A new extension of the State of Emergency has been signed by Alex Azar. This extends coverage of telemental health services and audio only services until January 20, 2021.

Click here for the Memo

Let me know if you have questions at lwgroshong@clinicalsocialworkassociation.org

Laura Groshong, LICSW, Director, Policy and Practice

A new source of funds for behavioral health/mental health providers who have worked with anyone affected by the COVID-19 pandemic is now open. Phase 3 of the CARES Act Relief Fund will be available starting today, October 5, 2020, to any LCSWs who have met the criteria listed below until November 6, 2020. Any LCSW who meets one of the yellow outline requirements in the first section may apply.  All criteria in the second section must be submitted.  The link to apply is also listed below.

To be eligible to apply, the applicant must meet at least one of the following criteria:

• Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Mar.31, 2020; or
• Billed a health insurance company for oral healthcare-related services as a dental service provider as of Mar. 31, 2020; or
• Be a licensed dental service provider as of Mar. 31, 2020 who does not accept insurance and has billed patients for oral healthcare-related services; or
• Billed Medicare fee-for-service during the period of Jan.1, 2019-Mar. 31, 2020; or
• Be a Medicare Part A provider that experienced a CMS approved change in ownership prior to Aug. 10, 2020;
• Be a state-licensed / certified assisted living facility as of Mar. 31, 2020
• Be a behavioral health provider as of Mar. 31, 2020 who has billed a health insurance company or who does not accept insurance and has billed patients for healthcare-related services as of Mar. 31, 2020

Additionally, to be eligible to apply, the applicant must meet all of the following requirements:

• Filed a federal income tax return for fiscal years 2017, 2018, 2019 if in operation before Jan. 1, 2020; or be exempt from filing a return; and
• Provided patient care after Jan. 31, 2020 (Note: patient care includes health care, services, and support, as provided in a medical setting, at home, or in the community); and
• Did not permanently cease providing patient care directly or indirectly; and
• For individuals providing care before Jan. 1, 2020, have gross receipts or sales from patient care reported on Form 1040 (or other tax form)

Note: Receipt of funds from SBA and FEMA for coronavirus recovery or of Medicaid HCBS retainer payments does not preclude a healthcare provider from being eligible.

To apply go to https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html#how-to-apply

Let me know if you have any questions.

Laura Groshong, LICSW, Director, Policy and Practice

Dear CSWA Members,

Today, October 5, is the last day that comments about the possible Medicare cuts by CMS to LCSWs will be accepted. If you have not yet sent your comments to CMS, or messages to your members of Congress, please do so by TODAY at 5 pm ET or they will not be included.

As always, please let me know when you have sent these messages at lwgroshong@clinicalsocialworkassociation.org.

LWG

Dear CSWA Member,

On September 16, you should have received a Legislative Alert to members of Congress regarding the proposed cut to Medicare reimbursement for LCSWs scheduled for January 1, 2021 ( copied below).  Many thanks to the hundreds of members who have sent these messages.  If you have not done so, it is not too late.  While the issue of Medicare cuts is being opposed in the House through Rep. Rush’s letter, it is fine to send your message to Senators as well.  All messages must be sent by October 5, 2020.

Now I am asking you to send another message directly to CMS (Centers for Medicare and Medicaid Services), the organization that oversees reimbursement rates for all Medicare providers, including LCSWs.  Both messages are necessary to make our position on this issue clear by October 5, 2020.  Send the following message (use your own words if you like) to the following link:

https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part

“I am a Medicare provider [if you are] and wish to express my concern about the proposed rate reduction for Clinical Social Workers set to begin on January 1, 2021. Clinical Social Workers are already paid 25% less than other mental health providers for the same CPT Codes as other mental health providers. Though some psychotherapy CPT codes have increased, the 10.6% cut will result in a net reduction of about 7%.  My fixed costs have not changed and I cannot afford this reduction in my fees for my mental health services.

The onslaught of COVID-19 has increased the need for mental health services.  Please make it possible for me to continue to provide them by eliminating the proposed Medicare reimbursement cut.”

