Judy Ratliff and Wayne Martin, Co-Chairs, VA Legislation and Advocacy Committee
Information contained in this article has been taken from communications from the Governor’s office, Delegate Ken Plum and our lobbyist, Sue Roland.
BOARD OF SOCIAL WORK
The Board will cease making hard-copy licenses, certifications and registrations. During the next renewal, a final hard copy that contains the expiration date will be issued. The renewal period for the Board of Social Work will begin in early May and the Board will send out email notices at that time. This final copy should be maintained, carried or posted in accordance with relevant applicable laws and regulations. State health regulatory boards, insurance providers and citizens seeking verification of current licensure status in the Commonwealth of Virginia may obtain this information via “License Lookup”.
Judy Ratliff, LCSW, (recently retired from work but not from GWSCSW or from life). She is the Co-Chair, VA Legislation and Advocacy Committee.
YOUR VIRGINIA LEGISLATIVE AND ADVOCACY COMMITTEE AT WORK FOR YOU
The Virginia Legislature has just completed a 30 day session and will begin a special session on February 9. In order to identify bills that will impact us and our clients. Our lobbyist, Sue Rowland, reviews all the bills and sends daily updates to Wayne Martin, my co-chair, me, and Rick Goodling and Joe Lynch from the Virginia Society of Clinical Social Work (VSCSW). The four of us met with Sue twice a week on Zoom since the legislative session began. We will continue to meet to monitor the passage of pertinent bills through the special session.
BILLS HB 1987 AND SB 1338 PERTAIN TO EXTENSION OF REIMBURSEMENT FOR TELEHEALTH
These bills pertain only to Medicaid recipients and not to private insurance. The bills cover NO mental health diagnoses and only a few physical diagnoses. I have written to my delegate, Ken Plum, who is one of the sponsors of the House Bill, inquiring as to why mental health was excluded but I have not yet had a reply.
Both societies and our lobbyist know that extension of telehealth coverage for our clients is very important, as are other insurance concerns. Therefore, our group has decided to continue our meetings on a less frequent basis to deal with insurance-related other concerns.
LEGALIZATION OF MARIJUANA is very complicated and will probably not pass this year. According to Delegate Ken Plum, BILLS PENDING this session include repealing mandatory minimum sentencing, ending felony possession for drugs, reforming the broken probation system, instituting automatic expungement of criminal records, establishing pay parity for public defenders, ending presumption against bail, and eliminating the death penalty.
CONTINUING EDUCATION
Another benefit of the collaboration between the two societies is that both groups benefit from reciprocity for continuing education classes. Members in each Society can enroll in classes for the member cost. Please take advantage of this opportunity to extend your options for free or lower cost CEs.
COVID 19 TESTING, VACCINATIONS AND UPDATES
Wayne and I urge Virginia members to subscribe to the email lists for newsletters from your county supervisors, the head of your county Board of Supervisors and your Virginia delegate and senator. These emails are "chock full" of information as to testing and vaccinations sites, updates and other important information. Just put "constituent" in the subject line and request to receive their newsletters.
Hot off the Press! As of November 4, with 2556 precincts out of 2585 reporting, the Constitutional Amendment described as follows did pass, with 65.85% voting "Yes" and 34.15% voting "No".
The question was: "Should the Constitution of Virginia be amended to establish a redistricting commission, consisting of eight members of the General Assembly (4 Republicans and 4 Democrats) and eight citizens of the Commonwealth, that is responsible for drawing the congressional and state legislative districts that will be subsequently voted on, but not changed by the General Assembly and enacted without the Governor's involvement and to give the responsibility of drawing districts to the Supreme Court of Virginia, if the redistricting commission fails to draw districts or the General Assembly fails to enact districts by certain deadlines."
NEW LAWS PERTAINING TO POLICE AND CRIMINAL JUSTICE REFORM, AS OF NOVEMBER 1, 2020
The laws:
PROHIBIT law enforcement officers from seeking or executing a no-knock search warrant.
REDUCE the militarization of police by prohibiting law enforcement from obtaining or using specified equipment, including grenades, weaponized aircraft and high-caliber firearms However, law enforcement will be able to seek a waiver to use restricted equipment for search and rescue missions.
CREATE statewide minimum training standards for law enforcement officers, including training on awareness of racism, the potential for biased profiling and de-escalation techniques.
MANDATE law enforcement agencies and jails to request the prior employment and disciplinary history of new hires.
EXPAND AND DIVERSIFY the Criminal Justice services Board (CJSB) ensuring that the perspectives of social justice leaders, people of color and mental health providers are represented in the state's criminal justice policymaking.
STRENGTHEN the process by which law enforcement officers can be decertified and allow the CJSB to initiate decertification proceedings.
