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!

Policy affects practice
The NASW said it best, the social work profession was founded in social change. Social workers are there for those who need it. They are the public's biggest advocates in times of need. They also see the effects of law every day in practice, and those who endorse the laws can be moved by the important stories social workers have to tell. 
Why is law important to know? 
Social workers help all kinds of people. They assist in adoption, therapy, poverty, addiction, unemployment, disability, abuse, discrimination, and so much more. All these things that they help with, have laws that are attached. 
Being involved with legislative action keeps social workers up to date on current issues and issues to come. Being engaged in legislative action also prepares them to better serve their clients. They can help shape policy and help constituents by working with federal, state and local agencies to get individual appropriate assistance. For social workers to help change law, it is important for them to stay current on laws. 
If social workers want to create new policies, it is best to first understand why existing policies were developed. They can then be able to identify problems in these policies, find ways policies could be improved, and design solid proposals to help move towards change. In the end, these changes can help all people and improve humanity. 

How do social workers advocate for policy change?
Social workers can interact with their communities to learn more about the challenges they face. They can then raise awareness about those issues by educating everyone, from the lawmakers to nonprofit groups and empower community members to advocate for policy change. Social workers can also go to their elected officials and working within their agency to make a change.

To get policy updates, go to:
http://www.socialworkers.org/Advocacy/Policy-Updates 
To see policy issues, go to:
https://www.socialworkers.org/Advocacy/Policy-Issues 
To stay informed, act, or to get legislative alerts from the NASW to:
https://www.socialworkers.org/Advocacy/Legislative-Alerts 

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It is that time of the year again. A time where you, the sovereign individual, can express any concerns or support of ideas through way of voting. Fortunately, voting turnout has reached record-breaking numbers in the past few years. In the U.S. 2020 general election, upwards of 158.4 million people voted, amounting to about 62.8% of people of voting age (Desilver, 2022). That marks the largest voter turnout in U.S. history, and Kentuckians did their part. With over two million Kentuckians doing their civic duty, the state saw the highest number of voters in a Kentucky election (Shreve, 2021). So, it is evident we are all doing our part in the U.S. general election, but what about voting for our local representatives? Unfortunately, for this year's primary election, the unofficial turnout for the state only reached 19%, which was short of the 31% turnout we had for the 2020 primaries (Watkins, 2022). 
Luckily, we have another chance. The general election in Kentucky is Tuesday, November 8th. This is our last chance of the year to cast our vote and fight for what we believe in. A common theme amongst people who do not vote is that their vote will not matter or that their lives will not be affected whether they vote or not. This thought could not be further from the truth. If you decide not to vote, you simultaneously decide not to have a voice. The consequences will affect your job, family, healthcare, and overall way of life. Use your freedom. Use your right. Moreover, use the most essential tool any human has at their disposal, their voice. And use it by going out to vote!
Voting Deadlines

• Early voting (in-person absentee voting) is Nov 3-5
• In-person is November 8th.

Resources

• Find your polling location: https://elect.ky.gov/Voters/Pages/Polling-Locations.aspx 
• Candidates running for open positions: https://www.ballotready.org/ky 
• Learn about local issues (to Lexington): https://www.civiclex.org/ 
• Voter guide: https://www.kentuckyelection.org/  

References
Desilver. (2022, November 1). Turnout in U.S. has soared in recent elections but by some measures still trails that of many other countries. Pew Research Center. Retrieved from https://www.pewresearch.org/fact-tank/2022/11/01/turnout-in-u-s-has-soared-in-recent-elections-but-by-some-measures-still-trails-that-of-many-other-countries/ 

Shreve. (2021, January 14). 2020 Saw Kentucky’s Highest Voter Turnout Ever. 2020’s Record-High Kentucky Voter Turnout. Retrieved from https://spectrumnews1.com/ky/louisville/news/2021/01/14/kentucky-2020-election-turnout-highest-ever 

Watkins. (2022, May 19). Voter turnout figures are in for Kentucky’s primary. Here’s how they compare to past years. The Courier-Journal. Retrieved from https://www.courier-journal.com/story/news/politics/2022/05/19/kentucky-primary-election-2022-how-voter-turnout-compares-prior-years/9826730002/ 

Vote “NO” November 8th!
Right now, abortions are not currently being performed in Kentucky except for medical emergencies because the Supreme Court struck down Roe v. Wade earlier this year. Pro Choice groups have filed lawsuits stating that the ban is unconstitutional, but the
Supreme Court will not even hear the case until November 15th, which is after the election.

The right to abort should be between the patient and the provider, not the governments and politicians decision. Some may not see it, but abortion is absolutely part of health care. Women's health should be for theirs to decide. No one should be allowed to make
that decision for them and their health.

In 2021, 34 girls, ages 15 and younger received abortions because of first degree rape. Why would someone force a child to raise a child? The thought is imaginable! The wording on the ballot will ask if you’re in favor of amending the state constitution. The question will be at the end of the ballot. This is how the question will appear:

“Are you in favor of amending the Constitution of Kentucky by creating a new Section of the Constitution to be numbered Section 26A to State as follows: To protect human life, nothing in this Constitution shall be construed to secure or protect a right to abortion or
require the funding of abortion”

So, if you vote “no” it means you do not support the proposed changes.
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Vote for reproductive freedom, vote “NO” on 2!