Social Workers as Elected Officials and Why We Need More

Social workers play many roles. As advocates, change agents, case managers, educators, facilitators, and organizers, Social Workers play an important part in helping people and communities make positive changes in their lives. Despite their under-representation in elected positions throughout the United States, Social Workers are excellently prepared to run with these positions and build a better life for their constituents.

An Understanding of Advocacy

Elected officials represent their constituents. They must be able to understand the needs of those constituents and what it will take to get said needs met. This is the essential element of advocacy and something that Social Workers excel at. While those in other fields also learn to perform advocacy, Social Workers constantly prioritize listening to their clients and trying to understand each individual’s viewpoint.

A Large Network

Running for any elected position requires networking. With a career emphasizing the importance of social connections, many Social Workers are already involved in community groups, advocacy organizations, volunteering, and client service that can help an election campaign. Leveraging networks and connections allows one to more effectively spread their message. This is a huge benefit, both throughout the process of running for election as well as fulfilling the responsibilities of the position.

A Deep Understanding of Policy

City Councillors make policy. State legislatures write laws. Most elected officials will be working in some kind of policy writing role that requires an understanding of the impact of their decisions. The accumulated training and experience that Social Workers have makes them excellent in this role. Not only will they understand the direct effects of policies like closing schools during COVID-19 or adding a beverage tax, but they will also be aware of the less obvious effects – for example, how these changes will affect people in poverty.

Cultural Competency

More than nearly any other career, Social Work requires an in-depth assessment and awareness of personal bias. Considering the diversity of the United States, with citizens from all different walks countries, ethnicities, cultures, and linguistic backgrounds, this awareness of bias is extremely important. Social Workers can use their understanding of cultural competency to establish coalitions of diverse individuals and ensure that all stakeholders truly feel heard in a government environment that frequently does the opposite.

Conclusion

While there are 682,000 Social Workers in the United States, there are only 2 Social Work-Senators and 4 Social Work-Members of Congress. Compare that number to the 1.35 million lawyers in the United States and the 47 Lawyer-Senators and 145 Lawyer-Members of Congress. This means that there is 1 Senator-Social Worker for every 341,000 Social Workers in the United States, and 1 Member of Congress-Social Worker for every 170,500 Social Workers in the United States. On the other hand, there is one Lawyer-Senator for every 28,723 Lawyers in the United States and 1 Lawyer-Member of Congress for every 9,310 Lawyers!

Social workers are sharply underrepresented in these and various other elected positions compared to members of other career paths. Even so, based on their experiences and training, Social Workers could create very positive and impactful changes in these roles.

Older People Living Alone With Dementia

Dementia-Signs-and-Symptoms-Include-Alzheimers

We are having a conversation, social worker to social worker, about the older constituents and clients who we each try to help. She works in a small senior center, and I work in the district office of a New York State Senator. I believe it is those of us on the front line of senior issues in our city who see first-hand the breadth and depth of the ever-growing population of older adults who are left to their own resources to navigate the complexities of life in this large urban city. So many are suffering from some form of mental illness, most often dementia. They are only one step away from winding up in a shelter system where they do not belong. To most people, they are invisible.

Sounding frustrated, she says,”They just keep coming”. I reply, “And they are all mentally ill or in some phase of dementia, right?” “Absolutely, she replies, “either that or they are broke…or, more likely, both.”

And yet, over the past several years, with a very heavy heart, I have had to refer elderly people to our city’s shelter system.This comes only after exhausting my own resources to find them even just a bed for the night. Programs that once offered temporary emergency shelter are full. One program director told me, “Clients used to come in and stay for a few weeks or a few months until they could find permanent accommodations. Now they seem to stay forever, and we very rarely have even a single bed available.”

Add to this the fact that these are people who have no social support network. They have no children or are estranged from their children, their friends have all died; and in some cases they have physical and/or mental limitations, that keep them isolated. These constituents are not anomalies, they are part of a cohort of seniors and elderly community members who come into or call our office every day. One day a young staffer said to me, “Wow, all seniors are mentally ill”. My answer was “No, not all seniors are mentally ill, only the ones that come to see us.”

