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LEGISLATION & ADVOCACY - MARYLAND
Alice Neily
This was the most partisan and acrimonious year we have experienced since 1981.
Most of the bills that the Governor vetoed were overridden by the legislature
and are now law. A culture of special interests and partisanship made it more
difficult than ever to accomplish legislative goals.
It was crucial for LCSW-Cs to be highly visible this year in order to be invited
to the table in the coming four years. While much of the social worker
legislation did not pass, legislators were aware of – and appreciated – how hard
LCSW-Cs worked this year to promote greater access to quality mental health care
for Maryland.
Legislative committee members of GWSCSW and the Maryland Society (together we
are the Maryland Legislative Council of Social Work Organizations: MD-LCSWO) met
in Annapolis with lobbyist Alice Neily bi-weekly during the five months of the
Maryland Assembly session to develop strategy, often following the meeting with
lobbying at the State House. Over 2,856 bills were screened, and every piece of
health-related legislation was scrutinized.
Here is a review of the issues we followed, and how they fared:
Scope of Practice and Credentialing
Physical therapists, massage therapists, physicians, mental health counselors, and psychologists all had legislation affecting their practices; we monitored these bills throughout the session to ensure that no amendments were added which could impact upon social workers. The counselors’ bill for authorization to do testing failed.
The bill we worked on most intensively, SB 808/HB 1257, providing parameters for evaluating a juvenile for competency to stand trial, passed but excluded clinical social workers. Betsy Amey (Council co-chair, from the Maryland Society) and your lobbyist joined the workgroup crafting this bill last summer and fall, and achieved success in having LCSW-Cs included with psychiatrists and psychologists as potential evaluators of competency.
Clinical social workers sent emails, letters, and faxes to committee members; MD-LCSWO met with legislative staffers; and Maryland Society’s Maggie Barris and your lobbyist both testified in favor of the bill -- which passed through both the House and the Senate committees with a favorable report. Opposition from the psychologists and psychiatrists was termed by sympathetic legislative staffers a “turf battle,” and Senator Grosfeld assured us of her intent to keep clinical social workers in the bill.
In the House, however, the sponsors became convinced that the late but forceful opposition by the Office of the Public Defender (OPD) would jeopardize passage of the important legislation. The OPD argued that the Maryland Health Code law does not authorize LCSW-Cs to diagnose “mental retardation.” An Attorney General’s opinion confirmed that LCSW-Cs were barred from making a mental retardation diagnosis, but also stated that this should have no bearing on evaluating juveniles for adjudicatory competency.
We sent the sponsors and committee members information describing the actual scope of practice of LCSW-Cs and clarifying the difference between diagnosis alone and evaluation of functional competency; we obtained letters of support from the Board of Social Work Examiners and from Professor Carlton Munson of University of Maryland School of Social Work; and GWSCSW and Maryland Society members wrote letters, sent supporting testimony, and made calls. NASW lent its support. We proposed a clarifying amendment which would keep us in the bill.
As it turned out, Senator Brian Frosh of Montgomery County, Chair of the Senate Committee, was not supportive of the inclusion of social workers. The bill eventually passed with his amendment to delete LCSW-Cs from the bill. Senator Grosfeld has offered to help next session with legislation to change the restriction of social workers from diagnosing mental retardation.
NASW took the lead on SB 494/HB 713 to permit social workers to evaluate permanent impairment due to mental or behavioral disorder for Workers' Compensation; this bill failed in committee. We have supported this bill for two years. It has been vigorously opposed by the physicians.
HB 753 enabling an LCSW-C and a licensed physician to sign and verify a certificate of competency in a petition for guardianship of a disabled person also was introduced by NASW and failed passage.
SB 32 passed, providing an opportunity for social workers to assist with across-the-border emergency services; This bill sets up the process for training for licensed LCSW-Cs and authorization for out of state clinical social workers to respond to catastrophic health emergencies.
SB 636/HB 574 streamlines the process for being credentialed by an insurance carrier. The Maryland Insurance Administration, in consultation with health care providers, will be comparing the credentialing system for health providers used in Maryland to systems used in other states, identify mechanisms used by health care providers to complete credentialing; and identify additional ways to improve the credentialing system; a report is due by January 2007.
Provider Issues
MD-LCSWO sits on the Maryland Provider’s Council, working with other health professions to support initiatives preserving access to care for our clients and promoting fairness in contracting for providers. Following are bills we supported as part of that coalition.
SB 686 / HB 1003 passed with changes. It addresses the so-called “phantom panel” issue, requiring that HMOs verify availability of their providers, and furnish subscribers with providers within a 10 mile (urban) or thirty mile (rural) radius. than originally proposed.. Marsha Carow testified for us in favor of this bill, which passed, but with softer penalties than originally proposed.
SB 250 died in committee. This specified that a covered employee seeking medical treatment for a workers’ compensation claim may select a physician or health care provider of the employee’s choice. The House Economic Matters Committee believed the current law is clear and the bill is unnecessary.
SB 555 / HB-868 passed. It prevents the arbitrary assignment of a provider’s contract without his consent in Workman’s Compensation cases. The bill preserves access to care for patients and fairness in contracting for providers.
HB 549 passed. It provides that an insurance company or managed care company must make determinations for emergency inpatient admissions within two hours of the request and may not render an adverse decision within 72 hours of a patient’s admission.
SB 410 / HB 1152 failed in committee. It would establish the Maryland Universal Health Care Plan. MD-LCSWO was one of the first signatories of this plan, and we are represented at “Health Care For All” meetings by Nancy Cedar Wilson (GWSCSW) and Jim David (Maryland Society). Health Care for All will continue to push for passage of this legislation.
Regulatory Arena
SB 805 passed. This bill was introduced on behalf of the Board of Social Work, to “fine tune” social work licensure regulations. Unfortunately, it did not address the reciprocity problems we had brought to the attention of the Board, and the law still does not allow the BSWE to evaluate “equivalent or better” qualifications in the case of supervisors and PhDs from other jurisdictions. We will continue to discuss this issue with the Board.
There have been no recent regulations that affect LCSW-Cs. A study to evaluate the potential for an omnibus board, which could have had a negative effect on the profession, never saw the light of day.
We will be seeking updated information regarding consumers’ insurance appeals process from the Attorney General and Maryland Insurance Administration. With these guidelines, your clients will be able to pursue complaints and questions regarding lack of benefits and disallowances of payment for services aggressively.
Alice Neily of Capital Consultants of Maryland is the lobbyist for the Maryland Legislative Council of Social Work Organizations, a coalition of GWSCSW and the Maryland Society for Clinical Social Work.
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