As always, let me know when you have sent both messages at lwgroshong@clinicalsocialworkassociation.org.  Thanks for your help.

Laura Groshong, LICSW, Director, Policy and Practice, Government Relations Chair 

Clinical Social Work Association
he National Voice of Clinical Social Work
Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY

============================================================

September 16, 2020

There is a proposed cut to Medicare reimbursement for many health care providers, including LCSWs, scheduled for January 1, 2021.  This 7% cut is connected to Evaluation and Management services, for diagnostic and treatment services that LCSWs provide.  It is imperative that all LCSWs contact their members of Congress as soon as possible to let them know how damaging this would be for LCSWs.

We are fortunate to have the support of Rep. Bobby Rush (D-IL) and 93 members of Congress in stopping this cut.  Please check the letter they wrote to Congressional leadership at -

https://rush.house.gov/sites/rush.house.gov/files/documents/Letter%20t%20Leadership%20on%20EM%20Code%20Cuts%20General.pdf  and thank your legislator if he or she signed on.

Even if you are not a Medicare clinician, please send the following message to your members of Congress at https://www.contactingcongress.org:

“I am a member of the Clinical Social Work Association, a Medicare provider [if you are], and a constituent.  Maintaining budget neutrality on the backs of clinical social workers and other mental health providers is a burden that I will not be able to bear.  I am already paid 25% less than other mental health providers for the same diagnostic and treatment services as other mental health providers.  My fixed costs have not changed.

The onslaught of COVID-19 has increased the need for mental health services.  Please make it possible for me to continue to provide them by eliminating the proposed Medicare reimbursement cut.”

As always, let me know when you have sent your messages

at lwgroshong@clinicalsocialworkassociation.org

On September 16, you should have received a Legislative Alert to members of Congress regarding the proposed cut to Medicare reimbursement for LCSWs scheduled for January 1, 2021 ( copied below).  Many thanks to the hundreds of members who have sent these messages.  If you have not done so, it is not too late.  While the issue of Medicare cuts is being opposed in the House through Rep. Rush’s letter, it is fine to send your message to Senators as well.  All messages must be sent by October 5, 2020.

Now I am asking you to send another message directly to CMS (Centers for Medicare and Medicaid Services), the organization that oversees reimbursement rates for all Medicare providers, including LCSWs.  Both messages are necessary to make our position on this issue clear by October 5, 2020.  Send the following message (use your own words if you like) to the following link: https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part

““I am a Medicare provider [if you are] and wish to express my concern about the proposed rate reduction for Clinical Social Workers set to begin on January 1, 2021.  Clinical Social Workers are already paid 25% less than other mental health providers for the same CPT Codes as other mental health providers. Though some psychotherapy CPT codes have increased, the 10.6% cut will result in a net reduction of about 7%.  My fixed costs have not changed and I cannot afford this reduction in my fees for my mental health services.

The onslaught of COVID-19 has increased the need for mental health services.  Please make it possible for me to continue to provide them by eliminating the proposed Medicare reimbursement cut.”

As always, let me know when you have sent both messages at lwgroshong@clinicalsocialworkassociation.org.  Thanks for your help.

Laura Groshong, LICSW, Director, Policy and Practice, Government Relations Chair 
Clinical Social Work Association
The National Voice of Clinical Social Work

Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY

September 16,2020

There is a proposed cut to Medicare reimbursement for many health care providers, including LCSWs, scheduled for January 1, 2021.  This 7% cut is connected to Evaluation and Management services, for diagnostic and treatment services that LCSWs provide.  It is imperative that all LCSWs contact their members of Congress as soon as possible to let them know how damaging this would be for LCSWs.

We are fortunate to have the support of Rep. Bobby Rush (D-IL) and 93 members of Congress in stopping this cut.  Please check the letter they wrote to Congressional leadership at - https://rush.house.gov/sites/rush.house.gov/files/documents/Letter%20to%20Leadership%20on%20EM%20Code%20Cuts%20General.pdf  and thank your legislator if he or she signed on.

