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An Electronic Newsletter for the NASW Washington State Chapter

Index Board of Directors .......1 Title Protection……...2-4 Member honored…......4 Online CE Institute....5-6 Continuing Ed………6-7 Medicare...…………..7-9 Advocating….……..9-13 Provider Refusal…13-21 Pre-Existing………21-23 Wounds of War II..23-28

Congratulations to the 2011-2012 Board of Directors! The WA Chapter NLIC met throughout the FY 2011 to identify candidates for the open races to be held the Spring of 2011.

NLIC Committee was: John Edwards, Frank DiCostanzo, Lesli Redenbaugh, and Kristen Ohler. The attached list is the result of the 2012 election that was presented to the membership for voting from mid April to early June 2011. The candidates elected will take office July 1, 2011, with their terms either ending in June 30, 2012, or June 30, 2013. On behalf of the NLIC, this report is respectfully submitted for your review and acceptance.

President Rocco Bagala Treasurer Elect Paul Snow V.P. Social and Political Action – Ann Allen V.P. Professional Development – Sarah Chamberlin Central Washington Region Rep. Cheryl Flowers-French Inland Empire Region Rep. - Patricia Garcia Mount Baker Region Rep. - Amber Lynn Ford North Puget Sound Region Rep. Pat Lagerwey MSW Student Rep. Jamie Dinsmore BSW Student Rep. Deidra Parsinen

The NLIC did encounter some difficulties do to a very small but very active committee. The NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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

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


An Electronic Newsletter for the NASW Washington State Chapter

July 2011 Volume 1, Issue 4

State Chapter and it members have been advocating for Social Work Title Protection. The historic day came on March 5 when the Washington State Senate passed SB 5020 by a vote of 44-5 and on April 5 when the Washington State House of Representatives passed the SB5020 by a margin of 76-20-1. Several NASW WA State Chapter Presidents, Brian Giddens, Celeste Carey, and Taylene Watson, testified in support of Social Work Title Protection legislation over the past six years.

over the years. ―I am so proud of the sustained effort my colleagues and I were able to manage. Great work and what an amazing accomplishment‖, stated McNeal Parker a member of the Washington State Chapter Legislative Action Committee (LAC). NASW Washington State Chapter testified every year title protection legislation was heard in the Washington State Legislature. Numerous members and WA Chapter leaders testified on the importance title protection will mean for the public and to the profession.

Social Work Title Protection Is Law! April 15, 2011, was a great day! No, not because you paid your federal income taxes on time, but because Washington Governor Christine Gregroire signed the Social Work title Protection legislation into law. ―Enacting Title Protection for WA social work practitioners is a significant step toward increased professionalism for those who choose to take an active role in advocating and protecting vulnerable groups‖, stated Celeste Carey, Chair of the NASW Washington State Chapter Legislative Action Committee (LAC). For nearly 13 years, the NASW Washington NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Washington NASW social workers worked tirelessly on social Work Title Protection. The voice of the profession was heard throughout the halls the Legislature Website: www.nasw-wa.org Email: info@nasw-wa.org

Title protection legislation, SB 5020, when it becomes effective in January 2012, will require any employer that has a job Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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category titled social worker will now have to fill those positions with only someone that has a degree in Social Work from an accredited School of Social Work. Social Workers will now fill jobs titled social work.

training, and the how the tasks, duties, and functions are done that make someone a Social Worker. Ann Allen, the 2012 Chair of the NASW WA State Chapter LAC expressed, ―For me Social Work Title Protection ensures that public confidence in our profession can be raised to the standards we deserve by our adherence to our ethical standards. Knowing that a Social Worker in the law is a member of our profession helps me to have a universal trust in clinical skills including our multicultural approach by professionals serving our diverse community.‖

This legislation will ensure members of the public that the person they are working with in a job titled social worker has the Social Work degree. ―Now each year hundreds of new graduates in social work programs can be assured that their professional title is not compromised. The public can be assured that social workers in the private and nonprofit sectors have a professional practice that is back by a strong code of ethics and competency standards‖, explained Roseann NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Martinez, the Washington State Chapter title protection task force coordinator. ―The need for Social Work title protection became evident not only for maintaining the integrity of the profession, but also that the public trust and safety was affected by a lack of standardization and clarity regarding who holds social work positions. High profile media stories of alleged mishandling of cases by 'social workers' began raising questions of their judgment and qualifications‖ stated Lynn Carrigan a past chair of the WA Chapter LAC. A social work job title does not make one a ―social worker‖. The task functions, duties of the job do not make one a ―social worker‖. It is the education, the Website: www.nasw-wa.org Email: info@nasw-wa.org

To the many hundreds of NASW Washington state chapter members that worked on title protection legislation over the years, we thank Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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you. This is an important accomplishment for the profession of Social Work. ―Social Workers make contributions to our communities every day. Social Work title Protection legislation is a huge victory for the profession of Social Work and recognizes that Social Work is a profession and Social Workers are professionals‖ Taylene Watson current president of NASW Washington State Chapter stated.

commitment to social justice and social reform in different roles. Join us in congratulating Dr. Williams. The award will be give at the May 6th commencement.

Congratulations to all Social Workers!

―Photo courtesy of the Washington State Senate." NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

NASW-WA Member Honored Jane Addams College of Social Work Announces Pioneer Award Recipient

The Jane Addams College of Social Work Pioneer Award was established to recognize an alumnus who has made a significant, pioneering, or standout contributions to a community, state, or nation consistent with the mission of the college. This year‘s award recipient is James Williams, MSW ‘93, PhD ‘03. He is being recognized for the outstanding leadership he provided in establishing mental health courts here in Illinois, and in Savannah, Georgia, and for his overall sustained Website: www.nasw-wa.org Email: info@nasw-wa.org

Congratulations James Williams! If you know a fellow NASW WA Chapter Member that has been honored please forward the information to: ―Currents‖ at NASW WA Chapter, 522 N 85th St. Suite #B-100 Seattle, WA 98103

NASW Washington State Chapter Offers Members Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter

