Though I have not been sending the voluminous posts that I was sending last summer, the issue of immigrant children who are separated from their families, given inadequate housing, and denied basic care is one that CSWA is carefully tracking. Here is some information that will keep you up to date and provide options on how to stop these injustices. There are currently between 1000 and 3000 immigrant children in the US separated from their parents; some older (8 and up) children are being forced to care for younger children.

Summary of Harm – this article is a good summary of the current issues:

https://time.com/5613435/government-moves-migrant-kids-border-inadequate-shelter/

Agencies for Immigrant Children –Here are some good agencies that are working to improve the conditions of immigrant children and reunite them with their families:

Kids in Need of Defense (KIND) works to ensure that no child appears in immigration court alone without representation.

Women’s Refugee Commission offers Resources for Families Facing Deportation and Separation in English and Spanish.

Young Center for Immigrant Children’s Rights advocates for the safety and well-being of unaccompanied kids arriving in the United States. They recently announced a project specifically dedicated to helping children separated from their parents at the border.

Donations to Help – here is one of many organizations that are using donations to help immigrant children:

https://secure.actblue.com/donate/borderfamilies2019?refcode=20190624esborderd&link_id=0&can_id=1dd38bb56c3bb701463ff79392bbbcf5&source=email-this-is-not-immigration-policy-it-is-inhumane-and-cruel&email_referrer=email_569843&email_subject=this-is-not-immigration-policy-it-is-inhumane-and-cruel

Let me know if you have any questions.

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

Clinical Social Work Association

I would like to bring to your attention a group that shares some important goals with CSWA. Please see the Psychotherapy Action Network (PsiAN) invitation below.

Here is some context. A little over two years ago, I sent Margot Aronson, CSWA Deputy Director of Policy and Practice, to Chicago for a meeting of therapists deeply concerned – as we at CSWA are - about the marginalization of relation-based psychotherapy by our professional training programs and by the insurance market. From this meeting came the Psychotherapy Action Network, an excellent match with our CSWA advocacy priorities of promoting awareness of the value of in-depth psychodynamic psychotherapy, of increasing access to and insurance coverage for psychotherapy (especially for chronic disorders), of advocating restoration of respect for clinical judgment over the privileging of medication and short-term treatments, and of addressing the need to improve clinical coursework in schools of social work.

Margot has continued as our liaison to PsiAN; CSWA and PsiAN have become strategic partners; CSWA is also a co-sponsor of the upcoming PsiAN conference (December, San Francisco). Just as CSWA supports their efforts, please consider doing the same as individuals.

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

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

From the Co-Chairs of the Psychotherapy Action Network (PsiAN)

Dear CSWA Membership: 

We invite all of you to become individual members (it’s free!) and thereby share in the rich international conversation and advocacy that PsiAN has begun. 

Since that first meeting [described above in Laura’s note], we’ve grown rapidly to be more than psychologists and more than psychoanalytically oriented – we have nearly 1000 members and 43 organizational partners. We include social workers, counselors, marriage and family therapists, psychologists, psychiatrists, group therapists, and counseling psychologists. Individual members and strategic partners ascribe to theoretical orientations including psychoanalytic, humanistic, Jungian, sensorimotor, and more. We aspire to be a big tent that includes all clinicians, whatever discipline and theoretical orientation, who share our concerns  

Our mission:  The Psychotherapy Action Network is a global community of mental health professionals and stakeholders dedicated to promoting psychotherapies of depth, insight and relationship.  PsiAN aims to restore these therapies to their fundamental place in the mental health landscape through education and advocacy regarding their personal, economic, and sociocultural effectiveness in alleviating suffering and transforming lives.   

PsiAN is a place both to listen and to be heard, and to find avenues for advocacy about issues that concern you. We invite you to visit our website, psian.org, and become a part of the conversation by hitting the "Join Us" button and signing on.

Janice Muhr, PhD, Linda Michaels, PhD, Nancy Burke, PhD

Co-Chairs, Psychotherapy Action Network

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 25^thbest 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.

