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An Electronic Newsletter for the NASW Washington State Chapter

March 2012 Volume 2, Issue 2

March is Social Work Month!

Index Social Work Month………………..........1 Clinical Social Workers Beware…….2-4

Thank you for your dedication and hard work. You are truly appreciated and needed greatly in the community.

Continuing Ed……………………..........5 Retiring ………………........................5-9

Mental and Be Treatment

2013 Slate and Petition Process…10-12 Online CE…………………………........13 Release of Records………………..13-19

Military and V

Meeting the Challenges…………..19-30 Social Workers and 5010..……......30-32

Happy St. Patrick’s Day! ‘Tis the luck o’ the Irish smilin’ at ya! Wishin’ you the best for a Happy St. Patrick’s Day!

fit Manageme

Development ces

Poverty Redu Health Care Naviga

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

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An Electronic Newsletter for the NASW Washington State Chapter

Clinical Social Workers Be Aware: Version 5010 is Coming! Effective January 1, 2012, clinical social workers and other health care providers, health care clearinghouses, covered entities, and business associates who use electronic transactions mandated by the Health Insurance Portability and Accountability Act (HIPAA), will be required to replace the current software, Version 4010/4010A standards, with Version 5010 standards. Version 5010 updates standards including claims submission and status, remittance advice, eligibility, and referral authorizations. Electronic transactions that do not use version 5010 beginning January 2012, will be rejected for noncompliance with HIPAA electronic transactions. Rejections include denial of reimbursement. Clinical social workers are encouraged to transition to Version 5010 prior to January 2012. Doing so allows them to participate in training and testing of the new software and systems to ensure it is working properly before the compliance date. The Centers for Medicare and Medicaid Services (CMS) is assigned by the Department of Health and Human Services (HHS) to oversee compliance of the standards. Currently, there is no delay expected in the implementation of Version 5010. Changes in Version 5010 Version 5010 brings improvements in technical, structural, and data content NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

and system changes and will improve standards functionality between providers and payers. The software also does the following: • accommodates the reporting of clinical data of the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) which is scheduled for implementation on October 1, 2013 • increases the number of diagnosis codes allowed on a claim• enhances data collection and transmission • distinguishes between principal and admitting diagnoses and reasons for service codes • monitors treatment outcomes and clinical care • improves claims receipt and procedures • acknowledges and rejects transactions across all jurisdictions • returns early in the process claims requiring corrections. Preparing for Implementation of Version 5010 Clinical social workers should develop an implementation plan for compliancy in transitioning to Version 5010. Full functionality is expected by CMS on January 1, 2012. The following steps may help prepare clinical social workers for the conversion: • contact your practice management and/or software vendor to determine when

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An Electronic Newsletter for the NASW Washington State Chapter

Version 5010 will be available and installed into your computer system • contact your billing service, clearinghouses, payers and other covered entities to determine when they will have upgrades completed and when testing can begin • identify and make any changes that will occur as a result of the new software • enroll in training courses to become familiar with the software • conduct internal and external testing to ensure that electronic transactions can be sent and received • begin using Version 5010 prior to January 1, 2012 to ensure that electronic transactions are working smoothly Clinical social workers should be aware that successful implementation of Version 5010 will be dependent on when they are able to acquire and install the new software. The amount of time that it takes for clinical social workers to become compliant will depend on the size of their private practice and available resources. To avoid placing themselves at risk for payment denials and other interruptions of services due to inappropriately submitted claims, clinical social workers are responsible for confirming compliancy of Version 5010 with practice management and billing services employed by them to NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

perform electronic billing. Additional information about Version 5010 is available online from the CMS Website NASW members may also contact NASW for questions at mcoleman@naswdc.org. Resources HIPAA Insurance Reform: Modifications to the Health Insurance, Portability and Accountability Act (HIPAA): Final Rules, 74 Fed.Reg.3296. (January 16, 2009). Available online at http://edocket.access.gpo.gov/2009/pdf/E9-740.pdf

