April is Alcohol Awareness Month, a time to focus on the dangers of alcohol abuse and addiction and to promote healthy drinking habits. With alcohol being the most commonly used addictive substance in the United States, raising awareness about the risks associated with excessive drinking is essential.
Alcohol Awareness Month was established in 1987 by the National Council on Alcoholism and Drug Dependence (NCADD) to encourage people to assess their drinking habits and seek help if needed. Since then, it has grown into a nationwide observance, with organizations and communities coming together to raise awareness about the effects of alcohol abuse and to promote prevention, treatment, and recovery resources.
The theme for Alcohol Awareness Month 2023 is “Awareness is Key: Sustaining Healthy Communities.” This theme emphasizes the importance of raising awareness about alcohol abuse and addiction and how it affects individuals, families, and communities. It also highlights the need for communities to come together to support those struggling with alcohol addiction and to create a culture of responsible drinking.
Excessive alcohol consumption can have serious health consequences, including liver disease, cancer, and heart disease. It can also lead to addiction, which can cause a range of social, emotional, and financial problems. In addition to the health risks, alcohol abuse can contribute to car accidents, violence, and other harmful behaviors.
To promote healthy drinking habits and raise awareness about the risks of alcohol abuse, the NCADD recommends the following:

1. Educate yourself and others about the dangers of alcohol abuse.
   
2. Set limits for yourself and others when it comes to alcohol consumption.
   
3. Know the signs of alcohol abuse and addiction.
   
4. Support those struggling with alcohol addiction by connecting them with resources and treatment options.
   
5. Be a role model for responsible drinking.
   

Throughout April, organizations and communities across the country will host events and activities to raise awareness about alcohol abuse and addiction. These events may include educational seminars, community outreach programs, and fundraising events for local addiction treatment centers.
Alcohol Awareness Month is an important reminder that alcohol abuse and addiction is a severe problem that affects millions of people across the country. By working together to raise awareness about the risks of excessive drinking and promoting healthy drinking habits, we can create a safer and healthier community for everyone.

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On March 27th, Nashville, TN joined the 13 communities that have experienced a school shooting this year. This morning, a gunman opened fire at Covenant School, a private elementary school for students in preschool through sixth grade. At the time of this blog post, at least 7 individuals are dead after this tragedy, including the shooter.

For a list of the 350+ school shootings that have taken place since Columbine, click here: https://en.wikipedia.org/wiki/List_of_school_shootings_in_the_United_States_(2000%E2%80%93present)

The United States holds the record for most school shootings, following the US is Mexico with 8 school shootings.

This information begs the question: What can we do to stop mass school shootings?

1. Demand gun control. It’s a fact: US states with more relaxed gun control laws and higher rates of gun ownership have higher rates of mass shootings. For example, in Texas it’s alarmingly easy to buy and openly carry a gun and, not surprisingly, is close to leading the US in school shootings. We know what we need to do. Lobby and advocate for gun control laws. These laws can include raising the age to purchase semi-automatic firearms, require background checks on all gun sales, and/or pass extreme risk laws. 
2. Build a culture of secure gun storage. This can include enacting and enforcing secure firearm storage laws.
3. Foster a safe and trusting school climate.  According to a study done by Alfred University, only around half of students would tell an adult if they heard another student talk about shooting someone at school. We need to foster an environment where students feel safe to talk to adults when they hear alarming information. You can check out the study here: https://www.alfred.edu/about/news/studies/lethal-school-violence/can-we-prevent.cfm
4. Initiate trauma informed emergency planning. This ensures that staff can secure schools and law enforcement can respond quickly when there is an emergency in schools. 
5. Avoid practices that can cause harm and traumatize students. This is a no brainer. Protect our students.