 

Laura Groshong, LICSW, Director, Policy and Practice

Clinical Social Work Association
The National Voice of Clinical Social Work

Missouri Medicaid Audit & Compliance (MMAC) requests that any provider who believes documentation in support of servicing Missouri Medicaid participants is no longer available due to recent weather events, complete the Attestation of Medical Record Loss or Destruction Form which can be found at https://mmac.mo.gov/providers/provider-enrollment/new-providers/provider-enrollment-forms/ 

CSWA has been receiving many questions about the use of 'text therapy' and texting in general as part of LCSW practice. 

The paper attached is CSWA's attempt to clarify the issue for our members. 

Thanks to Margot Aronson, LICSW, CSWA Deputy Director of Policy and Practice, for her great work on this project.

CSWA - Text Therapy - 5-22-19 (1).pdf

Dear CSWA Affiliated Members,

Late last night (December 1) the Senate passed its version of HR 1, the House tax reform bill, and I have been up since 6:30 amtrying to read and digest the 400+ page bill.  The truth is, I wish that I had slept in today.

This bill seems to contain a lowering of taxes for the wealthy over the next 10 years and, for the most part, raising taxes for everyone else. One of the ways this has been done is by elimination of the individual mandate for the Affordable Care Act.  The mandate provided $338 billion for the ACA. It is estimated that premiums for insurance in general will rise by 10% or more, causing many to stop using the ACA marketplace, with the likely effect of making the survival of the ACA questionable.

There are some other specific ways that HR 1 will be harmful to clinicians, not the least of which is having graduate students count their tuition as taxable income, adding a huge tax burden to most doctoral students. Additionally, with the elimination of the requirement that Essential Benefits be included in all insurance plans, we will see a return to the pre-ACA days, when most plans didn’t offer mental health treatment/substance use coverage, and those that did were prohibitively expensive. 

Passage by the Senate of such a mean-spirited bill is discouraging. However, keep in mind this is not the final form that the bill will take:  a Conference Committee will be working to integrate the House Tax Reform bill and the Senate version over the next few weeks, with hopes of coming to agreement for the President’s signature by Christmas.  CSWA encourages members to write members of the Conference Committee as soon as they are appointed; we’ll have contact information available soon.

For right now, we urge you to send the following message to your representative: “I am a member of the Clinical Social Work Association and a constituent.  HR 1 as passed by the Senate will harm those covered by the Affordable Care Act by eliminating required access to the mental health and substance use services that they need.  We are in the midst of an opioid crisis; the majority of people affected by it also have mental health problems. Please make required mental health and addiction coverage part of all health insurance plans.” You can find email addresses of your senators and representative at https://www.congress.gov/members ; .

Please let me know when you have sent your messages and watch for more legislative action in the next week.

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

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

As you know, the American Psychiatric Association makes minor changes to the Diagnostic and Statistical Manual (currently DSM-5) each year based on changes to the International Classification of Diseases (currently ICD-10).  Here are the changes which went into effect yesterday.  This year almost all changes are related to substance use disorders. 