Center for Workforce Studies & Social Work Practice Recent Publications Occupational Profiles • Social Work Salaries by Gender • Social Work Salaries by Race/Ethnicity • Social Workers in Colleges and Universities • Social Workers in Government Agencies • Social Workers in Health Clinics & Outpatient Health Care Settings • Social Workers in Hospice and Palliative Care • Social Workers in Hospitals and Medical Centers • Social Workers in Mental Health Clinics & Outpatient Facilities • Social Workers in Private Practice • Social Workers in Psychiatric Hospitals • Social Workers in Schools • Social Workers in Social Service Agencies

Social Work Practice Perspectives: • 2011 Medicare Changes Clinical Social Workers

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for

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An Electronic Newsletter for the NASW Washington State Chapter • Adolescent Depression and Suicide Risk: How Social Workers Can Make a Difference • Advocating for Clinical Social Workers: Highlights of 2010 • Creativity and Aging • Dangerous Rites of Passage: Trends in College Alcohol Consumption • Domestic Violence and Human Trafficking: Double Jeopardy for Immigrant Women in the United States • Domestic Violence and Women of Color: Complex Dynamics • Engaging Young People in Their Transition Planning • Healthy People 2020: Social Work Values in a PublicHealth Roadmap • Opting Out of Medicare as a Clinical Social Worker • Results of 2010 Psychotherapy Survey • Support for Family Caregivers: The National Landscape and the Social Work Role • Supporting the Child Welfare Workforce to Reduce Child Maltreatment • The Medical Home Model: What Is It and How Do Social Workers Fit In?

March 2012 Volume 2, Issue 2

• Outside the Lines: Maximizing the Flexibility of a Social Work Degree • Presenting Your Work to Others • Publishing as a Practitioner • Risk Management in Clinical Practice • Strengthening Your Writing Skills: An Essential Task for Every Social Worker • The Tech-Savvy Social Worker: Prepared for the Challenges of 21st Century Practice • The Value of Dual Degrees

New Practice Standards For a complete list of practice standards, click here. • NASW Standards for Social Work Practice with Family Caregivers of Older Adults (2010) 750 First Street NE, Suite 700 Washington, DC 20002-4241 SocialWorkers.org The views and opinions expressed in this article are those of the author and do not necessarily represent the views and opinions of NASW Washington State Chapter. This article is reprinted with the permission of the author, National Association of Social Workers National Chapter.

Leadership Ladders: Steps to a Great Career in Social Work • From the Front Line to the Corner Office • Letting Your Voice be Heard • Managing Stress • Navigating Large Service Systems • Opening a New Private Practice NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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An Electronic Newsletter for the NASW Washington State Chapter

Upcoming Workshops March 17, 2012 LICSW/LASW Licensure Exam Prep Workshop, Seattle, WA Jonathan R. Beard, LICSW, CPRP March 23, 2012 Good Ethics, Good Practice, Seattle, WA Joan C. Golston May 18-19, 2012 2012 Annual Conference, Seattle, WA May 19, 2012 LICSW/LASW Licensure Exam Prep Worshop, Seattle,WA Jonathan R. Beard, LICSW, CPRP September 7, 2012 The Art of Writing Mental Health Records, Seattle Area Federico Grosso September 15, 2012 LICSW/LASW Licensure Exam Prep Worshop, Seattle Area Jonathan R. Beard, LICSW, CPRP September 28, 2012 Ethics, Seattle, Area Brian Giddens October 26, 2012 Compassion, Fatigue, and Vicarious Trauma, Seattle Area Mary Jo Barrett, MSW NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

RETIRING? Tips for closing your private practice First Step After you have selected a date for retirement, your patients should be amongst the first to be informed of your retirement. Inform current patients faceto-face early on about your plans at least 60 days in advance. Early notification will provide you time to work on termination and separation issues and allow time for patients to locate another psychotherapist if continued services are warranted. Former patients should also be informed of your retirement. Since there continues to be concerns about confidentially using online resources, a formal letter by postal service may be the best source of communication in this situation. The letter should inform the patients when your practice is closing, how they can arrange to transfer their records, where the records will be stored, and how to access their records in the future should a copy be needed. You may also notify a former patient by publishing a public notice in the legal section of a newspaper. A retirement announcement in the community or local newspaper, school bulletins, neighborhood or organizational newsletters are secondary sources to consider. Thirdparty payers with whom you provide services are an important group to make aware of your plans to retire. Review

