June 9, 2019

There was a recent article in the Los Angeles Times about the serious problem at the University of Southern California School of Social Work (USC) which started their online MSW program in 2009. In 2013 CSWA wrote a position paper about the ways we thought this online program could undermine the interpersonal understanding and ability to connect to others that are necessary components of becoming a competent clinical social worker. You can find this paper on the website at https://clinicalsocialwork.wildapricot.org/Resources/Documents/CSWA%20-%20Position%20Paper%20-%20Online%20MSW%20Programs%20-%209-13-1.pdf.

Our focus was on the clinical skills that would be lost if there is not the direct contact with professors, supervisors, and patients that many online MSW programs minimize or eliminate. As these programs have proliferated, there are two other issues which we touched on in our paper – the cost of these programs, around $90,000 at USC, and the way that the marketing of this program was done by a for-profit marketing firm, 2U, which had to meet certain quotas according to their contract with USC.

Over the past 6 years, the problems with the way that the USC School of Social Work has evolved, and especially the way that 2U allowed students to enter the program who were not qualified to do so, has created a maelstrom of problems. In the past week, two articles have been written about these problems in the Los Angeles Times, https://www.latimes.com/local/lanow/la-me-usc-social-work-20190606-story.html,and the New York Times, https://www.nytimes.com/2019/06/03/upshot/student-debt-big-culprit-graduate-school.html.

CSWA encourages its members to educate themselves about the way that clinical social work is being endangered by the general lack of adequate training in online programs, as well as the stifling debt that many students accumulate. While some students think that they have gotten the training they need (see comments in these articles), U.S. News and World Report gave USC School of Social Work a rating of the 25thbest school in 2018, down from its usual place in the top ten schools.

The Council of Social Work Education, which accredits all MSW programs, has endorsed the use of online MSW programs without reservation, if they conform to the coursework standards of brick and mortar programs. This was a mistake in the opinion of CSWA for the reasons stated above and in our Paper. We encourage members to let their schools know, as alumnae, that the possible diminished training of MSWs using online courses, and the staggering debt accrued, are bad for our profession and bad for the well-being of future clinical social workers.

The majority of schools of social work now have online MSW programs as an option. It is time to take a stand on the harm this may do to the clinical social work profession.

June 5, 2019

By Laura Groshong, LICSW, Director, Policy and Practice and Margot Aronson, LICSW, Deputy Director, Policy and Practice

Text Therapy – Start Feeling Better Today with Talkspace Online Therapy. A Convenient and Affordable Solution That Provides Access to Therapy Whenever You Need. 100% Private & Secure. Secure & Confidential. 1 Million Happy Users. 2000+ Licensed Therapists. As Low As $49/Week. (Talkspace Website, https://help.talkspace.com/hc/en-us )

Texts are primarily used for social purposes: short missives conveying limited information. Much has been written about the negative impact of reliance on this mode of communication (Turkle, 2012), but the popularity of texting is obvious, particularly among those under the age of 30 who have texted regularly throughout their lives. Therefore, the increasing use of texting in the context of therapy cannot be ignored.

While there is no definitive research as yet, it appears that texting can play a useful role in some mental health treatment. Certainly for anyone who is most comfortable with texting as the preferred form of communication, this may be where a treatment relationship can best begin.

Responsibilities of the LCSW Providing Text Therapy

Clinical social workers should be knowledgeable about the promise of digital innovations in treatment, and equally about the potential downside. LCSWs choosing to engage in text therapy must be willing to explore ethical complications, perhaps even license violations, in the terms of agreement with the client and/or the texting platform.

The first issue: is text therapy really psychotherapy?

This simple definition of psychotherapy, paired with the already quoted Talkspace web advertisement, illustrate the very real differences that exist between psychotherapy and text therapy. Psychotherapy (whether in person or through synchronous videoconferencing) is a continuous process based on an established emotional relationship, an ongoing dialogue between two people in real time about complex issues with deep emotional content. Texting, on the other hand, is by its nature short, often with a gap in the timing of communications between client and therapist; it is not consistent with a dialogue based on emotional meaning, as with psychotherapy.

While texting platforms may emphasize, in the small print of the User Agreement, that the services provided are not psychotherapy, most continue to display the term “text therapy” prominently in their ads. This can create confusion for clients seeking psychotherapy and may give an appearance of misleading advertisement.

