Tracking Legislation


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The House Health Care Reform bill HR 3500

 

October 8, 2009

Dear Affiliated Society Members,

Here is another update on the health care reform bills winding their way through Congress and some ways that they are  likely to affect LCSWs.

The Baucus bill, sponsored by Sen. Max Baucus (D-MT), is about to pass out of the Senate Finance Committee, after almost two weeks of debate. While there is still much work to do to create agreed upon health care reform bills, some issues are emerging as the major points which will be negotiated in the separate Houses of Congress, and then the Conference Committee which develops the final bill. Some are relatively new, like wellness provisions, some have been ongoing like the public option. In addition, there are issues which specifically affect LCSWs and/or other mental health professionals. There are currently five bills in play, three in the House with relatively minor difference, and two in the Senate with significant differences. There are still difficulties with how to increase health care coverage while decreasing costs.

1. Public Option - there have now been about four different approaches to a "public option" or government-run insurance for the working poor up to 400% of poverty. These include public plans to be run by the Federal government, plans to be run by states (Cantwell amendment), plans that go to 133%, 200%, and 400% of poverty respectively, and a "trigger" option which would create a public option if a certain percentage of the uninsured do not gain insurance in other ways by a certain date. This politicization of this issue has made it hard to see whether cost neutrality could be achieved in any form of a public option.

2. Rating - there have been differences in the way that insurance plans are "rated" or premiums are increased, by age. The Baucus bill has a rating for those over 65 of 4:1 while the HELP bill has a rating of 2:1, as does the House bill. The lower the rating, the less money paid in premiums by those over 65. As an aside, anyone who receives mental health treatment is rated by actuarial as well, but that is not being addressed in this health care reform effort, and would likely be a major battle to change.

3. Wellness "Discounts" - this is a hot topic right now, partly because Safeway has instituted a discount for employees that have a body mass index (BMI) of under 30; have normal blood pressure and cholesterol levels; and do not use tobacco. This may unfairly tax those who do not meet these criteria, aside from the privacy issues involved in employers knowing such personal health information. Safeway claims that 76% of its employees are happy with this system.

4. Psychotherapy Reimbursement - neither Senate bill contains the 5% increase for Medicare psychotherapy services, due to go into effect in 2010, but the House bills include it. Hopefully this will be included in the Conference Committee bill.

5. Medicare Part A - the HELP bill and the House bills return the right of LCSWs to be independent providers in skilled nursing facilities (SNFs), but tie it to the inclusion of LMFTs and LPCs to become approved Medicare providers. This compromise is probably the way that getting LCSWs back into Medicare Part A will occur, if it does.

6. Mental Health Parity - all bills have mental health parity in them for all the plans that are being proposed, a virtual guarantee that there will be a mental health benefit as a 'basic' health benefit. The way that the package of basic benefits will be developed is still under consideration. It is likely that a new oversight body of experts will be created to make this determination.

7. Sustainable Growth Rate Cuts - Medicare payments vary by region. Ever since 2002, payments were also supposed to be tied to the "sustainable growth rate", which is almost an oxymoron at this point, to keep provider reimbursement rates from growing too fast. This year the SGR was supposed to be a 22% cut which will almost certainly be postponed, as it has every year since it was enacted. However, it was not included in the Baucus bill and will need to be postponed through the other health care reform bills which all include it.  It had been hoped that the SGR would be ended in health care reform but whether it will or not is unclear at this time.

It is likely that the final bill will not be decided until late November or December. 
 
A word on contacting your legislators.  I have not asked you to do so over the past three months of the health care reform debates because there has been so many issues that I wanted to see how the bills developed before we decide which ones to weigh in on.  I will be asking you to contact them in the next 2-3 weeks with specific recommended support/concerns.

Please let me know if you have any questions. I will keep you posted on health care reform in the coming days.

Laura Groshong, LICSW, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org
 
 

 

September 15, 2009

Dear CSWA Affiliated Society Members

I have just returned from three days of lobbying in Washington DC for the Clinical Social Work Association and have some new ideas of what the President and Congress (the five committees and one informal "Group of Six") are doing to develop a health care reform plan.

I think the President is trying to pull together at least four major political groups in Congress (Democratic progressives, 'Blue Dog' conservative Democrats, Republican conservatives, Republican moderates), which are being influenced primarily by PHarma, the AMA/other clinical groups, insurers, hospitals, and AARP/other consumer groups. Any of the political groups could theoretically sink health care reform. Mental health groups/associations (57) are working well together in the Mental Health Liaison Group, but don't have the kind of influence that the AMA does. We are working with the AMA on several issues where we have common cause, e.g., stop the proposed 21% Medicare cut to providers scheduled to go into effect in 2010, keep the "evidence based practice" provisions from taking clinical decisions out of our hands (even though this concept started in medicine, and has increasingly become the de facto way that insurers operate), expansion of care to include the uninsured, etc.

As a clinician and lobbyist, I think there is rarely a time when you can accomplish everything you want, in working with patients or in legislation, no matter how strongly you feel. I think President Obama, Speaker Pelosi, and Majority Leader Reid are trying to deal with the reality that the conflicting interests here will not allow wholesale reform of the health care delivery system or expansion of the kind that would be most humane.
 