Even if you are not a Medicare clinician, please send the following message to your members of Congress at https://www.contactingcongress.org:

“I am a member of the Clinical Social Work Association, a Medicare provider [if you are], and a constituent.  Maintaining budget neutrality on the backs of clinical social workers and other mental health providers is a burden that I will not be able to bear.  I am already paid 25% less than other mental health providers for the same diagnostic and treatment services as other mental health providers.  My fixed costs have not changed. The onslaught of COVID-19 has increased the need for mental health services.  Please make it possible for me to continue to provide them by eliminating the proposed Medicare reimbursement cut.”

As always, let me know when you have sent your messages at lwgroshong@clinicalsocialworkassociation.org

There is a proposed cut to Medicare reimbursement for many health care providers, including LCSWs, scheduled for January 1, 2021.  This 7% cut is connected to Evaluation and Management services, for diagnostic and treatment services that LCSWs provide.  It is imperative that all LCSWs contact their members of Congress as soon as possible to let them know how damaging this would be for LCSWs.

We are fortunate to have the support of Rep. Bobby Rush (D-IL) and 93 members of Congress in stopping this cut.  Please check the letter they wrote to Congressional leadership at https://rush.house.gov/sites/rush.house.gov/files/documents/Letter%20to%20Leadership%20on%20EM%20Code%20Cuts%20General.pdf  and thank your legislator if he or she signed on.

Even if you are not a Medicare clinician, please send the following message to your members of Congress at https://www.contactingcongress.org:

“I am a member of the Clinical Social Work Association, a Medicare provider [if you are], and a constituent.  Maintaining budget neutrality on the backs of clinical social workers and other mental health providers is a burden that I will not be able to bear.  I am already paid 25% less than other mental health providers for the same diagnostic and treatment services as other mental health providers.  My fixed costs have not changed. The onslaught of COVID-19 has increased the need for mental health services.  Please make it possible for me to continue to provide them by eliminating the proposed Medicare reimbursement cut.”

As always, let me know when you have sent your messages -  lwgroshong@clinicalsocialworkassociation.org

Laura Groshong, LICSW, Director, Policy and Practice, Government Relations Chair 
Clinical Social Work Association
The National Voice of Clinical Social Work

Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY

2020 has been a challenging year for everyone. The pandemic has increased anxiety, fear, isolation and grief, leading to declining mental health and increased substance use in our communities that will only continue to get worse.

In July, the Federal Communications Commission (FCC) made the historic announcement that it had unanimously voted to designate 9-8-8 as the universal three-digit dialing code for the National Suicide Prevention Lifeline. 

Unfortunately, the bipartisan, non-controversial National Suicide Hotline Designation Act is stalled in Congress, putting at risk the promise that this easy-to-access, three-digit dialing code for the life-saving services 9-8-8 could provide.

To date, the House and Senate have each approved similar, but not identical, bills establishing 9-8-8 as the dialing code and supporting the new hotline by establishing a funding mechanism through states and wireless phone carriers. But that legislation is not yet over the finish line. Without this bill becoming law, our communities will not be able to respond to the increasing demand for needed suicide prevention services.

CSWA urges you to call all your Members of Congress by tomorrow to help pass the National Suicide Hotline Designation Act. Go to https://www.contactingcongress.org/ to get their emails or phone numbers and leave the following message: “I am a member of the Clinical Social Work Association and a constituent. Please pass the National Suicide Hotline Prevention Act and save lives.  The pandemic and other natural disasters have increased the number of citizens who have hopeless helpless feelings leading to suicidal thoughts.  They need ways to access mental health treatment which the over 250,000 clinical social workers can provide.”

Thanks for your help.  As always, let me know when you have sent your messages.

Laura Groshong, LICSW, Director, Policy and Practice, Government Relations Chair
Clinical Social Work Association
The National Voice of Clinical Social Work

Strengthening IDENTITY | Preserving INTEGRITY | Advocating PARITY

Regardless of how we feel about providing psychotherapy through telemental health, LCSWs are currently in the position of having to continue to use telemental health or audio only mental health treatment for many months to come.   Since mid-March, the vast majority of LCSWs who used to have an office where they met in person with patients, have been working from home.  We have mostly made peace with the frustrations and, occasionally, surprising advantages, of working from home online or on the phone.