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An Electronic Newsletter for the NASW Washington State Chapter

your provider contract for proper notice of termination procedures. If there is no formal contract, contact the third-party payer to learn of their termination policies to determine if they pertain to you. When you have selected a retirement date, it will be necessary to place your National Provider Identifier (NPI) FEBRUARY 2012 Retiring a solo or group practice can be challenging especially when working in a high volume practice. Because there are many things to consider, it’s important to retire your practice with careful planning to avoid any problems after your practice has officially closed. This Leadership Ladder outlines several important areas to help you as you terminate your practice. NASW National Association of Social Workers 750 First Street NE, Suite 700 Washington, DC 20002-4241Number in inactive status. This can be done by calling the National Provider Identifier Enumerator Call Center at 800-4653203 or going to https://nppes.cms.hhs.gov to change your NPI status online. Notify all groups, organizations, and others with whom you have a legal contract about the retiring of your practice. Utility companies, your landlord, the cable company, the postal service, and NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

other support services should also be notified. RECEIVING AND MAKING REFERRALS Referrals may continue after the announcement of your retirement. Setting a date when new referrals will not be accepted is important and new patients should be informed of the retiring date during the initial referral and given an opportunity to accept or deny services. If continued services are required, patients should be given several options for treatment and at least three referrals. Patients should also be informed of the credentials, name, address, and phone numbers of the clinicians or organizations to whom you are referring them. Websites, pamphlets, business cards, and other information about the referral sources would be helpful. To facilitate referrals of their choice, patients should sign the appropriate release of information forms. CLOSING OR TRANSFER DOCUMENTATION The closing or transfer treatment record should include a psychosocial assessment, treatment plan, and progress notes and documentation of all visits and contacts. In addition, a closing or transfer summary of each patient is recommended to assist in a smooth transition to future services. The

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An Electronic Newsletter for the NASW Washington State Chapter

following information is helpful to include: › Summary of the case, including a diagnosis and treatment plan › Progress in meeting treatment plan › Transfer or closing plans › Follow-up recommendation STORAGE OF RECORDS Retain all of your clinical records for all patients, including those who have died. Many states have statutes of limitations for professional liability and regulate how long you need to keep records. Because statues of limitations are based on when the injured party realizes or should have known that the clinical social worker harmed him or her, NASW recommends that you retain your records indefinitely in the event a malpractice suit arises against you later. Proper storage of records is very important and special safeguards should be taken to protect them. You may store them at your home in a dry, secure, fireproof file cabinet or other container or rent storage space at a facility. Many clinical social workers store records electronically. In such instances, special HIPAA security measures, including encryption software and firewalls should be followed when maintaining an electronic file. An emergency back-up file for electronic records should be maintained in the event of a natural disaster or other emergency. NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

MALPRACTICE INSURANCE Your professional liability insurance agency should be notified that you are closing your private practice prior to your retirement date. Continuous payment of your malpractice insurance will avoid any gaps in coverage. Most professional liability policies offer an option to extend coverage after you close your practice. The extended reporting period, also known as “tail,” provides coverage for future claims based on events that occurred before your practice was closed. Maintaining continuous extended liability coverage after retiring your practice is important because it protects you from liabilities from former patients who may sue you at any time. Discuss your options with your insurance carrier prior to retiring your practice. If you have professional malpractice insurance through NASW, you may contact the American Professional Agency at 1-800-421-6694. When retiring a private practice there are many things to do including terminating with patients, documenting services, making appropriate referrals, and contacting third-party payers. PROFESSIONAL WILL Clinical social workers in private practice should have a professional will. If you do not have one at the time of retirement, it is best practice to prepare a professional will that provides

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An Electronic Newsletter for the NASW Washington State Chapter

instructions on how patient records should be maintained and appoints a custodian for the patients’ records in the event of your death. Consulting with an attorney or legal representative can be helpful in preparing a professional will, estate planning, and other legal issues concerning the retirement of your practice. OTHER TIPS For 60 to 90 days, maintain a simple message on your business voicemail regarding the closing of your practice and how emergency services can be obtained if necessary. In the event patients try to contact you by e-mail, your practice e-mail address should have a response informing others of the closing of your practice and how emergency services can be obtained. If appropriate, make arrangements to remove Web sites that you maintain for your practice and complete a change of address form with your local post office. Retiring a practice can be emotionally draining due to the work involved and the termination of a way of life that you have had for many years. You may experience emotions such as anxiety and depression in situations of a forced or voluntary retirement. In such cases, it is important to take care of yourself and seek help as needed.