References:
https://wisevoter.com/country-rankings/school-shootings-by-country/
https://www.scientificamerican.com/article/the-science-is-clear-gun-control-saves-lives/
https://www.usnews.com/news/best-states/articles/2022-05-27/states-with-the-most-school-shootings

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Laura Groshong, LICSW, Director, Policy and Practice
March, 2023
The Public Health Emergency (PHE) is ending on May 11, 2023. This has caused some concern for LCSWs who have been working through telemental health since the pandemic began in 2020. The question of whether psychotherapy will be covered when the PHE ends is a complex one. Here is what we know about telemental health coverage at the moment:

• Coverage of Telemental Health – The Consolidated Appropriations Act of 2023 extended Medicare coverage of telemental health until December 31, 2024, which is good news. While most commercial insurers tend to follow CMS guidance, this time it appears that this may not be the case. Some insurers have already begun to limit telemental health coverage; this may increase after May 11. It is not too early to have patients check with their insurers about the likelihood that telemental health will be limited/no longer covered going forward.
• Meeting In-Person – The CMS requirement that Medicare patients be seen in person at least once a year when the PHE ends has been delayed until December 31, 2024.
• Audio-Only Telemental Health – CMS coverage of Medicare patients through audio-only telemental health will continue until December 31, 2024.
• If a patient’s insurer is planning to stop telemental health or audio only coverage in some way, it would be helpful to have patients talk to their HR person about keeping telemental health coverage in place. It may also be helpful to file a complaint with state insurance commissioners if insurers are unwilling to continue coverage of telemental health treatment.

There may be other questions that members have about the way that the end of the PHE will affect LCSW practices. Please let me know if you do.  For more information on these topics go to https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/policy-changes-after-the-covid-19-public-health-emergency#permanent-medicare-changes . CSWA will be tracking these changes for members.

Happy Children’s Advocacy Week, social workers! This week, social workers from all over the tri-state will meet in Frankfort to advocate on behalf of children’s safety, health, education, and economic well-being. With this going on and Lobby Day coming up in less than 2 weeks, I think it is crucial that we take the time to understand not only what it takes to be a good advocate, but an effective advocate.

• BE PREPARED. Identify the issues you’re passionate about and do your research.  Look at all sides of the potential argument and make sure you have concrete information. Below, I will attach the proposed KMHC Legislative Priorities, courtesy of Brenda Rosen. This document will give you concise information about some legislature that social workers will be advocating for (or against) during Lobby Day 2023. I have also attached the Social Work Lobby Day Toolkit. This tool kit will help you engage with the legislative process and give tips on how to make your advocacy more effective. 
  
• ENGAGE WITH THE COMMUNITY. Engaging with the community that is being impacted by the legislation you were advocating for will further educate you on the topic. Listen to people who may be personally impacted by the issue for what you were advocating. Bring their stories (with consent) or your personal stories to the legislators you are speaking to. Engaging with the community will also create traction, which will hopefully inspire others to support the issue and create a movement. Social media is a great way to do this!
  
• STAY MOTIVATED. Remember — change takes time. This can be very discouraging, but don’t get frustrated with yourself or the lawmakers. Be patient and consistent.
  

Whether you use this information in person this February 22 for Lobby Day, or you use it to contact your legislator via email or letter, it is valuable as a social worker to understand how to be an effective advocate. Advocacy is an important part of social work, as we promote equality, inclusion, and social justice.

Have any more tips on how to become a more effective advocate? Leave a comment!



Sources: https://kyyouth.org/childrens-advocacy-week/
https://nbacl.nb.ca/module-pages/tips-for-being-an-effective-advocate/

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This week, we celebrate the beginning of Black History Month. Black History Month was founded by Carter G. Woodson in 1926, however it was not officially adopted as a federal holiday until 1976. 

Since becoming a federal holiday, The Association for the Study of African American Life and History assigns a new theme each year that is endorsed by the US Government. This year's theme is resistance. This theme recognizes the resistance of brutality, oppression, and injustice demonstrated by the Black community. 