Easy Access to Online Learning

Professional social workers are more pressed for time than ever, but the fact that there are too few hours in a day doesn‘t let us off the hook when it comes to continuing education requirements. This is a good thing. We all want practitioners in our profession to be on top of their game and that means staying current on the latest research, techniques, and best practices. Sometimes, however, we need to find creative solutions to help us keep up with CE requirements. Technology is just such a creative solution, as it can provide the means to access continuing education at any time of the day from anywhere Internet access is available. This opens up NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

a whole new world for those of us trying to squeeze CE into an already full schedule. At NASW Washington State Chapter, we recognize that online CE is both an important tool and a necessity for busy social workers. That is why we have developed a brand new online CE program. We call the program, the Online CE Institute. The Institute is a part of the NASWWashington Chapter website where members can browse and select courses from an extensive CE catalog. Institute courses include self-study programs, live online seminars, taped video presentations, and audio workshops. And the Institute is designed to make it easy for members to find, register, and participate in courses. Since Washington State social workers are allowed to earn twenty six of the required 36 continuing education credits online, Website: www.nasw-wa.org Email: info@nasw-wa.org

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the Institute provides the perfect opportunity to participate in highquality courses and programs at your convenience and through a trusted source. By the time this article goes to print, the NASW Washington State catalog will have grown to hundreds of online options. Course content includes subject areas from addiction, adolescent behavior, and anxiety to depression, geriatrics, PTSD and much more. Tips for Getting Started Using the online catalog is simple. Just go to the NASW Washington State website and click on the Online CE Institute banner in the right sidebar. Or look for ―continuing education‖ in the top pull down menu and click on ―online continuing education‖. Once you are on the Online CE Institute page, use the tabs to Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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navigate to the courses you are interested in.

and we welcome your thoughts about the Institute and continuing education in general.

Purchasing a course is also easy, just click ―buy now,‖ complete your registration, and pay for the program. That‘s all there is to it. One of the advantages of an online course is that you can complete it in multiple sittings (unless it is a live seminar). If you want to take a break for a minute or a week, just return at your convenience and go to the ―MyAccount‖ tab. Your course will be waiting for you, right where you left off. When you complete a course, take the test, and fill out the course evaluation. Once completed, you will be prompted to print your certificate. It‘s straight forward and convenient. But if you do happen to run into technical difficulties while registering or taking a course, NASWWashington State has NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

that covered. We have included a ―HELP‖ tab that is accessible on any Online CE Institute website page. There, you will find answers to commonly asked questions as well as contact information for live technical support-email, chat, and phone. So you are covered, no matter when you happen to be taking the course. CE Where and When You Need It Social work is a challenging and rewarding career. It also requires a commitment to ongoing learning. At NASW-Washington State Chapter, it is our goal to support your commitment to continuing education by making it easier for you to find and participate in high quality courses and workshops. The Online CE Institute was created to do just that. We hope you will visit the Institute next time you are online Website: www.nasw-wa.org Email: info@nasw-wa.org

Happy learning! NASW-Washington State Chapter

Upcoming Workshops ****SAVE THE DATE**** NASW-WA Conference May 17-May 19, 2012 September 10, 2011 North Seattle Community College, Seattle, WA Licensure Exam Preparation Workshop Jonathan Beard, LICSW, CPRP September 23, 2011 North Seattle Community College, Seattle, WA Good Ethics – Good Practice: How Rules, Laws, Risk Management & Codes of Ethics relate to the Dynamic Realities of Our Day-to-Day Work Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter Joan Golston, DCSW, Clinical Supervision: LICSW Theory and Practice Marshall Jung, DSW October 15, 2011 – Microaggressions in December 3, 2011 Highline Medical Center, Everyday Life: Race Burien, WA Gender & Sexual Orientation Implications for Licensure Exam Clinical Practice Preparation Workshop Jonathan Beard, LICSW, Derald Wing Sue, Ph.D. CPRP October 20-21, 2011 Swedish Medical Center, Click here to Cherry Hill, Seattle, WA Register! The Dynamics and Skills of Clinical Supervision: An 2011 Medicare Interactional Approach Changes for Dr. Lawrence Shulman, Clinical Social M.S.W., Ed.D. October 28, 2011 – North Seattle Community College, Seattle, WA Impact of Post-Traumatic Stress Disorder (PTSD) on children, youth, and families: Focus on clients served by the Child Welfare System Randi Hankins, CSW, CMHS

Workers Effective January 1, 2011, the Centers for Medicare and Medicaid Services (CMS) announced the following Medicare policy changes that affect clinical social workers who are Medicare providers.

1. Outpatient Mental Health Services

November 4-5, 2011 Providence Sacred Heart Medical Center, Spokane, WA

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)

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

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

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eliminated co-payments for Medicare outpatient mental health services. By statute, Medicare requires 50 percent copayment for outpatient mental health services, as compared to 20 percent for most other health services. MIPPA phases out the 50 percent co-payment beginning 2010 and expanding to 2014. For 2011, CMS will pay 55 percent of the approved amount of outpatient mental health services which is the same as for 2010. 2. Bonus Incentive Payment MIPPA provides an additional one percent Medicare bonus incentive payment for clinical social workers who use quality measures in 2011 through the Medicare Physician Quality Reporting Systems, formerly known as the Physician Quality Reporting Initiative Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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(PQRI). Information on how to submit measures to receive this bonus is available online. For 2011, participation in the bonus incentive program is optional for clinical social workers.

Association of Social Workers NASW is advocating on behalf of its members to seek Medicare electronic health incentives for clinical social workers who use electronics in their practice.