March 2012 Volume 2, Issue 2

starting a private practice. There are many things to do including terminating with patients, documenting services, making appropriate referrals, and contacting third-party payers. The tips provided help organize retiring activities for a smooth transition in closing your practice. The checklist that follows serves as a guide to help you close your practice successfully. Task Date Completed Task Date Coed Select Retirement Date Prepare a Professional Will Select Deadline for Accepting Prepare Closing Message New Referrals for Voicemail Review Provider Contracts Prepare Closing Message for Termination Procedures for E-mail Inform Current Patients Complete Change of Address Form Send Letters to Former Patients Notify Utility Companies of Closing Place Legal Notice in Newspapers Contact Movers Contact National Provider Obtain “Tail” Liability Coverage Identifier Enumerator Inform Third-Party Payers Disconnect Cable Inform Appropriate Agencies/ Organizations/Landlord Obtain Release of Information Forms When Appropriate Make Appropriate Referrals Complete Closing Documentation Locate Proper Storage for Records

SUMMARY Retiring a private practice can be a long process and just as challenging as NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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An Electronic Newsletter for the NASW Washington State Chapter

SAMPLE CHECK LIST FOR CLOSING YOUR PRACTICE Date Task

Date Completed

Select Retirement Date Select Deadline for Accepting New Referrals Review Provider Contracts for Termination Procedures Inform Current Patients Send Letters to Former Patients Place Legal Notice in Newspapers Contact National Provider Identifier Enumerator Inform Third Party Payers Inform Appropriate Agencies/Organizations/ Landlord Obtain Release of Information Forms when Appropriate Make Appropriate Referrals Complete Closing Documentation Locate Proper Storage for Records Prepare a Professional Will Prepare a Closing Message for Voicemail Prepare a Closing Message for Email Complete Change of Address Form Notify Utility Companies of Closing Contact Movers Obtain “Tail” Liability Coverage

March 2012 Volume 2, Issue 2

online from NASW Assurance Services,Inc. at naswassurance.org/social_worker_professional_liability.php ?page_id=11. Postal service address is: NASW Assurance Services, Inc. 50 Citizens Way, Suite 304, Frederick, MD 21701. NASW. 2011. Closing a social work private practice. Legal Issue of the Month. Available online at socialworkers.org /ldf/legal_issue/2011/062011.asp NASW. 2003. Retiring or closing a private practice: tips to help you along the way. Brochure Available online at naswpress.org NASW. 2011. Risk management in clinical practice. Leadership Ladders. Available online at careers.socialworkers.org/documents/RiskManagement.pdf NASW. 2001. Retiring from practice. NASW Insurance Trust. Practice Pointers. Available online at naswassurance.org/retiring_from_practice.php NASW. 2005. Social workers and HIPAA security standards. Available online at socialworkers.org/hipaa/security.asp?back=yes ©2012 National Association of Social Workers. All Rights Reserved The views and opinions expressed in this article are those of the author and do not necessarily represent the views and opinions of NASW Washington State Chapter. This article is reprinted with the permission of the author, National Association of Social Workers National Chapter.

REFERENCES Coleman, M. 2009. When a clinical social worker in solo or group practice dies. Clinical Social Work Practice Update. NASW. Available online at socialworkers.org/assets/secured/documents/practice/clinica l/1109b.pdf. Malpractice insurance application is available

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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An Electronic Newsletter for the NASW Washington State Chapter

Announcement of 2013 Preliminary Election Slate and Petition Process Saturday, March 10, 2012, the 2013 preliminary election slate was reviewed by the Chapter Board of Directors. The Directors approved the preliminary slate. The 2013 preliminary slate has elections for state wide offices, regional representatives for the Chapter Board of Directors, and region representatives for the Nominations Leadership Identification Committee (NLIC). In accordance with the NLIC guidelines and procedures, the Chapter membership is required to be notified of the 2013 preliminary election slate. Also, the membership is required to be informed of the petition process that allows a member to be added to the final ballot. The Washington State Chapter of the National Association of Social Workers is pleased to announce the candidacy of the following members for the positions indicated. The 2013 election slate is as follows:

Statewide Directors)

March 2012 Volume 2, Issue 2

Positions

(Board

of

President Elect July 1, 2012-June 30, 2013 Jonathan Beard Marian Harris Secretary July 1, 2012-June 30, 2014 Cathy Blanchard Brigitte Folz VP Communications July 1, 2012-June 30, 2014 Phyllis Duncan Souza VP Diversity July 1, 2012 - June 30, 2014 D’Artagnan Caliman LouAnn Carter BSW Student July 1, 2012-June 30, 2013 Lauren Cutright Jennifer Rubio MSW Student July 1, 2012-June 30, 2013 Estee Catti Jamie Weber Delegate Assembly (Non Board of Directors) Position 1:

July 1, 2012 - June 30, 2015

Beda Herbison Position 2:

July 1, 2012 - June 30, 2015

Jennifer Stucker

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

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An Electronic Newsletter for the NASW Washington State Chapter Region Position July 1, 2012 - June 30, 2014 Blue Mountain Region Rep. Oliver von Birkenwaldau Columbia River Region Representative

March 2012 Volume 2, Issue 2

In accordance with Chapter NLIC guidelines and policies, a member is allowed to petition to be slated on the final ballot of a statewide position or slated to be on the final ballot of the region position in which he or she resides. The positions that can be petitioned are noted below: Statewide Positions

No candidates identified

President Elect July 1, 2012 - June 30, 2013

Mt. Rainier Region Representative No candidates South Puget Sound Region Rep. No candidates identified Suburban King County Region Rep. No candidates identified

Secretary

July 1, 2012 - June 30, 2014

V.P.Comm.

July 1, 2012 - June 30, 2014

V.P.Diversity

July 1, 2012 - June 30, 2014

BSW Student

July 1, 2012 - June 30, 2013

MSW Student

July 1, 2012 - June 30, 2013

NLIC Reg. Reps July 1, 2012-June 30, 2014

Region Positions

Columbia River NLIC Region Reps.

Region Reps.

July 1, 2012 - June 30, 2014

NLIC Reps.

July 1, 2012 - June 30, 2014

No candidates identified

Delegate Assembly

Inland Empire NLIC Region Rep. No candidates identified Mount Rainier NLIC Region Rep. No candidates identified South Puget Sound NLIC Region Rep. No candidates identified Suburban King County NLIC Region Rep. No candidates identified

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

Position 1

July 1, 2012 - June 30, 2015

Position 2

July 1, 2012 - June 30, 2015

Members wishing to have their names added to the ballot by petition have 30 days from the date of this email notice (March 13, 2012) to submit a petition. The petition period will end close of business (5:00PM on April 13, 2012). The petitions must be received in the office by 5:00 PM on April 13, 2012. To

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An Electronic Newsletter for the NASW Washington State Chapter

be successful, a petition for a position elected by the membership statewide must include the signature and the printed legal name 46 of 2,308, 2% of the total Chapter membership as of March 13, 2012, the most recent update of the Chapter membership database by the national office. For a regional position, the signatures of 2% of the total number of members of the region are needed. The local regions require the following number of signatures: o o o o o

o

Blue Mountain Region requires 2 signatures of 99 members; Inland Empire Region requires 4 signatures of 218 members; Columbia River Region requires 5 signatures of 269 members; Mt .Rainer Region requires 6 signatures of 289 members; South Puget Sound Region requires 6 signatures of 323 members; Suburban King County requires 6 signatures of 293 members.

March 2012 Volume 2, Issue 2

the Chapter office to the NASW National membership database as of March 13, 2012. Any candidate who is not a member or any signature on a petition from a non-member will invalidate the petition request to have a candidate added to the final ballot. If you are petitioning for a state wide position, you MUST have at least one signature from each of the nine Washington Chapter Regions. Official petition forms are available from the Chapter office and questions about the petition may be addressed to Taylene Watson, Chairperson of the NLIC care of info@nasw-wa.org. Please put “Election Petition” in the subject line of the email. Please join me in congratulating the Chapter NLIC Committee for a job well done and the identified candidates to date wishing to serve the Chapter.