The older adult that seeks our assistance comes with a legitimate presenting problem; i.e. my landlord is harassing me, someone is coming into my apartment when I’m not home, I’m not getting my food stamps or SSI credits. It is only when I sit down to talk with the constituent, whether in person or by phone, that I very soon realize that the presenting issue is just one piece of a much larger problem. When I make the decision that the constituent’s issues are not appropriate for a legislative office, I then refer the constituent to a senior service agency. It is my hope that the agency will be able to assign her to a case worker who can holistically see the entire picture and assist her in getting the help she needs.

While we need the many extraordinary social workers who are dedicated to helping these constituents with direct service, I can’t help wondering why we are having such an influx of older adults with mental health issues. It is only when we can answer that question that an effective solution can be found…or perhaps legislation can be written…to ameliorate the situation. As a macro social worker, this is my job.

Geotagging Memories? A Brief Exploration of Social Work Implications

panoramio-geotagging
Photo Courtesy Panoramio.com

Sometimes social workers ask me how they can connect Geographic Information Systems (GIS) or spatial analysis to their work. For macro social work, the connections are easy. We can visualize community assets, identify crime hotspots, look at the ways in which environmental hazards cluster in certain communities…the possibilities are endless. But, for clinical and micro focused social work, the connections are not as easy to draw. In this article, I want to open up this discussion in order to consider the ways place and space shape our memories and how they may hold broader implications for the use of spatially oriented technologies in social work practice.

When I reviewed an article suggested by Nancy Smyth, the dean at the School of Social Work at the University at Buffalo SUNY, I was drawn to the potential implications for social work. The article was on a recent study conducted by Michael Kahana and his colleagues at Penn State University where the participants used a game-based simulation in which they walked around a virtual town dropping off packages. The researchers then measured participants’ brain response when asked to recall where they had dropped off packages. They determined that neurons in the hippocampus act as a “brain GPS device” that stores and “geotags” memories. Put simply, their tests and brain images revealed that during the recall process, these memory geotags activate just before the participant recalls a memory.

Their interest is in the role of the hippocampus in cognition; I’m interested in some of the practical implications of these findings for social workers. Micro social workers might be able to use these types of findings to better understand how the macro environment and the notion of “place” can shape their clients’ well being. How do we work with a client who experiences a traumatic event in their home or community? If memories contain geotags, these place-based triggers could be an important area for intervention especially if they are places the client cannot avoid.

From a macro perspective, could community locations trigger collective trauma? In my work in the Homewood neighborhood of Pittsburgh, I’ve observed how places can shape and inform collective memories. In the middle of the once thriving neighborhood business district lies a vacant building bearing the telltale shape of a Kentucky Fried Chicken restaurant. Years ago, a teenager was shot and killed there while in the drive through with his mother. The restaurant closed but the building remains a scar on the landscape; a geotagged community trauma yet to be healed.

What other social work implications might the concept of memory geotags lend itself to?

[youtube]https://www.youtube.com/watch?v=Q5TRU9A1t9k[/youtube]

The True End to the 2014 NCGA Short Session

legislative building

Legislators finally adjourned for the 2014 short session on Wednesday, August 20th which is almost seven weeks after originally anticipated. You may recall my Week 12 update where I claimed that week was a wrap but it did come with a catch. Legislators wanted time to decide if they needed to come back in November for a special Medicaid and/or Coal Ash Session as well as take up any number of other provisions. By law, legislators had to continue meeting every four days while leadership decided what to do. Legislators held skeleton (or no vote) sessions until they came back on Thursday, August 14th to really wrap up the short session.
Relevant bills with action

After a few committee meetings, Senators created 3 adjournment bills hoping the House would pass at least one of them:

House Joint Resolution 182 Adjournment Resolution: a bill that would end session but come back in November for a special Medicaid Reform short session.

House Joint Resolution 901 Adjournment Resolution: a bill that would end session but come back in November to discuss Medicaid Reform, conference committee reports, and a few other measures.

House Joint Resolution 1276 Adjournment: the winning bill that ended session with no plans to return in November. Unless the Governor calls legislators back for a special session, we won’t see legislators passing bills again until the 2015 long session which will start in January.

Legislators also wrapped up a few bills that were awaiting concurrence. Of interest to social workers:

House Bill 369 Criminal Law Changes was passed by both the House and the Senate and presented to the Governor for signature. The bill makes several changes to various criminal laws. Most pressing, section four of the bill directs the North Carolina Human Trafficking Commission to work with various organizations, including NASW-NC, to study and develop age appropriate sexual abuse education to be taught in schools to students and educators.