How, then, do we as LCSWs conceptualize and engage in text therapy? Perhaps “text therapy” might more accurately be called “text assessment” or “text coaching”. Texting might also be the means for starting the therapeutic process, to be converted to an in-person or videoconferencing process if it becomes an ongoing psychotherapy.

Reading any contract with care is essential, and this is most certainly true for provider contracts offered by texting platforms. Does the contract address issues such as diagnosis, HIPAA compliance, state-to-state licensing laws, and dual relationships? Does the platform set limitations on helping a client understand the differences between in-person treatment and text therapy, or on recommending in-person therapy when such treatment is indicated?

LCSW Standards of Practice

The use of ongoing asynchronous texting changes the process of therapy for LCSWs. The therapeutic alliance is significantly different when the primary means of communication is not direct ongoing communication between the client and therapist, as the asynchronous method of communication tends to preclude in depth exploration of emotional understanding. Further, a key part of psychotherapy, the “frame”, is lost if client and therapist text and reply at different times, or if the client is limited – as with some agreements - to making and receiving two texts a day to a therapist five days a week.

LCSWs base their understanding of a client on a biopsychosocial assessment, leading to a diagnosis. ASWB Technological Guidelines (2015) identifies additional factors that may contribute to determining whether a client is suitable for text therapy: age, technological skills, disabilities, language skills, cultural issues, and access to emergency services in the client’s community. How does the platform provide for assessment? Can you ensure that our standards of practice will be upheld by the texting platform?

When more intensive treatment is called for, will the platform respect and support the licensed provider’s clinical judgment? LCSWs know that a client with a psychotic disorder, an autistic spectrum disorder, or an acute episode of depression or anxiety may need in-person communication or hospitalization. Are there contractual provisions for such a situation?

Regulatory Considerations

Benign as texting seems, some texting platforms ask clinicians to communicate in ways that may violate state laws and regulations and/or federal laws and rules.

Most states require a clinical social worker to be licensed in both the state where the LCSW resides and the state where the client resides, if different, to provide therapeutic services. A text platform’s claim that text therapy is not psychotherapy but rather “therapeutic communication” is a blurry distinction not necessarily recognized by state social work boards. It is the LCSW’s obligation to ascertain and comply with relevant regulations of both state boards.

Licensed therapists are also responsible for making sure that the text platforms used by both client and therapist are HIPAA compliant. Further, the texts themselves are personal health information sent electronically (PHI) and must be kept private and secure. It has been reported that one text platform permitted employees – even non-clinically-trained employees – to review the content for training purposes. A Business Associate Agreement might provide a guarantee of the LCSW’s confidentiality standards, if the platform agrees to sign (HIPAA Basics for Providers, 2018, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf )

Ethical Considerations

Most states use the NASW and CSWA Codes of Ethics as the basis for ethical clinical social work practice. Some text platforms have contractual terms that require the therapist to meet sales targets through their text exchanges. For a clinical social worker to engage in such a dual relationship, i.e., as a corporate representative for the texting services and, at the same time, as a therapist addressing mental health problems is a clear and serious ethical violation.

Some companies use marketing techniques that also may be ethical violations. One example, potentially misleading advertising, has been mentioned. Advertising with testimonials from former clients is another. From the NASW Code of Ethics (2016)

4.07(b) Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client's prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.

Would the company agree to keep the LCSW provider from being caught up in these sorts of business-driven ethical dilemmas?

Summary

Basic to mental health treatment is thoughtful consideration of the conditions being treated and of the biopsychosocial needs of the client. The challenge for the LCSW is incorporating these basics, along with accepted standards of practice, regulatory requirements, and ethical considerations, into the texting format as contracted by the particular text platform. It is the responsibility as LCSWs to apply clinical social work standards of practice, ethics, and regulations to any work we choose to do.

References

June 2, 2019

There is a move in New York State to change the requirements for mental health clinicians, including LCSW-Rs. For those of you who are not familiar with the clinical social work license in New York, these requirements have been much more rigorous than in most states, with 5 years of supervised post-MSW experience. Only psychiatrists, psychologists, and LCSW-Rs are required to be covered by insurance and allowed to diagnose.