To have your name added to the final ballot you must be an NASW Chapter member. The signatures on the petition have to be signatures of members of NASW Washington State Chapter. All membership information, for candidates and petition signers, will be verified by NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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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”.

Release of Records and Client Privacy By Sherri Morgan, Associate Counsel, LDF and Office of Ethics and Professional Review and Carolyn I. Polowy, NASW General Counsel ©2011 National Association of Social Workers. All Rights Reserved.

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

March 2012 Volume 2, Issue 2

Introduction Social workers who receive a request for client records from a third party or a subpoena will have a number of questions. These may reflect concerns regarding the client’s privacy, the social worker’s obligations and/or rights, potential liability, the social worker’s role in responding to clients’ legal matters and questions concerning the scope of the request, such as: Am I allowed or required to release the client’s information? How much information must I disclose? What type of client information should be released? This Legal Issue of the Month article will address questions related to making well-reasoned decisions when responding to requests for confidential client information. This review does not address situations where the social worker is the target of a lawsuit or complaint. Basic Client Privacy Considerations Client’s privacy rights are embedded in professional healthcare provider standards, the U.S. and state constitutions and other state and federal

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An Electronic Newsletter for the NASW Washington State Chapter

laws addressing patient records (Morgan, Polowy, Carvino & Kraft, 2007). Clients’ rights to exercise selfdetermination (NASW, Standard1.02, 2008) are at the core of decisions regarding the release or disclosure of client information However, these rights may be impacted by the requirements of certain legal proceedings or court orders or may be affected by the requirements of insurers, employers, or other requesting entities (Polowy, Morgan, Bailey & Gorenberg, 2008). It is the social worker’s obligation to maintain the client’s confidences, as guided by the client, to the extent permitted by law (NASW, Standard 1.07, 2008). It is generally helpful whenever confidential information has been requested by a third party to communicate directly with the client or former client about the request, if possible, so that the client’s consent to release information (or withholding of consent) is fully informed (NASW, Standard 1.07(b),(d) and (e), 2008). Social workers who receive a request for records from an attorney or law firm may also find it necessary to seek more information before responding, including:

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

March 2012 Volume 2, Issue 2

What is the type of legal action involved and who are the parties? Is the client suing or being sued? Is the client a criminal defendant? Is the client applying for public benefits? Does the social worker have any concerns about the details of the client’s information that are contained in the records? Is the information contained in the record likely to portray the client in a negative light or negatively affect the outcome of their legal case? Informed Consent In any situation where a client’s record is to be released, it is the social worker’s obligation to ensure that the client’s consent is fully informed. In order to accomplish this, the client needs to be fully aware of the content of the record that is to be disclosed. It is not unusual for clients to have little awareness of the information that has been documented in the course of therapeutic sessions. After a discussion or review of the contents of the clinical record with the social worker, the client will be in a better position to determine whether to agree to a potential release of information or to revoke an authorization

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that they may have already signed (Reamer, p. 54 – 56, 2006). Requests Counsel

from

Clients’

Legal

Because the client’s attorney has an obligation to vigorously represent the client’s legal interests, it is often valuable to the client for their attorney to have access to complete information about the client’s mental health. Client consent is a primary consideration whenever confidential information is released. There is no legal barrier to releasing the client’s records if the client has signed a valid authorization to release them to the attorney. In some states, health care providers are obligated to release the records to the client’s legal counsel upon receipt of a written authorization signed by the client. If a social worker has concerns about sending a copy of the client’s records to the client’s designated attorney, two options may be considered: 1. Offer to provide the records directly to the client. Client’s have a legal right to access their own information and the client will then have the sole decision making role as to further NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

disclosing the information to the attorney. 2. Request that the attorney put the request in the form of a subpoena. Most subpoenas are issued by attorneys, so this is a routine procedure within a law firm. A written release from the client will still be needed to document the client’s consent. With a subpoena, the social worker may have additional justification to support the release of information in the event it is later challenged as improper. Subpoenas A subpoena is a special type of request for client information, usually issued by an attorney representing a party in a legal matter. Similar issues concerning the client’s informed consent apply to subpoenas. This is addressed in an earlier Legal Issues of the Month article, Responding to a Subpoena (Morgan & Polowy, 2009). When a social worker has received a subpoena, it is important to note which party is requiring the disclosure of information: Is it the client (through their attorney) or the opposing party? Additional caution and review are required when responding to subpoenas from opposition counsel, as an improper or unauthorized release of information could have a lasting and

