Every now and then, something very significant takes place during my work day. Yesterday was one of those days. I had the opportunity to meet and spend some time with Congressman John Lewis from Georgia. I imagine almost all of you recognize his name. He is often called “one of the most courageous persons in the Civil Rights Movement” and he has dedicated his life to protecting human rights and securing civil liberties. Just this past weekend, Congressman Lewis attended the 45th anniversary of Bloody Sunday in Selma, AL, the march that led to the Voting Rights Act of 1965. .

His office contains the numerous honors that have been bestowed upon him during the last half century. While it felt almost like a museum,. Mr. Lewis is living testament to a lifetime of work on behalf of others..

Mr. Lewis is dynamic, passionate and engaged. He understands and appreciates what social workers do and what our goals are. Two of his staff, including, his chief of staff, are social workers.

If you have not read Congressman Lewis’ book, Walking with the Wind:: A Memoir of the Movement, I hope you will take the time to do so. Congressman Lewis reminds us of what one person can do to change the world.

As another Social Work Month begins , we want to acknowledge social workers everywhere for the outstanding work that you do. Together, we are making a difference.

Happy Social Work Month.

Elizabeth J Clark, PhD, ACSW
Executive Director, NASW

On February 23, 2010 NASW attended a fundraiser for the Honorable Elijah E. Cummings (D-MD.) to discuss his support for the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act (H.R.795).  Representative Cummings, while conveying the significance of social work within the 7^th Congressional District, specified how instrumental the profession is to the alleviation of poverty as well as how social workers help to eradicate dire circumstances on behalf of underserved communities.  In addition, the Congressman proudly articulated the contributions of the Morgan State University School of Social Work, especially their efforts in improving the education system in Baltimore city and the tireless work of social workers throughout human service agencies, especially during an austere economic climate.

Today the President’s Middle Class Task Force released its annual report with significant recommendations that would provide support for families.   Chaired by Vice-President Joe Biden with social worker Dr. Jared Bernstein serving as Executive Director, recommendations were categorized in the following four areas:

• Protecting Workers and Creating Middle Class Jobs
• Retirement Security
• Balancing Work and Family Responsibilities
• Pathways to the Middle Class
  

The National Association of Social Workers (NASW) enthusiastically supports the recommendations of the Task Force and wrote a letter, along with a number of other groups, specifically regarding “Helping Families Balance Work and Caregiving Obligations.” The proposed policies in this area supported our own suggestions and experience in working with families who care for their older relatives.

In 2006 and 2008, NASW, in partnership with the New York Academy of Medicine (NYAM), conducted research focusing particularly on sandwich generation women (SGW) who were between the ages of 35 and 54 and caring for their own children and aging relatives. Key findings from our surveys support the need for the expanding the Dependent Care Tax Credit, which has only been raised once in 28 years, as well as expanding the $102.5 million Caregiver Initiative, which provides resources for respite care, transportation, and assistance with activities of daily living.

To see all of the letters on this issue, click here.  For more information on the Middle Class Task Force, go to www.astrongmiddleclass.gov.

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

First Lady Michelle Obama has made military families a priority throughout her time in the White House. First, she thanked veterans and their families privately for their contributions. Then, she publicly stated her support alongside Dr. Jill Biden at the 2009 World Series.

Now, she has delivered the most meaningful contribution of all: a promise of funding. According to Mrs. Obama, a three percent increase in funding will be implemented to a wide range of military programs. Official information, including a video, can be found at the official White House website here.

This work comes on the heels of other White House announcements that not only benefit veterans, but social workers as well. For example, one year advanced funding for the Veterans Administration was authorized by President Obama in October. Multiyear budgets can help social workers understand their job security within the VA’s employment structure.

Additionally, The White House has announced the construction of 359 military facilities across the country, to provide our nation’s veterans with improved rehabilitation and support services. This was part of The Recovery Act, described in greater detail here.

All in all, the first year of the Obama Administration has witnessed important gains not just for military personnel and veterans, but for the social workers who serve them.

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.

Employment Non-Discrimination Act

NASW continues to work diligently on the Employment Non-Discrimination Act (H.R.3017/S.1584).  With 194 sponsors in the House of Representatives and 44 in the Senate, E.N.D.A. has begun to attract enormous attention.  The Employment Non-Discrimination Act is dedicated to the principle that every worker should be judged solely on his or her merits.  Further, hardworking Americans should not be kept from supporting their families and making a positive contribution to the economic life of our nation due characteristics that have no bearing whatsoever on their acumen to do a job.  The Association remains allied with traditional civil rights groups who affirm that inequality and discrimination subvert the principles of Democracy.

