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January 2011

An Electronic Newsletter for the NASW Washington State Chapter

Index

LOBBY DAY 2011 Please Join Us for:

Lobby Day 2011...........1 Visiting Legislators…1-2 Online CE ……………..3 CE Workshops……......3

Lobby Day 2011 February 21, 2011 at: The United Churches 110 11th Ave SE Olympia, WA 98501

Volunteer………………4 Join NASW…………….4 Facebook………………4 Awards………………4-5 Title Protection…......5-6 DOH........................6-13 Legal Issue…........13-20

Join all your social work colleagues for NASW WA Chapter Lobby Day February 21, 2011. Lobby Day is an opportunity for the social workers across the state to speak one on one with their state legislators and voice support for legislation that impacts children, families, health care, the profession of social work, and many other social justice issues.

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The last several years, approximately 200 social workers participated in the WA Chapter Lobby Day. Lobby Day will be held at The United Churches of Olympia, 110 11th Street SE, Olympia, WA 98501. The events will begin at 8:30AM and run until early afternoon with your visits to your state legislators. Come together on February 21, 2011, and support the profession of social work and the clients we serve.

Visiting Your State Legislators When visiting your state Legislators for Lobby Day, you will need to schedule an appointment in advance. Lobby Day is February 21, 2011. The schedule of the Legislators is hectic and


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

Legislators are racing from committee meetings to floor actions to other appointments. You will have to be flexible when you schedule an appointment. The WA Chapter Lobby Day activities will end at 11:00AM it would be best to schedule your appointment after 11:00AM. If you do not know who your Legislators are, it is easy, visit Find Your Legislators and fill in your address, city, and zip code to find your State legislators. When Visiting Policymakers Mention Your Association The number of constituents that walk in and out of a policymaker's office can be mind-boggling. Even at the local level, our elected officials are NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

bombarded by constituent requests and member visits to the point that it can be hard to remember every name and face. That's why it's important to let them know who you're affiliated with and why. When you indicate to your elected leaders the associations to which you belong, they can understand the big picture needs of their constituents. Most likely, they work with your association at some level on developing policy and when you, the constituent, mention the organizations you're affiliated with, the elected official will take notice of the issues you feel strongly about. They know that, as a member, you are informed about the issues affecting your industry or profession, and are serious about making the right policy Website: www.nasw-wa.org Email: info@nasw-wa.org

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decisions that impact your cause. Our leaders understand the power of associations and recognize the importance of working with organizations like the National Association of Social Workers. They understand that you belong to an organized group and will share your experience with peers. This understanding is reinforced when you, the voter, express your affiliation with a larger constituency. The next time you meet with your elected officials, be sure to tell them which association you belong to. You don't represent just one voice but many and in the future your leader will have stronger interest in working with you as well as NASW.

Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

NASW-WA State Chapter has CE ONLINE! NASW WA Chapter has developed ONLINE CE for the 24/7 convenience of licensed social workers, marriage and family therapists, and mental health counselors. Select ONLINE CE from an OnDemand Catalog or participate in a live webcast. To view ONLINE CE workshops, go to our website, NASW-WA Website, click on the CE Institute button on the home page that says: ”NASW-WA ONLINE CE INSTITUTE”.

Upcoming Workshops Social Work Ethics: New Perspective, New Applications, Enhanced Fidelity Workshop March 25, 2011 Presented By: Jonathan R. Beard, LICSW, CPRP

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Clinical Considerations in Addressing Addiction in the Family May 20, 2011 Presented by: Claudia Black, M.S.W., Ph.D. Red Lion Hotel Bellevue 11211 Main Street Bellevue, WA 98005

Providence Sacred Heart Medical Center 101 West 8th Avenue Spokane, WA 99204 LASW/LICSW Licensure Exam Prep May 14, 2011 Presented By: Jonathan R. Beard, LICSW, CPRP North Seattle Community College 9600 College Way N. Seattle, WA 98103

NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Website: www.nasw-wa.org Email: info@nasw-wa.org

Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

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5. High ethical standards. 6. Lobbying for legislative activities on behalf of social worker & client concerns. 7. Malpractice insurance – lowest rates. 8. Networking. 9. United voice for the profession. 10. Credentials for your professions.

health and safety of others. As individuals in the profession and as a profession as a whole, we advocate for changes to many of the social injustices in our society and culture.