Now that session is truly done for the short session, NASW-NC will now focus on work with our Political Action for Candidate Endorsement Committee (NC PACE) on endorsing candidates that support the social work profession. Through these endorsements, we hope to elect social work friendly candidates that can help advance our profession and support the clients we serve.

2014 NC Short Session: That’s Hardly a Wrap!

Senators wrapped up the 2014 short session shortly after a midnight on Friday when they finally approved a state budget. House members  followed by issuing their final votes on Saturday. But there’s a catch, legislators will return this week to agree on an actual adjournment date as the House made more changes to the Senate’s original plan.

On August 14th, legislators will return for a brief additional session to take up any bills that might get vetoed by the Governor, wrap up any bills that got assigned to a conference committee, and attempt to complete nine different other provisions held over in adjournment resolutions. There’s still one more catch, legislators will return again on November 17th for a special session to discuss Medicaid Reform and possibly Coal Ash, and there is no word on how long this session will last.

So, while legislators have adjourned, they have not technically finished working. We should have a better idea of  their plan to meet again in August by the later part of this week.

Relevant Bills with Action:

SB 744 Appropriations Act of 2014: This bill has been in the works since session started. When legislators couldn’t agree, they turned to appointing a 42 member conference committee. Last weekend, they reported that they had come to an agreement. The conference committee budget highlights are below. With the Governor’s signature, this will be the state budget for the 2014 fiscal year. View the Money Report for further explanation on the spending plan with accompanying page numbers listed after each highlight. Please note, it is difficult to capture all the provisions in the budget due to the amazing variety of the social work profession so information below is only a snapshot of changes.

  • Provides funds to support the costs related to the education of children in private psychiatric residential treatment facilities (F-6).
  • Provides funding for one year for group home residents who were determined to be ineligible for Medicaid personal care services on or after January 1, 2013. The maximum monthly payment is set at $464.30 and is based on providing 33 hours of service per eligible recipient (G-3).
  • Reduces General Fund appropriation for the Home and Community Care Block Grant (HCCBG) by 3%, leaving a balance of $31,808,889. Cuts are $969,549 (G-4).
  • Changes the income eligibility for the State-County Special Assistance (SA) Program from a method that bases income eligibility on the payment rate for the facility type where the recipient resides, to a method based on the federal poverty level for all recipients regardless of where they reside. The SA eligibility level is set at 100% of the Federal Poverty Level. Current recipients of SA are grandfathered in and will continue to receive SA. (G-8).
  • Provides funding to replace $4.5 million in federal block grant funds that counties lost in 2013-14 that was utilized to pay for Child Protective Services (CPS) workers. An additional $2.8 million in funding is provided effective October 1, 2014 to reduce county departments of social services caseloads to an average of 10 families per worker performing Child Protective Services assessments (G-9).
  • Provides $4.5 million for Child Welfare In-Home Services to serve at-risk families (G-9).
  • Provides $218,538 recurring and $125,750 nonrecurring funds for the implementation of drug screening for Work First Benefits applicants (G-10).
  • Provides funding through incentives and rebates to end the waiting list of the Aids Drug Assistance Program (G-11).
  • Provides $2.2 million for community-based crisis services (G-15).
  • Provider rates are cut, once again, by 1% (G-18).
  • Mental Health Drug Management: Authorizes DHHS to impose controls including prior authorization, utilization review criteria, and any other restrictions on mental health drugs (G-18 and pg 87 of the budget).
  • Provision to hold special session in November to discuss Medicaid Reform (pg 87, budget).

Other Bills of Interest with Action:

HB 884 Dropout Prevention/Recovery Pilot Charter School: This bill establishes a two year pilot program for one charter school who has had students drop out. The purpose is to increase graduation rates and reengage students. The bill passed the House and Senate and was presented to the Governor for signature.

SJR 881 Adjournment: This bill directs legislators to adjourn but to return on August 14th and November 17th. As mentioned above, the November special legislative session will be focused on Medicaid Reform.

HJR 1276 Adjournment: The House version of the adjournment resolution. While the dates to return are the same as the Senate, the House has a few more issues to keep alive including any bills related to autism insurance reform. The House gives the Senate until Wednesday, August 6th to take up the new adjournment resolution.

2014 NC Legislative Short Session Nears End But No Deal on Budget

Last week, the General Assembly saw more action from the Senate than the House, and Senators have been meeting in Rules Committee the past couple of weeks to pass a few pressing bills. On Thursday, while discussing Medicaid Reform on the Senate floor, Senator Bryant sought an amendment to expand Medicaid. Unfortunately, but not surprisingly, the amendment failed.