Returning to the Office – The conditions that would allow us to return to our offices without major changes to the air flow and air cleaning, use of masks, plastic shields, are not easy to create and there will be a high level of risk in some areas that is potentially harmful to many of us.  That is why it is so important that Secretary Azar extended the public emergency declaration to October 23, 2020, this week to allow the use of telemental health to continue to be covered by Medicare.  Be aware that this does not guarantee that private insurers will continue to cover telemental health.

Legislative Goals – Other immediate goals are to make telemental health a permanent option through Congressional laws; to make reimbursement for telemental health at the same level as for in office visits; and to compare the use of in office and telemental health treatment delivery methods.  There are about 10 bills that would impact some or all of these issues.  CSWA will keep you aware of the progress of these bills as they affect LCSWs.

Inter-state Telemental Health Practice – There continue to be variation in state rules that allow LCSWs in one state to see patients in another state through telemental health.  This is especially difficult for ongoing patients who were seeing a patient in office from a state in which the LCSW was not licensed.  I hope this chaos will resolve soon, but for now check on current laws and rules for practicing telemental health in states where you are not licensed with the state Board.

Self-Care – Please know that telemental health is more tiring for many LCSWs than office work and build in ways to give yourself more down time, whether it is through seeing fewer clients in a day; having longer breaks between clients; and having some time for relaxation, exercise, and other self-care. 

Many of us have been paying for an office the past five months that we only use for billing or our own research.  More and more requests to sublease offices are showing up.  This painful decision is affecting all of us.  The webinar given last month “To Be or Not To Be: LCSWs Returning to the Office” offers a template for helping make this decision and can be found at the CSWA website in  the Members Only Section.

Be safe, stay well, and let CSWA know if there is any way we can help.

CSWA is pleased to see that the Office for Civil Rights has issued guidance on compliance with civil rights laws during the COVID-19 pandemic.  The health disparities between Black, Indigenous, and People of Color (BIPOC) citizens and white citizens has been a major concern of CSWA.  We hope this guidance will improve the underlying problems that are barriers to mental health care for BIPOC citizens.  The lack of attention to LGBTQ citizens in this guidance is a glaring omission which we hope will be corrected in future guidance.

To read the whole OCR Bulletin, please visit: Title VI Bulletin - PDF

===================================================================================

OCR Issues Guidance on Civil Rights Protections Prohibiting Race, Color, and National Origin Discrimination During COVID-19

Yesterday, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued guidance to ensure that recipients of federal financial assistance understand that they must comply with applicable federal civil rights laws and regulations that prohibit discrimination on the basis of race, color, and national origin in HHS-funded programs during COVID-19. This Bulletin focuses on recipients' compliance with Title VI of the Civil Rights Act of 1964 (Title VI).

To help ensure Title VI compliance during the COVID-19 public health emergency, recipients of federal financial assistance, including state and local agencies, hospitals, and other health care providers, should:

• Adopt policies to prevent and address harassment or other unlawful discrimination on the basis of race, color, or national origin.
• Ensure – when site selection is determined by a recipient of federal financial assistance from HHS – that Community-Based Testing Sites and Alternate Care Sites are accessible to racial and ethnic minority populations.
• Confirm that existing policies and procedures with respect to COVID-19 related services (including testing) do not exclude or otherwise deny persons on the basis of race, color, or national origin.
• Ensure that individuals from racial and ethnic minority groups are not subjected to excessive wait times, rejected for hospital admissions, or denied access to intensive care units compared to similarly situated non-minority individuals.
• Provide – if part of the program or services offered by the recipient – ambulance service, non-emergency medical transportation, and home health services to all neighborhoods within the recipient's service area, without regard to race, color, or national origin.
• Appoint or select individuals to participate as members of a planning or advisory body which is an integral part of the recipient's program, without exclusions on the basis of race, color, or national origin.
• Assign staff, including physicians, nurses, and volunteer caregivers, without regard to race, color, or national origin. Recipients should not honor a patient's request for a same-race physician, nurse, or volunteer caregiver.
• Assign beds and rooms, without regard to race, color, or national origin.
• Make available to patients, beneficiaries, and customers information on how the recipient does not discriminate on the basis of race, color, or national origin in accordance with applicable laws and regulations.

