Thursday, May 12, 2011

Weathering The Storm

If you are having trouble figuring out how the proposal for Health Care (Payment) Reform will effect your practice of social work, you are in good company.  Everyone is struggling, wondering and obsessing.

I am not just talking about social workers who have clinical practices, or to the majority of NASW members who practice their trade in the dozens of other social work settings but to all.  If you are a clinician providing mental health services to clients you need to be particularly vigilant as the changes will impact your livelihood and your personal health care needs.  If you are practicing social work in any other setting, you need to be aware of the changes for the population and communities that you are working in, as well as for yourselves and your families.

There are a number of the key issues that we are looking at from the social work perspective :  First, is the place of mental health services and specifically social work services in the proposed reform.  Social workers are in an excellent position to play key roles in the new Accountable Care Organizations (ACO) models.  We are expertly trained for the case management or care coordination roles that are integral parts of the Health Reform proposal. (Keep in mind that there are numerous phrases that describe this 'coordination' function and care management, care coordination, case management, etc. are just a sampling of the job functions.)  From our theoretical and practice training  we know that a client/patient/individual needs to be seen from the perspective of 'person in environment' which basically means being aware of all the influences on a client's life and not just one medical or emotional symptom that the individual may present at the doctor's office. Besides this expertise in coordination, social work clinicians are highly trained to provide therapy services to those individuals with mental health and emotional needs. 

Social workers provide over 60% of mental health services delivered in the country.

We need to make sure that social work is the profession of choice in the new system. There are job opportunities that we need to be vigilant about and promoting amongst our colleagues and the schools of social work.

Second, we are wondering, where mental health is going to fit? If the ACO's are going to be given a certain amount of money to provide for all the health needs of its clients, how can we be sure that the ACO (headed by a medical/PCP person) will deploy some of that money to the mental health needs of its patients when mental health treatment is indicated? NASW is working hard to get to the bottom of these questions.

The MA Chapter is paying close attention to these two major concerns of our members and the clients they serve.

Besides having established a work group made of NASW members who are knowledgeable about systems, health care, advocacy and practice, THE CHAPTER WILL TESTIFY ON MONDAY MAY 16th at the State House about our concerns.  We are on the 'case' in the State House, with the administrative bodies that are charged with implementing the new Health reform proposal and with our colleagues in the other mental health and patient advocacy groups.

We ask that you keep abreast of the proposed changes in health reform by reading the accounts in the newspapers and other media, talking with your elected officials and continually bringing your questions and concerns to the Chapter.  We need to get feedback from you and take full advantage of your wisdom.  You can reach me at

Carol J. Trust

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