Senators commented that this was the fourth time they voted down to expand Medicaid in the state. The House did meet on Thursday and Friday of last week, but they had little committee activity during the week. Despite filing an adjournment resolution for Friday, July 25th, the House does plan to meet this week. Rumors started over the weekend that legislators have reached another deal on the budget, so we hope to see the proposal this week.

Relevant bills with action:

short sessionHB 1181 Medicaid Modernization: This is the bill that would create a new department to oversee the operation of Medicaid and NC Health Choice run by a seven member appointed board, create full capitation by 2018 (instead of fee for service), integrate physical and behavioral health by 2016, and much more to reform Medicaid in our state. The bill went to committee to push back a few dates in the bill including the creation of the new department from August 1, 2014 to September 1, 2014. Senators will take a third, and final, vote on Monday night. The bill then has to get approval from the House before it is made law. No word yet on the House’s position on the bill.

HB 369 Criminal Law Changes: This bill passed out of the Senate last week and is scheduled to be heard on the House floor on Tuesday. The bill will allow NASW-NC and other partners to work with the Human Trafficking Commission on age appropriate sexual abuse education for students and teachers. The bill also makes several changes to various criminal laws such as expungement for certain offenses and higher penalties for providing inmates with cell phones.

HB 1133 Technical and Other Corrections: A bill that normally marks the end of the legislative session, the House and Senate have been working on a technical corrections bill to tie up loose ends of the session. Usually very technical in nature (spelling errors, corrections to previous bills, etc), the bill had a surprise section that would eliminate the Child Fatality Task Force that makes statewide recommendations to prevent unnecessary deaths of children.

During the existence of the Task Force, childhood death has decreased by as much as 32% in the past three decades. During floor debate, Representative Grier Martin (D-Wake), ran an amendment to eliminate this section of the bill and it passed overwhelmingly. The bill passed out of committee and passed the floor Friday. The bill will now go to the Senate.

The Struggles of Being a Macro Student and How We Can All Be Supportive

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We all know that social work is a versatile field. There are many opportunities within the field to do a variety of things on a variety of levels. We all should know that all levels of work are necessary in order to successfully implement the mission of social work. Even though all levels of social work are necessary, many schools and social workers tend to put efforts in micro level initiatives. There is certainly a need for these initiatives, but focusing the majority and almost all resources on micro efforts can be a struggle for many macro students. Without proper support and resources, macro students can have a hard time during the time in a program.

Here are some of the examples of struggles I have come across and discovered for macro students. These struggles compliment and repeat some of the issues released in the Rothman Report , which you all should read if you have not had the chance.