LIMIT circumstances in which law enforcement officers can use neck restraints.
REQUIRE law enforcement officers to intervene when they witness another officer engaging or attempting to engage in the use of excessive force.
EMPOWER localities to create civilian review boards and to give these boards the authority to issue subpoenas and make binding disciplinary decisions. Five pilot programs have been designated, with one located in Alexandria, VA. (Fairfax County already has an oversight committee.)
MANDATE the creation of minimum crisis intervention training standards and require law enforcement officers to complete crisis intervention training. Please note that crisis intervention systems have already been set up in our jurisdictions and that money has been appropriated. Mental health professionals will be included in response teams.
The 2021 Legislative Session will begin on January 13 and will last for 45 days. Bills are now being introduced.
udy Ratliff
Extension of Coverage for Telemental Health by Insurance Companies
Our GWSCSW Virginia Legislation and Advocacy Committee met with our lobbyist, Sue Roland, via Zoom on July 17. We focused on the issue of extending telemental health (video and audio) insurance coverage and to eventually making it permanent. According to Sue, Scott Johnson, the lobbyist for the Virginia Medical Society, said that he does not think that anything will really change regarding payment and interactions with insurance companies until well into next year. Unfortunately, there is no guarantee that private insurers will continue to cover telemental health services. However, Secretary Azar has extended the public emergency declaration that covers Medicare reimbursement until October 23, 2020.
Our Committee members joined Sue Roland and the Board of the Virginia Society for Clinical Social Work (VSCSW) on July 18, to discuss mutual legislative concerns. We decided to form a committee of members from both societies to focus on this issue in preparation for the 2021 convening of the General Assembly. Eventually, we will be requesting information and feedback from GWSCSW's Virginia members that will help us in this task.
Laura Groshong, Director, Policy and Practice, Clinical Social Work Association (CSWA), has stated that the goals of CSWA are to make telemental health a permanent option through federal laws; to make reimbursement for telemental health at the same level as for in office visits; and to compare the use of in office and telemental health treatment delivery methods. They will also be focusing on the issue of variation in state rules that allow LCSWs in one state to see patients in another state virtually or through audio.
Review of Health Insurance Coverage for Behavioral health and Medical Services
In 2020, the General Assembly passed HB 280, requiring the State's Bureau of Insurance (BOI) to collect and report new information in its annual report, comparing health insurance claims for behavioral health services to those for medical services. The bill also directs the Joint Legislative Review Commission (JLARC) to evaluate whether BOI's annual report includes sufficient information to assess whether health insurance plans are adequately covering behavioral health services (parity).
The legislation requires JLARC to report recommendations for modifying the report to the Senate and House Commerce and Labor Committees and to the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the Twenty-First Century.
This work will be completed by JLARC's Health and Human Resources Unit. JLARC staff will determine whether Virginia is collecting adequate information from insurance plans to assess parity and evaluate whether insurance plans appear to be meeting parity requirements. If the team determines there are not enough behavioral health providers in some networks, JLARC staff will collect provider and insurance plans' perspectives on the reasons for that.
HB 51 directs several agencies to jointly study the feasibility of developing an early childhood mental health consultation program that would be available to all early care and education programs serving children from birth to 5 years of age. A final report is due by the start of the 2021 General Assembly session.
(Thanks to Sue Roland for the information on these pertinent bills.)
From the Governor
Governor Ralph Northam has called a special session on August 18, 2020 to resolve the budget.
On July 15, "Governor Ralph Northam announced the adoption of statewide emergency workplace safety standards in response to the novel coronavirus, or Covid-19. These first-in-the-nation safety rules will protect Virginia workers by mandating appropriate personal protective equipment, sanitation, social distancing, infectious disease preparedness and response plans, record keeping, training and hazard communications in workplaces across the Commonwealth. The actions came in the absence of federal guidelines." (Taken from a press release from the Governor's office.)
HB 795, which would have allowed associations that represent independent contractors to create and provide their own medical insurance plans to their members was passed by both houses and vetoed by the Governor.
HB 1301, which became law on July 1, 2020, "created the Office of Children's Ombudsman, charged with reviewing and investigating the Commonwealth's child-serving agencies to ensure that children and their families are being treated with fairness."
Judy Ratliff, LCSW, (recently retired from work but not from GWSCSW or from life) Co-Chair, VA Legislation and Advocacy Committee.