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An Electronic Newsletter for the NASW Washington State Chapter

damaging impact on the client’s legal matter and be a potential basis for a malpractice complaint against the social worker. How Much Information Should a Social Worker Disclose? With few exceptions, social workers are generally advised to release confidential client information only with a written release signed by the client or their authorized representative (such as the parent of a minor, guardian, etc.). The release form typically describes the scope of the information requested, which may vary considerably. Reviewing the description of the information contained in the signed release form is informative; however, if additional questions remain about what is requested the social worker may consult with the client as to their intentions and/or with the individual who sent the request. The range of responses may include: A treatment summary Invoices showing dates of treatment and amounts charged Completion of a pre-prepared checklist of specific questions concerning the client’s mental health and/or history NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

A complete copy of the entire client file A copy of the entire clinical file, as well as copies of appointment calendar dates, all health plan claims and correspondence and all reimbursements received A copy of the complete clinical file, financial records and separate psychotherapy notes. Factors for determining how much and which information to release may include the following: Is the requesting person or the client willing to accept a treatment summary in lieu of the entire client chart? Sometimes an attorney wants the clinician to make specific statements to support a legal strategy, but that may create the appearance of bias. An objective and complete summary will present an accurate overview of the client’s treatment. Is the confidentiality of other individuals compromised by releasing the client’s record? For any therapy sessions where multiple clients were present, each individual’s privacy rights also need to be protected. Each individual may need to consent to release of information before joint sessions records are released,

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although parents can generally consent on behalf of their minor children. Notes of joint therapy sessions often present complexities and may raise potential conflicts of interest, requiring legal and ethical consultation by the social workers. Is it feasible to redact information in the client’s record that identifies other individuals? One approach is to make a copy of the client chart, then blank out the other individual’s information (e.g. with a heavy marker or “Wite-Out”) and then make a copy of the redacted version of the chart. Whenever a portion of a record is withheld it is appropriate to indicate in a cover letter the nature of the information redacted and the basis, such as, “This copy contains the records of Client X; however, it excludes references to other individuals based on ethical requirements,” or, “This copy contains confidential information about the services provided to Client X as an individual. Information from sessions where other individuals may have been present is not included due to lack of written consent.” It is never appropriate to re-write a redacted or revised NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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record and present it as complete copy of the original.

a

Were the social worker’s personal notes maintained in a separate file, so they are protected by HIPAA as “psychotherapy notes”? Detailed session notes that are maintained separately from the primary client chart may meet the definition as “psychotherapy notes” under HIPAA and would not be subject to release unless the client has signed a separate consent form specific to those notes. This topic is further discussed in Social Workers and Psychotherapy Notes (Morgan & Polowy, 2006). Psychotherapy notes do not have ironclad protection from disclosure under all circumstances (and a court may order their release in some situations); however, they do require a separate review and analysis before disclosure. NASW strongly recommends the use of separate psychotherapy notes to increase the privacy protections available to clients’ information. Does the client’s record contain specific information that would be harmful to their case if it were released? If the record contains clearly negative