  • Forced Micro Experiences: Everyone knows that every social work program has some forced micro component. There are some program implementing macro components in requirements, but it is predominantly micro. This probably has to do heavily with state licensure exams content and schools accommodating to their requirements. If a student knows they want to do macro work, why are they forced into micro opportunities? Yes, there are skills that all social workers need to know, but schools can certainly accommodate to the needs of macro students. Social work is what you make of it, and you can’t make much of the opportunities if you are forced into certain ones
  • Minimal Exploration Opportunities: While you are a student, you should be exploring the career fields you would like to pursue. Since social work students have a short amount of time to obtain their degree, it is hard to explore various macro opportunities if you spend half the time in a micro setting. Trying out new experiences if how we learn and how we develop our career aspirations. Without time to explore, schools are feeding us down a certain path.
  • Lack of opportunities with Social Work Programs: There are a numerous opportunities out there macro students and in some ways more flexibility, but social work program tend to focus their efforts on micro students based on the overwhelming amount of micro students and faculty. Micro classes are offered more often and micro opportunities are encouraged.
  • Quality of opportunities: With a micro focus, many schools focus their resources on those opportunities and the macro courses suffer. This causes many macro students to go outside the program to search for quality education and opportunities or not even enter the programs. I know my decision to enter my social work program was based on the macro education, and I dismissed many schools with poor macro concentrations.
  • Trouble with post-graduation employment: Since the quality of macro educations are many times sub-par, the students leaving the programs are then sub-par and may not be able to attain the macro job opportunities they desire and have to settle for a micro job. If a student has a primarily micro background, then they won’t be qualified for macro jobs without proper experience or if they obtained the job, they perform poorly. Macro students are losing positions to other professionals because their programs are preparing them better and allowing for flexibility.
  • Risk of Being Classified as an UNFIT Social Worker: This is an interesting point, but also sad at the same time. I will repeat myself again that not all social work is focused on clinical intervention, and if we only focus on clinical treatment, societal problems will not be addressed. Micro work is not for everyone. I certainly do not want to perform therapy, and I should not feel incompetent as a social worker because of it. I have heard of incidences of macro students being kicked out of their programs because they do not want to perform therapy or asked to do micro work and their field supervisors claim they are unfit social workers. There is even a person in my school that tells students to withdraw from the program if they do not want to do therapy in their field placements which is ridiculous. I don’t have to be a good therapist to be a good social worker.
  • The Constant Questioning of Goals/Intentions: Every student gets asked “What do you want to do with your degree?” This is a reasonable question to engage in conversation and learn about the individual, but for macro students it can be a challenging subject. Many experienced social workers constantly suggest ideas and have an expectation of social workers that they force on current students. Macro social work sometimes does not cross their radar as “real” social work. Also, a micro focused curriculum and field experience forces does not help students pursue macro social work. If macro students are constantly being told what they want to do is not social work and being forced into opportunities they do not want to do, then why should they purse a social work degree?
  • The Struggle to Stay Motivated: As we all know, social change takes a long time and a lot of effort. If macro students who desire to pursue social change are surrounded by people who do not want to contribute or are too burned out from their clients, then macro students can struggle with staying motivated to want to implement change. Instead of giving support, micro social workers can limit macro students’ perceptions of social workers and diminish their motivation.

There are ways that each one of us can help continue to promote macro social work and encourage students to pursue this tract. Here are some ways EVERYONE can help:

  • Never limit your definition of social work: Social work is what people make it, and as long as it is promoting social justice and ameliorate society, then it should count as social work. Never tell someone their work does not matter nor it’s not social work because you don’t think it is.
  • Ask to Help rather than give Advice: This is an issue in many fields, especially social work. Experienced social workers and fellow peers should be asking students how they can help them, rather than giving unsolicited advice. Of course, advice that is welcomed is very useful, but don’t just assume a student wants or needs to hear your perspective on social work. It can be more harmful than helpful.
  • Start Connecting: I wrote in a previous article that all social workers need to be networking! If we keep connecting people with each other, than people can find support and resources in ways they could not have on their own.
  • Unite together: I know this may seem cheesy, but many students think doing stuff on your own is easier and shows strength, but asking for help sometimes is necessary. Getting together with fellow students or asking alumni for support could be really beneficial. If students are having problems, people should offer to help or at least provide support as much as they can. A unified front is stronger than several smaller individual ones.
  • Encourage instead of Discourage: Discouragement is definitely a struggle for many macro students, and it is important to support them in their exploration process. Remember, all levels of social workers are needed, and we need to ensure all are supported through their education process.
  • Challenge and Help Change: If you think your program does not do a good job supporting macro social work students, speak up and ask for the reasons. Sometimes it’s intentional, and sometimes it is not. If things about be better, try to offer solutions or create a task force that could help. Change doesn’t happen without a challenge first.

2014 NC Short Session, Week 10: The Newest Medicaid Reform Plan

Bay Area Activists Protest Cuts To Medicaid

What a week at the General Assembly! The Senate decided to work on bills that were sitting in the Senate Rules Committee all last week and move them to the floor for votes.The most controversial was Medicaid Reform which the Senate proposes to create a completely new Department. The House did not meet last week and have nothing on their calendar for tonight, but it is possible that they meet later in the week to work on the bills the Senate is working through their Rules Committee.

Relevant Bills with Action:

HB 369 Criminal Law Changes: This is the omnibus bill that will expunge certain drug offenses and includes language on Erin’s Law. Under Section 4(a), the bill directs the Human Trafficking Commission to study the inclusion of age appropriate sexual abuse education in the classroom as well as gather information on sexual abuse in NC. Under the bill, the Commission is directed to work with several organizations to do this, including NASW-NC. The bill will be heard a third time tonight and, if it passes the Senate, will be sent to the House for concurrence.