DSM-5 Diagnoses and New ICD-10-CM Codes

As Ordered in the DSM-5 Classification

Download Easy-to-Print Guide

Disorder	DSM-5 Recommended ICD-10-CM Code for use through September 30, 2017	DSM-5 Recommended ICD-10-CM Code for use beginning October 1, 2017
Avoidant/Restrictive Food Intake Disorder	F50.89	F50.82
Alcohol Use Disorder, Mild	F10.10	F10.10
Alcohol Use Disorder, Mild, in early or sustained remission	F10.10	F10.11
Alcohol Use Disorder, Moderate	F10.20	F10.20
Alcohol Use Disorder, Moderate, in early or sustained remission	F10.20	F10.21
Alcohol Use Disorder, Severe	F10.20	F10.20
Alcohol Use Disorder, Severe, in early or sustained remission	F10.20	F10.21
Cannabis Use Disorder, Mild	F12.10	F12.10
Cannabis Use Disorder, Mild, in early or sustained remission	F12.10	F12.11
Cannabis Use Disorder, Moderate	F12.20	F12.20
Cannabis Use Disorder, Moderate, in early or sustained remission	F12.20	F12.21
Cannabis Use Disorder, Severe	F12.20	F12.20
Cannabis Use Disorder, Severe, in early or sustained remission	F12.20	F12.21
Phencyclidine Use Disorder, Mild	F16.10	F16.10
Phencyclidine Use Disorder, Mild, in early or sustained remission	F16.10	F16.11
Phencyclidine Use Disorder, Moderate	F16.20	F16.20
Phencyclidine Use Disorder, Moderate, in early or sustained remission	F16.20	F16.21
Phencyclidine Use Disorder, Severe	F16.20	F16.20
Phencyclidine Use Disorder, Severe, in early or sustained remission	F16.20	F16.21
Other Hallucinogen Use Disorder, Mild	F16.10	F16.10
Other Hallucinogen Use Disorder, Mild, in early or sustained remission	F16.10	F16.11
Other Hallucinogen Use Disorder, Moderate	F16.20	F16.20
Other Hallucinogen Use Disorder, Moderate, in early or sustained remission	F16.20	F16.21
Other Hallucinogen Use Disorder, Severe	F16.20	F16.20
Other Hallucinogen Use Disorder, Severe, in early or sustained remission	F16.20	F16.21
Inhalant Use Disorder, Mild	F18.10	F18.10
Inhalant Use Disorder, Mild, in early or sustained remission	F18.10	F18.11
Inhalant Use Disorder, Moderate	F18.20	F18.20
Inhalant Use Disorder, Moderate, in early or sustained remission	F18.20	F18.21
Inhalant Use Disorder, Severe	F18.20	F18.20
Inhalant Use Disorder, Severe, in early or sustained remission	F18.20	F18.21
Opioid Use Disorder, Mild	F11.10	F11.10
Opioid Use Disorder, Mild, in early or sustained remission	F11.10	F11.11
Opioid Use Disorder, Moderate	F11.20	F11.20
Opioid Use Disorder, Moderate, in early or sustained remission	F11.20	F11.21
Opioid Use Disorder, Severe	F11.20	F11.20
Opioid Use Disorder, Severe, in early or sustained remission	F11.20	F11.21
Sedative, Hypnotic, or Anxiolytic Use Disorder, Mild	F13.10	F13.10
Sedative, Hypnotic, or Anxiolytic Use Disorder, Mild, in early or sustained remission	F13.10	F13.11
Sedative, Hypnotic, or Anxiolytic Use Disorder, Moderate	F13.20	F13.20
Sedative, Hypnotic, or Anxiolytic Use Disorder, Moderate, in early or sustained remission	F13.20	F13.21
Sedative, Hypnotic, or Anxiolytic Use Disorder, Severe	F13.20	F13.20
Sedative, Hypnotic, or Anxiolytic Use Disorder, Severe, in early or sustained remission	F13.20	F13.21
Amphetamine-type Substance Use Disorder, Mild	F15.10	F15.10
Amphetamine-type Substance Use Disorder, Mild, in early or sustained remission	F15.10	F15.11
Amphetamine-type Substance Use Disorder, Moderate	F15.20	F15.20
Amphetamine-type Substance Use Disorder, Moderate, in early or sustained remission	F15.20	F15.21
Amphetamine-type Substance Use Disorder, Severe	F15.20	F15.20
Amphetamine-type Substance Use Disorder, Severe, in early or sustained remission	F15.20	F15.21
Cocaine Use Disorder, Mild	F14.10	F14.10
Cocaine Use Disorder, Mild, in early or sustained remission	F14.10	F14.11
Cocaine Use Disorder, Moderate	F14.20	F14.20
Cocaine Use Disorder, Moderate, in early or sustained remission	F14.20	F14.21
Cocaine Use Disorder, Severe	F14.20	F14.20
Cocaine Use Disorder, Severe, in early or sustained remission	F14.20	F14.21
Tobacco Use Disorder, Moderate	F17.200	F17.200
Tobacco Use Disorder, Moderate, in early or sustained remission	F17.200	F17.201
Tobacco Use Disorder, Severe	F17.200	F17.200
Tobacco Use Disorder, Severe, in early or sustained remission	F17.200	F17.201
Other (or Unknown) Substance Use Disorder, Mild	F19.10	F19.10
Other (or Unknown) Substance Use Disorder, Mild, in early or sustained remission	F19.10	F19.11
Other (or Unknown) Substance Use Disorder, Moderate	F19.20	F19.20
Other (or Unknown) Substance Use Disorder, Moderate, in early or sustained remission	F19.20	F19.21
Other (or Unknown) Substance Use Disorder, Severe	F19.20	F19.20
Other (or Unknown) Substance Use Disorder, Severe, in early or sustained remission	F19.20	F19.21

Please let me know if you have any questions.