Most successful legislation in my 12 years of experience is incremental and works pretty well because most issues do not arouse the conflicting passions that health care is right now. I think it has become the lightening rod for other sources of anger and anxiety, not the least of which is job loss and income reduction in general. This is unfortunate because it could stop our getting some improvements in health care delivery and coverage altogether.

Much as some legislators and interest groups have framed this as an all or nothing situation, it does not have to be. The HELP draft bill, HR 3200 in the House and the Baucus/Group of Six bill draft all contain several pilot projects which would give us a chance to see what works best in containing costs, the driving force behind any health care reform.

The legislator working the hardest to make sure that any bill has a strong mental health and substance abuse benefit is Rep. Patrick Kennedy (D-RI). Sen. Barney Frank (D-MA) on the Senate side is the most vocal about making sure there is a strong mental health benefit. But neither House wants to determine what the basic benefits package should look like at this time. A new Federal oversight body may be created to do this, the Department of Health and Human Services could be charged with developing the package, or Congress could eventually decide to do it themselves.

Here's the time frame as I see it. Things are on hold until the Baucus bill comes out on Tuesday or Wednesday. After amendments are considered by the Finance Committee (the 'mark up'), the bill will be passed by the Finance Committee. Then the full Senate will consider the HELP bill and the Finance Committee bill and reconcile them. This will influence the bill, HR 3200, which has been passed out of three committees in the House, but has not passed the whole House of Representatives.  The Majority Leader intends to pass a bill by mid-October; the President has asked for a bill to sign before Thanksgiving, so the two bills which emerge would have to go to conference committee as soon as possible to be integrated.  Again, the Baucus bill is seen as the most likely framework for a bill that could be passed by both Houses.

A word about the "public option", or a government health plan to cover the uninsured who cannot find insurance that they can afford. Though this is a popular concept for liberal representatives in particular, and some clinical groups, keep in mind that the way it is being developed is to tie payment to Medicare rates, possibly plus 5-10%. That could be a reimbursement decrease for some mental health clinicians. It appears that the public option will not be part of the final bill but I wanted you to be aware of the financial piece which is not widely known.

I hope this is helpful in understanding the incredibly complex process taking place in Congress which will affect all LCSWs, and all other mental health and medical clinicians, in some way. Please let me know if you have any questions.


Laura Groshong, LICSW, Director, Government Relations
Clinical Social Work Association

lwgroshong@clinicalsocialworkassociation.org
 
 

 

October 5, 2009


Dear Society Presidents,

Having received several requests from Societies for a newsletter article on health care reform, I have written this summary of the way I think that the major changes being proposed would affect clinical social workers.  Please feel free to include this in your newsletters.
Best regards,
Laura W. Groshong, LICSW, Director, Government Relations
Clinical Social Work Association
206-524-3690
lwgroshong@clinicalsocialworkassociation.org

 

Society Newsletter Article
Health Care Reform and LCSWs: A Good Fit?
Laura Groshong, CSWA Director, Government Relations
July, 2009

In spite of the barrage of information about health care reform over the past few months, there has been little that directly focuses on the way that LCSWs could be impacted by the many changes being considered. This article is an attempt to address the way these potential changes could affect LCSWs. Cost is the driver of most of the proposed changes, but not all the changes would have a negative impact on the income, or health care premiums, of clinical social workers. The Clinical Social Work Association believes that LCSWs should be informed about the potential changes which may affect the ways we are paid, the ways we bill, even where we have our offices.

As responsible professionals, LCSWs need to educate themselves on the ways that health care reform could benefit or harm our patients and ourselves. Many LCSWs are small business owners and have had difficulty finding affordable insurance; health care reform affects us on a personal level as well as the way we get reimbursed for providing mental health treatment. The health care reform issues that I will address here are health homes, Medicare/Medicaid expansion, electronic health records, mental health parity, and the individual insurance market.

'Health homes', also called 'medical homes', could significantly change the professional lives of sole practitioners. This model of health care delivery would require all providers for a given patient to demonstrate on-going communication with each other for third-party reimbursement. One way of organizing health homes would be to have all staff on salary. The models most often cited are the Mayo Clinic in Minnesota and the Cleveland Clinic in Ohio. These clinics have the capacity to provide in-house consultation for any medical or mental health condition. The primary reason that LCSWs should care about this concept is that most clinics currently do not use LCSWs as mental health providers; social workers have the role of discharge planners. The health home model could also offer a new role for social workers, as there will be a 'care coordinator' who would determine what services are included for each patient, but this is not the work that most LCSWs choose to do. A 'virtual' clinic, where communication with other health care providers is done by electronic or phone communication, would be another way for LCSWs to continue to provide mental health treatment. This kind of 'clinic' would generally require closer communication with other medical/mental professionals than most LCSWs have today. In short, widespread implementation of health homes could limit the ways LCSWs currently provide treatment.

Medicare and/or Medicaid expansion could significantly increase the pool of potential clients for LCSWs. Expansion of Medicare coverage has gone as low as 45 years of age in some proposals; Medicaid coverage expansion has many supporters, and plans range from increasing coverage, currently 100% of the poverty level, to those earning from 133-400% above the poverty level. Another form of expanded access to health care would be the 'connector' model, like the one in Massachusetts which allows the people who do not have access to health care through their employers to obtain it through a new 'public option', which could also provide increased access to LCSW services, if we are included as providers. In general, expanded coverage would probably be beneficial for patients and LCSWs.

