On Friday, August 14, NASW participated in a conference call with the White House to discuss the current status of the health care reform/insurance debate, messaging and strategy.  The White House also announced its new webpage, www.whitehouse.gov/RealityCheck to help separate fact from fiction about health insurance reform.  The conference call speakers included Tina Tchen, Director of the White House Office of Public Engagement; Michael Strautmanis, Chief of Staff to the Assistant to the President for Intergovernmental Relations and Public Engagement;  Michael Hash and Lauren Aaronson, Senior Advisors; and David Simas, White House Communications Office, Office of Health Reform.

As a professional social worker, educator, Executive Director of the NASW New Hampshire Chapter, and long-time advocate for universal health care, I was privileged to attend the President’s town hall meeting in Portsmouth, NH on August 11. I wasn’t sure what to expect as the high school where the event was held was surrounded by supporters and opponents carrying signs and bullhorns. However, inside the crowd was diverse and the discourse civil. President Obama did an excellent job answering a range of questions and explaining his vision for healthcare reform. He elaborated on the need for a public option and gave a strong, solid defense of it in response to a critic. He further explained that the public option would need to be self-supporting and could not rely on government funds. He said competition from a public option is necessary to keep the insurance companies honest and was quite critical of both the insurance and drug companies. My sense is that the administration’s new focus on insurance reform is aimed at individuals who currently have coverage and do not see what stake they have in reform. I think it’s more a change of emphasis than substance.

President Obama assured older attendees that he did not intend to cut Medicare benefits.  He refuted the idea that his goal was a single-payer system, which he argued would be disruptive since so many peple have coverage through an employer-based system.  It is becoming increasingly obvious that it is going to be difficult to garner enough votes to secure a public option, and at this point a single-payer system seems an impossible goal.  Finally, he strongly supported the importance of mental health benefits and parity.

This experience was encouraging and I think most people walked away with a renewed sense that we can and will accomplish healthcare reform. Moreover, my sense, as well as my wife’s (who is also a social worker), was that the president’s supporters outnumbered his opponents.  Obama did an excellent job: he had the knowledge and understanding to answer every question and the skill to deflect distractions.

Stephen Gorin, PhD, MSW

Executive Director, NASW New Hampshire Chapter

Photos

Photo Credit: Stephen Gorin, PhD, MSW

For ongoing information on health care reform, please visit NASW’s health care reform page.

Legislation

Medicare payment rates for clinical social worker services and payments for all physician services, delivered independently under Part B are scheduled for a 21% cut in 2010. Congress is addressing Medicare provider payment rates in health care reform legislation. In addition, NASW seeks inclusion of a Medicare provision expanding clinical social work services delivered to certain Medicare beneficiaries in nursing homes. These very important improvements in clinical social work payments are included in the House health reform bill (H.R. 3200), and NASW is strongly supporting these provisions. They appear likely to remain in the House bill, but their status in the forthcoming Senate bill is still unknown.

The FY 2010 Senate Labor Health and Human Services (LHHS) bill included report language encouraging Substance Abuse and Mental Health Services Administration to increase funding for the minority fellowship program.   The LHHS Committee notes that the demographics of our society are changing dramatically. Minorities represent 30 percent of the population and are projected to increase to 40 percent by 2025. Yet only 23 percent of recent doctorates in psychology, social work and nursing were awarded to minorities. The Committee encourages SAMHSA to increase funding for the minority fellowship program in order to train an increasing number of culturally competent mental health professionals. Increased funding is also needed given the recent expansion of eligibility for this program to include additional professions.

Legislative Climate

With both houses of Congress now in recess, the dialogue on health care reform will shift over the next month in both nature and tone.  The “inside the Beltway” approach to constructing specific bills is now on hiatus, and the process of selling Americans on the benefits of reform (for most Democratic members of Congress) or the hazards of it (for many Republican members of Congress) is now underway.  Town halls and Q&A sessions will be predominant for a few weeks, while Washington-based interest groups ponder strategies to support or hinder reform after Labor Day.  Since multiple bills still exist and there is not yet one specific health care reform proposal at present, Members of Congress will be challenged to explain the ideas and concepts behind health care reform without getting too specific.

August Recess

Over the August recess we encourage social workers to attend Town Hall Meetings and discuss health care reform. We are sending announcements to Advocacy Listserv members when we hear of a Town Hall Meeting in your district or state. Personal stories are very effective at these Town Hall Meetings. Make sure you identify yourself as a social worker. Here are some talking points you can use at the Town Hall Meeting:

1. Pass health care reform now
2. We want all people covered; national policy must ensure a universal right to insurance coverage for a continuum of health and behavioral health services.
3. We want quality health care. Health care reform must promote wellness, maintain optimal health, prevent illness and disability, ameliorate the effects of unavoidable incapacities, and provide supportive long-term palliative end-of-life care.
4. We want health care that recognizes the need for social work services; social workers are an important part of the health care team.