OCR is responsible for enforcing Title VI's prohibitions against race, color, and national origin discrimination. As part of the federal response to this public health emergency, OCR will continue to work in close coordination with our HHS partners and recipients to remove discriminatory barriers which impede equal access to quality health care, recognizing the high priority of COVID-19 testing and treatment.

Roger Severino, OCR Director, stated, "HHS is committed to helping populations hardest hit by COVID-19, including African-American, Native American, and Hispanic communities." Severino concluded, "This guidance reminds providers that unlawful racial discrimination in healthcare will not be tolerated, especially during a pandemic."

"Minorities have long experienced disparities related to the medical and social determinants of health – all of the things that contribute to your health and wellbeing. The COVID-19 pandemic has magnified those disparities, but it has also given us the opportunity to acknowledge their existence and impact, and deepen our resolve to address them," said Vice Admiral Jerome M. Adams, Surgeon General, MD, MPH. "This timely guidance reinforces that goal and I look forward to working across HHS and with our states and communities to ensure it is implemented."

A hearing for about 20 mental health bills in the House of Representatives Energy and Commerce Committee was scheduled yesterday on June 30.  Unfortunately, the bill that CSWA has been sponsoring for about 7 years in various forms, H.R. 1533, has not been included in the bills to be heard.  This is the bill that would increase Medicare reimbursement to LCSWs and allow us to again work independently in skilled nursing facilities.

We need an all-out effort to get the bill included.  Please send the following message to your representative, ESPECIALLY if they are on the E&C Committee.  To check whether you representative is on the Committee, go to https://energycommerce.house.gov/about-ec/membership . Feel free to send messages to other members of the Committee as well.

Dear Rep. ___________,

I am a constituent and a member of the Clinical Social Work Association.

Please consider adding HR 1533 to the agenda for the Energy and Commerce Hearing on June 30.  This bill, Improving Access to Mental Health Act, would greatly improve the access of Medicare beneficiaries to mental health services provided by clinical social workers.  As the largest group of mental health providers in the country, clinical social workers are currently a key part of the treatment of behavioral disorders in Medicare and across the country.

I notice that HR 945, which addresses mental health counselors and marriage and family therapists, is included in this hearing, a sister bill to HR 1533.  The goals of these bills are similar, to allow Master’s level mental health clinicians to provide independent services in skilled nursing facilities and give beneficiaries much needed access to mental health services. Currently, HR 945 does not include clinical social workers.  It would make sense to include all Master’s level mental health providers at this hearing.

Thank you for your attention to HR 1533.

Sincerely,
[your name, license, email]

CSWA appreciates your help and continued partnership. As always please let me know when you have sent your messages.

Laura Groshong, LICSW, Director, Policy and Practice
www.clinicalsocialworkassociation.org

On June 16, President Trump issued an Executive Order, “Safe Policing for Safe Communities”, to begin to law enforcement reform.  While it is not as strong as CSWA would wish, it is a start. In the spirit of collaboration on this crucial topic, CSWA has written a response to the Order. 

To ensure clinical social work ideas get included in the discussion we hope the Order will generate, please send the attached document to all your members of Congress, and state legislators with the following message:

“I am a member of the Clinical Social Work Association (CSWA) and a constituent. The President’s recent Executive Order, “Safe Policing for Safe Communities”, is of great interest to us, as clinical social workers.  We offer some suggestions about how to implement the goals of the Order, which we have been working on for decades.  Please let me know if there is any way we can help further this discussion.” 

Click here to find emails for members of Congress.

As always, let me know when you have contacted your legislators.

Laura W. Groshong, LICSW, Director, Policy and Practice