3. Medicare Fee Changes There are two important changes: A. On June 1, 2010, Medicare providers received a 2.2 percent increase. The Medicare and Medicaid Extenders Act of 2010 (MMEA) established a payment increase for 2011 of zero percent allowing the 2.2 percent increase given on June 1, 2010, to continue to the end of 2011. This 2.2 percent replaces the 25 percent pay reduction NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

schedule to take place on January 1, 2011. B. Even though the Medicare conversion factor is a scaling factor that converts the adjusted number of relative value units (RVUs) for each service in the Medicare payment schedule into a dollar payment amount. Work, practice expense and liability expenses of the relative value scale were reweighted changing the numerical value of the conversion factor based on geographic location. As a result, clinical social workers may see increases or decreases in fees. The National Website: www.nasw-wa.org Email: info@nasw-wa.org

4. Mental Health AddOn Payment Mental health services continue to be increased by five percent in 2011. MMEA extends the five percent increase in payments for mental health services through December 31, 2011 for clinical social workers. . 5. Electronic Health Record Incentives For 2011, clinical social workers and other nonphysician practitioners continue to be ineligible for electronic health record incentives. NASW is advocating on behalf of its members to seek Medicare Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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electronic health incentives for clinical social workers who use electronics in their practice. Resources Medicare and Medicaid Extenders Act (MMEA), 111th U.S.C. (2010). Available online at www.gpo.gov/fdsys/pkg/BILLS111hr4994enr/ pdf/BILLS-111hr4994enr.pdf Medicare Improvements for Patients and Providers Act (MIPPA), 110th U.S.C. (2008). Available online at http://frwebgate.access. gpo.gov/cgi-bin/getdoc.cgi?dbname=110_ cong_bills&docid=f:h6331enr.txt.pdf 750 First Street NE, Suite 700 Washington, DC 20002-4241 SocialWorkers.org Practice Perspectives Issue 08 February 2011 Workforce Studies & Reports available at Workforce.socialworkers.org/studies/ot her.asp • Criminal Justice Social Work: Adapting to New Challenges • Child Welfare Social Workers’ Attitudes Toward Mobile Technology Tools: Is There a Generation Gap? • 2009 Compensation & Benefits Study: Summary of Key Compensation Findings Social Work Practice Updates available at SocialWorkers.org/practice/default.asp • 2010 Medicare Changes for Clinical Social Workers • A Shift in Approach: Addressing Bullying in Schools • Biopsychosocial Challenges Related to Transitions of Care • Clinical Social Workers Be Aware: The ICD–10–CM is Coming • Delivering Culturally Appropriate Care for Older Adults • Enrolling In Medicare as a Clinical Social Work Provider • From Poverty to Child Welfare Involvement: The Critical Role of Housing in Family Stability • MDS 3.0: Implications for Social Workers In Nursing Homes and Community-Based Settings

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

• Medicare-Mandated Reportable Changes for Clinical Social Workers in Solo or Group Practice • Meeting the Challenge of Supervision in School Social Work • Meeting the Needs of Immigrant Children and Youth In Child Welfare • Part II: Advocating for Change in Home Health Care • Pharmaceutical Industry Prescription Assistance Programs: Benefits and Challenges • Results of Request for Compelling Evidence to Increase Psychotherapy CPT Codes • Social Work and Transitions of Care • Social Workers: A Bridge to Language Access Services • The Childhood Obesity Epidemic: The Social Work Response • The Economic Downturn: Implications for School Social Work • Trends in Medication Adherence • When A Clinical Social Worker in Solo or Group Practice Dies • Women and Domestic Violence: Implications for Social Work Intervention • Youth Aging Out of Foster Care: Supporting Their Transition into Adulthood

Advocating for Clinical Social Workers: Highlights of 2010 Introduction On behalf of NASW members, the Website: www.nasw-wa.org Email: info@nasw-wa.org

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Association engages in a multitude of advocacy efforts to improve social work practice. The Center for Workforce Studies & Social Work Practice receives numerous calls from social workers identifying areas of concerns in clinical practice. In response to these issues, NASW provided the advocacy and resources described below. Medicare Reimbursement for Health and Behavior Assessment and Intervention CPT Codes Currently, clinical social workers are unable to receive reimbursement for Medicare services performed under the Health and Behavior Assessment and Intervention Current Procedural Terminology (CPT) Codes. These codes identify services related to the psychological, Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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behavioral, emotional, cognitive, and social factors significant to prevention, treatment, or management of a physical illness. During 2010, NASW had several discussions, including a face-to-face meeting with the Centers for Medicare and Medicaid Services (CMS) to reverse this decision and allow clinical social workers payment access to these codes. CMS is considering the request and informed NASW that it would also be helpful for the Association to seek a legislative change of the definition of ―clinical social work‖ in order for clinical social workers to receive payment. NASW‘s Government Relations Department is reviewing possibilities for legislative consideration. NASW‘s efforts to obtain payment of these codes are ongoing.

Social Security Disability Eligibility Determinations

is reviewing NASW‘s application, however it may take several months to receive a response.

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

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

Clinical social workers are unable to determine eligibility determinations for persons with a disabling mental illness applying for Social Security disability benefits. In partnership with the Clinical Social Work Association, NASW submitted a request to the Social Security Administration to allow clinical social workers to become ―medical sources‖ to determine eligibility for disability benefits. Documents detailing education, evidencebased practice, supervision, regulations and statutes were submitted to substantiate that clinical social workers had the requisite expertise and skills to determine eligibility for Social Security mental health benefits. The Social Security Administration

Low Reimbursement Fees Through its participation on the American Medical Association Relative Value Update Committee and its Health Care Professional Advisory Committee, NASW is advocating for increases in reimbursement for clinical social workers. To determine reimbursement rates, over 75 percent of health plans use the resource based formula and work and practice expense values approved by CMS and these committees. During the summer of 2010, NASW participated in a psychotherapy survey during the Five Year Review Process of CPT codes sponsored by CMS and the American Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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Medical Association. The purpose of the survey was to determine if new work values for CPT psychiatric codes were warranted. Work values comprise 54 percent of the CPT codes and include the mental effort, skills, and time it takes to perform a psychotherapy service. NASW invited the Clinical Social Work Association to participate in the survey process, and between members of both associations, over 532 clinical social workers participated in the survey process. Although the survey results revealed that work values should be decreased, due to the low values submitted by clinical social workers, implementation of these values will not take place at this time. Instead, clinical social workers will have another opportunity to participate in a new survey using new CPT psychiatric codes that

are currently being developed.

Association did submit comments to the draft DSM-V during the public comment period in April 2010 and requested that members also submit comments. Clinical social workers have been accepted for clinical trials for the DSM-V, and NASW was involved in developing clinical indicators for clinical social workers to participate in the clinical trials. NASW will be available to assist its members in the transition from the DSMIV to the DSM-V during the implementation phase which is expected to occur sometime within the next two years.