Volunteer to be on a Committee Decide which committee that would be just right for you. Click here for descriptions of each committee. Please fill out an application to be considered to join a committee. We look forward to working with you and thank you for your willingness to help.

10 Reasons to Join NASW-WA Chapter 1. Accountability as profession to clients. 2. Group efforts for community activities as social workers. 3. Friendship & support from colleagues in NASW. 4. Discounts on workshops, car rentals, credit cards. NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Follow Us on Facebook:

Social Work Awards 2010 Social Workers are dedicated and committed professionals. We have a unique conscience and concern for the Website: www.nasw-wa.org Email: info@nasw-wa.org

Social workers are a unique breed of people and professionals. We all deserve to be recognized for our contributions at work and in society. There is usually a social worker that stands out each year and it is time to identify and select the recipients of the NASWS Washington chapter social worker awards. NASW WA State Chapter would like to honor people from the following categories. If you know of someone that you think deserves to be recognized please download the nomination form and send it back to the Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

NASW WA State office. The award categories are listed below (click on the position to read what the criteria are for that award category). Social Worker of the Year Public Citizen of the Year MSW Student of the Year BSW Student of the Year President’s Award To nominate a fellow NASW member for one of these awards, please complete the 2010 Awards Nomination Form which can be found on the NASW-WA Chapter website or click here. Please return your nomination form to the NASW WA Chapter office by February 1, 2011.

NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Title Protection Legislation Reintroduced The NASW WA Chapter has reintroduced title protection legislation. The bill numbers are HB 1043 in the House and SB5020 in the Senate. Read the bill text. The House Bill 1043 is sponsored by Representatives Orwall, Dickerson, Pettigrew, and Ladenburg and the Senate Bill 5020 is sponsored by Senators Murray and Regala. What is the best way you can support the efforts to pass title protection legislation? It would be very helpful if NASW WA Chapter members would write letters to the editors of their local newspapers. There are sample letters on the WA Chapter Website: www.nasw-wa.org Email: info@nasw-wa.org

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website you can use. Letters to Editors. When writing a letter to the editor for placement in a local newspaper it is important to follow these steps: 1. Keep your message concise, approximately 200 words, and only make one specific point. 2. Do not make inflammatory statements. 3. Include your name, address, and telephone number. 4. Look in the Editorial page of your newspaper to find how to send your letter to the editor, some papers ask for it to be emailed others ask for the letters to be mailed. Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

Your voice will increase public understanding of the issue of title protection.

New Department of Health Counseling Credentials: Implications and (Hopefully) Answers for the Social Work Profession By Jonathan R. Beard, LICSW A new state law created eight counseling credentials beginning July 1, 2009. It abolishes the registered counselor credential on July 1, 2010. Previous NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

holders of the registered counselor credential and all new counseling applicants must apply in one of the following new categories. Agency Affiliated Counselor Certified Adviser Certified Counselor Chemical Dependency Professional Trainee Marriage & Family Therapist - Associate Mental Health Counselor Associate Social Worker Associate Advanced (SWAA) Social Worker Associate Independent Clinical (SWAIC) Since well before the creation of these new credentials, and on a pretty regular basis Website: www.nasw-wa.org Email: info@nasw-wa.org