Political Climate
Despite the many twists and turns health care reform has taken in the past several months, we are not necessarily closer to a solution in mid-December than we were in mid-September.  The Senate still has not completed its own bill, and is trying to write legislation that can earn 60 votes.  Once they do so, a conference between House and Senate negotiators will have to occur in order to send a single bill to President Obama.  At this point, no one can guarantee when such a conference will take place.  The cause of this delay is simple: for all the attention rightfully placed on abortion-related aspects of the discussion, there is still no agreement on the fundamental way in which more Americans would receive health care coverage.  Many reasonable approaches have been mentioned in the Senate, including expansion of Medicare and a public option.  But one week before Christmas Day, there is still no single plan that has garnered the support of 60 Senators.  Until that happens, there can be no conference with the House and thus no bill for President Obama to sign into law.NASW has called on its members to contact their Senators to support the bill (H.R. 3590), and a link to our most recent action alert is here. NASW has written to Majority Leader Reid supporting the Senate reform bill, and a copy may be viewed on the NASW Web site.

Reinvestment for Educators
NASW President Jim Kelly, Baccalaureate Social Work Program Directors President Freddie Avant, and Action Network for Social Work Education and Research Chair Jeane Anastas, recently filmed a video regarding “Reinvestment for Educators” to discuss why the Social Work Reinvestment Initiative is important for social work educators. The bill will support recruitment of new social work students, retain experienced social workers, and fund social work education and research. To view the full legislation, please click here. After viewing the video, please send a letter of support to your Representative and Senators.

Social Work Medicare Equity Act in Health Care Reform
Section 1307 of the House health care reform bill (H.R. 3200) authorizes clinical social workers eligible to participate under Medicare Part B to bill independently for services to Medicare Part A covered residents of Skilled Nursing Facilities (SNFs). The provision removes Part B-eligible clinical social work services from the Medicare SNF per diem rate and alternatively authorizes them to bill for them separately. This is a long-sought change by NASW that will expand the availability of clinical social work services to SNF residents covered by Medicare Part A and provide parity recognition for the profession in a SNF setting. The Senate version of health care reform legislation (H.R. 3590) does not contain a similar provision, and this difference must be ironed out in conference committee on the legislation. NASW is working with House and Senate offices to support the provision when conference committee consideration begins.

SWRA Provisions Advance on Health Care Reform
There are several provisions within Health care reform legislation, H.R. 3590, which advance the Social Work Reinvestment Act (SWRA).  Related provisions are contained in the House-passed measure, H.R. 3200. The Senate bill includes the following key provisions addressing social work professional education and training needs:

• Sec. 3508 - Establishes a demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals. Schools of social work are among the eligible grantees.

• Sec. 5101 - Creates a National health care workforce commission tasked with reviewing health care workforce and projected workforce needs. The needs of the social work profession are among those that would be considered by the Commission and schools of social work also have representation.

• Sec. 5102 - Creates state health care workforce development competitive grants to s. enabling State partnerships to complete comprehensive planning and to carry out activities leading to coherent and comprehensive health care workforce development strategies at the State and local levels. All health professions are eligible for state planning attention, including social work.

• Sec. 5203 - Establishes health and behavioral health workforce loan repayment programs for pediatric subspecialists and providers of mental and behavioral health services to children and adolescents who are or will be working in a Health Professional Shortage Area, Medically Underserved Area, or with a medically underserved population.

• Sec. 5305 - Authorizes funding for geriatric education and training; career awards; comprehensive geriatric education to advanced practice nurses, clinical social workers, pharmacists, and psychologists.

• Sec. 5306 - Awards to mental and behavioral health education and training grants to schools for the development, expansion, or enhancement of training programs in social work, graduate psychology, professional training in child and adolescent mental health, and pre-service or in-service training to paraprofessionals in child and adolescent mental health.

• Section 756 of the Public Health Services Act is amended to include language regarding the qualifications of institutions eligible for these training grants and that at least four will go to Historically Black Colleges and Universities (HBCU) or Minority Serving Institutions (MSI).  Authorization for up to $8 million in funds is provided for social work.

Medicare MD & MSW Fee Schedule Update
Clinical social workers that participate in Medicare Part B will have their payment rates temporarily protected against large cuts scheduled for 2010 because Congress acted on a short-term bill to delay the cut required by the flawed sustainable growth rate (SGR) formula, which determines outpatient payment rates in Medicare and TRICARE. The SGR formula is frequently inappropriately described as the Medicare “physician fee” formula, but it actually sets the rate of increase or decrease for all Medicare Part B independent practitioners, including clinical social workers. NASW supports legislation that would halt scheduled cuts in Medicare payments to clinical social workers and other health professionals and has urged Congress to adopt legislation to recalibrate how these payments are set each year. See NASW’s letter to Congress here.