The most likely change which will impact LCSW practice is the implementation of electronic health records, commonly called health information technology (HIT). This is an important component of the 'health homes' where HIT records would be available to all providers for a given patient electronically. The option of keeping paper records will very likely no longer be in effect for third party reimbursement within the next five years. Record keeping will be much more important and the dual record-keeping in HIPAA Rules, i.e., the Medical Record and Psychotherapy Notes, will probably become more common to protect sensitive information. If the privacy requirement which were enacted in the ARRA/HITECH bill are implemented, i.e., encryption, audit trails, minimum necessary transmission of information, notification of breaches, etc., this may not be a serious problem for LCSWs. Those of us who still use paper records will either have to stay 'off the grid', i.e., keep all services private pay, or switch to electronic record-keeping.

Mental health parity as an offering was enacted at the Federal level in the past year, in addition to a phased in equal co-pay for Medicare patients which would reach parity with medical co-pays in 2014. Most proposed bills on health care reform would strengthen these first steps to implement mandated parity and equal co-pays sooner, possibly by 2011, which would benefit the patients seen by LCSWs, as  well as by other mental health providers.

Access to individual insurance plans may not be an issue if sole practitioners are required to administratively join health homes, which would likely provide some form of health insurance.  The options for access to the individual market, if that is where LCSWs get their insurance, are very likely to expand, as most bills require equal access for small businesses and individuals to insurance markets. The current high premiums for individual health insurance is very likely to fall to the range of small business insurance premiums.

There are other proposed changes which could affect LCSW practice including revising self-insured (ERISA) plans, some of which currently exclude LCSWs as providers, and preventive services, which currently are not covered for most providers, including LCSWs.

In short, it seems likely that LCSWs will find there are changes in the way we get reimbursed for our services and access insurance for ourselves over the next few years, if health care reform takes place. The most helpful changes could be the expansion of Medicare/Medicaid and the implementation of true mental health parity and co-pays, as well as more reasonable health care premiums for sole practitioners. The greatest cause for concern at this time is the implementation of medical homes, which could exclude LCSWs as mental health clinicians. The Clinical Social Work Association, an independent membership organization, is working hard at the national level to make sure that LCSWs are included in all health delivery systems and have access to their own good health insurance. To join CSWA, please download the application which can be found at www.clinicalsocialworkassociation.org.


July 25, 2009

Dear Affiliated Society Members,

I wanted to let you know about a helpful document on HR 3200, the House health care reform bill, prepared by the House Energy and Commerce Committee.

Health care reform legislation continues to be complicated and hard to integrate. This District by District Analysis for each Federal district of all House members shows the ways each district would be impacted, were HR 3200, the House bill working its way through three House Committees, to pass. It is a useful way to look more closely at how the bill would impact small businesses, seniors in Medicare, health care providers, and the uninsured. This Analysis also includes an estimate of the impacts of the surtax that is used to pay for the legislation. HR 3200 will also eliminate the 24% cut to Medicare providers, including LCSWs who are Medicare providers, currently set to take effect on December 31, 2009. You can find the Analysis on the House Energy and Commerce Committee website at
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1717:hr-3200-americas-affordable-health-choices-act-of-2009-markup-district-by-district&catid=156:reports&Itemid=55

While much work remains to be done before a viable health care reform bill is created, this may be helpful to you in understanding how the House bill would specifically address some of the problems we are trying to fix in our health care system. CSWA is working vigorously to insure a strong mental health benefit as part of the final health care reform bill.

Let me know if you have any questions about this document or the health care reform process at this point. I will continue to try to provide information and materials on the legislative process of health care reform and how it will affect clinical social workers.

Laura Groshong, LICSW, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org


Federal Stimulus Plan, Act of 2009 Mandates Changes to HIPAA:

April 2, 2009

We, psychotherapists and counselors, are already highly attentive to privacy issues and set high standards in regard to confidentiality and disclosures. As a result, our existing standards often exceed the minimum standards mandated by HIPAA. It is, however, critically important to stay abreast of changes in the law requiring increased vigilance in protecting our patients' right to privacy.

The different provisions of the new Federal American Recovery and Reinvestment Act of 2009 have different effective dates. Some provisions take immediate effect, while others will not go into effect until 2010.

Summary of some of the new Act's provisions relevant to psychotherapists:
Expansion of individual rights: When patients, according to the new law, pay 100% out of pocket, they can direct their therapists to limit disclosure and specify that information cannot be provided to their health insurer (or others). As psychotherapists we are already required to obtain clients' disclosure in such situations.

"Minimum necessary" rule: Previously, under HIPAA, the "minimum necessary" rule instructed covered entities to keep disclosures to the minimum amount necessary to accomplish the intended purpose. Therapists must always keep the "minimum necessary" rule in mind and reveal only what is truly necessary when communicating (always with clients' permissions) with medicating psychiatrists, GP's, etc. The new Act intends to tighten up what information may be disclosed.