HB 1181 North Carolina Medicaid Modernization: Last week, the Senate came up with an entirely new Medicaid plan. Under the new plan, the Division of Medical Assistance (DMA) would become an independent agency called the Department of Medical Benefits which would manage behavioral, physical and other specialized care for Medicaid and NC Health Choice recipients under a Managed Care Organization (MCO) or Accountable Care Organization (ACO) model.

The Senate scheduled this new Department to be created by August 1, 2014 and governed by a 7 member Board of Directors. The Senate plan also directs the Department of Health and Human Services to immediately cease any activities related to Medicaid reform. This plan is certainly fast-moving in the Senate and controversial among many. The bill is scheduled for a floor vote in the Senate tonight. If it passes, it will need to go to the House for concurrence. The Governor has already stated opposition to the new plan but the House has not spoken much for or against the bill.

Relevant Bills Filed:

HB 1276 Adjournment Sine Die: Yes, you read that correctly. The House bill filed last week sets adjournment for this Friday, July 25th. Keep in mind, the Senate filed an adjournment bill on June 27th, and legislators are still in session.

Short Session, Week 7 and Still No Budget

The end of session should be approaching soon. The evidence? The large volume of bills that were gutted, amended, and flew through the legislature last week. The House and Senate are still divided on how large the Medicaid shortfall really might be – up to a $248 million difference between the two proposed budgets.

Pope-Southern StudiesThis was evidenced when the Senate nearly subpoenaed the State Budget Director, Art Pope to show up at their second budget meeting on Medicaid as he and his staff did not show up to one the previous week. Legislators grilled Mr. Pope on not being able to give definite numbers on the shortfall or how many adults and children are enrolled in Medicaid in the state. This tension continues to hold up the proposed budget for the House and the Senate.

Today, the House read the Suicide Prevention Resolution. The resolution called on NC to develop measures to help prevent suicide particularly for youth and veterans. Those in attendance were recognized by legislators in the House gallery during session. Many spent the day talking to legislators about how important the resolution is for young people and veterans in our state.

Last week, the Governor sent a directive to state departments to operate with the biggest cuts in the proposed budgets, but this does not include teacher assistants and massive cuts to the Aged, Blind, and Disabled on Medicaid. This would also mean no pay raises for state employees and teachers- a major goal outlined by legislators prior to the start of the short session.

Relevant bills with action:

  • SB 3 2014 Budget Mods./Pay Raises/Other Changes: Deemed the “mini budget,” this bill is a smaller version of the budget bill Senate Bill 744 and adjustments to the current budget. Raises for state employees and teachers will be paid for with agreed upon cuts. The bill does not do much to Medicaid. The bill passed the House unanimously, 117 to 0, and was sent to the Senate for concurrence. It is unsure if the Senate will agree to this mini budget with all the controversy regarding the Medicaid shortfall calculations.
  • SB 493 Health and Safety Regulatory Reform: Last Tuesday, legislators split the large Regulatory Reform Bill (Senate Bill 493) into two separate bills. SB 493 became Health and Safety Regulatory Reform that includes measures for autism insurance for anyone up to age 23 that was diagnosed before age 8, establishes a behavioral analyst licensing board, requires all health benefit plans cover prescribed, orally administered cancer drugs, and prohibits tanning bed use by anyone under age 18. The bill quickly passed committee and went to the floor. On Wednesday night, after much debate, legislators approved the bill with a vote of 78 to 32. Because of changes made to the bill, the bill has to return to the Senate for concurrence. It does not have to go through Senate committees. and if the Senate confers, the bill will go to the Governor to be signed into law.
  • SJR 882 Honor Senator Martin Nesbitt: Both the House and Senate honored late Senator Martin Nesbitt who died suddenly on March 6th, a week after being diagnosed with stomach cancer. Senator Nesbitt, from Buncombe County, was a champion for the social work profession. He was a long standing legislator, serving in both the House and Senate during his time. He is greatly missed!
  • HB 369 Criminal Law Changes/WC Illegal Aliens: The original bill was gutted and new language was inserted in the bill to address several criminal law changes. This bill does multiple things: it will expunge certain drug offenses with no age limitation and it directs the Human Trafficking Commission to study Erin’s Law (a bill NASW-NC has been working on to get a licensed clinical social worker involved). It will be heard on the Senate floor tonight. If approved, it will only need concurrence from the House before it goes to the Governor to be signed into law.
  • HB 1220 Hope 4 Haley and Friends: After passing the House last week, a Senate committee debated the bill and it was sent to the Senate floor. The bill allows for hemp oil extract from the cannabis plant to be used for youth with certain seizure disorders when no other treatment has worked. The bill does allow for UNC Chapel Hill, East Carolina, Wake Forest and Duke Universities to develop, conduct research, and participate in clinical trials with the oil. Neurologists, patients and caregivers who prescribe or are prescribed the oil would have to register under the legislation with a registry established by the Department of Health and Human Services (DHHS). Once DHHS approves measures and establishes the registry, families can start using the oil. The bill passed the Senate, the House concurred with a few changes that were made, and the bill was sent to the Governor for signature. The Governor has stated he will sign the bill into law.