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since, the chapter office and yours truly have received many inquiries requesting information and/or guidance on these new credentials. The WA Chapter office and I always try to be helpful to these callers, but can only go so far. Both the chapter office and I must stop short of offering fully qualified information and guidance because we do not work for the WA Department of Health (DOH), which has the final definitive authority on licensing regulations. So, a disclaimer is offered to callers that any information provided is an opinion only and cannot substitute for contact with DOH. Reliance can only be made on information supplied by DOH. That same disclaimer is offered here as I attempt to provide a summary of these new credentials and their implications for Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

the social work profession in our state. The WA Chapter asked me to do so as the principal trainer for the chapter’s licensure examination preparation course and a frequent presenter on supervision and ethics. NASW-Washington State Chapter and I believe that the new categories are a positive development overall for our state. The Chapter and I also believe that the new categories will result in MSW level social workers who previously held the registered counselor credential seeking a social work licensure credential. This is also a positive development as it contributes to the further professionalization of social work. So, to begin, here is some basic information NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

about the new credentials and some thoughts about the ones most germane to professional social work practice. First, all holders of the registered counselor credential must apply for one of the new credentials. There is no grandfathering. No application means no credential as of July 1, 2010. No credential could mean no employment. DOH recommends that an applicant for one of the new credentials first review the licensing requirements, scope of practice and laws relating to the counseling professions to determine which credential is the best fit for the services provided. It offers the following list with the basic requirements and typical counseling settings for each of the eight new counseling Website: www.nasw-wa.org Email: info@nasw-wa.org

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credentials: Agency Affiliated Counselor – Applicants must be employed by or have an offer of employment from an agency or facility identified by rule, (WAC 246-810-016) OR an agency or facility recognized by the secretary as meeting the requirements to employ agency affiliated counselors as defined in rule (WAC 246-810017). Click here for a list of these approved agencies. Affiliated Counselors may only practice in an approved or recognized agency. Certified Counselor – Applicants must have held a registered counselor credential for five years in good standing OR have a bachelor’s degree in a counseling related field. Applicants must complete coursework Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

and pass an exam in risk assessment, ethics, appropriate screening and referral and Washington State law. Applicants must complete four hours of AIDS education and have a consultant/supervisory agreement with another license holder. Certified counselors may be found in practice settings such as private practice or in agencies/facilities not recognized to employ agency affiliated counselors. Certified Adviser – Applicants must have an associate’s degree in a counseling related field, pass an exam in risk assessment, ethics, appropriate screening and referral and Washington State law, complete four hours of AIDS education and have a supervisory agreement with another license holder. Certified NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

advisors may be found in practice settings such as private practice or agencies/facilities not recognized to employ agency affiliated counselors. Chemical Dependency Professional Trainee (CDPT) – Applicants must provide written documentation to meet the eligibility criteria including: declaration he/she is enrolled in an approved school and gaining the experience required to receive a chemical dependency professional certification, completion of four hours of AIDS education, declaration with their annual renewal they are enrolled in an approved education program and gaining the experience requirements for a chemical dependency professional certification. This credential may only be renewed four times. Website: www.nasw-wa.org Email: info@nasw-wa.org

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CDPTs may be found in practice settings such as alcohol and substance abuse agencies. Mental Health Counselor Associate (MHCA) – Applicants must hold a master’s or doctoral degree in mental health counseling or a behavioral science master’s or doctoral degree in a field relating to mental health counseling from an approved school. Applicants must declare that they are working toward full licensure and complete four hours of AIDS education. This credential may only be renewed four times. MHCAs may be found in practice settings such as facilities, agencies or private practice under the supervision of an approved supervisor. Marriage and Family Therapist Associate (MFTA) – Applicants Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

must hold a master’s or doctoral degree in marriage and family therapy or a behavioral science master’s or doctoral degree with equivalent coursework from approved school. Applicants must declare that they are working toward full licensure and complete four hours of AIDS education. This credential may only be renewed four times. MFTAs may be found in practice settings such as facilities, agencies or private practice under the supervision of an approved supervisor. Social Work Associate Advanced (SWAA) – Applicants must be a graduate of a master’s or doctoral social work educational program accredited by the Council on Social Work Education and approved by the secretary based upon nationally recognized standards. Applicants must declare NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

that they are working toward full licensure and complete four hours of AIDS education. This credential may only be renewed renew four times. SWAAs may be found in practice settings such as facilities, agencies or private practice under the supervision of an approved supervisor.