State attorneys general are now allowed to bring HIPAA enforcement actions.

Electronic Medical Records concerns

March 9, 2009

Dear Affiliated Society Members,

CSWA has been tracking the move toward electronic medical records in a careful, concerned way. Aside from the major privacy concerns electronic records raise, the question of whether the use of electronic records will really save money in health care has been debatable.

Though the recently passed Economic Stimulus Bill (see CSWA post on ARRA, 2/19/09) had a strong privacy component for electronic medical records, the risks to privacy are still possible. As clinicians, we need to continue to monitor the impact of electronic health records on privacy.

This article in TIME magazine, March 5, "Electronic Medical Records: Will They Really Cut Costs?" by Scott Haig, MD, suggests that the push to electronic records, will not only lead to less privacy, but will ultimately increase the cost of health care. While this may not have a major effect on psychotherapy codes (because the code options we have are limited and not generally connected to inpatient care), I thought you might like to read this excellent 'big picture' article, which can be found at http://www.time.com/time/health/article/0,8599,1883002,00.html .

I hope this article useful in thinking about the issue of electronic health records, a topic which will directly affect the practices of clinical social workers who use third party payers, in the near future.

Laura Groshong, LICSW, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org

CSWA has a new look on our website - be sure to check it out at www.clinicalsocialworkassociation.org .



ARRA/HITECH Act Signed by President

February 17, 2009

The President has signed the American Recovery and Reinvestment Act (H.R. 1), which includes the HITECH Act on rules for the use of electronic health information. There are some important elements that affect clinical social workers.
The bill contains the Health Information Technology for Economic and Clinical Health or "HITECH Act" (at Title XIII), about which I have sent several alerts. I am happy to report that this form of the HITECH Act is much better than any of the previous bills regarding privacy and privilege,including the original HITECH Act.

There was a last minute consideration of the removal of the patient-psychotherapist privilege, granted by the Supreme Court (1996)in Jaffee v. Redmond. This would have been a terrible blow to the cornerstone of our clinical work. Due to much work by mental health associations, the bill instead has a protection of privilege, stating that nothing in the Subtitle on privacy will constitute a waiver of "any privilege otherwise applicable to an individual with respect to the protected health information of such individual." Section 13421(c).
Additionally the bill includes the following protections of health care information:
· Patient notification of all disclosures without consent, or "breaches", of protected health information;
· Creation of an Health Information Technology Policy Commission charged, among other things, with creating electronic records which will "segment" or separate mental health information (and other sensitive information) from the general record with greater privacy protection;
· Encryption of patient information when sent outside a health care network;
· Audit trails to determine who has accessed health care information and for what purpose;
· The right of the provider to determine what "minimum necessary" information is for disclosures (the Secretary may issue guidelines later); and
· Opt-in requirements for sale of patient information, i.e., patients must consent in writing to the sale of their health care information.

Finally, there will be grant money available for providers who need financial assistance for building an electronic health care record. I will let you know as I learn more about the details of this option.

Thanks to all of you who responded to alerts on health information technology. You contributed to making privacy protection of health care records much stronger.

Laura Groshong, LICSW, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org


Fair Pay Act and S-CHIP

February 2009

Dear Affiliated Society Member,
I thought you would like to see this good news.
President Obama signed the S-CHIP legislation into law this afternoon after the House re-passed the Senate version of the bill. The major difference in the Senate bill was that physicians cannot self-refer to hospitals in which they have part ownership.
The mental health parity requirement now included is critical because although low-income children have much higher rates of mental health conditions, only about 40 percent of states offer full coverage of necessary services for children with complex mental health needs.
The bill aims to cover at least 4.1 million additional children, funded primarily by a 62-cent increase in the federal tax on cigarettes, with proportional increases for other tobacco products. Some legislators see this as an important step toward achieving universal health coverage.
I know some people have had trouble with the President's email address, especially those on AOL. I recommend trying www.whitehouse.gov and then go to "Contact Us".

Please send the following message: "Dear President Obama, I am a member of the Clinical Social Work Association. On behalf of all our nation's children, I applaud your signing the S-CHIP bill which will benefit us all. Sincerely, __________LCSW [or MSW]


Thanks for your help. As always let me know when you have sent your messages and any responses you receive.

Laura Groshong, LICSW
CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org


January 29, 2009

Dear Affiliated Society Members,
The SCHIP Bill, which will provide health care for 4 million more children and was vetoed twice by President Bush, has passed the House and Senate tonight - again - and is poised to be signed into law by President Obama. This is a tangible sign that the needs of children are finally being taken into account.
The Lilly Ledbetter Fair Pay Act (S. 181), reversing the Supreme Court decision that limited women and other workers' ability to sue for wage discrimination, was signed into law today by President Obama. This bill was named after the Goodyear Tire employee who sued when she found she was being paid $6000 less than any employee at her level, some with less seniority. She was present at the signing.
The goals and values of the Clinical Social Work Association are being implemented. Please send your thanks to President Obama for his recognition of equal pay for equal work and encourage him to sign the S-CHIP bill when it reaches his desk.
Please send President Obama the following message at www.whitehouse.gov/contact: "Dear President Obama, I am a member of the Clinical Social Work Association. Thank you for supporting clinical social work goals in signing the Lilly Ledbetter Fair Pay Act into law. I hope you will also sign the S-CHIP bill into law when it reaches your desk. I am proud to have a community organizer as our President. Sincerely, ___________, LCSW/LICSW"
Thanks for your help. As always let me know when you have sent your messages and any responses you receive.
Laura Groshong, LICSW

CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org.