Correcting the problem before the rate cuts go into effect on Jan. 1, each year is politically difficult due to the multi-billion dollar costs of correcting the formula. Current law requires large annual reductions in Medicare SGR determined fees, which include rates paid to clinical social workers. Congress rejected several earlier SGR bills this fall, but then passed an eight week extension into February, enabling it to address the payment problem once it finishes work on health care reform. NASW is continuing to work with coalition partners in support of an SGR remedy.

Appropriations Bill Funds Study on Mental Workforce Issues
During the week of December 9, Congress finished the annual appropriations bill for the federal FY 2010, Labor-HHS-Education spending bill, which is available on the House Appropriations website. One item of special interest to the social work profession is the inclusion of $900,000 for the Institute of Medicine (IOM) to study mental health workforce needs focused on (1) a systematic analysis of the current and projected mental and behavioral healthcare needs of the American people, particularly for aging and growing ethnic populations; and (2) developing policy recommendations for achieving a competent and well-trained mental health workforce to address those needs.  Congressional authors justified the study as necessary in light of the projected doubling of the aged population by 2030, new evidence of the importance of addressing mental health needs as part of effective chronic disease management, increased numbers of veterans with post traumatic stress disorder, improved diagnostic techniques, and implementation of the new federal mental health parity law. The study expands on IOM’s 2008 broader study on the geriatric workforce, which did not explore mental health workforce needs in depth. NASW worked with other mental health professional groups to support this funding in the new law, and will advocate vigorously for the representation of the social work profession in the work of the IOM.

Health Legislation Prospects for 2010
At the start of the new year, Congress is not expected to consider major new health legislation, but congressional committees will consider routine health legislation, particularly those bills that were set aside last year to make time for health reform legislation. These include the 21st Century Cancer ALERT Act, reauthorization of HHS/Public Health Service programs under the jurisdiction of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA). Furthermore, congressional oversight of new federal programs to promote the use of health information technology (HIT) and to protect confidential patient information is expected to be a priority. NASW will represent clinical social worker interests to ensure the profession is included for all Medicare HIT incentive payments and that psychotherapy notes are protected in federal privacy regulations.
Congress also faces a variety of funding challenges to implement health care reform, particularly programs that support the education and training of the health professions. NASW will aggressively pursue expanded federal support for the social work profession in these federal initiatives. As in past years, Congress has not settled on a long-term solution to the Medicare physician payment formula, which also determines the payment rate for clinical social workers and all the health professions that directly bill Medicare Part B.  NASW will continue to advocate for adequate payment rates for the profession during this protracted debate. NASW members who wish to stay informed about health and behavioral health developments in the new Congress should follow NASW’s webpage.

NIH Approves New Stem Cell Lines
On December 2, the National Institutes of Health (NIH) approved 13 new human embryonic stem cell lines for use by NIH funded researchers. Another 96 embryonic stem cell lines are undergoing NIH review. In March, President Obama expanded the number of such cell lines beyond those available under a policy set by President George W. Bush, which permitted research to begin only with lines already available on Aug. 9, 2001. To read more, go to the NIH press release.

Needle and Syringe Exchanges Ban Lifted
On December 13, the Senate passed the Consolidated Appropriations Act of FY2010 by a vote of 57 - 35.  The President is expected to sign the bill before the continuing resolution expires.  Among many other important provisions, the bill removes the federal funding ban on syringe exchange. The provision allows the distribution of syringes through syringe exchange as long as local public health or local law enforcement authorities do not object to a specific location as being inappropriate for distribution.

NASW Supports Child Welfare Workforce Improvement Act
On November 30, NASW sent a letter to Senator Blanche Lincoln (AR) thanking her for introducing S. 2837 the Child Welfare Workforce Improvement Act. The bill will help ensure a workforce that can accurately assess the strengths and needs of children and families, connect children and their families to services, monitor their progress, and improve outcomes for children. NASW sent an alert to the Advocacy Listserv looking for cosponsors.

Immigration Bill Introduced in House
Representative Luis Gutierrez (IL-4) introduced immigration legislation, Comprehensive Immigration Reform for America’s Security and Prosperity (H.R. 4321), in the House on December 15. Congress is beginning to shape the immigration debate with the introduction of this bill and NASW is developing our strategy. You can view the bill here. Immigration will be an important issue tackled in 2010.