Related news:

While not a priority piece of legislation for NASW-NC, we wanted to address the comments made by Representative and Speaker Pro Tem Skip Stam regarding sexual orientation in the Diagnostic and Statistical Manual IV- TR (DSM-IV-TR) when discussed during debate on Senate Bill 793 Charter School Modifications. During debate, Representative Fisher put forth an amendment to prohibit charter schools from discriminating based on sexual orientation and gender identity.

The debate spurred questions on the definition of sexual orientation and Representative Stam shared with House members a memo from the outdated 2000 DSM-IV-TR on sexual paraphilias that listed a number of sexual perversions and disorders as well as homosexuality. The DSM removed homosexuality as a disorder in 1974. The amendment did not pass. On the second day of debate, Representative Ramsey pushed an amendment that would prohibit charter schools from discriminating based on any category under federal law or the Constitution. This amendment was approved and the bill passed.

NASW-NC does not support any form of discrimination based on sexual orientation or gender identity. We are pleased that House members found common ground not to discriminate in charter schools to further protect North Carolinians.

Photo Courtesy of Southern Studies

North Carolina Legislators Heading Towards Adjournment, Week 6 Recap

ChamberGavel_8

Legislators are still going back and forth on an adjournment date, but our latest predictions are that legislators will go home by the second week of July if they are not done the week of July 4th. With a lot of controversial bills still on the table and not having reached an agreement on the budget yet, legislators have a lot more work to do before adjourning for the year. It is possible for legislators to leave with the current budget in place that was passed in the 2013 long session and only make a few adjustments to cover the shortfalls in Medicaid and the Department of Revenue.

Week 6 of the short session started off with a new regulatory reform bill that created controversy for many House members that did not see the bill until shortly before it was presented. Legislators commented that their uneasiness with the bill stemmed from the bill being more than just regulatory reform and included other provisions. This uneasiness slowed down the bill and it was sent back to the Regulatory Reform Committee before going to the floor. Additionally, on Wednesday night, House Health and Human Services Committee members introduced a new Medicaid Reform plan that makes big changes for provider payment and certain I/DD clients in Cardinal Behavioral Health’s catchment area. More information about these two bills is below.

Relevant bills with action:

  • HB 712 Clarifying Changes/Special Ed Scholarships: This bill allows $3,000 for eligible students with disabilities per semester to attend private schools and exempts certain private schools from child care licensure requirements. The exemption is extended to private schools that provide more than 6.5 hours of child care as long as they are not funded by childcare subsidies or NC Pre-K. This may open the door for more private schools to offer after school care knowing they do not have to be licensed and meet certain state requirements for health and safety. The bill passed the Senate and was sent back to the House.
  • HB 1181 Partnership for a Healthy North Carolina: This bill addresses a new Medicaid Reform plan. The plan would set provider capitation rates over the next 5 years instead of fee for service. This would make providers responsible for overspending but also allows them to absorb any savings. Section 10 of the bill directs Cardinal Behavioral Health to pilot integrated care, physical and mental health care, with certain I/DD clients living in group settings. This bill is supported by the Governor. It was discussed in committee this week and referred to Appropriations. Read more about this plan and House and Senate differences on Medicaid.
  • HB 1220 Hope 4 Haley and Friends: This bill establishes standards for the use of hemp oil extract from marijuana plants to be used for people suffering from intractable seizure disorders when no other medicines have worked. The bill sets up a registry of neurologists who prescribe the extract, caregivers, and patients. The bill also encourages UNC Chapel Hill, Duke University and Wake Forest University to further study the use of hemp oil extract. The bill passed the House and was sent to the Senate.
  • HJR 1262 Suicide Prevention Resolution: This bill directs the Legislative Research Commission to examine ways to prevent suicide among minors and veterans in NC as suicide in these populations more prevalent. The bill directs the commission to study evidenced-based treatment and prevention strategies and ways to engage and train professionals who work with minors and veterans. It was assigned to the Committee on Rules, Calendar, and Operations of the House.
  • SB 493 2014 Regulatory Reform Act: This bill makes several changes but the biggest for social workers is that it would direct insurance companies to cover autism services and allows for reimbursement of licensed clinical social workers to provide therapeutic care. This is the language from House Bill 498, supported by NASW-NC, that passed the House in the 2013 long session. The bill also establishes a board for Behavioral Analysts in NC (there is currently no state level licensing board for behavioral analysts). Additionally, the bill prohibits tanning bed use for minors under the age of 18. The bill is going through House committees at this time.
  • SB 761 Credit for Military Training: This bill enhances the effectiveness of military members and veterans obtaining occupational licenses and directs the Board of Governors for the University System and the State Board for Community Colleges to submit a plan that would grant college credit for students with military training. The bill passed the Senate and will be sent to the House.