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found in practice settings such as facilities, agencies or private practice under the supervision of an approved supervisor.

Social Work Associate Independent Clinical (SWAIC) – Applicants must be a graduate of a master’s or doctorate level social work educational program accredited by the Council on Social Work Education and approved by the secretary based upon nationally recognized standards. Applicants must declare that they are working toward full licensure and complete four hours of AIDS education. This credential may only be renewed renew four times. SWAICs may be

The new social work associate credentials are the ones that should be of interest to social workers in our state. DOH advises that ―an associate is a prelicensure candidate with a graduate degree in a mental health field. (RCW 18.225.090) The associate is gaining the experience necessary to become a licensed independent clinical social worker, licensed advanced social worker, licensed mental health counselor or licensed marriage and family therapist. An associate cannot provide independent mental health counseling, marriage and family therapy, or social work for a fee, monetary or otherwise. If an

Website: www.nasw-wa.org Email: info@nasw-wa.org

Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

associate is working under the supervision of an approved supervisor, it is not considered independent practice. An associate must keep records and progress notes. Associates are held to the same standard a licensed counselor (WAC 246809-035). Associate licenses are valid for one year and must be renewed every year on the date of issuance. You cannot renew your license more than four times. This should allow you enough time to complete the supervision requirements for full licensure.‖ It may be helpful to clarify some additional language in these definitions. The MHCA, MFTA and the two social work associate definitions state that these credentials may only be renewed four times. What this says to NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

me is that one must complete the requirements for full licensure within that four year period. So, there is (only) a four year window for an applicant to accrue the required hours of employment experience and hours of approved supervision in order to achieve full licensure. As DOH states above, four years should be enough time. These same four credentials also state that an applicant must be working under the supervision of an ―approved supervisor‖. It is vital for those seeking the associate credential to know the definitions and standards of approved supervision so as to choose their employment and supervisors carefully and wisely. DOH advises that ―in accordance with RCW 18.225.090, to provide Website: www.nasw-wa.org Email: info@nasw-wa.org

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supervision to a LASW (candidate) one must be licensed or certified for at least two years. To supervise a LICSW (candidate) one must be licensed or certified for at least two years.‖ WAC 246-809-334 states that ―to supervise a license candidate, you must hold a license without restrictions and have been in good standing for at least two years. You shall not be a blood or legal relative or cohabitant of the license candidate, license candidate’s peer or someone who has acted as the license candidate’s therapist within the last two years. Prior to the commencement of any supervision you must provide the license candidate this declaration, stating you have met the requirements of WAC 246-809-334 and you qualify as an approved supervisor.‖ Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

WAC 246-809-334 requires the ―approved supervisor‖ to attest ―I have completed the following: A minimum of fifteen clock hours of training in clinical supervision obtained through a supervision course, continuing education credits on supervision, supervision of supervision or any combination of these; twenty-five hours of experience in supervision of clinical practice and has two years of clinical experience post license.‖ The approved supervisor must further attest that ―I attest I will gain thorough knowledge of the supervisee’s practice activities including: practice setting, recordkeeping, financial management, ethics of clinical practice and a backup plan for coverage.‖ The implications for the NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

associate social work credentials are obvious. Associates are encouraged to make sure that they are working under the supervision of someone who meets the approved supervisor definition in full. This is best done by assuring that the potential supervisor signs off on the approved supervisor declaration form as required by DOH. This form may be found at the DOH website at Think of it as the informed consent disclosure form that the supervisor is required to provide you at the commencement of services rendered. That is exactly what it is. Those just beginning their path to social work licensure would be wise to find out, in advance, if they can receive approved supervision where they work. Recent graduates will want to specifically Website: www.nasw-wa.org Email: info@nasw-wa.org