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

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

Social Work Representation on the DSM-V The Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) is currently being revised by the American Psychiatric Association and will soon become the DSM-V. Clinical social workers expressed concerns about lack of representation on the DSM-V Committee. NASW made several unsuccessful requests to the American Psychiatric Association for representation on the DSM-V The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) is currently being revised by the American Psychiatric Association and will soon become the DSM-V. Committee and its subcommittees. However, the

Quality Measures Use of measures in health care is becoming a standard of practice to determine whether quality services are being performed. CMS, the Joint Commission and other accreditation bodies, and managed Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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care companies are recommending that health and mental health providers use them as the industry moves into an era of patientcentered, integrative care. Clinical social workers are expected to use measures in their practice, and NASW is part of the movement to develop integrative measures with other professionals. The Association is a member of the Physician Consortium for Quality Improvement (PCQI) where measures are developed as required by the Medicare Improvements for Patients and Providers Act of 2008. NASW is also working with health plans, accreditation bodies, associations and other private groups to assist in the development of measures that social workers can use in their daily practice.

Center for Workforce Studies & Social Work Practice Recent Publications

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

Social Workers NASW has online resources designed to help clinical social workers stay current with practice and advocacy efforts occurring in the field. Over 75 products are listed on NASW‘s clinical social work page covering subjects such as reimbursement, documentation, billing codes, managed care, and technology. The link to NASW‘s clinical social work resources is here. In addition, other clinical social work products are available for purchase through the NASW Press. These highlights are just a few examples of NASW‘s advocacy efforts. More information is available on NASW‘s Website. NASW strives to meet the needs of members and encourages them to inform the association of areas of concerns affecting the social work practice community. Website: www.nasw-wa.org Email: info@nasw-wa.org

Workforce Studies & Reports available here • Criminal Justice Social Work: Adapting to New Challenges • Child Welfare Social Workers’ Attitudes Toward Mobile Technology Tools: Is There a Generation Gap? • 2009 Compensation & Benefits Study: Summary of Key Compensation Findings Social Work Practice Updates available at SocialWorkers.org/pra ctice/default.asp • 2010 Medicare Changes for Clinical Social Workers • A Shift in Approach: Addressing Bullying in Schools • Biopsychosocial Challenges Related to Transitions of Care Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter

• Clinical Social Workers Be Aware: The ICD–10– CM is Coming • Delivering Culturally Appropriate Care for Older Adults • Enrolling In Medicare as a Clinical Social Work Provider • From Poverty to Child Welfare Involvement: The Critical Role of Housing in Family Stability • MDS 3.0: Implications for Social Workers In Nursing Homes and Community-Based Settings • Medicare-Mandated Reportable Changes for Clinical Social Workers in Solo or Group Practice • Meeting the Challenge of Supervision in School Social Work • Meeting the Needs of Immigrant Children and Youth In Child Welfare • Part II: Advocating for Change in Home Health Care • Pharmaceutical Industry Prescription Assistance Programs: Benefits and Challenges

• Results of Request for Compelling Evidence to Increase Psychotherapy CPT Codes • Social Work and Transitions of Care • Social Workers: A Bridge to Language Access Services • The Childhood Obesity Epidemic: The Social Work Response • The Economic Downturn: Implications for School Social Work • Trends in Medication Adherence • When A Clinical Social Worker in Solo or Group Practice Dies • Women and Domestic Violence: Implications for Social Work Intervention • Youth Aging Out of Foster

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

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

Provider Refusal and Conscience Clause Controversies By Sherri Morgan, Associate Counsel, LDF and Office of

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Ethics and Professional Review, Carolyn I. Polowy, NASW General Counsel, and Amber Khan, Legal Researcher ©2011 National Association of Social Workers. All Rights Reserved.

Introduction Controversy over the intersection of patient rights, health care practitioner‘s rights and professional health care ethics is continuing in legal and legislative skirmishes in states across the country. This topic was the focus of a 2010 Legal Issue of the Month article (Morgan, S. and Polowy, C., 2010) which outlined a number of unresolved complexities and highlighted relevant legal, regulatory and legislative provisions. A recent federal appeal in Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter

a Michigan-based case, Ward v. Wilbanks, et al., highlights the refusal by a counseling intern to treat a gay client based on her religious beliefs disapproving of homosexuality. Several state legislatures have introduced provisions known as ―conscience clause‖ or ―provider refusal‖ laws, depending on whether one weighs in on the side of the practitioner/health care employee or the patient who seeks access to timely and complete health and mental health information and services. The Ward case and examples of proposed state legislation are reviewed in this Legal Issue of the Month article. Ward v. Wilbanks (Eastern Michigan University)

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

The Ward case (Ward v. Wilbanks, 2010 WL 3026428 (E.D. Mich.)) was filed by a former student who was dismissed from a master‘s counseling program at Eastern Michigan University after she refused to provide services to a gay client in her counseling practicum and indicated an intent to categorically refer all gay clients to other practitioners. The student‘s violation of the American Counseling Association‘s (ACA) Code of Ethics (which has several provisions similar to NASW‘s) was a key basis for her dismissal, as adherence to its standards is a prerequisite for participation in the program. The federal trial court closely analyzed a number of provisions of the ACA Code, such as ―respect Website: www.nasw-wa.org Email: info@nasw-wa.org

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the dignity and to promote the welfare of clients,‖ ―avoid imposing values that are inconsistent with counseling goals,‖ ―respect the diversity of clients,‖ and ―do not discriminate against clients…in a manner that has a negative impact,‖ among others (Ward v. Wilbanks,*4). The court discussed at length how the school properly distinguished between Ward‘s speech (as evidenced by classroom discussion and A+ written work) and her conduct (refusing to counsel a client), finding that it was her unacceptable conduct that was the basis for the school‘s disciplinary action. Ward‘s legal complaint was dismissed on a summary judgment motion and the court Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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concluded that the student‘s constitutional rights to free speech, freedom of religious belief and equal protection were not violated by holding her to a secular, professional standard requiring counselors not to categorically discriminate against an entire class of clients (Ward v. Wilbanks, 2010 WL 3026428 (E.D. Mich.)). The decision has been appealed to the U.S. Court of Appeals for the Sixth Circuit. A number of organizations, including the American Counseling Association (ACA), the American Civil Liberties Union (ACLU) and Americans United for Separation of Church and State, filed amicus briefs in support of the University. NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