CSWA has a new look on our website - be sure to check it out at www.clinicalsocialworkassociation.org .

Mental Health Parity

October 6, 2008

Dear Affiliated Society Members,
I've received some questions about the Act which contains mental health and substance abuse parity that I will try to answer here.

Here is what the Act contains.
The Act requires parity between mental health/substance abuse services and medical/surgical services, i.e., if a mental health/substance abuse benefit is offered, it must be at parity with medical surgical benefits in the following areas: 1) co-pays; 2) coinsurance; 3) deductibles; 4) out-of-pocket expenses; and 5) out-of-network coverage.
Here is what the Act does not contain.

First, the Act does not contain a mental health mandate; it contains a mental health offering, meaning that any insurance plan covering large businesses, whether it is a self-insured plan (with Federal oversight) or a state regulated plan, must offer mental health benefits AT PARITY with medical/surgical benefits in IF mental health benefits are offered. There is no requirement that a mental health benefit or substance abuse benefit be offered. This mainly covers about 82 million enrollees in ERISA plans who had no protection in the plans that were exempt from state parity laws.

Second, there are several major groups that are not included in this Act. They are Medicare (which has a recently mandated mental health co-pay at parity with medical/surgical co-pays which will be phased in over the next 6 years, passed in separate legislation); Medicaid; small business plans; and individual health
plans.
Third, there is no mention in the Act of the mental health/substance abuse diagnostic categories which must be covered if a mental health/substance abuse benefit is offered, or the length of treatment that must be provided. 'Medical necessity' can still be determined by public or private insurers in these areas, though it is likely that attempts to limit parity to certain diagnostic categories will be under more scrutiny.

This Act must be implemented by the Departments of Labor, Health and Human Services, and the Treasury by October 3, 2009.

Many thanks once again to all of you who responded to the legislative alerts I and others sent requesting your help in contacting members of Congress. Your actions contributed to this achievement.

Laura Groshong, LICSW

Laura W. Groshong, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org


October 3, 2008

Dear Affiliated Society Members,

The House passed the Emergency Economic Stabilization Act today, which included the mental health parity bill, on a vote of 263-171.

You can find how your Representative voted by going to:
http://clerk.house.gov/evs/2008/roll681.xml.

Please thank your Representative for passing this legislation with the following message: "Thank for supporting the Emergency Economic Stabilization Act and giving our citizens better access to mental health services."

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

Regards,
Laura Groshong, LICSW
CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org



October 3, 2008

Dear Affiliated Society Members,

I just wanted to respond to some concerns which have been raised about the fact that mental health parity has been rolled into the economic bailout bill and give you the CSWA Government Relations Committee's thinking about it.

Those who object to the connecting of parity and the financial bailout have a good point. This is not a perfect bill, or an ideal legislative situation. And reasonable people can disagree, especially in a situation like this.

Politics in my experience is the art of compromise. There is rarely a perfect bill, and as the old saying goes, politics makes strange bedfellows. This occurs in bills as well. We would rather have seen mental health parity pass as a free standing bill, but would rather have it pass as part of a bill that is unrelated, than not pass at all.

Some people may object to the Emergency Economic Stabilization Act on its merits. We haven't heard from anyone who objects to the mental health parity on its merits. We do understand the problem with having a good bill connected to a less good bill. But this is a major part of legislative success.

Pragmatism is also crucial in legislative success. The CSWA Government Relations Committee pays close attention to the line where political collaboration undermines our ethical standards while meeting our legislative goals, and when political collaboration, while not a 'natural' fit, is congruent with our ethical standards and meets our legislative priorities.
I hope this helps explain the reasoning the CSWA Government Relations Committee went through to reach the decision to support the linking of mental health parity and the Emergency Economic Stabilization Act.

Laura Groshong, LICSW
Director, Government Relations
Clinical Social Work Association
4026 NE 55th Street
Suite C
Seattle, Washington 98105
206-524-3690
lwgroshong@comcast.net



October 2, 2008

Dear Affiliated Society Members,


I need your help immediately to pass mental health parity in the House.
As you know, the Emergency Economic Stabilization Act passed the Senate yesterday 74-25, with the mental health parity bill (HR 1424) that we have been fighting for.

The bill will go to the House tomorrow for their vote. call their U.S. Representative by using the toll-free Parity Hotline: 1-866-parity4 (1-866-727-4894). (The Parity Hotline reaches the U.S. Capitol switchboard, which can connect callers to the offices of their members.)

PLEASE CALL your Representative IMMEDIATELY with the following message:"I am a member of the Clinical Social Work Association [or your Society] and a constituent. Please have Representative _______ vote for the Emergency Economic Stabilization Act that includes needed mental health and addiction parity legislation."

With any luck, we will be watching the President sign this bill shortly!
As always, please let me know if you send any messages or receive any responses from your Representatives.
Laura Groshong, LICSW

CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org



September 29, 2008

Dear Affiliated Society Members,

The Social Work Revitalization Act needs your attention!