Budget Conferees:

The Senate voted not to concur with House budget changes last week and a conference committee was established. The 41 member appointed committee is compromised mostly of appropriation chairs that will work to flush out the details and other influential legislators. Only one Democrat was appointed to the committee that will work to combine the House, Senate and Governor’s budgets. No persons of color were appointed. Legislative staff released a Comparison Report of the differences in the House and Senate budgets.

North Carolina General Assembly (NCGA) 2014 Short Session, Week 5 Review

By Kay Castillo, Director of Advocacy, Policy and Legislation, National Association of Social Workers, NC Chapter

Week five of the North Carolina General Assembly’s short session brought to us the House budget. Unlike the Senate, the House took extra measures to introduce and discuss their budget. Last Tuesday, House members reviewed their budget section by section in subcommittees to hammer out details before taking it to the full Appropriations Committee on Wednesday.

North Carolina General Assembly
North Carolina General Assembly

Following Wednesday’s seven-hour committee meeting, the bill went to the Finance and State Personnel Committees before going to the floor for debate on Thursday afternoon with a final vote on Friday morning.Moving forward, a conference committee will be appointed to combine the Governor, Senate, and House budgets. While the House debated the budget all week, the Senate took up mostly non-controversial bills and adjourned early Thursday morning.

House Budget Proposal Highlights:

House Budget Money Report (special provisions, further descriptions about the budget)

  • No prior authorization for mental health medications (in Senate and Governor’s budget) or cuts to the medically needy on Medicaid (in Senate budget).
  • Medicaid Reform similar to Governor’s recommendation and funded at $1 million. (pg G-19 of Money Report)
  • Provides funds for implementation of drug screening and testing for Work First Program Assistance. This is only funded in the House budget. This comes from legislation passed in the 2013 long session but was never funded. (G-9 of Money Report)
  • Funds $750,000 to Critical Time Intervention (a social work supported model) to support short-term case management services for persons leaving inpatient psychiatric facilities, adult care homes, and other institutions. This is only funded in the House budget. (G-15 of Money Report)
  • Funds $300,000 for Child Protective Services (CPS) Initiative to help decrease caseloads to 10 per worker and other division changes. Additionally, the budget contains: $8.3 million in additional funding for CPS (same as Senate); $4.5 million for expanded in-home services (same as Senate); $750,000 increase for statewide oversight of child welfare services; $700,000 increase for CPS evaluation; and Foster Care Assistance is increased by $5 million. (starting on pg 81 of the budget)
  • Creates a strategic state plan for Alzheimer’s Disease including ways to improve research, awareness and education, caregiver assistance, long-term care, and more. (pg 88 of the budget)
  • Funds $5 million to expand community-based crisis intervention services. (pg 94 of the budget)
  • Funds over $2.3 million for Traumatic Brain Injury supports and services. (pg 91 of the budget)
  • Allows funding for Personal Care Services to residents in group homes that was provided in last year’s budget but will not all be spent by the end of the fiscal year, June 30th, 2014 to be extended until June 30th, 2015. This is approximately $2.2 million left from the $4.6 million appropriated.

While not perfect, the House budget is much better than the Senate budget put forth. You can visit this link to see a House and Senate Budget Comparison for the Health and Human Services Budget. We thank House members for taking our state’s most vulnerable populations into consideration while developing the budget and providing extra money to mental health, developmental disabilities, child welfare, and other necessary services.

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