NASW is closely monitoring the litigation. A March 11, 2011 public statement about the case issued by the University asserts the professional basis for its discipline of the student, as follows: ―This case has never been about religion or religious discriminati on. It is not about homosexua lity or sexual orientation. This case is about what is in the best interest of a client who is in need of counseling, and following Website: www.nasw-wa.org Email: info@nasw-wa.org

July 2011 Volume 1, Issue 4 the curricular requiremen ts of our highlyrespected and nationallyaccredited counseling program, which adheres to the Code of Ethics of the American Counseling Association and the Ethical Standards of the American School Counselor Association . Those Ethical Standards require that counselors are not to Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter allow their while others prohibit personal employers from taking values to action against intrude into employees who refuse their service. Some of these professiona provisions died in l work committee, while others (Eastern passed and others are Michigan pending; however, University, together they represent 2011).

State Legislation Proposed in 2011 State legislation regarding freedom of conscience or provider refusal that was introduced in the 2011 session is fashioned in several ways. Some state provisions address higher education programs where social workers are trained; other provisions limit the authority of licensing boards to discipline social workers (and other license holders); some attempt to amend licensing regulations NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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Arizona In direct response to the Eastern Michigan University case, H.B. 2565, 50th Leg., 1st Reg. Sess. (Arizona 2011), was introduced and finally signed into law on

April 29, 2011. Applicable to state universities and community colleges, it amends Arizona Revised Statutes § 151862 by adding several provisions, including ―E. A university or community college shall not discipline or discriminate against a student in a counseling, social work or psychology program because the student refuses to counsel a client about goals that conflict with the student's sincerely held religious belief if the student consults with the supervising instructor or professor to determine the proper course of action to avoid harm to the client.‖ The NASW Arizona Chapter submitted a letter to the governor, requesting that she veto the legislation, citing

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

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a mosaic of policy positions that address a perceived paradigm shift in U.S. society. The arguments for or against such positions are multifaceted and depend heavily on the context in which they are proposed and the specific health care services or group of clients which they affect.


An Electronic Newsletter for the NASW Washington State Chapter

potential conflicts with state social work professional standards and social work education program accreditation standards. Counseling, social work and psychology programs in Arizona universities and community colleges will need to carefully analyze how they can meet professional ethics standards required for accreditation and avoid violating the new law, in the event that a student attempts to categorically refuse to provide services to an entire class of clients, such as those who are gay or lesbian. Alabama The Health Care Rights of Conscience Act (S.B. 322/H.B.46, Reg. Sess. (Alabama 2011)) has been proposed to the legislature in Alabama. Practitioners, providers,

and payers including HMOs, insurance companies, health plans, hospitals, medical centers, physicians, nurses, social workers, and pharmacists are permitted to refuse the following services:

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

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

―medical care, treatment or procedure, [including] Patient referral, counseling , therapy… prescribing ,... administeri ng any device, drug, . . . or any other care ... [provided] for abortion,

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artificial birth control, artificial inseminati on, assisted reproducti on, human cloning, euthanasia , human embryonic stem cell research, fetal experiment ation, physicianassisted suicide, and sterilizatio n (§3). Under the Act, no health care practitioner, provider, or payer can be held civilly, criminally, or administratively liable for refusing to perform one of the enumerated Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


An Electronic Newsletter for the NASW Washington State Chapter

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health care services due to his/her conscience (§4). It is also unlawful under the Act for any person, health care provider, public or private institution, public official, or professional board ―to discriminate against any health care provider in any manner based on his or her declining to participate in a health care service that violates his or her conscience‖ (§4).

substantially burden a person‘s exercise of religion, unless there is a compelling government interest. Such an interest does not include policies prohibiting discrimination against certain individuals in housing, public accommodations or employment (H.B. 2384, 84th Leg., Reg. Sess. (Kansas 2011)). The Bill has been referred to the House Standing Committee on Federal and State Affairs.

NASW‘s summary arguments against the Act were discussed in talking points reviewed by the Alabama Chapter during the legislative session: It is inconsistent with existing requirements of Alabama Law (social workers‘ code of conduct); It violates patients‘ constitutionally NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

protected right of informed consent; It would place an undue hardship or unreasonable burden on employers; and It is likely to violate the First Amendment Freedom of Association rights of the National Association of Social Workers (NASW) to review the conduct of members and impose sanctions as determined by the Professional Review process. The Bill is in the House Local Legislation Committee. Other States’ Proposed Legislation During 20102011 Kansas House Bill No. 2384 prohibits the government from enforcing rules that Website: www.nasw-wa.org Email: info@nasw-wa.org

Arkansas House Bill 1917 prohibits the government from enforcing rules that burden a person‘s free exercise of religion, unless it is to further a compelling government interest. Burdens include withholding benefits and assessing penalties. Compelling Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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government interest has not been defined in the Bill, so it is unclear whether it would include anti-discrimination rules (H.B. 1917, 88th Leg., Reg. Sess. (Arkansas 2011)). The Bill has been passed in the House and transferred to the Arkansas Senate. Alaska Senate Bill 14 allows employees of health care providers to refuse to provide health care services that violate their consciences, as long they have provided notice to their employers. Under the Bill employers must provide reasonable accommodations to such employees, and cannot discriminate against them because of their objections. However, employers do not have to accommodate an NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

employee‘s objection if it will create an undue hardship for the employer or the employee is the only health care provider able to provide health care services in a life threatening circumstance (S.B. 14, 27th Leg., 1st Sess. (Alaska 2011)). The Bill is being discussed in the Health and Social Services Committee. Illinois Senate Bill 1123 permits a religiouslyaffiliated child welfare agency to decline a foster family or adoption application from a person who is a party to a civil union based on a conflict with the organization‘s ―sincerely held religious beliefs.‖ A minimal referral to the Department of Children and Family Services is required (S.B. 1123, 97th Gen. Assembly (Illinois Website: www.nasw-wa.org Email: info@nasw-wa.org