This Act (S. 2858/H.R. 5447) is currently in Congress and being supported by CSWA and NASW. To see the CSWA Position Paper on SWRA, go to http://www.clinicalsocialworkassociation.org/policy-paper-letters.

This Act will create a Commission to review the work being done by social workers and clinical social workers of all kinds in all settings;compare the educational debt taken on by social workers in pursuing their education to the anticipated income of social workers and clinical social workers; and consider ways to defray educational costs for social workers.

Please go to http://www.visi.com/juan/congress/ to access the email address of your representative and send the following message to your members of Congress: "I am a member of the Clinical Social Work Association and a constituent. Please support the Social Work Revitalization. This Act will help determine all the crucial roles being filled by social workers and clinical social workers and how to support social work education."

As always, please let me know when you have sent your messages and if your receive responses from your members of Congress. Many thanks for your help on this important issue.

Laura Groshong, LICSW

CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org



September 23, 2008

Dear Affiliated Society Members,

The saga of Federal mental health parity continues. Today the Senate and House each passed parity legislation by strong vote margins.

The Senate vote of 83 to 12 is posted as vote #204 at:
http://www.senate.gov/legislative/LIS/roll_call_lists/vote_menu_110_2.htm
This was the Floor vote to pass the Baucus/Grassley amendment #5635, which combined the House/Senate agreement on parity (the Paul Wellstone and Pete Domenici MH Parity & Addiction Equity Act of 2008) with tax extenders, AMT and disaster relief.

The House vote of 376 to 47 is posted at http://clerk.house.gov/evs/2008/index.asp, H.R. 6983, the Paul Wellstone and Pete Domenici MH Parity & Addiction Equity Act of 2008.

These bills need to be consolidated, because they are different bills, to be sent to the President. This is our next goal.

Please check the roll calls and thank any of your legislators who voted in favor of the bills, especially ones you contacted with the following message: "I am a member of the Clinical Social Work Association and a constituent. Thank you for voting in favor of mental health parity today. I hope you will continue to work for a bill that can be sent to the President." Use the Parity Hotline: 1-866-parity4 (1-866-727-4894). The Parity Hotline reaches the U.S. Capitol switchboard; ask for the offices of your members of Congress.

As always, please let me know if you receive messages from your members of Congress and/or have sent your messages. Many thanks to all of you who participated in getting the bills this far.

Best regards,

Laura Groshong, LICSW
CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org

Some members have requested clarification on the URLs for the votes listed below. Here are the direct links.
Senate: http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?
congress=110&session=2&vote=00204
House: http://clerk.house.gov/evs/2008/roll625.xml

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September 22, 2008

Dear Affiliated Society Members,

I wanted to give you an update on the mental health parity bills winding through Congress. The situation is very fluid and will no doubt change between now and the eventual passage of the compromise bill, if it occurs, by the end of the week.

No action is needed at this time UNLESS you have not contacted your Senators and Representative in response to the three previous emails that I have sent requesting action on mental health parity. If that is the case, please refer to yesterday's email on contacting your Representative, and include your Senators as well.

Here's the story. House leadership today decided not to act on its own mental health parity bill. Instead, they will wait to see whether the Senate parity bill passes tomorrow.

The Senate is planning to make the parity bill part of an energy tax bill, H.R. 6049, which would offer funding for a variety of areas, including disaster relief and alternative minimum taxes. If this bill, with parity included, passes the Senate tomorrow, it will be sent to the House where it will be acted upon quickly.

Both Houses of Congress have strong support of the mental health parity offering (remember, it is not a parity mandate, but a parity offering, i.e., if mental health benefits are included in an insurance plan, they must be at parity with medical benefits). The highly charged economic and political environment in Congress right now is affecting the process, i.e., the 'horse trading' that occurs as the deadline for passing any bill comes into play.

The wish to honor Sen. Edward Kennedy (D-MA) and have passage of parity as part of his legacy is an important component of the situation and will influence the process in both Houses.

Sorry for the many emails on this. It is a very important and complex process.

Regards,

Laura Groshong, LISCW, Director, Government Relations
Clinical Social Work Association
lwgroshong@clinicalsocialworkassociation.org



September 18, 2008

Dear Affiliated Society Members,

Many thanks to all the CSWA and affiliated society members who contacted their members of Congress to request that a Federal mental health parity bill be passed this past week. CSWA and affiliated society members also attended the Mental Health Parity Rally held yesterday in Washington D.C. to pass the bill.

Funding in the Senate has been achieved for the parity bill through the inclusion of the bill in a bipartisan tax package, which includes many crucial pieces of legislation. The Senate will be taking up the legislation shortly. The House leadership is meeting this afternoon to determine how to address the Senate bill and/or parity separately.

I will keep you posted on developments. No action is needed at this time. The possibility of mental health parity passing this year is looking more positive.

Regards,

Laura Groshong, LICSW, CSWA Director, Government Relations
lwgroshong@clinicalsocialworkassociation.org



Legislative Reports from Capitol Consultants

Weekly Legislative Update
February 20, 2009


This Week in Review

The State House Quote of the Week
"Ya'll know Mr. Kirsh is a DINO. Not only because he is old, but he is also a Democrat In Name Only."