Veteran’s Affairs
Recently, we heard from a member of NASW who is an MSW student and a veteran who recently returned from Afghanistan.  He hoped to find a mental health counselor who was both a veteran and a social worker.  While he strongly supports the work of all social workers, he wanted to find one who could directly relate to his experience in war.  The Veterans Administration in his area was unable to locate such a person for him, and other non-VA efforts came up empty as well.

This is a clear connection between member needs and NASW advocacy.  Veterans represent a constituency who may choose to enter social work to benefit both their peers and other members of society, but only if there is a distinct path for them to do so.  Thus, NASW has intensified its focus on veteran’s issues.  This improvement is meant to benefit not just veterans, but the field of social work as well.

Senate Continues Consideration of Health Care Reform

The Senate is currently debating health care reform legislation. Numerous amendments are pending and each will require 60 votes for passage, a high threshold for inclusion. NASW has mobilized its members on reproductive rights, coverage for routine patient care costs associated with clinical trials participation, and we anticipate further mobilization on other issues in the debate. Final passage may occur late this week, and reconciliation of differences with the House versions could extend into early 2010.

NASW has recently called on all of its members to contact their Senators to support the bill (H.R. 3590), and a link to our most recent action alert is here. NASW has written to Majority Leader Reid supporting the Senate reform bill, and a copy may be viewed on the NASW Web site.

NASW Supports Clinical Trials Amendment

On December 7, NASW sent a letter to Senators Sherrod Brown (D-OH) and Kay Bailey Hutchison (R-TX) in support of their amendment to H.R. 3590, the Patient Protection and Affordable Care Act. The amendment would require that all third-party payers cover routine patient care costs incurred by patients enrolled in clinical trials. The amendment will apply to all phases of clinical trials for cancer and other life-threatening illnesses.

To view the entire letter, please go here.

Social Work Medicare Equity Act in HCR

Section 1307 of the House health care reform bill (H.R. 3200) authorizes clinical social workers eligible to participate under Medicare Part B to bill independently for services to Medicare Part A covered residents of Skilled Nursing Facilities (SNFs). The provision removes Part B-eligible clinical social work services from the Medicare SNF per diem rate and alternatively authorizes them to bill for them separately. This is a long-sought change by NASW that will provide parity recognition for the profession in a SNF setting and expand the availability of clinical social work services to SNF residents covered by Medicare Part A. The Senate version of health care reform legislation (H.R. 3590) does not contain a similar provision, meaning the difference between the two bills must be ironed out in conference committee on the health reform legislation. NASW will work with House and Senate offices to support the provision when conference committee consideration begins.

Medicare MD & MSW Fee Schedule Update

Clinical social workers that participate in Medicare Part B will have their payment rates protected against large cuts scheduled for 2010 if Congress acts quickly on legislation to repeal the flawed sustainable growth rate (SGR) formula, which determines outpatient payment rates in Medicare and TRICARE. The SGR formula is frequently inappropriately described as the Medicare “physician fee” formula, but it actually sets the rate of increase or decrease for all Medicare Part B independent practitioners, including clinical social workers. NASW supports legislation that would halt scheduled cuts in Medicare payments to clinical social workers and other health professionals and has urged Congress to adopt legislation to recalibrate how these payments are set each year. See NASW’s letter to Congress here.

Correcting the problem before the rate cuts go into effect on Jan. 1, is politically difficult due to the multi-billion dollar costs of correcting the formula. Current law requires large annual reductions in Medicare SGR determined fees, which include rates paid to clinical social workers. Congress has rejected several SGR bills this fall, but is expected to address the payment problem once it finishes work on health care reform. There is a real possibility that corrective legislation may not pass until sometime after the cuts go into effect on Jan. 1. In the past Congress has occasionally failed to enact the SGR payment legislation by the end of the year, but has later passed retroactive legislation that restores provider payment rates. Without congressional action, payment rates for Medicare physician and clinical social worker services will drop by 21 percent on January 1, 2010. NASW is continuing to work with coalition partners in support of an SGR remedy.

Appropriations Bill Funds Study on Mental Workforce Issues

This past weekend, Congress finished the annual appropriations bill for the federal FY 2010, Labor-HHS-Education spending bill, which is available here on the House Appropriations website. One item of special interest to the social work profession is the inclusion of $900,000 for the Institute of Medicine (IOM) to study mental health workforce needs focused on (1) a systematic analysis of the current and projected mental and behavioral healthcare needs of the American people, particularly for aging and growing ethnic populations; and (2) developing policy recommendations for achieving a competent and well-trained mental health workforce to address those needs. Congressional authors justified the study as necessary in light of the projected doubling of the aged population by 2030, new evidence of the importance of addressing mental health needs as part of effective chronic disease management, increased numbers of veterans with post traumatic stress disorder, improved diagnostic techniques, and implementation of the new federal mental health parity law. The study expands on IOM’s 2008 broader study on the geriatric workforce, which did not explore mental health workforce needs in depth. NASW worked with other mental health professional groups to support this funding in the new law, and plans to advocate vigorously for the representation of the social work profession in the work of the IOM.