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inquire about this when seeking employment. Also, while continuing education is required for those social workers licensed at the advanced or independent clinical level, it is not required for those licensed at the associate level. What about those MSWs who have held the registered counselor credential in good standing for at least five years? Good news. The new laws allow registered counselors with MSWs to become a LASW or LICSW without the normally required documentation of their postgraduate supervised experience. All other requirements, including a passing score on the relevant national examination, must be met in full. Such individuals are in a position to make application for either the LASW or LICSW credential immediately Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

without spending any time in the associate category. It appears that all that would be needed is a passing score on the ASWB advanced or clinical level exam. To those MSWs who have previously held the registered counselor credential, the social work associate credentials are the logical choice if you still are accruing experience or supervision. The LASW or LICSW credential is the logical choice if you have held the registered counselor credential for at least five years. Social work licensure at the advanced or independent clinical level is a significant professional milestone and one that should be sought and obtained. It speaks to the pride that we all should have in our professional training. It broadcasts our professional identity to client and community. NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Coupled with title protection, which is very close to passage in our state, it establishes social work as a legitimate, respected and protected player in the delivery of social and health services in our state. And that is something to which we all should aspire! I hope to see more of you at an upcoming social work licensure examination preparation course. Best wishes in your efforts towards social work licensure. About the Author: Jonathan R. Beard holds a Master of Science in Social Work degree from the University of Texas at Arlington with dual concentrations in mental health and administration and planning. He is a Washington State Licensed Independent Clinical Social Worker and also holds the credential of Certified Psychiatric Rehabilitation Practitioner as issued by the United States Psychiatric Rehabilitation Association. In Mr. Beard’s career, he has worked in a number of states in nonprofit and public sector settings that provide services to/for/with adults with serious mental illness and other co-occurring disorders as a direct services provider and as a supervisor, manager and senior executive. These include outpatient,

Website: www.nasw-wa.org Email: info@nasw-wa.org

Volume 1, Issue 1 case management, psychiatric rehabilitation, advocacy, supported housing, supported employment, and supported education. He has helped to develop community mental health programs from the ground up in two states. Mr. Beard is particularly interested in psychiatric rehabilitation, recovery focused/consumer driven services, benefits counseling and entitlement advocacy, consumer rights, ethics, and supervision and management in nonprofit and public sector human service organizations. Mr. Beard is a member of the National Association of Social Workers-Washington State Chapter and a past member of the chapter’s board of directors. Mr. Beard is also a member of the National Alliance on Mental Illness and the United States Psychiatric Rehabilitation Association. Mr. Beard currently serves as a Project Manager with the Washington Institute for Mental Health Research and Training (Western Branch) where he develops and delivers a variety of training, technical assistance and consultation products to assist in the transition of public sector mental health services in the State of Washington to a more consumer driven and recovery focused system. He also teaches graduate students at the School of Social Work at the University of Washington. In addition, Mr. Beard operates his own business, Progressive Strategies, where he provides a variety of project management, consulting, training, and program and/or organizational development services to public and nonprofit human service providers and organizations. He regularly presents for NASW-Washington State Chapter a well received course on

Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter preparing for the social work licensure examination in Washington. He has also provided continuing education workshops on social work ethics, public entitlements, and leadership training for the chapter. Mr. Beard also provides clinical social work supervision and consultation services as part of his private practice.

Legal Issue Preventing And Responding To Electronic Privacy Breaches Introduction Concerns about the protection of client privacy are on the rise as health records are increasingly made available in multiple electronic formats. Due to the ease with which large amounts of data can be stored and transmitted in small, portable devices such as laptop computers, NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

handheld and fingertip devices, social workers need to be prepared to respond quickly and appropriately in the event a privacy breach should occur. This Legal Issue of the Month article reviews existing and emerging standards for responding to privacy breaches involving social workers’ confidential client information contained in electronic systems, including an overview of state laws and federal regulations. What Is A Privacy Breach? Health care entities, including private social work practices, should define what constitutes a breach for their staff when developing security and privacy policies. The Health Information Technology for Economic and Clinical Health Act (HITECH) (2009), which amended the Health Website: www.nasw-wa.org Email: info@nasw-wa.org