Judy Ratliff
Board of Social Work Changes to the Regulations Governing the Practice of Social Work
Laws Passed by the Virginia Legislature and Signed into Law in 2020
(Please note that summaries of the bills in items 4-8 are courtesy of Delegate Ken Plum, Reston)
The 2020 Virginia Legislative session has seen the passage of some bills beneficial to social work. These bills passed the House in which they were initiated and went to the other House for reconciliation on February 11, which is known as "Crossover Day." SB 1046, Clinical social workers: patient records; involuntary detention orders. This bill adds clinical social workers to the list of eligible providers that includes treating physicians and clinical psychologists who can disclose or recommend the withholding of patient records, face a malpractice review panel and provide recommendations on involuntary temporary detention orders. SB1562, Music Therapy: definition of music therapist, licensure. Requires the Board of Social Work to adopt regulations establishing a regulatory structure to license music therapists in the Commonwealth and establishes an advisory board to assist the Board in this process. Under the bill, no person shall engage in the practice of music therapy or hold himself out or otherwise represent himself as a music therapist unless he is licensed by the Board.
Another bill that has been proposed is SB53: licensure by endorsement, which requires the Board of Social Work to establish in regulations the requirements for licensure by endorsement as a social worker. The bill allows the Board to issue licenses to persons licensed to practice social work under the laws of another state, the District of Columbia or a US possession or territory, if in the opinion of the Board, the applicant meets the qualifications required of licensed social workers in the Commonwealth.
Other more general but equally important bills include a bill passed in the House that ends discrimination in housing, accommodations, employment and other forms of discrimination and a bill to extend protections of the hate crime bills to all persons, regardless of their sexual orientation or gender identity.
There is also a bill to raise the minimum wage to $15.00, with multi-year step increases. The laws that had been passed in prior years designed to make it more difficult for a woman to have access to an abortion when necessary are being repealed. Additionally, a number of laws that have made it more difficult and cumbersome to vote have been repealed and the law regarding absentee voting will now enable voters to cast an absentee ballot for any reason, with no restrictions.
The last item of focus in this article is the prospect that I may be leaving my position as Virginia Chair of the Legislation and Advocacy Committee as early as July, 2020. Thus far, a few students have expressed an interest, but, as students, have had no time to consider even accompanying me to Richmond or Charlotesville to attebd board meetings of the Virginia Society of Clinical Social Work (VSCSW). If there is no one to fill my position, then we will literally have no voice in how legislation affecting us in Northern Virginia will be shaped.
Yes, it's a lot of work. Yes, it means driving to Richmond three times a year and Charlotesville once a year. Yes, it's easier for me to do this because I am single and have no family obligations. Yes, you write a quarterly article for the Newsletter. And, yes, if there is crucial legislation pending, then there are times when there are weekly legislative committee telephone meetings to strategize and plan actions. Yes, it is a lot of work. Yet, the rewards are great. Because of the work done by Margot, Delores and Alice before me, and continued by me (forcefully at times), we now have true joint decision making and an equal voice in how legislation is shaped to include Northern as well as southern Virginia social work and client interests. It would be very sad if this is lost because no one (or two or three) will step up to take over this important work.
Judy Ratliff, Chair, Virginia Legislation and Advocacy Committee
SOCIAL WORK LICENSING CHANGES
The changes to licensure which have recently gone into effect include establishing separate tests for LMSWs and LBSWs. In the past, both have taken the same test. As a result, LMSWs who took the old test for BSWs will now have to take the new test for LMSWs. Also, the definition of a Masters Social Worker as it is written in the Code of Virginia Chapter 37 is problematic. It states: "Master's social worker" means a person who engages in the practice of social work and provides non-clinical generalist services, including staff supervision and management." According to Joe Lynch, head of the Virginia Society for Clinical Social Work Legislation Committee, is working hard on behalf of all Virginia social workers to fix the problem, "We are stuck with that definition until there is a change in the law."
There is a level of mental health professional called the Qualified Mental Health Professional (QMHP) which is regulated by the Board of Counseling. QMHPs are "registered", not licensed, and therefore cost less to employ than licensed MSWs. They are thus more likely to be hired by the Department of Medical Assistance Services (DMAS) than licensed social workers. This is complicated by the fact that we define masters social workers, as non-clinical. The QMHP regulations require only registration while our social work regulations require licensure. As it now stands, in order for LBSWs and LMSWs to compete with a QMHP for DMAS jobs, "they will have to acquire registration as a QMHP from the Board of Counseling in order to be paid by DMAS for providing services that are within the scope of practice of their license." (Per Joe Lynch) This process also "may have created an anti-competitive impact on social workers." The GWSCSW and VSCSW are working together to explore corrections to this potentially unfair employment situation for social workers.
STEP VIRGINIA SERVICES
The Mental Health in the 21st Century Committee of the Virginia Legislature is chaired by Senator Creigh Deeds. I was able to attend the luncheon sponsored jointly by VSCSW and GWSCSW in Charlottesville this summer to honor Senator Deeds. One of the things he wrote about was the creation of "Step Virginia" by the Committee. The services outlined in the steps are presented below, including their progress.
(Note: The services that were "launched" have not been fully implemented.)