There is currently a move by other Master's mental health groups who do not have the same standards as LCSW-Rs and are not required to be covered by insurance to give these practitioners the same insurance coverage and the right to diagnose. The New York State Society for Clinical Social Work (NYSSCSW), an affiliate of CSWA, is fighting this effort, as well as an attempt to lower clinical social work standards.

I am bringing this to the attention of all CSWA members for two reasons. There may be LCSW-Rs who are licensed in New York but do not live there, are not members of NYSSCSW, but are members of CSWA. We want all New York CSWA members to support the opposition to the proposed changes. Please see below for more details on how to oppose the changes to Article 163. The second reason is that this kind of attempt to undermine strong clinical social work licensure laws can always be a threat. Texas just successfully stopped an effort to undermine their clinical social work law. We must be vigilant in protecting our licensure laws.

Keep track of your licensure laws and protect them. For all of you who are among the almost 30,000 clinical social workers in New York, make sure to let your voice be heard using the message from Marsha Wineburgh, DSW, LCSW-R, NYSSCSW Legislative Chair AS SOON AS POSSIBLE.

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For those LCSW-Rs in New York who called your legislators, thank you.

For those of you who haven't yet, read the following alert and please please please call.

By Marsha Wineburgh, DSW, LCSW-R, NYSSCSW Legislative Chair

For the last several years, a bill to mandate insurance reimbursement for mental health services provided by individuals licensed under Article 163 of the Education Law - Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, Licensed Creative Arts Therapists and Licensed Psychoanalysts has been introduced into both houses. While, on the surface, this idea is not unreasonable, there is a huge clinical experience discrepancy and as such, we, along with Psychiatrists and Psychologists have opposed the measure.

Currently, the only clinicians that insurance is REQUIRED to reimburse for mental health services are a Psychiatrist (MD), Psychologist (PhD) and an LCSW who has an additional three years of supervised experience in the provision of diagnosis and psychotherapy in addition to the three years required for licensure as an LCSW (known as the "R" provision). On the other hand, Article 163 licensees postgraduate training requires only a fraction of such experience. Nor can they diagnose a serious mental illness or treat without referral to a physician. Requiring insurance to reimburse such providers but NOT LCSW's, is unacceptable and lowers competence for private practice.

Despite this glaring inequity, the bills are on the move. The Assembly version is on the Codes Agenda this week. As such, We have STRONGLY SUGGESTED amendments to STRIKE PROVISIONS REQUIRING THE THREE ADDITIONAL YEARS OF EXPERIENCE FOR REIMBURSEMENT for LCSWs, but thus far, they have been ignored. We must protect our profession! There are only three weeks left of this legislative session and this battle will require teamwork from now until June 19th. It will require constant internal legislative work and a loud constituent outcry!

We have an easy three-step process of engagement:

1. If you don't know who your Senate or Assembly Member is, log onto https://www.elections.ny.gov/district-map/district-map.html -- Simply fill in your address and click on Senate and Assembly to reveal your members.

2. Take five minutes out of your day to CALL YOUR SENATE AND ASSEMBLY MEMBER using the script provided below. The Senate Switchboard # is 518-455-2800. The Assembly Switchboard is 518-455-4100 At first glance, staffers may tell you the current law already includes the LCSW - you must tell them to keep reading to the next line where it requires such LCSWs to have an additional three years of experience as this is where the egregious discrepancy between providers, exists.

3. When you are done...let your organization know you've made your call  and share this alert with as many Clinical Social Workers and those working toward LCSW licensure.

Please utilize the following Script:

Hello. My name is ----- and I am a constituent who is VERY concerned about Assembly Bill 670 (Bronson) and Senate Bill 6212 (Senator Kennedy). While the bills are not yet identical, we expect they soon will be. Each of them will require insurance providers to reimburse for mental health services provided by individuals licensed under Article 163 of the Education Law - Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, Licensed Creative Arts Therapists and Licensed Psychoanalysts BUT NOT LCSWs who have MUCH HIGHER EXPERIENCE AND EDUCATION REQUIREMENTS. I am asking you as a constituent to honor my education and experience and protect my livelihood by amending the bill by striking subparagraph D, which requires LCSWs to have an additional three years of experience in order to receive reimbursement. While the LCSW-R is the highest level licensure, an LCSW without the additional requirements is by authority of statute, already authorized and qualified to independently provide diagnosis, assessment based treatment planning and psychotherapy and as such, should be reimbursed for such work!