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Insurance Portability and Accountability Act of 1996 (HIPAA), defines a ―breach‖ as: [T]he unauthorized acquisition, access, use or disclosure of protected health information which compromises the security or privacy of such information, except where an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information (Sec. 13400(1)(A)). Before A Privacy Breach Occurs Social workers have high standards for the protection of client privacy, as articulated in the NASW Code of Ethics, NASW practice standards, state social worker licensing laws and regulations, as well as social worker—client privilege laws Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


January 2011

An Electronic Newsletter for the NASW Washington State Chapter

recognized by the courts. The HIPAA Security Standards set out the basic requirements for securing clients’ protected health information. Each health care entity is expected to engage in a formal review of all electronic systems and devices that are used to handle confidential client information, to assess the potential threats and vulnerabilities to the security of that information, and develop a written plan for addressing areas of risk, and then implement the plan (Morgan & Polowy, 2005). This is recommended for all social work practices, with periodic reviews of potentials vulnerabilities. The regulatory compliance process should include appointing a HIPAA security officer and identifying someone NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

responsible for responding to security breaches. NASW’s Legal Defense Fund has made available several articles and booklets that outline the detailed HIPAA security specifications without charge to NASW members here. New HIPAA regulations promulgated in 2009 create a strong incentive for all health care entities to use encryption software to secure electronic client data (74 Fed.Reg. 42739 (2009)). Use of encryption may be one of the most highly recommended security steps and social workers who ignore the use of this highly available technology may do so at the risk of more onerous reporting requirements and serious consequences should they experience a privacy breach. Website: www.nasw-wa.org Email: info@nasw-wa.org

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What To Do If Your Social Work Practice Experiences A Privacy Breach A number of immediate steps are recommended in the event that a privacy breach occurs: Notify the police of any criminal activity related to the breach and file a report Identify the scope of the breach (how many client records, the nature of the client data, etc.) Determine whether the breached data were protected by encryption technology Prepare an internal breach incident report Review the potential for misuse of the information under the circumstances Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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An Electronic Newsletter for the NASW Washington State Chapter

and determine the likelihood of serious harm or misunderstanding due to the breach Review your state’s consumer notification law Review the HIPAA requirements for breach notification and obtain sample notification forms Determine what is needed to mitigate the possibility of misuse of the breached data and what changes are needed to prevent a similar breach from occurring in the future Prepare and send notifications for clients affected by the breach Carry out appropriate NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

employee sanctions Prepare notifications for government agencies as required. State Notification Laws A majority of states have passed laws requiring notification for breaches involving personal information contained in electronic systems or databases and a generally accepted standard for responding to a privacy breach includes client (or consumer) notification within a particular timeframe (for example, see California Office of Privacy Protection (2009)). According to the National Conference of State Legislatures (NCSL), as of April 2010, only four states, Alabama, Kentucky, New Mexico, and South Dakota, had not passed such Website: www.nasw-wa.org Email: info@nasw-wa.org

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requirements (NCSL, 2010). To comply with HIPAA’s preemption provisions, when comparing state law requirements and the HIPAA notification requirements, the shortest deadline for giving notice to clients is the one that should be followed, as it affords the highest level of privacy protection for consumers. For example, if a state law gives a business 15 days to give notice and HIPAA allows 60 days, clients should be notified within 15 days. The NCSL maintains an online list of the notification provisions in each state, are available here. HIPAA Privacy Breach Notification When Individual Notice is Not Required A key consideration in determining whether a breach requires client Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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An Electronic Newsletter for the NASW Washington State Chapter

notification is the potential for actual harm to the client. The HITECH Act created exceptions to individual notice requirements that are consistent with this perspective. HIPAA and HITECH do not require individual notice of breaches that occur to information that is secured with encryption technology, as the potential for it to be misused is much lower than unencrypted data (45 CFR § 164.402, § 164.404; also see, Morgan & Polowy, 2010a). Additionally, good faith, unintentional access by a health care employee or a business associate of the health care entity does not trigger HIPAA notification requirements, as long as the information was not further disclosed or any inadvertent disclosure was made only to someone within the health care entity who is

authorized to access protected health information (45 CFR § 164.402, § 164.404).

NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Website: www.nasw-wa.org Email: info@nasw-wa.org

Deadlines for Individual Notices The breach notice rules require a health care entity to notify each individual affected by a breach without unnecessary delay and not later than 60 calendar days of the discovery of the breach. The 60 day time period begins to run from the first day that the breach is discovered by anyone other than the person committing the breach (45 CFR § 164.404). Form of Breach Notice NASW has sample breach notification letters available online for members. These include the required regulatory information, but must be tailored to the specific circumstances of a particular breach

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incident. Notices are to be in writing by firstclass mail to the client’s last known address (or electronically, if specified as a preference). The regulations provide other procedures to be used when there is insufficient or outdated contact information. Notice may also be provided by telephone if it is a matter of urgency (45 CFR § 164.404(d)). NASW’s sample documents are available here. Content of Breach Notice As reported earlier in the NASW LDF Legal Issue of the Month article, HITECH HIPAA for Social Workers, (Morgan & Polowy, 2009), The notice provided to an individual of a privacy breach is to contain: A brief description of the Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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incident, including dates A description of the types of information involved (SSN, name, address, etc.) The steps individuals should take to protect themselves from potential harm due to the breach A brief description of the covered entities’ actions to investigate, mitigate harm and prevent future occurrences Contact procedures for questions or additional information that shall include a toll-free number, email address, Web site or postal address.

NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Reporting to Federal Government and the Media Health care entitles are required to report annually to the Secretary of the Department of Health and Human Services (DHHS) on all privacy breaches (45 CFR § 164.408). In cases where a breach affects more than 500 people HITECH also requires covered entities to report breaches to the media (45 CFR § 164.406) and contemporaneously to DHHS, rather than waiting to submit the report annually (45 CFR § 164.408). NASW Standards For Electronic Client Information The NASW Code of Ethics (NASW, 2008) includes several references to electronic records, including Standard 1.07(m) Privacy and Website: www.nasw-wa.org Email: info@nasw-wa.org

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Confidentiality, which specifies the following expectation: (m) Social workers should take precautions to ensure and maintain the confidentiality of information transmitted to other parties through the use of computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology. Disclosure of identifying information should be avoided whenever possible. Ethical standard 1.07(d) also states the expectation that social workers will inform clients about disclosures of information, supporting the concept of individual breach notification. The NASW and ASWB Technology Standards for Social Work Practice (NASW, 2005) directly Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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An Electronic Newsletter for the NASW Washington State Chapter

address the expectation that practitioners adhere to HIPAA requirements and to maintain current technological privacy protections for clients’ electronic health and mental health information. Standard 7, Privacy, Confidentiality, Documentation, states: “Social workers shall protect client privacy when using technology in their practice and document all services, taking special safeguards to protect client information in the electronic record. Interpretation ...Social workers should be aware of privacy risks involved when using wireless devices and other future technological innovations and take proper steps to protect client privacy. Social workers should adhere to the privacy and NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

security standards of applicable laws such as the Health Insurance Portability and Accountability Act (HIPAA) and other jurisdictional laws when performing services electronically….All practice activities should be documented and maintained in a safe, secure file with safeguards for electronic records.‖

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Analysis and Conclusions New communications technologies and new federal regulations lead to the inescapable conclusion that social work competence requires diligent attention to electronic security technology as well as attention to the person-to-person skills that are the hallmark of the profession. Social workers who lack this technical expertise may utilize information technology specialists to

assist them in the capacity as ―business associates,‖ a relationship that is clearly defined in the HIPAA regulations and that requires a written agreement to abide by HIPAA privacy and security standards (see Morgan & Polowy, 2010). Clients’ right to self-determination and their right to privacy and confidentiality require that they be fully informed of breaches to their confidential information. Federal and state legal requirements provide further specificity to the breach notification requirements and create strong incentives for the use of encryption technology. Social workers should explore the feasibility of using encryption to secure confidential client records and should conduct a thorough assessment of the threats and