This theme seems fitting, as the world witnessed another public display of police brutality on a Black man last month. Nature photographer and father to a 4-year old son, Tyre Nichols, was tased, punched, kicked, and beaten with a baton by three police officers in Memphis, TN. Shortly after the public release of the body camera footage, the officers were arrested. Mostly peaceful protests of police brutality have ensued across the country. This incident serves as a reminder that the Black community still faces unfair oppression, violence, and  prejudice. 

Black History Month is a time to spotlight Black achievement, celebrate triumphs, and honor the struggles of African Americans. Here are some ways to support Black communities this month:

• Support Black-owned businesses
  
• Fundraise for Black causes
  
• Purchase and read books by Black authors
  
• Educate yourself on Black figures and their contributions to society
  

Have more ideas on how to support Black communities during Black History Month? Leave a comment!


Sources: https://www.npr.org/2023/01/28/1151504967/tyre-nichols-memphis-police-body-cam-video
https://www.salesforce.org/blog/8-ways-to-honor-black-history-month/


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To all social workers. Please see the message below from the Clinical Social Work Association regarding legislative updates:

1. Compact Delay – as you know, the Social Work Compact, which would allow LCSWs to practice in any state that joins the Compact, has been in development since October of 2021. CSWA President, Kendra Roberson, and I are members of the Technical Assistance Group (TAG) which has provided information about what the Compact should look like, along with representatives from other clinical social work and social work organizations. The process is being overseen by the Department of Defense and Council of State Governments. DoD and CSG had told us that the document, which will be submitted as bills to state legislatures, would be ready at the end of 2022. Unfortunately for several reasons, that deadline could not be met. Correspondingly, Kendra Roberson and I will be attending a meeting in Washington, DC in early February to finalize the document. We are hopeful that the document will be ready by early spring and will keep you posted on how to support the compact in your state legislatures when it is ready. CSWA knows how many members are looking forward to the Compact, as is CSWA.
2. Medicare Rules – there are two issues regarding new Medicare rules that have caused confusion. First, the need for in-person meetings with patients will not be put in place until 151 days AFTER the end of the Public Health Emergency. With many regions seeing increases in COVID and other viruses at this time, it is unlikely that the PHE will end any time soon. Second, the ability to see Medicare beneficiaries across state lines will not be in place until the end of the PHE as well. Please keep this in mind.  We are all looking forward to the ability to work across state lines. CSWA will let you know when that becomes a reality.

As the holidays come to an end and we begin a new year, it's time to focus on some important  changes that are happening that impact social workers. Recently congress passed a Medicare $1.7 trillion spending bill. See below for the details:
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The rule addressing working across state lines is for LCSWs who are Medicare paneled and working with Medicare beneficiaries. This does not apply to LCSWs who are opted out, or not opted in or out. The rule does not apply to commercial insurers. ~LWG
 
Medicare in $1.7 Trillion Spending Bill – Effect on LCSWs
December 21, 2022
Congress just passed a $1.7 trillion spending bill which has some impact on LCSWs through Medicare coverage. Now it is up to the President to sign it. Here are the ways that our practices will be affected if all these changes take place on January 1, 2023:

• Medicare Rates – We had anticipated a 4.5% cut to Medicare reimbursement in 2023 and instead, this cut was 2%. It is better than expected. We will continue to advocate for a change to the RVU that determines what LCSWs are paid through Medicare, which is currently 25% less than what psychologists and psychiatrists are reimbursed for the same psychotherapy codes we use.
• Telemental Health Extension – Coverage of telemental health was supposed to end 151 days after the end of the Public Health Emergency. There is a new extension of telemental health (and all health care) until Dec. 31, 2024. This is a positive development which increases the likelihood that telemental health will be made permanent.
• Practicing Across State Lines – There is a provision that ends the requirement that providers be licensed in the same state as the patient receiving care, allowing more types of practitioners to provide telemental health services, including audio-only services.  This change is one that CSWA has been advocating strongly for and hopes will remain in place.
• Delay In-Person Requirement – There is a delay in the requirement to see patients in-person via telehealth. The previous requirement had been that patients would have to be seen 6 months or 12 months every year in-person. For the foreseeable future, there is no need to see patients in person that are being seen virtually.
• Telemental Health Services in FQHCs and RHCs - The bill would also extend telemental health services through 2024 for federally qualified health clinics and rural health clinics.