April 17, 2019

Much excitement has been generated in the mental health community since “the UBH decision” – that is, the decision in the US District Court in Northern California case of Wit et al versus United Behavioral Health, filed March 5, 2019 - found UBH liable with respect to the denials of benefits claims. The clarity and detail of Chief Magistrate Judge Joseph Spero’s 106-page Findings of Fact and Conclusions has provided us with an extraordinary resource for moving forward.

At the same time, there are clear limits to this big win: this is not the end of insurance denials and parity violations. UBH will surely be appealing the judgment, and other judges may or may not uphold the present ruling. Further, the insurance arena is complex. Each state has its own insurance regulations, and each type of plan (ERISA, Medicare, Medicaid, Exchange Plans, or private) has a different source/s of oversight. (CSWA has posted information to clarify the differences in the Clinical Practices section of our website.)

How, then, can we use this decision effectively to affect access to mental health and substance use treatment? At the individual level, if your client is being denied care that you deem critical, the detailed court document provides a list of “generally accepted standards of care” that may prove very helpful in your discussion with the insurance representative.

Judge Spero spent considerable time during the hearing determining what is meant by generally accepted standards of care. Many sources exist, and CSWA will post the judge’s summary of these on our website. The standards listed below were agreed upon by both plaintiffs and UBH; the wording is taken from the court document itself:

The nine plaintiffs whose cases were reviewed during the ten-day bench trial included denials of residential treatment for substance use disorder, for rehab, for mental health treatment, and, in two cases, for teenagers with substance issues, as well as denials of outpatient mental health treatment two to three times per week, and Intensive Outpatient Treatment (IOP) for a minor with SUD. The Judge provided detail for each case considered, noting the discrepancy between the UBH stated standard of care and the actual guidelines that the reviewers was expected to follow. His descriptive language throughout, when referring to the UBH testimony, tended toward generous use of the words “evasive” “even deceptive” and “not credible”.

Given the widespread interest in this case, LCSWs may want to be assertive in appealing denials of care, especially where there is any failure to meet the standards. As you present your argument - even if you are dealing with a different insurer and a different type of plan - a mention of the UBH case will likely have an effect on the discussion. (The CSWA website has an Appeals template in the Members-only section; the generally accepted standards of care list will also be there, as well as a description of the five types of insurance plans.)

Another important avenue for LCSWs may be their state insurance laws/regulations and then perhaps their legislators. The plaintiffs came from different states, and three of these states – Illinois, Connecticut and Rhode Island - have legislation mandating use of the American Society of Addiction Medicine (ASAM) Standards in their insurance laws/regulations; it was not difficult to demonstrate that the UBH denials violated the state laws/regulations. A fourth state, Texas, has Department of Insurance criteria for standards of care; this proved equally effective.

Summary

The UBH decision is a good step toward making mental health and substance use parity a reality but is far from the end of making this happen. For now, we can speak out strongly on standards of care, ensure that standards in the client’s policy is being respected in any review process, and feel comfortable noting the UBH loss in court based on violation of these standards, as a basis for appealing a denial of care. As for the next steps, LCSWs should look to state laws/regulations governing insurance, including any standards of care or enforcement of parity. (Such information may be online at the website of the Office of the Insurance Commissioner). Insurance is a state-based system and it may be possible to make a legislative proposal about mental health and substance use that would appeal to your state legislators. Watch for more information from CSWA on this topic soon.

Footnote: Case 3:14-cv-02346-JCS Document 18 (Findings of Fact and Conclusions of Law). Heard and ordered UBH liable 2/28. Filed 3/05/19. 106 pages. United States District Court, Northern District of California.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

November 26, 2018

You may have already heard that the CSWA Webinars on the Merit-Based Incentive Payments (MIPS) which were to be held on November 29 and 30 have been canceled. This post explains why.

Clinical social workers were among the 12 additional practitioner groups that were to be included as eligible providers (EPs) for the MIPS bonus of 2% a year in 2019 if reports on quality, cost, improvement in treatment, and increased use of health care records were met. There were some options that would have allowed LCSWs to be eligible if they had less than $90,000 in Medicare claims and less than 200 Medicare beneficiaries as clients with less reporting. Most LCSWs who are sole practitioners would be in this category. There would have been no penalties for LCSWs who did not submit data in the areas described above.