Resources

For ongoing information, please visit our health care page.

Keep up with the latest from NASW on Facebook, Twitter, and the NASW Advocacy Blog.  We want your feedback:  post to the Wall and leave your comments on the blog.

NASW has posted briefing papers on a range of issues. You may want to check out the briefing papers on Health Care Reform, Health Care Disparities, and Care Coordination.

August 3, 2009

Edward M. Kennedy
Chair
Committee on Health, Education, Labor & Pensions
317 Russell Senate Office Building
Washington, DC 20510

Dear Senator Kennedy:

On behalf of the 150,000 members of the National Association of Social Workers, I am writing in support of the confirmation of Francis S. Collins, MD, PhD, as Director of the National Institutes of Health (NIH). Founded in 1955, NASW is the largest membership organization of social workers and seeks to enhance the well-being of individuals, families and communities through its work and advocacy.

Professional social workers have an important and growing presence at NIH.  This is not only through the provision of clinical services, but also due to a portfolio of research grants on psychosocial care, health disparities, family caregiving, and innovative, community-based health, mental health, and substance abuse intervention.

Dr. Collins’ lengthy career has focused on revolutionizing our collective understanding of disease genes and the human genome map. Thanks to this work, social workers and a wide range of other medical care providers are able to better understand the personalized nature of illnesses.    Dr. Collins’ work shines a light on the entire spectrum of human conditions, and the need to more fully address the interactions of genes, behavior and the environment.

Dr. Collins’ work has a direct and invaluable impact for our society.  In addition to his long list of contributions to basic genetic research and scientific leadership, Dr. Collins is known for his close attention to ethical and legal issues in research. He has been a strong advocate for protecting the privacy of genetic information and has served as a national leader in efforts to prohibit gene-based insurance discrimination.

We know that understanding genetics is one key to the research work of NIH, because of the way such research changes how disease will be addressed.  For example, in the case of schizophrenia,  this understanding can lead to new possibilities for cure or disease management, but may also  create dilemmas stemming from earlier awareness that a person will develop a disease.  All of these factors have psychosocial dimensions that will benefit from the knowledge, skills and practice of social work.

Dr. Collins leadership and management skills, broad-based scientific knowledge, his understanding of the linkages between research and clinical services, including social work services, his long-standing engagement with the research and advocacy community make him an excellent choice to lead NIH at this time of attention to translational research and personalized medicine.

NASW looks forward to working with Dr. Collins to continue to address the critical issues of health disparities and the elimination of diseases through behavioral change and addressing social and environmental conditions.  Because Dr. Collins understands the field of social work’s contribution to health and well-being, and his commitment to enhancing the health of Americans everywhere, it gives me great pleasure to support Dr. Collin’s nomination and I ask for his confirmation. Thank you for your consideration.

Yours truly,

Elizabeth J. Clark, PhD, ACSW, MPH
Executive Director

During the August Congressional recess, your member of Congress may be hosting a Town Hall Meeting. We would like you to go to the Town Hall Meeting and talk to your member about Health Care Reform.

While many Members of Congress notify constituents of Town Hall Meetings, you can join NASW’s Advocacy Listserv to receive notices regarding planned meetings by your members of Congress. Join the NASW Advocacy Listserv here. You can also go to www.house.gov, search for your member of Congress, and find the district office phone number to call for information about Town Hall Meetings.

Here are some talking points on Health Care Reform

1. Pass health care reform now
2. We want all people covered; national policy must ensure a universal right to insurance coverage for a continuum of health and behavioral health services.
3. We want quality health care.  Health care reform must promote wellness, maintain optimal health, prevent illness and disability, ameliorate the effects of unavoidable incapacities, and provide supportive long-term palliative end-of-life care.
4. We want health care that recognizes the need for social work services; social workers are an important part of the health care team.

You can also relate your personal experience with the health care system. Members of Congress love to hear real stories about what people face in their district.

After you attend the Town Hall meeting, it would be very helpful to NASW’s legislative efforts to have your feedback.  We can then follow up with the Member of Congress.  Click here for an online form or email advocacy@naswdc.org.

If you’d like additional information about health care reform and NASW’s efforts, visit our health care reform Web site page.

The Final FY2010 Wage Index Rule was posted on the Federal Register public inspection desk just now.  NHPCO is thrilled to announce that the reimbursement cuts associated with the elimination of the Budget Neutrality Adjustment Factor have now been spread out over 7 years, instead of being harshly phased in over just 2 years.