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2011). The Bill was killed in committee. NASW Involvement Several NASW chapters have submitted comments, signed onto opposition letters and made contacts with influential legislators to block or amend provisions that would permit categorical refusal of service to populations of clients or that would limit the authority of professional licensing boards or associations to discipline members who violate ethical or professional standards in the treatment and referral of clients. These efforts have met with mixed success and it is likely that conflicts regarding the appropriate line between professional conduct and personal beliefs will Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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continue to play out in the public arena.

have received increased social and legal recognition, tension around the full acceptance of LGBT individuals and their families has continued. Unfortunately, individual clients who receive inaccurate or incomplete treatment information or services are less likely to be in a position to challenge refusals of service. Patients seeking treatment are often vulnerable due to poor health, mental health crises, lack of social support or personal privacy concerns which may prevent them from advocating vigorously to pursue services, or they may be unaware of the services they were denied. Consumer and provider groups, as well as rights-focused groups such as those representing women

Analysis and Conclusions NASW has long held the position that it is consistent with social work professional values for individual social workers to refuse to provide certain types of services due to reasons of conscience; however, it has also stated the expectation that clients be properly referred for services elsewhere in those circumstances (NASW, 2009). Additionally, NASW has not supported the wholesale exclusion of services to an entire class of clients, an approach which may be permitted by some of the state legislation proposed in 2011. NASW respects diversity of many types, including diversity of NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

religion, gender identity, sexual orientation, race and others (NASW Code of Ethics, Standard 1.05(c), 2.01 (b) 6.04); however, various freedoms and rights are subject to reasonable limitations and religious expression does not automatically trump other legitimate interests.1 The rights of women and racial minorities to be treated as individuals and not property are well-established and accepted principles in the United States supported by law and professional ethics, although once opposed on religious grounds (and still so, within certain religious traditions). As the human rights of gay, lesbian, bisexual and transgender individuals

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and GLBT persons may be best positioned to advocate for the full availability of health care services to all populations. Individual social workers will have the continued ethical dilemma of struggling with matters of conscience and carefully evaluating how to balance moral and professional obligations while respecting the integrity of each client. References Bathija, S. (2011). Religious right seeks Biblebased exemption from public university counseling program’s ethics standards, Americans United for Separation of Church and State [Online]. Available at http://www.au.org/media/church-andstate/archives/2011/04/counseling-clash.html. Eastern Michigan University (2011). EMU's response to Attorney General's brief [Online]. Available at http://www.emich.edu/aca_case/ag brief.php.

Morgan, S. and Polowy, C. (2010). Social workers and conscience clauses. National Association of Social Workers, Legal Defense Fund, Legal Issue of the Month [Online]. Available at https://www.socialworkers.org/ldf/le gal_issue/2010/201005.asp.

controversy on back burner, but still simmering [Online]. Available at http://www.nabp.net/news/conscien ce-clause-controversy-on-backburner-but-still-simmering/.

National Association of Social Workers (8th ed., 2009). Family planning and reproductive choice in Social Work Speaks 127.

The Pre-Existing Condition Insurance Plan – Washington — A New Coverage Option for the Uninsured The Pre-existing Condition Insurance Plan-Washington State (PCIP-WA) is the temporary federal high risk pool created as part of the new federal health reform law, the Affordable Care Act. PCIP-WA provides a new health insurance option to eligible individuals with pre-

National Association of Boards of Pharmacy (2011). Conscience clause

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existing conditions who have been uninsured for at least six months – with no waiting period. This transitional program is available for children and adults until 2014, when all Americans—regardless of their health status— will have access to affordable health insurance when the nation transitions to a new marketplace. Under this health insurance plan, you‘ll receive insurance coverage for a wide range of medical benefits including physician‘s services, hospital care, and prescription drugs. All insurance benefits are available to you—even to treat a pre-existing condition. You won‘t be charged a higher Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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premium because of your medical condition and your eligibility is not based on your income. Like standard health insurance plans, you‘ll be required to pay a monthly premium, a deductible, and some cost-sharing expenses.

treatment that may be recommended, so why bother? After enrolling in PCIP-WA Dusty now has the peace of mind he deserves and he doesn‘t have to worry about the financial instability that goes with being uninsured.

PCIP-WA is already getting results that are changing the lives of Washingtonians who don‘t have health coverage and need medical care. Laura, who lives in King County, was born with psoriasis and developed psoriatic arthritis. Rejected by the individual market, she seriously considered closing her business and getting a job that offered health insurance, until she learned of PCIP-WA. Sherrie, from Pierce County, needed a new NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

hip and knee at the age of 48. She had been walking with a walker for four months. She couldn‘t get insurance without a nine month waiting period. She enrolled in PCIP-WA on November 1st and had hip surgery scheduled for December. Dusty, who lives in Thurston County, is 28 years old and has lymphoma. When he was 25 he started his own business. In order to save money he chose not to purchase health care insurance. Like others of his age, he felt he could take the risk. He was diagnosed with stage A-4 lymphoma six months later. He received treatment and owes over $200,000 in medical bills. He had not been to the doctor in months because he could not afford any Website: www.nasw-wa.org Email: info@nasw-wa.org

These stories are just a snapshot of what we‘re hearing from people who are participating in PCIP-WA –just one of many new initiatives resulting from the health care reform law which are helping Americans across the nation. To qualify, you must: be a citizen of the United States or residing here legally, have been uninsured for at least 6 months, and have a preexisting condition or have been denied insurance coverage

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because of your medical condition. For information about how to apply, go to PCIP-WA web site or call the plan toll-free at 1-877-505-0514.