Two weeks ago CMS took LCSWs off the list of EPs who would be included in 2019 for the bonus. While this certainly will cut down on the administrative work MIPS would have required, it also takes the option for a bonus away from LCSWs. So is the glass half empty, or half full? That depends on how you feel about the loss of the bonus option.

One other note of interest: it appears that there will be a 2-3% increase in reimbursement for psychotherapy services in 2019. The exact amount will vary by region.

In January, CSWA will be presenting a webinar on the ins and outs of Medicare, a complicated topic about which I receive questions regularly. Watch for the announcement next month on “Everything LCSWs Need to Know about Medicare Practice”.

Please let me know if you have any questions on the MIPS changes.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

November 16, 2018

With all the other issues that have been demanding our attention this election season, the effort by the administration to detain immigrants indefinitely flew under the radar.

The administration has proposed new regulations that, among other things, would expand its powers to detain immigrant families indefinitely, as compared to the current situation where there is a limit to how long they can detain minors. The proposed rule, Apprehension, Processing, Care, and Custody of Alien Minors and Unaccompanied Alien Children, would allow the federal government to open its own detention centers with unlimited detention. Currently, these centers must be licensed by states with state oversight. As you know, the administration has been trying to implement this policy by ignoring the states and keeps losing in court. That is why this attempt to bring the policy under Federal oversight is being made.

PLEASE send the message below to the Regulations.gov website at https://www.regulations.gov/comment?D=ICEB-2018-0002-0001 TODAY by 5 pm EST.

“I am a clinical social worker and a member of the Clinical Social Work Association. Please do not pass the proposed rule 2018-19052 which would allow immigrants to beheld indefinitely. This is very harmful to children and adults. The states need the freedom to continue managing this complex situation.”

Thanks for your help and apologies for the late notice.

September 10, 2018

I am pleased to send you the latest installment of “The Aware Advocate,” a quarterly report on legislative activity and advocacy being tracked or conducted by the Clinical Social Work Association This is not meant to be a complete summary of all activities, but a review of what I see as current highlights.

***SPECIAL ALERT – Global Tech Review for Medicare***

The Global Tech review identified 10,000 LCSWs who are Medicare providers as providing more psychotherapy than 50% of the LCSWs in their state or nationally. The review also compared the psychotherapy done by LCSWs to the psychotherapy done by psychiatrists. CSWA has written a letter to CMS Administrator Seema Verma rebutting these criteria along with a detailed description of psychotherapy as practiced by LCSWs. To find these items, go to the CSWA website at www.clinicalsocialworkassociation.org.

The Big Picture – Federal News Affecting LCSWs

Proposed Medicare Rule

CSWA just sent in comments on the proposed Medicare rule to charge the same amount for an office visit, no matter what condition is being treated. CMS-1693-P, part of the FY 2019 Physician Fee Schedule, Medicare Shared Savings Program, Quality Payment Program, and Medicaid Promoting Interoperability Program, could seriously limit the access of Medicare beneficiaries to needed psychotherapy. This rule could have a chilling effect on the different psychotherapy codes available to LCSWs, which have already been rejected by some insurers (90837). Many other medical groups have sent in comments as well. The comments will be reviewed in the next month and a decision about implementing this rule will be made. Stay tuned.

Tricare and Humana

Ever since Humana was named as the administrator for veterans on the eastern side of the country, there have been problems with the processing of claims; difficulty contacting a liaison at Humana; lowered reimbursement; higher copays; and a definition of clinical social work that is quite unclear, i.e., no distinction between casework and psychotherapy. CSWA, led by Government Relations member Susan Horne-Quantannens, LCSW, has been working with the Health Defense Agency to solve the myriad problems LCSWs are facing in this important realm of clinical social work practice.

On the Home Front – Legislative Action in the States

Washington State

There are three areas of activity that will positively affect LICSW practice if enacted in Washington State. The first is the long-sought ability to provide psychotherapy for injured workers who are struggling with emotional distress. A Task Force has been established by Labor and Industries to begin a pilot project allowing LICSWs to provide these services beginning in 2019.

Additionally, there is a project to allow LICSWs to perform mental health evaluations on those incarcerated who may have mental health problems. These people have waited months to get an evaluation about whether they are competent to stand trial, represent themselves, and whether they can be treated in the community. More clinicians are needed to speed up the evaluations. It appears that Department of Social and Health Services has a plan to include Masters clinicians to do evaluations. Details can be found at https://www.disabilityrightswa.org/cases/trueblood/#anchor.