For nearly 18 months, the hospice community has been fighting a regulation originally proposed in the FY2009 Wage Index issued by the previous Administration, which would reduce hospice reimbursement by eliminating the budget neutrality adjustment factor (BNAF).   In the FY2010 Wage Index released today, the current Administration considered, through their review of the submitted comments, the severity of the economic conditions facing the hospice community and the ever-increasing desire by patients and families to have access to high-quality end-of-life care.

The seven-year phase out of the BNAF affords the hospice community a more rational approach to absorbing the eventual rate reductions over a much longer period of time.  While the end result is the same, a substantial and unwarranted rate reduction, this approach recognizes the ongoing financial pressures facing the hospice community and prioritizes compassionate and high-quality care for our nation’s most vulnerable population, the dying and their families.  More information…

Source:  NHPCO

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.

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.

Legislation Introduced
On July 14, 2009, Rep. Dingell (MI-15) introduced the America’s Affordable Health Choice Act of 2009, H.R. 3200. This act is the result of work among three committees in the House to fulfill President Obama’s goals of reducing health care costs, protecting and increasing consumers’ choices, and guaranteeing access to quality, affordable health care for all Americans.  NASW was pleased with this initial bill.  Three committees have considered the bill and numerous amendments have been made as the bill moves through the legislative process.   To watch the committee markups and obtain information about the amendments, go to the Energy and Commerce Committee, Ways and Means Committee, or Education and Labor Committee. The Energy and Commerce Committee has yet to report the bill out of committee.

Legislative Climate
While House Democratic leadership has negotiated with conservative Blue Dog Democrats to achieve significant progress, the party lacks sufficient support from its own Members in the Senate.  As a result, the White House and Democratic Senate leadership are working with moderate Republicans to try and achieve meaningful reform.  The primary items up for discussion are the idea of a government “cooperative” to compete with private health care companies, rather than a public option, as well as a possible tax on higher-cost health care plans in the country.  Meanwhile, President Obama has continued to tour the country, providing updates on health care legislation and urging Americans to support his ideals for reform.

Meetings Attended
NASW has attended several meetings on health care reform over the past week, including:

• Patients’ Access to Responsible Care Alliance meeting focusing on the legislative concerns of non-medical doctor providers participating in the Medicare program.
• Alliance for Health Reform briefing on mental health benefits in health care reform legislation.
• Senate staff on an amendment concerning state and federal law on non-medical doctor billing under health care reform.
• Key member of Congress on health care reform during a PACE-supported dinner.

Letters Signed (The text of these letters will be posted on the Health Care Reform Page)

• Mental Health Liaison Group to Chairmen Waxman, Rangel, and Miller expressing support for H.R. 3200, America’s Affordable Health Choices Act.
• Mental Health Liaison Group (MHLG) letter expressing support for the Reed Amendment to the Affordable Health Choices Act. This important measure is aimed at improving the overall health status of Americans served by Community Mental Health Center (CMHCs) and other community-based mental health and addiction providers.
• Four letters from the Consortium for Citizens with Disabilities supporting the introduction of H.R. 3200, America’s Affordable Health Choices Act. The letters went to Chairmen Waxman, Rangel, and Miller, and Speaker Pelosi.
• Consortium for Citizens with Disabilities letter to Chairman Kennedy expressing deep appreciation for the effort that has gone into getting the Affordable Health Choices Act successfully passed by the Health, Education, Labor and Pensions (HELP) Committee.  This comprehensive health reform legislation represents a positive sea change that will significantly improve access to health and long term services and supports for people with disabilities and chronic conditions.

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Resources

• Families USA released a new report, Coverage for America: We All Stand to Gain. The report provides state-by-state estimates of how many people will gain coverage under America’s Affordable Health Choices Act of 2009. The report indicates that the health reform bill proposed by key committees in the House will benefit all Americans.
  
• For ongoing information, please visit our health care page.
  
• Keep up with the latest from NASW on Facebook, Twitter, and the NASW Advocacy Blog.  We want your feedback: Post to the fan page’s wall and leave your comments on the blog.
  
• You can visit the White House Web page to see updates on health care reform. After you read it, come and post a note on our Social Work Blog (hyperlink to the blog)  about it.

NASW has recently signed onto the CCD Letter to Chairman Kennedy

“The following members of the Consortium for Citizens with Disabilities (CCD) are writing to express our deep appreciation for the effort that has gone into getting the Affordable Health Choices Act successfully passed by the Health, Education, Labor and Pensions (HELP) Committee.”

For more information on NASW’s Health Care Reform efforts, visit www.socialworkers.org/advocacy/healthcarereform

NASW has been working on health care reform for decades. Most recently, we have collaborated with a number of groups that are aiming to enact health care reform now. For more information on our efforts, visit our Health Care Reform page.  This page attempts to bring together the work that NASW is doing in collaboration with other organizations on health care reform.