PART II Confronting the Hidden Wounds of War II: What We Can Do Part I of this two-part article described veterans‘ psychological problems. This segment introduces constructive roles for helping former service members. First, Learn Everyone who wants to help veterans needs to develop an understanding of military Life - a world apart from what we know as civilians. Life in the armed forces is hierarchical, traditionconscious and highly structured, replete with NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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its own legal system (the Uniform Code of Military Justice). From the outset, training is designed to relegate individual identity to automatic obedience to authority. The military also provides a protective cocoon of basic needs (summed up as ―three hots and a cot‖). After living in this world of clearly defined statuses and procedures, recently discharged veterans typically find themselves in ambiguous relationships, and often anxious about seeking a new livelihood. Deployment abroad to quell a counterinsurgency creates an experience even more alien to us as civilians, and we must work to grasp the intensity of the experience in our minds and our hearts. In recent years, much material on present-day war and soldiering has become available via journalism and mass media,

literature and the performing arts. Works of fiction are problematic because we typically gravitate to portrayals that gratify our pre-existing ideologies: after all, the right wing loved John Wayne‘s The Green Berets for its take on the Vietnam War, whereas people of a progressive ilk were moved by Platoon. The arts offer grist for our emotions, but the best approach is to consult work based in the social and behavioral sciences along with solid documentaries and the factually vetted accounts of survivors—soldier and civilian—who were there. Then Prepare to Listen When they come for help, combat veterans talk about experiences that make for particularly difficult listening. Descriptions of suffering are hard to endure under any circumstances, but the toxic situation on the

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ground in Iraq and Afghanistan (briefly described in Part I) results in harm to innocent civilians. When a combat veteran describes participation in maiming, torture or killing—particularly of noncombatants - the therapist faces a nearunique emotional dilemma. Research indicates that therapists have difficulty listening and extending sympathy to patients with PTSD who talk about killing.xxxiii Although many veterans do not have such experiences, every therapist involved should prepare for building a therapeutic alliance with the combat veteran by developing a thorough understanding of atrocity-producing situations.xxxiii

To promote the Soldiers Project and its guiding concepts, Dr. Broder has been speaking to every appropriate audience she can find, and her organization welcomes expansion to new regions of the country. Readers may also be aware of NASW‘s endorsement of the Give an Hour program, a nationwide effort to mobilize mental health professionals who can provide free services to military personnel and their families.xxxiii

Volunteering— Spotlight on the Soldiers Project Six years ago, psychiatrist Judith Broder began organizing a professional movement in Los NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Angeles to provide psychological services to military service people. The Soldiers Project, a nonprofit organization, has been providing free counseling to Iraq and Afghanistan war veterans, active-duty personnel, and their families. Today the project now boasts some 400 volunteers in California, and more than 180 additional volunteers at satellite programs in Sacramento, Seattle, Albuquerque, Chicago, Boston and New York. All participating clinicians have licensure, and before interacting with clients, therapists receive education in military culture and the significance of combat experience. The program exercises rigorous standards of confidentiality, and their web page states, ―We do not report to any government agency.‖ Website: www.nasw-wa.org Email: info@nasw-wa.org

The Virtues of Volunteer Groups Volunteer groups have the organizational leeway to innovate in ways that bureaucracies cannot, and the new professional connections created in the course of volunteering are invaluable. Volunteer therapists could also provide valuable data on the effectiveness of interventions that rely on Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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face-to-face, personalized interaction. Human professional inputs are too often replaced by ―pharmacological interventions‖—a medicate-and-drop treatment seen in both the military and the VA to compensate for a personnel shortage.xxxiii Veterans have played an important role in voluntary initiatives also. Peer-to-peer counseling originated in spontaneous rap groups initiated some 35 years ago by Vietnam war veterans for both therapy and political activism. Today, the Veterans Administration‘s Readjustment Counseling Services, which houses the VA‘s peer-to-peer counseling program, will expand to 300 centers by January of 2011, and two-thirds of the staff will be combat veterans.xxxiii U.S. Vets (the United States Veterans

Initiative), perhaps the largest of the non-profit organizations dedicated to helping at-risk veterans in need, prides itself on its peer-to-peer support via its veteran staff.

join a genuine community with a mission and a wide range of occupations. Exhibitors at the FVC event came from a variety of specialties, from aquaculture and cattle farming to apiary management, the Peace Corps, and restaurant supply. Social workers can assume important tandem roles: among exhibitors at the job fair were organizations dedicated to combating substance dependence or employing service disabled veterans. One agency, CalAgrAbility, applies innovations in farming that accommodate physical disabilities.

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

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Innovative Communities—Spotlight on the Farmer-Veteran Coalition Recent innovations to help veterans heal promise some exciting career opportunities. One far-reaching effort, the Farmer Veteran Coalition (FVC), recruits veterans into jobs in local food production, providing much-needed employment for vets in a welcoming community that poses challenging work. At a recent FVC job fair in Los Angeles, farmer-veteran Matt McCue explained, ―We joined the Army to be tested, to find out who we are, and this tests us too.‖ Farming and food distribution offer more than just work: these are unique opportunities to

The Legal System and Restorative Justice The behavioral problems among returning veterans (briefly described in Part I) are causing an influx of cases involving veterans in the country‘s criminal justice system.xxxiii Two Phone: (206) 706 – 7084 Fax: (206) 706 - 7085


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years ago, Buffalo New York City Court Judge Robert Russell crafted a pioneer effort, The Veterans‘ Court.xxxiii It channels veterans into appropriate treatment programs and modifies sentences accordingly. The program serves as a model for other jurisdictions now formulating their own programs for veterans that apply dynamic risk management.xxxiii Several jurisdictions in California now have veterans‘ courts (or ―veterans‘ treatment court‖). In Orange County, veterans referred by public defenders can have their convictions erased from the record,xxxiii removing a serious impediment to job hunting. Social workers specializing in criminal justice have a promising field for development here. A few social workers are informally discussing the possibility of adapting selected concepts and

techniques from restorative justice (RJ) programsxxxiii to help combat veterans. Experiences of Vietnam War veterans who have returned to Southeast Asia hint at the potential for a transformative experience from RJ. William Broyles, author and Vietnam War veteran, recounted that ―the nightmares stopped‖ after he returned to Vietnam and met his former enemies. xxxiii RJ techniques have yet to be systematically applied and evaluated, however.

care in the U.S. vastly complicates treatment for veteransxxxiii –and everyone else. Sentencing reform groups argue forcefully that the processes created in the criminal justice system for veterans should be applied to others as well.xxxiii The farming for veterans movement addresses several critical needs in our country: localized production of wholesome foods does not require unsustainable inputs of petrochemicals and reduces dependence on a permanent underclass of cheap labor. But even the local food movement is severely limited by federal policies that currently favor agribusiness.xxxiii There are movements confronting these issues, and social workers who join forces with them bring us closer to lasting solutions for veterans.