Items of Interest from the White House

New Video by Vice President Biden on Seniors and Health Reform

http://www.whitehouse.gov/photos-and-video/video/vice-president-biden-dispells-myths-around-medicare-and-health-reform

Reality Check: CMS Report Confirms Reform Will Benefit Seniors, Slow Cost Growth

http://www.whitehouse.gov/blog/2009/12/11/reality-check-cms-report-confirms-reform-will-benefit-seniors-slow-cost-growth

Take Action Today - Click here!

Action Requested

Please contact your Senator today and urge them to support passage of health care reform legislation. Tell them passage of this legislation (H.R. 3590) is vital to rebuilding the nation’s health and economic security and you urge an “aye” vote on the floor.

NASW members that are constituents of the following Senators are especially encouraged to let your representative know your views. Key swing votes are: Collins R-ME; Landrieu D-LA; Lieberman I-CT; Nelson D-NE; Snowe R-ME; Lincoln D-AR; Bayh D-IN; and Webb D-VA.

Background

Social workers are long-time advocates for major health care reform. For decades they have carried the vision of former Secretary of Labor Frances Perkins, a pioneer in the social work profession, who included universal health care on the 12-item agenda she brought to President Franklin Roosevelt. This was the only item on her agenda that did not pass into law, and social workers have actively sought health care reform since that time.

NASW believes the health reform legislation, H.R. 3590, now pending before the Senate will provide more affordable, quality coverage for millions more Americans. It calls for shared responsibility by individuals, employers and government and would also expand health insurance coverage choices, including retaining one’s current coverage, expanding private plan options within the states, and offering a Medicare buy-in option for residents aged 55-64. NASW gave its support to the Senate bill when floor debate began two weeks ago, and since then important changes have been made in the bill. You may view our Senate letter here on the NASW Web site.

Although details of the latest Senate Democratic changes on health care reform are not yet public, the outlines are known and they please many supporters of reform. The new deal would substitute the original rather weak “public option” in favor of a large expansion of Medicare coverage. An important advantage of the new compromise is that it would limit the high administrative costs of for-profit insurers, and offer Medicare coverage for those aged 55-64. Senate leaders have kept the details under wraps to preserve their freedom to rewrite their plan if initial Congressional Budget Office (CBO) estimates of its cost prove unsatisfactory.

Another aspect of the latest proposal would create a new system of private national health insurance plans administered by the Office of Personnel Management (OPM), the agency that currently manages health care benefits for federal employees. In the House, OPM is overseen by the Oversight and Government Reform Committee, chaired by Edolphus Towns D-NY, a life-long professional social worker and supporter of NASW. Rep. Towns would therefore have major influence over the new national plans developed by OPM.

Last, an item of special interest to the social work profession is the Senate bill’s inclusion of important provisions from the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act, (SWRA). The Senate and House bills contain similar provisions that would authorize several million dollars for social work education and training grants in mental and behavioral health.  Furthermore, some of these grants are targeted to Historically Black Colleges and Universities (HBCU) or Minority Serving Institutions (MSI).  NASW is very pleased social worker advocacy has been so successful on this important issue.

For more information on health care reform, visit our Web page

Take Action!

S. 2837, The Child Welfare Workforce Improvement Act, was recently introduced by Senator Lincoln and aims to improve the child welfare workforce for the thousands of children and families who depend on this system every day. NASW lobbyists worked for many years to create this legislation, in collaboration with the Children’s Defense Fund and other coalition partners, and we are fully committed to enhancing the federal response to protect children and to prevent abuse and neglect. Highlights of the bill:

• A study that would result in recommendations to recruit and retain a high quality workforce to include training, workloads, and staff supervision.
• Flexible use of Title IV-E training dollars to support child welfare staff providing preventive, protective, reunification, and post-permanency services in addition to foster care, kinship guardianship, and adoption services.
• A demonstration grant program to help states and municipalities improve their workforce. Projects would focus on improving the child welfare systems’ ability to conduct needs assessments and secure resources.

Action Requested:

Please contact your Senator and ask them to cosponsor The Child Welfare Workforce Improvement Act (S. 2837). Let them know that passage of this important legislation will enable social workers and other professionals to improve the crucial services for children and families in the child welfare system.

Thanks for your advocacy!