- Rep. Gilda Cobb-Hunter was making jest of the fact that Rep. Herb Kirsh (D-Clover) voted for a dramatic cut to local funding. In Thursday evening's full Ways and Means budget hearing, all of the other Democrats on the committee voted against this measure leaving Rep. Kirsh as the only Democrat to side with the Republicans. Rep. Kirsh is the oldest and longest serving member of the House of Representatives.

During the sixth week of the first session of the 118th General Assembly, House Ways and Means members passed their version of the state appropriations bill and Senators finally finished up the State Ports Authority reform bill.

Cigarette Tax Bill: A long-awaited cigarette tax bill was introduced this week by House Speaker, Bobby Harrell. Under Harrell's plan, the state's cigarette tax would increase to 57 cents, an increase of 50 cents. The additional funds that could be generated by the tax increase would be going to help small businesses and low-income workers to buy health insurance. Last year, Governor Sanford vetoed the cigarette tax bill because he wants the additional revenue to help pay for the elimination of corporate income taxes.

Dollars and Cents: Members of the House Ways and Means committee passed their version of the State Appropriations bill a few minutes before 10:00 PM on Thursday night. Members acknowledged that state tax revenues will not begin to increase at a self sustaining level until FY 2011-2012 when the stimulus money runs out. However, they said that the choice to decline federal money would have meant $700 million in cuts from this year's budget.

Word of the Week: "Audit": During the Ways and Means budget deliberations, Representative Brian White (R-Anderson) noticed that there was more than $250,000 missing from the Office of Veteran's Affairs. To his surprise, he discovered the Governor's staff had spent the money on a new facility and on the Governor's security detail. White's suggestion? Maybe it is time the Governor's office was paid a visit from the Legislative Audit Council.

Dropping the Hammer on State Agencies: The SC Legislative Audit Council (LAC) is the state agency that performs independent audits of state operations. They are governed by a Board made up of five public members and four legislative members. Most recently, the LAC uncovered that the Department of Disabilities and Special Needs (DDSN) allowed $9 million that was originally allocated for the autism program had been rerouted to the agencies general fund instead. Governor Sanford used his executive power to remove four Commissioners at DDSN. Commissioners John Vaughn of Greenville, Edythe Dove of North Charleston, John Powell of Walhalla, and William F. Bishop of Leesville were asked to resign from the Board earlier in the week.

State Ports Authority: Senators finally passed a bill Tuesday that would restructure the State Ports Authority. The Senate passed the bill by a vote of 28 – 15 after they agreed to an amendment that would limit Governor Mark Sanford's power over the authority's board. Another amendment to the bill by Sen. Greg Ryberg (R-Aiken) shortens the terms of Ports Authority board members from seven years to five.

Local Governments Take A Hit: In the Ways and Means committee hearing on Thursday night, the Local Aid to Subdivisions Fund was cut by $122 million. What makes this even more troubling is the maneuvering that took place to carve out a law that prohibits such a cut. Just before budget debate resumed, committee members voted to pass a bill that removes the prohibition against cutting local aid to subdivisions more than the level at which it was funded in the previous fiscal year. The fund would go from $48.1 million to $27.7 million. The Local Aid to Subdivisions fund was established in the early 90's to give local governments a stable funding mechanism so these governments would not be solely reliant on property taxes and other fees.

This publication is produced for you by the legislative team at Capitol Consultants, Inc. If you would like further information, please contact Ashley Smith Hunter at Ahunter@capconsc.com or at 803-252-1087.


Weekly Legislative Update- 3rd week
February 5, 2009


This Week in Review

State House Quote of the Week
"Like my momma always said, growing old is mandatory. Growing up is optional. Bet you can't guess which one applies to me."

- Senator Harvey Peeler (R-Gaffney) teased Senator Nikki Setzler (D-West Columbia) when they
were having a discussion on how the current state tax structure affects the aging population. Senate Finance Committee members were discussing the Tax Realignment Commission (Senate Bill 12) in a hearing on Tuesday afternoon. During the third week of the first session of the 118th General Assembly, House members discussed pay day lending reform and Senators were in Perfunctory Session on Tuesday and Wednesday. Payday Lending Update: The House Labor Commerce and Industry Committee passed the payday lending bill this week. The bill extends the payment period for borrowers who are unable to pay back their loans on time. The bill will be taken up on the House floor Tuesday, February 10.
Gilda Takes Democrats to Task: In Tuesday's meeting of the House Minority Caucus, Rep. Gilda Cobb-Hunter (D-Orangeburg) admonished members of the caucus who are supporting the bill that were debated in House Judiciary this week regarding the abortion laws. She said "If men could have babies we wouldn't be having this debate!" She urged the caucus members to stop being afraid to speak up and take sides on the issues. One bill, dealing with a mandatory 24 hour wait period before an ultrasound passed the full Judiciary committee and was sent to the House floor. The other, dealing with life saving techniques performed on an aborted fetus, passed the House Judiciary subcommittee and will be heard in the full House Judiciary committee next week.

