as a two-bill strategy, one immediately following the next.

Under the two-bill strategy, the first step would require House passage of the Senate health bill (HR. 3590). Getting to majority House support for this bill (at least 218 votes) is extremely difficult because many Democrats have important differences with provisions in the Senate bill. Democratic House leaders say they do not now have the necessary votes to pass the Senate measure. The second bill would be necessary to secure the necessary votes in the House for the first bill. The second bill would be considered under procedures known as budget reconciliation.  This bill would include many compromises and changes to the Senate bill. The reconciliation measure would also include any provisions negotiated with the White House and Senate leaders. The two-bill option has important legislative advantages. Most importantly, any bill taken up under reconciliation procedures may move under fast-track floor procedures in the House and Senate, and passage requires 51 votes in the Senate, instead of a filibuster-proof 60 votes.

Another strategy would involve going back to the drawing board and breaking the bill into smaller components, passing those where there is more agreement. Given this highly fluid political environment, NASW will continue to press for its legislative priorities as Congress debates a new approach. Our current Action Alert is here, and we urge members to track our actions here.

Mental Health and Substance Abuse Parity Update

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) became effective for most private health plans on January 1, 2010, but federal agency regulations defining how it will be interpreted have not been cleared by the Administration. Thus health insurance carriers, which must have their 2010 plan benefits in compliance in the absence of any regulations, may be uncertain or confused about exactly what mental health and substance abuse benefits are required to be equivalent to medical and surgical benefits they offer.

According to a HHS/CMS website here, the now current federal law applies to two different types of coverage:

• 1) Large group self-funded group health plans (CMS has jurisdiction over self-funded public sector (non-federal governmental) plans, while the Department of Labor has jurisdiction over private sector self-funded group health plans.

• 2) Large group fully insured group health plans.

Some state’s insurance regulations may also contain additional coverage protections for fully insured group health plans or individual coverage. MHPAEA is designed to prevent large group health plans from imposing financial requirements and treatment limitations on mental health and substance use disorder (MH/SUD) benefits that are more restrictive than financial requirements and treatment limitations on medical/surgical benefits.  MHPAEA also prevents large group health plans from placing annual or lifetime dollar limits on mental health and substance abuse benefits that are lower than annual or lifetime dollar limits for medical/surgical benefits offered under the plan.

The law does not apply to small group health plans or health insurance coverage in the individual (non-employment based) market, but individual state law may require mental health parity in such cases. MHPAEA defines large group health plans as those with more than 50 workers and does not apply to group health plans sponsored by employers with fewer than 51 workers. Federal summary information about the law is available here and NASW has prepared its own summary, posted here and shown under January 2009.

Social Work Reinvestment

The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act continues to be a major focus of NASW. The bill currently has 80 House cosponsors and 11 Senate cosponsors and we need your help to secure more! Contact your Senators and Representative today in support of this important bill. NASW is working with the House Committee on Education and Labor to promote support with all members for the legislation.

NASW continues to support social work reinvestment provisions within health care reform and is seeking inclusion of the language in the final health care reform bill.

NASW recently sent a letter to President Obama’s staff asking for his support of a Social Work Reinvestment Commission. The letter cites a workforce shortage in the profession, along with an increasing demand for social work services. It further states, “the President has outlined a commitment to the values that drive the social work profession including service to others in need and the pursuit of social justice. For these reasons, we encourage the President to support the Social Work Reinvestment Commission which will help ensure that social workers can continue to provide services in numerous settings throughout the nation.”

Political Climate

Democrats were chastened by Massachusetts voters on January 19 when Republican Scott Brown defeated Democrat Martha Coakley for the Massachusetts Senate seat left vacant by the death of Sen. Ted Kennedy.  Voters have loudly expressed their concern by defeating a highly favored Democrat in a state widely regarded as the most Democratic of all.  The outcome of this race has already resonated throughout Washington, and could result in Democrats taking smaller, more measured steps in their proposed legislative agenda throughout the year.  The number of Senators has dropped from 60 to 59, although not every bill will be so threatened by filibuster that 60 votes will be necessary on each occasion.  Still, the political landscape has changed decisively now that Republicans hold a large enough minority to sustain leverage against the White House and Congressional Democrats.

From January 20 forward, legislative outcomes are bound to have a more bipartisan hue for the rest of the year and possibly beyond.

Temporary Assistance to Needy Families (TANF) Reauthorization

TANF is set to expire September 30, 2010. As such, NASW is working in coalition with other organizations to influence the reauthorization of TANF. It is believed that the House will introduce a bill to reauthorize TANF in February. During the last reauthorization, Congress extended TANF for short periods of time before reauthorizing it. We expect this may be the case again. Advocates are looking to add a number of items to the TANF reauthorization. One change is to suspend, at least until economic recovery has been achieved, the five year time limit imposed by Congress on receipt of TANF benefits. Another change would be to raise benefit levels at least to the official federal poverty guideline. Also, advocates would like to see countable work activities defined more broadly. Advocates encourage full family sanctions to be prohibited. TANF reauthorization should eliminate the mandatory cooperation requirement for child support and make the family violence option a requirement. Advocates call for the elimination of all restrictions on legally present immigrants. Advocates are also calling for a return to the matching funding system rather than the current block grant system. (more…)