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January 2011

An Electronic Newsletter for the NASW Washington State Chapter

vulnerabilities to their own electronic client information in order to provide a HIPAA ready practice environment. References California Office of Privacy Protection (2009). Recommended

Health Information Technology for Economic and Clinical Health Act (HITECH) (2009). [Online]. Available at http://thomas.loc.gov/cgibin/cpquery/R?cp111:FLD 010:@1(hr016): (Title XIII, Health Information Technology, et seq.) (last visited August 30, 2010).

practices on notice of security breach involving personal information. [Online]. Available at http://www.privacy.ca.gov/res/docs/p df/COPP_Breach_Reco_Practices_6 -09.pdf (last visited August 26, 2010). 45 CFR § 164.400 – § 164.414 (2009). [Online]. Available at http://ecfr.gpoaccess.gov/c gi/t/text/textidx?c=ecfr&tpl=/ecfrbrows e/Title45/45cfr164_main_0 2.tpl (last visited August 30, 2010). 74 Fed.Reg. 42739 (codified at 45 CFR 164.402) (2009). Breach notification for unsecured protected health information, Interim final rule. [Online]. Available at http://edocket.access.gpo. gov/2009/pdf/E920169.pdf (last visited August 30, 2010).

NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Morgan, S. & Polowy, C. (2010a). HIPAA amendments for a new decade: 2010 and beyond. Legal Defense Fund, National Association of Social Workers. [Online]. Available at http://www.socialworkers.o rg/ldf/legal_issue/2010/201 002.asp (last visited August 30, 2010). Morgan, S. & Polowy, C. (2010b). Disclosing confidential information to social workers’ business associates. Legal Defense Fund, National Association of Social Workers. [Online]. Available at http://www.socialworkers.o rg/ldf/legal_issue/2010/Ma rch2010.asp (last visited August 30, 2010). Morgan, S. & Polowy, C. (2009). HITECH HIPAA for social workers. Legal Defense Fund, National Association of Social Workers. [Online]. Available at

Website: www.nasw-wa.org Email: info@nasw-wa.org

Volume 1, Issue 1 https://www.socialworkers. org/ldf/legal_issue/2009/20 0903.asp (last visited August 30, 2010). Morgan, S. & Polowy, C. (2005). Social works and HIPAA security standards. Legal Defense Fund, National Association of Social Workers. [Online]. Available at http://www.socialworkers.o rg/ldf/legal_issue/200504.a sp (last visited August 30, 2010). National Association of Social Workers (2008). NASW code of ethics [Online]. Available at http://www.socialworkers.o rg/pubs/code/code.asp (last visited August 30, 2010). National Association of Social Workers (2005). NASW and ASWB standards for technology and social work practice. [Online]. Available at http://www.socialworkers.o rg/practice/standards/NAS WTechnologyStandards.p df (last visited August 30, 2010). National Conference of State Legislatures (NCSL) (2010). State privacy breach notification laws. [Online]. Available at http://www.ncsl.org/Defaultaspx? TabId=13489 (last visited August 26, 2010).

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January 2011

An Electronic Newsletter for the NASW Washington State Chapter

The information contained in this Web site is provided as a service to members and the social work community for educational and information purposes only and does not constitute legal advice. We provide timely information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this Web site and

its associated sites. Transmission of the information is not intended to create, and receipt does not constitute, a lawyerclient relationship between NASW, LDF, or the author(s) and you. NASW members and online readers should not act based on the information provided in the LDF Web site. Laws and court interpretations change frequently. Legal advice must be tailored to the specific facts and circumstances of a

Volume 1, Issue 1 particular case. Nothing reported herein should be used as a substitute for the advice of competent counsel. ―This article printed with the permission of the National Association of Social Workers.‖

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NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Website: www.nasw-wa.org Email: info@nasw-wa.org

Phone: (206) 706 – 7084 Fax: (206) 706 - 7085

Currents January 2011  

Newsletter for the NASW Washington State Chapter