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

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Let’s Coalesce for Vets and Beyond! The most effective actions we take on behalf of veterans will invoke our profession‘s person-in-environment perspective and its call for social justice to identify underlying problems and unite with like-minded groups to solve them. Underfunded and chaotic mental health

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Redirecting Our Tax Dollars Volunteering our services to veterans addresses only a fraction of their actual need. That‘s not cynical but simply realistic: little of any consequence gets done in the U.S. today without a healthy infusion of cash, particularly when it comes to the scale of our veterans‘ needs. The projected costs for treating and compensating injuries to our veterans of the Iraq War (not including Afghanistan) will come to some $700 billion.xxxiii We could meet much of this need by redirecting current military spending, which occupies over half of all federal discretionary spendingxxxiii and approaches the total for every other nation on earth, friend and foe combined.xxxiii Elaborate weaponry, foreign bases staffed by expensive contractors, and wars of choice

present a remarkable picture of bloat that is over-ripe for reform.xxxiii The Secretary of Defense himself recently related a striking example when he noted that the size of the U.S. battle fleet exceeds the next 13 largest navies combined.xxxiii A Reuters News Service article in July of this year reported that the U.S. Department of Defense was unable to account for $8.7 billion on its books from Iraqi oil and gas sales.xxxiii As we advocate for veterans‘ resources, let us summon some righteous indignation: any social work administrator found responsible for even a tiny fraction of such waste and irresponsibility would get skinned alive.

pivots on our ability to direct resources in America‘s political economy. These aren‘t simply calls to rise up angry. They‘re calls to rise up angry on behalf of our veterans, and every success will result in a better country for all of us. We just might rediscover the soul of social work in the process.

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

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Where Empowerment Ultimately Resides When we talk about empowerment we should reach for that power for ourselves. It

xxxiii MacNair, Rachel M. 2002, PerpetrationInduced Traumatic Stress: The Psychological Consequences of Killing. Westport, CT: Praeger, p.91. xxxiii Lifton, Robert J. 2004. ―Conditions of Atrocity.‖ The Nation (May 13). Retrieved February 12, 2010 from http://www.thenation.com/article/conditionsatrocity xxxiii NASW News. 2009. ―NASW Supports Give an Hour Efforts‖ 54:1 (January). xxxiii Robinson, Steve. ―Mental Health in the Military: What Happens When You Come Home?‖ Teleconference presentation for "Mental Health for Military Families: The Path to Resilience and Recovery." U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (August 3). xxxiii Berger, Thomas J. 2010. ―A New Name for an Old Story.‖ Teleconference presentation for "Mental Health for Military Families: The Path to Resilience and Recovery." U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (August 3). xxxiii Brown, Wiliam B. 2008. ―Another Emerging ‗Storm‘: Iraq and Afghanistan Veterans with PTSD in the Criminal Justice System.‖ Justice Policy Journal 5 (2): 2-37 (Fall). Downloaded on June 3, 2010 from http://www.cjcj.org/jpj/2008/12/justice/policy/journ al xxxiii Lewis, Libby. 2008. ―Court Aims to Help Veterans with Legal Troubles.‖ National Public Radio Morning Edition‖ (April 29). Accessed on July 1, 2010 at http://www.npr.org/templates/story/story.php?stor yId=90016059 xxxiii Brown 2010. xxxiii Jacobs, Ellen (GI Rights Hotline Attorney). 2010. ―Throwing a Lifeline to Your Loved One‖ Panel, Military Families Conference, Long Beach, California. Long Beach

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An Electronic Newsletter for the NASW Washington State Chapter Military Families Speak Out (October 2). xxxiii Interested social workers can consult the web site http://www.restorativejustice.org/ xxxiii Jersey, Bill and Jerry Friedman (producers/directors). 1987. Faces of the Enemy. Emeryville, CA: Quest / Catticus. xxxiii Berger 2010. xxxiii Lithwick, Dahlia. 2010. ―A Separate Peace. Slate.com, February 11. Retrieved on August 6, 2010 from http://www.slate.com/id/2244158 xxxiii Rogers, Heather. 2010. ―Slowed Food Revolution.‖ The American Prospect, 21: 5,6 (July/August). xxxiii Jannicelli, Jessica. 2008. ―Neurologic Injuries and Neuropsychiatric Disorders Likely to Increase Long-Term Medical Costs for Veterans.‖ Neurology Reviews.Com 16 (12), December. Retrieved on August 2, 2010 from http://www.neurologyreviews.com/08dec/VetNeur o.html xxxiii Morris, Rachel. 2009. ―Shock and Audit: The Hidden Defense Budget.‖ motherjones.com, June 22. Accessed on August 3, 2010, at http://motherjones.com/politics/2009/06/part-imother-jones-special-report-defensebudget? page=2 xxxiii Shah, Anup. 2010. ―World Military Spending / In Context: US Military Spending Versus the Rest of the World.‖ (Update of July 7.) Accessed on August 3, 2010, at http://www.globalissues.org/article/75/worldmilitary spending#InContextUSMilitarySpendingVersusR estoftheWorld xxxiii Johnson, Chalmers. 2006. Nemesis: The Last Days of the American Republic. New York: Metropolitan / Henry Holt. xxxiii United States Department of Defense. 2010. Robert Gates Speech of May 8 at the Eisenhower Library, Abilene Kansas. Downloaded on July 25, 2010, from http://www.defense.gov/speeches/speech.aspx?s peechid=1467 xxxiii Loney, Jim [reporter]. 2010. ―U.S. Can't Account for $8.7 Billion of Iraq's Money: Audit.‖ Reuters News Service (July 27). Accessed on August 1, 2010, at http://www.reuters.com/article/idUSTRE66Q5562 0100727

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3 Reasons Social Workers are Important to Our Nations Future: 1) We are the single largest group of people dedicated to helping others improve their lives 2)We fight for those who can't or are unabe to fight for themselves 3) Social Workers advocate for people affected by disabilities and for their families.

Have a Safe Summer and we look forward to seeing you at a workshop in the Fall!

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July 2011 Currents