This two-year extension is not without future implications. The bill instructs the Secretary of Health and Human Services to study how telehealth has affected Medicare beneficiaries’ overall health outcomes and whether there are geographic differences in use. It also calls for a review of medical claims data. The initial report is due by Oct. 1, 2024. 
One more item – the Good Faith Estimate is supposed to be given to patients every year so look at when you gave your patients their first GFE and prepare to repeat the process.

​UPDATE: Medicare Coverage and Parity Changes for LCSWS
There continue to be questions about the change to Medicare policy about treating patients across state lines. Different regions have different policies in this regard. Look at the section in yellow below and call your MAC to get information about a region you wish to practice in. Here is more detailed information on the telehealth changes: https://telehealth.hhs.gov/providers/billing-and-reimbursement/medicare-payment-policies-during-covid-19/
Telehealth Policy Changes
The federal government announced a series of policy changes that broaden Medicare coverage for telehealth during the COVID-19 public health emergency.
Some important changes to Medicare telehealth coverage and reimbursement during this period include:

• Location: No geographic restrictions for patients or providers
• Eligible providers: All health care providers who are eligible to bill Medicare can bill for telehealth services, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
• Eligible services: See the list of telehealth services from the Centers for Medicare & Medicaid Services
• Cost-sharing: Providers can reduce or waive patient cost-sharing (copayments and deductibles) for telehealth visits
• Licensing: Providers can furnish services outside their state of enrollment. For questions about new enrollment flexibilities, or to enroll for temporary billing privileges, use this list of Medicare Administrative Contractors (MACs) to call the hotline for your area
• Modality: The 2022 Physician Fee Schedule has codified the ability for behavior health services to do audio only. It is still required to complete an in-person appointment every 6 months.

Mental Health Parity
There is one more piece of good news in the omnibus bill. You may recall that when the parity act passed in 2008 there was a loophole that allowed public plans to opt out of having a mental health benefit at all. That meant that they did not have to have a benefit AT PARITY with medical/surgical benefits. That loophole has been closed in the omnibus bill. This means a million more people will have mandated mental health treatment. More information can be found at https://www.thekennedyforum.org/blog/these-major-employers-have-opted-out-of-providing-adequate-mental-health-addiction-coverage/
H.R. 432, Mental Health Access Improvement Act
The Mental Health Access Improvement Act passed as part of the omnibus bill. This means that LMFTs and LPCs are now Medicare providers. Their reimbursement rates will be 75% of psychologist rates, like LCSWs, or 80% of their usual and customary rates, whichever is less. This is possibly more than what LCSWs are paid and CSWA will be looking into keeping LCSWs at the same reimbursement level.
These changes were passed by the House this morning so the President should be signing the bill shortly.

The holidays can be triggering for many individuals. A time that can bring joy and laughter to some may bring tears and sadness to others. The holidays can be triggering for some individuals. How can we help our clients during these times:

1. Help your clients make a plan for the holidays. Identify possible triggers or stressors, coping/adaptive skills, and individuals they can reach out to when feeling triggered.
2. Have your clients identify a "roadmap" of at least 3 things they can look forward to during the upcoming month (these can be small things). Be willing to be creative with identifying these.
3. Teach clients how to set boundaries with unhealthy family members or friends. Teach them how to say "no" to prevent feeling overwhelmed or burnt out.
4. Normalize that it is okay to not always feel happy and excited about the holidays.

Helping connect clients with supports in an important part of preparing for the holidays. Some resources include:

https://mhanational.org/blog/looking-support-during-holidays-check-out-these-free-resources

https://onlinecounselingprograms.com/resources/mental-health-resources-holidays/

https://www.thetrevorproject.org/

Don't forget to take care of yourself and utilize self care techniques!