The Virginia Board of Social Work (VBSW) started the "Fast Track" on 8/15/2018 for proposed regulations to implement the 2018 General Assembly law adding definitions of Bachelors Social Worker and Master's Social Worker. The regulations have advanced through all stages and are now on the Governor's desk, where they have been for over 130 days. Please note that there is no timeline for how long regulations can be at the governor's office stage.
Joe Lynch, legislative vice president for Virginia Society for Clinical Social Work (VSCSW) has written to Dr. David E. Brown, Director of the Virginia Department of Health Professions on behalf of both of our Societies. The letter requests that Dr. Brown consider "updating the language in Code Sections of Virginia law that contain the phrase"...the individual's treating physician or the individual's treating clinical psychologist..." to include other licensed mental health professionals, such as social workers and professional counselors.
Joe Lynch has submitted public comments reflecting concerns of both of our Societies on aspects of definitions and requirements for Qualified Mental Health Professionals (QMHPs) that affect social workers who are also QMHPs. More will be presented on this as these issues evolve.
Several Laws were passed this year that will help low-income and other Virginia residents:
Judy Ratliff, LCSW, is chair of the Society’s Legislative Committee for Virginia. In addition to her years of GWSCSW service, Judy has served on the Fairfax County Long Term Care Coordinating Council and in Leadership Fairfax. She began her professional life as a medical social worker, has taught medical and social work students for the University of Maryland, and is currently in private practice in Fairfax.
IMPORTANT: VIRGINIA BOARD OF SOCIAL WORK'S CURRENT LICENSURE CHANGES AND REQUIREMENTS
Here is the most recent update on requirements for Continuing Education for social workers in Virginia. We still need 15 hours of continuing education per year, but even though you will have to renew your license on June 30, 2019, CEs will not be due until 2020. That means that you do not submit your CEs for 2019 and 2020 until 2020. No CEs are due when you renew your license in June, 2019. That includes 2 hours of Ethics due every two years, also in 2020.
Please note that in the future the number of Ethics CEs will increase to 6 hours, but it is not yet in the regulations. However, the Board of Social Work anticipates that it will be there by the next renewal date.
.Judy Ratliff, LCSW, is Chair of the Society’s Legislative Committee for Virginia. In addition to her years of GWSCSW service, Judy has served on the Fairfax County Long Term Care Coordinating Council and in Leadership Fairfax. She began her professional life as a medical social worker, has taught medical and social work students for the University of Maryland, and is currently in private practice in Fairfax.
Joe Lynch, Chair of the Legislative Committee of the Virginia Society of Clinical Social Work (VSCSW), several other members of the VSCSW, our lobbyist Sue Rowland and I met with Senator Creigh Deeds, Chair of the Mental Health Services in the Twenty-First Century (MHS Committee), on September 27, 2017. At that meeting, Joe Lynch spoke on behalf of both clinical societies stating that several Code sections contained the language "treating physician or clinical psychologist" and needed to be updated to include other licensed clinical mental health professionals. He recently wrote a follow-up letter to Senator Deeds requesting that this be considered for 2019 and asking whether the "updated language" legislation might be a type of legislation that could be put forward from the MHS Committee as a whole. Joe did his own research on the affected Codes and found that other licensed mental health providers in Virginia far exceeded the number of psychiatrists and psychologists in the state.
Joe further defined this legislation as:
Both societies owe a very large "Thank You" to Joe, whose tireless efforts and rigorous research have underpinned the success of many of our joint efforts.
VALEAP (VIRGINIA LAW ENFORCEMENT ASSISTANCE PROGRAM)
VALEAP is an all-volunteer program that was modeled after a highly effective FBI program. Janet Howell, a senior Senator from Virginia, helped Virginia law enforcement officers secure $100,000.00 a year in the budget for this peer-run program. A representative group of Virginia law enforcement officers met with her in Richmond to thank her. The program is designed to help people in law enforcement process the trauma they suffer in the course of doing their jobs.
MEDICAID
Legislation was recently passed in Virginia that includes expansion of Medicaid coverage to approximately 400,000 adults, most of whom are employed. Virginia is also creating a new unit at Joint Audit and Review Commission (JLARC) to constantly evaluate the program and recommend improvements. According to Janet Howell, it is estimated that Virginia will receive about two billion dollars a year from Washington for this expansion. This money will be used to provide professional help to people with substance abuse and mental health problems, as well as being an economic stimulus and job creator for our state. Funding will also be focused on preventing those with mental illness being sent to jails, which is often where they end up. As a compromise with Republican legislators (some of whom joined with Democrats to pass this legislation), a work requirement for those Medicaid recipients who can work was included in the legislation. (Thanks to Janet Howell for the medicaid and VALEAP updates.)
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