Confederate Memorial Day: Senator Robert Ford (D-Charleston) is the sponsor of a bill that would force counties and municipalities to give employees paid leave for Confederate Memorial Day (May 10th) Currently, only 10 of the state's 46 counties now recognize Confederate Memorial Day and allow employees to take paid leave. The bill passed the Senate Judiciary subcommittee on Tuesday. Many questioned Senator Ford, an African American, about this legislation because they see this as a bill honoring those who wanted to keep slavery intact.
Word of the Week: "Restructuring": This week, the Senate Transportation committee gave approval to a bill that would restructure the make up of the State Ports Authority Board. This is just the latest in a slew of restructuring bills being taken up by the members of the General Assembly. Speaker Bobby Harrell and Rep. Kenny Bingham also introduced a bill on Wednesday that would restructure and reform the Employment Security Commission. Restructuring has been a top agenda item for Governor Mark Sanford for the last six years. There have been more than a dozen restructuring bills introduced in the House and Senate this year.


SCENE AND HEARD
A glimpse of what is happening on the political scene and what the Cap Con legislative team is hearing behind the scenes.
The Sale of SC2: At a reception for the Myrtle Beach Chamber of Commerce on Wednesday night at the Clarion Hotel, Lt. Governor Andre Bauer was talking about the lack of privacy an elected offical has. The latest proof of this was numerous blog reports on the sale of Bauer's Smart Car. (Also known as "SC2" because of the Lt. Governor's license plate.) The car is for sale and parked outside of Bauer's Blossom Street home.

This publication is produced for you by the legislative team at Capitol Consultants, Inc.
If you would like further information, please contact Ashley Smith Hunter at Ahunter@capconsc.com or at 803-252-1087.

 

Weekly Legislative Update - second week
January 30, 2009


This Week in Review

State House Quote of the Week
"No sir! I just put mine out on the back porch with my beer in it."
- On Tuesday's meeting of the Senate Judiciary Committee, the members discussed Senate Bill 8
that provides financial assistance to low income citizens as an incentive for them to use energy efficient products in their home. This was the response that Dukes Scott, with the State Office on Regulatory Staff, gave to Senator Jake Knotts when he asked him if he had ever tried to take his refrigerator to the dump. During the second week of the first session of the 118th General Assembly, House members listened to state agencies present their budget requests and discussed payday lending. Senators spent a lot of time discussing the state tax systems in their subcommittees.
DSS Embezzlement: On Tuesday, during the Department of Social Services budget hearings, DSS Director Kathleen Hayes answered a lot of questions about the former DSS Finance Director that has been charged with embezzling $5.5 million from the agency. The members of the subcommittee asked questions about how the money was stolen. Most poignantly were the questions asked about when the Secret Service and SLED informed the Governor's office about the investigation. The members also asked who the independent firm was that audited the agency. Director Hayes informed the members of the subcommittee that she was very angry about the fraud- especially in such tight budget times. She also stated that she was working with SLED to develop new fraud prevention measures.
Word of the Week: "Stimulus" On Wednesday, the US House of Representatives passed an $819 billion economic stimulus plan. South Carolina stands to receive $3.2 billion. $480 million in the stimulus plan would go to roads and infrastructure. United States Senator Jim Clyburn inserted an amendment to the stimulus plan that would give the state legislative leaders to accept the stimulus money if Sanford did not act on it in 45 days. Governor Sanford is opposed to the stimulus package because he views it as using more federal deficit spending that will ultimately come back to cost the tax payers money.
Furlough: The members of the South Carolina House and Senate are taking furloughs in the coming weeks of the legislative Session to try to ease the burden of the state budget crisis. Each day that the legislature does not convene saves the taxpayers approximately $55,000.
Payday Lending: Speaker Bobby Harrell introduced a bill that would raise the minimum amount that payday lenders could lend to $600/ On Tuesday, this bill passed the House subcommittee. Proponents of the legislation say that in these difficult financial times, some people have no other means when they are faced with immediate financial crises. The legislation is co-sponsored by 75 House members and will be heard in the full House Labor Commerce and Industry Committee on next Tuesday.
Steele'n the Show: The race for the Republican National Committee Chairman was decided at 3:30 this afternoon. After the six rounds of voting, former Maryland Lieutenant Governor Michael Steele defeated South Carolina Republican Party Chair, Katon Dawson, by a vote of 91 to 77. Steele will be the first African American to lead the Republican Party. Governor of Virginia, Tim Kaine, took over the position of Democratic National Committee Chairman when Howard Dean stepped down earlier this month. SCENE AND HEARD
A glimpse of what is happening on the political scene and what the Cap Con legislative team is hearing behind the scenes.
A Warm Welcome Home: Former Canadian Ambassador and Speaker of the SC House of Representatives David Wilkins showed up at the House Republican Caucus's annual event on Tuesday night. At the event, several members of the General Assembly were thrilled to have Wilkins back from the cold. The Former Speaker was not the only surprise guest, many members of the Senate such as Speaker Pro Tempore Glenn McConnell, Lt. Governor Andre Bauer and Senator Mick Mulvaney surprised the House members by attending the event.

This publication is produced for you by the legislative team at Capitol Consultants, Inc. If you would like further information, please contact Ashley Smith Hunter at Ahunter@capconsc.com or at 803-252-1087

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