Finally, there is a lawsuit that has been brewing in which an LICSW and an LMHC sued Group Health/Kaiser for refusing to cover psychotherapy for out-of-network providers in an ERISA plan. This was heard in the 9th circuit after four years of wending its way through state and federal courts and sent back to state court where it has a much better chance of a positive result. If you want to read a summary of the case, go to Law360 at https://www.law360.com/articles/1079535/erisa-doesn-t-bump-providers-state-law-suit-9th-circ-says. Congratulations to member Karen Hansen, LICSW, who is one of the plaintiffs.

I hope anyone with knowledge of legislative matters that affect LICSWs in your state will let me know so I can include them in this quarterly report.

Now – what I know you’ve been waiting for – your next Licensure Tip:

Record Retention – since HIPAA passed in 2003, there has been increasing confusion about how long clinicians should keep records following the termination of treatment. Each state has its own laws about record retention as do Medicare and HIPAA. Currently Medicare requires that records be retained for 5 years; the HIPAA Notice of Privacy Practices (NPP) for 6 years; clinical social work state laws and rules require retention anywhere from 3 to 8 years. Be sure to check your state to make sure you are in compliance on record retention for clinical social workers. In addition, the prudent clinician will make sure that record disposal is in compliance with HIPAA requirements, meaning that paper records are shredded to microscopic bits and that discarded computer hard drives are totally cleaned.

June 28, 2018

Here is your reminder that there are over 700 events this Saturday to promote returning the over 2300 immigrant children separated from their parents. Find the one near you at https://www.familiesbelongtogether.org/. CSWA encourages all members to support this crucial effort. Keep in mind some advocacy agencies are suggesting that protests NOT occur at the shelters where children are being housed. The police need to be called for crowd control, prevent attorneys and others from meeting with the children, and further traumatize the children.

Here is a summary of what else you can do to support getting families reunited:

Call the following numbers with the message below:

DHS main number: 202-282-8000

DHS Public Comment line: 202-282-8495

HHS main number: 877-696-6775

HHS Office of the Secretary: 202-690-7000

“I am a member of the Clinical Social Work Association and live in [your state]. Please make all efforts to get immigrant children reunited with their parents immediately and give them all due process in determining whether they are eligible to stay in the US.”

Now that the President has agreed to reunite families, we must keep up the pressure on the Administration to follow through. It is not too late to call your legislators with the above message as well.

As always, let me know when you have made your calls.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

June 26, 2018

As the chaos of how immigrant children and their parents will get reunited continues, there is an ongoing need to plan to attend the rallies that will support this goal. Five major humanitarian advocacy organizations - ACLU, MoveOn, Human Rights Campaign, National Domestic Workers Alliance, and The Leadership Conference - are planning 130 rallies around the country next Saturday, June 30 to stop the damage being done to immigrant families. To find the rallies in your area go to https://act.moveon.org/event/families-belong-together/search/?source=ndwa.

NEW INCARCERATION PLAN: There is a new plan for immigrant children and their parents to be housed at military bases in Texas (https://www.military.com/daily-news/2018/06/25/pentagon-says-2-military-bases-house-immigrants.html). It appears that there will also be a renewed effort to separate children and parents, a plan that was temporarily stopped due to the massive opposition over the past two weeks. It is crucial to continue to let our voices be heard.

ACTION: Please send the following message to ALL MEMBERS of the House or Senate ASAP (emails and phone numbers can be found at https://www.congress.gov/members?q={%22congress%22%3A%22115%22}: “I am a member of the Clinical Social Work Association and a constituent. Please oppose the practice of housing of immigrant children and parents on military bases. It appears that there is still a strong effort to keep immigrant children separated from parents in such settings, causing trauma to them. Tell ORR and DHHS to stop the cruel methods being used on immigrant children and their parents now.”

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

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

June 21, 2018

CSWA is so committed to stopping the cruel immigrant policies of this administration toward children and families that we are going to send an action item a day for the next two weeks. If the damaging policies are still in place, we will continue. Some posts are from other groups, some are from our Government Relations Committee. Do your part and follow through with calls and emails.

As always, let me know when you have made your call or send your email.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice