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…)

On December 8, 2009, the White House issued an Open Government Directive requiring all executive departments and agencies to meet the standards of the Directive. Departments and agencies have been developing their plans and posting data and information on the website created for the project – www.data.gov. A separate interactive site has also been created to make comments regarding the plans, make suggestions, and vote on ideas that are being submitted.

Recently, NASW participated in a meeting held by the Social Security Administration (SSA). They were eager to hear from advocates like us about the types of information that should be easily available. We suggested forming “feedback loops” where people or organizations using the datasets or information could link back to SSA with any new results or research that had arisen because of the availability of the information.

While still a fairly new project, we appreciated the enthusiasm and commitment of the people at SSA in getting this project actualized. We encourage you to visit the site and become involved with your ideas and suggestions.

To join the NASW advocacy listserv, go to
http://capwiz.com/socialworkers/mlm/verify/

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/

Go here for more information on NASW’s advocacy efforts. 
Join the Advocacy Listserv to receive regular updates
NASW Standards for Social Work in Schools 
NASW Specialty Practice Section for School Social Work 
NASW School Social Specialist Credential

On March 18, Congress coupled the Student Aid bill with health reform legislation to advance President Obama’s two major domestic policy issues, the Health Care and Education Affordability Reconciliation Act (H.R. 4872). NASW strongly supports this bill and has tirelessly advocated for the creation of public policies that make health care and higher education more affordable and accessible for all Americans. The higher education provisions are expected to generate significant savings by ending lender subsidies to boost Pell Grant scholarships, keep interest rates on federal loans affordable, increase the number of students who enter and complete college.

The House passed the bill on March 21, and the Senate is expected to vote later this week. While there is generally strong support for the bill among Democrats, it has no Republican support and is considered controversial by some. A few Senators are concerned that banks and some lenders will jeopardize their long term viability by producing fewer loans and many higher education institutions, in anticipation of this legislation, have already increased their direct federal loan lending to students. In spite of these differences, the legislation is expected to pass. NASW believes that this legislation will make obtaining a higher education easier for thousands of social work students by reducing their existing financial debt or reducing their dependence on student loans. For more information about our advocacy efforts on loan forgiveness go to www.socialworkers.org/loanforgiveness

2009 Rates extended until March 31

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.

Within four weeks of taking office, Congress presented a “stimulus package” to President Obama, who signed it.  The American Recovery and Reinvestment Act (ARRA) is now one year old.  About half of the money has been distributed, mostly to states, as well as to extend unemployment benefits, expand eligibility for Food Stamps, support Medicaid for states.  Independent economic analyses of ARRA show where it has been effective.  It’s hard to make the argument that things would have been worse for people without the package, because for many people, their economic situation is difficult and challenging.  However, reading accounts of the mass suffering during the depression makes us glad that we did not have to witness similar challenges.  It was the work of social workers led by Frances Perkins and Harry Hopkins that supported people and institutionalized programs like unemployment insurance and social security to ensure people could be cared for throughout the ups and downs of economic cycles.

NASW, partnering with you, our members, continues this legacy of providing direct aid and advocating for structural economic changes.  (See our advocacy alerts on extending benefits to people who have lost their jobs and supporting Medicaid relief to states.) We look forward to continuing these efforts.

You may find these recent articles of interest regarding the ARRA:   http://www.nytimes.com/2010/02/17/business/economy/17leonhardt.html?src=twt&twt=nytimes and  http://online.wsj.com/article/SB10001424052748704804204575069772167897834.html?mod=WSJ_hpp_MIDDLTopStories

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 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.

NASW offices are closed December 24 – January 1. While we will be monitoring the developments of health care reform, the next Health Care Reform Roundup will be distributed the week of January 4.

Senate Breaks Logjam on Health Reform
After nearly 20 days of continuous debate, the Senate finally appears ready to complete consideration of its version of health reform legislation, HR. 3590. When Senate consideration is complete, a conference committee process between the House and Senate will occur, and conferees will negotiate a final agreement that must again pass both chambers. As the Senate completes consideration of their version, NASW has called on you to contact your Senators to support passage of their bill (H.R. 3590). A link to our most recent action alert is here.

The Senate breakthrough this week came in the form of a manager’s amendment that dropped the government-run insurance plan, or public option, which NASW supported. The now amended Senate bill would create a new system of national, private insurance plans supervised by the federal Office of Personnel Management (OPM), which currently administers health benefits for federal employees. OPM would be required to recruit at least two insurers to participate in a new system of national health insurance plans, and one must be a nonprofit. Additionally, states would organize and regulate their own insurance exchanges that would sell private plans available on a statewide basis. The new Senate amendment includes a financial requirement for private insurers that would establish minimums on insurers’ premium revenues that must be spent on medical claims known as the “medical loss ratio.” The latest Senate changes also tighten restrictions on insurance coverage for abortion, another crucial NASW concern.

Conference Committee Considerations
Conferees’ room for maneuvering is expected to be limited because any changes in the final conference bill could unravel the agreement that provided Democrats with the 60 votes necessary for final Senate passage. Conferees will have to find compromises on divisive issues such as abortion coverage, revenues to pay for expanded coverage, whether to include a government-run plan, and methods to expand coverage to those unable to pay full costs. On each of these issues the Senate is expected to have a stronger hand in negotiations.

At this time it is unclear what process House and Senate Democratic leaders will use for conference committee consideration. They may work out their differences in negotiations with a small group of Democratic leaders and committee chairmen, supported by key congressional staff. NASW expects the process will start at the staff level soon after the Senate passes its bill. Leaders hope to have the final bill on the President’s desk by late January.

NASW Strategy

When conference committee consideration begins, NASW will express its preferences among key competing provisions of the House and Senate bills. Among the differences NASW expects to weigh in on are provisions concerning Medicare Skilled Nursing Facility coverage of clinical social work services, workforce provisions under the Social Work Reinvestment Act, the public option, and reproductive choice. NASW is aware the final bill may not measure up to all the hopes of its members, but we will continue to press for improvements to the bill as it moves toward passage. To stay in touch with congressional developments and NASW’s response, please follow our webpage here.