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

Dear CSWA Affiliated Society Members,

I wanted to give you an update on where the Affordable Care Act stands at this moment.

As you know, the lat attempt to repeal the ACA failed two days ago when Majority Speaker Mitch McConnell announced he would not be bringing the Graham-Cassidy bill for a vote because it would not pass.

There are two more days for the Senate to pass a bill to repeal with only 50 votes.  On October 1, the number of votes needed will become 60 due to a technicality in Senate rules.  It is unlikely that another bill will be proposed and/or pass in two days.

The President has been discussing his intention to create an Executive Order to allow insurers to sell health care plans across state lines.  Whether this would change the way that the ACA works is unclear.  The lack of marketing for the ACA whose enrollment period starts on October 1 may affect the numbers of people who enroll as will the cutting of funds for the "navigators" who have helped guide enrollees through the system. But it is likely that the ACA will continue in spite of the barriers to becoming enrolled.

Please contact the Senators who made the continuation of the ACA possible, Sens. McCain, Collins, and Paul, as well as your own Democratic senators.  You can find numbers and emails at www.senate.gov/members .   Here is a sample message: "I am a constituent [if you are] and a member of the Clinical Social Work Association.  I am writing to thank you for your refusal to let the Affordable Care Act be repealed, which would have harmed millions of Americans by taking away their health care insurance. Your support of the ACA shows the best of our country's values and hopefully our ability to continue to help everyone get the health care they need."

As always. let me know when you have sent your messages, and thank you for doing your part these many months to protect access to mental health treatment and health care in general.

  

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

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

The Clinical Social Work Association is stunned and outraged at the violence by white supremacists that took place in Charlottesville, Virginia, yesterday.  CSWA sends our best wishes and prayers to the families of those who injured and killed in Charlottesville.  We oppose bigotry in any form and encourage all Americans to make it clear that our country will not stand for ‘internal’ terrorism based on prejudice.

According to the Southern Poverty Law Center, there are now 917 hate groups in the United State (www.splcenter.org) .  There has been a 67% increase in hate crimes (from 2014) as of 2015, the latest data available, according to the FBI (https://ucr.fbi.gov/hate-crime/2015) .

CSWA is disturbed by the fact that President Trump’s original statement about the incidents in Charlottesville was such a weak condemnation of the clear bigotry that led to the deaths of three people.  His support of actions based on discrimination during his campaign paved the way for white extremist groups to act destructively toward those that they see as their enemies.

We call upon President Trump to speak out against this rage that has been simmering in some of our citizens and stop this dangerous trend.  It is time for all Americans to take a stand against those of us whose racist anger is turning into actions that hurt or destroy those they hate.

Melissa Johnson, President

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

Dear CSWA Members,

Thanks to grassroots pressure to members of the Senate (including from many CSWA members – thank you!), Majority Leader McConnell has made the draft of the Senate's version of the House American Health Care Act available for review.  Titled the Better Care Reconciliation Act of 2017, this bill is not to be considered a finished version; changes are likely to be negotiated right up to next week's planned vote. 

As it currently stands, the BCRA could severely limit Medicaid through state-determined waivers and per-capita caps on enrollment. It would exclude services available to women under Planned Parenthood and services available to children under the CHIP program. Additionally,states would be able to redefine what constitutes pre-existing conditions and how they determine what essential benefits are.

High risk conditions including addictions, PTSD and serious mental health disorders have nowhere near the funding that is needed to cover them in this version. Medicaid enrollees have a 33% higher rate of these conditions and would thus be more severely affected in states that choose to put caps on Medicaid enrollment.

Since there is so much that is yet to be determined about this bill, CSWA is not prepared to offer any message different from the one that we recommended on Monday. Please continue to make calls to senators in opposition to per-capita caps to Medicaid/the end of Medicaid expansion, and in support of preserving essential benefits at the federal level.

Laura Groshong, LICSW, Director, Policy and Practice

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