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information about the client (e.g. evidence of malingering, deception, violence, etc.) it is particularly important to discuss with the client the possible implications of releasing the record and obtain a clear statement of the client’s intention, including a written revocation of consent if they decide not to pursue the matter that prompted the request. Clients who revoke a prior consent may suffer negative consequences, so they should be encouraged to consult their legal counsel about the legal effect of withholding or revoking consent to the release of information. Analysis and Conclusions Social workers who receive a request for confidential client information and have also received a written consent from the client to release the information are in a good position to handle the request by communicating clearly with the client and/or the requestor to clarify uncertainties. Situations where client contact is not possible, where multiple clients (or former clients) may be involved, or other concerns are present may require consultation with legal counsel, respected peers and/or ethics professionals. If a client objects to a NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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subpoena, a social worker may need additional assistance such as consultation with an attorney in order to file a motion to quash (or block) the subpoena. Resources available to NASW members include a risk management hotline (available through NASW Assurance Services, Inc. at 800897-0033), ethics consultations with the Office of Ethics & Professional Review (available Tuesdays, 10 a.m. – 1 p.m. and Thursdays, 1 p.m. - 4 p.m., Eastern Time, at 800-638-8799, Ext. 282) and legal consultations available from the Office of General Counsel/Legal Defense Fund (800-638-8799, Ext. 290). In addition, NASW members who have the NASW ASI professional liability insurance may have coverage for legal consultation related to the receipt of a subpoena for client records. Confirmation of coverage can be obtained by calling the ASI 800 number above. References Morgan, S., Carvino L., Polowy, C.I. & Kraft, E.G. (2007). The Social Worker and Protection of Privacy. NASW Legal Defense Fund Law Note Series. Wash., DC: NASW Legal Defense Fund. Morgan, S. & Polowy, C.I. (2009). Responding to a subpoena. NASW Legal Defense Fund, Legal Issue of the Month. Wash., DC: NASW Legal Defense Fund. Retrieved from http://www.socialworkers.org/ldf/legal_issue/2009/200904. asp.

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An Electronic Newsletter for the NASW Washington State Chapter Morgan, S. & Polowy, C.I. (2006). Social workers and psychotherapy notes. NASW Legal Defense Fund, Legal Issue of the Month. Wash., DC: NASW Legal Defense Fund. Retrieved from http://www.socialworkers.org/ldf/legal_issue/2006/20060 6.asp. National Association of Social Workers (2008). NASW Code of Ethics. Washington, DC: NASW Press. Retrieved from http://www.socialworkers.org/pubs/code. Polowy, C.I., Morgan, S., Bailey, W.D. & Gorenberg, C. (2008). Confidentiality and privileged communication. In T. Mizrahi & L.E. Davis (Eds.), Encyclopedia of Social Work, (Vol. 1, pp. 408-414). Wash., DC: NASW Press & New York, NY: Oxford University Press. Reamer, F.G. (2006). Ethical Standards in Social Work, (2nd ed.). Wash., DC: NASW Press. The information contained in this article 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 article and associated Web sites. Transmission of the information is not intended to create, and receipt does not constitute, a lawyer-client 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 article or Web site. Laws and court interpretations change frequently. Legal advice must be tailored to the specific facts and circumstances of a particular case. Nothing reported herein should be used as a substitute for the advice of competent counsel. The views and opinions expressed in this article are those of the author and do not necessarily represent the views and opinions of NASW Washington State Chapter. This article is reprinted with the permission of the author, National Association of Social Workers National Chapter.

Meeting the Challenges of Suburban Poverty Highlights 

Poverty in the suburbs expanded rapidly in the past decade, but most providers NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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of social safety-net services remain concentrated in central cities. In Chicago’s south suburbs, a community foundation forged new partnerships to craft a regional response to the foreclosure crisis. In Chester, Pennsylvania, cross-sector collaboration has been key to revitalization efforts. Poverty in the United States has long been concentrated in inner cities, particularly since the mid-twentieth century expansion of suburbia. Until 2000, most of the metropolitan poor lived in cities; as a result, the infrastructure to provide social services to the poor is more established in central city neighborhoods. Over the past decade, however, poverty grew almost five times faster in the suburbs than in urban areas. Although cities still contend with higher poverty rates — twice those of the suburbs, on average — in absolute numbers poor people in the suburbs now outnumber their urban counterparts by 1.5 million.1 The first decade of the twenty-first century also saw substantial growth of extreme-poverty neighborhoods in suburban areas. This increase is seen in newer suburbs as well as in older innerring suburbs that developed during the housing boom after World War II and have since been subject to the longterm effects of deindustrialization, demographic shifts, and high poverty levels.2 Like their urban counterparts,

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suburban communities have to provide the fundamentals that counter poverty — safety net services, affordable housing, and strategies for economic development that create jobs. The rise in suburban poverty has resulted in an overwhelming increase in demand for social services. In 2010, Scott Allard and Benjamin Roth found that 73 percent of the suburban nonprofits surveyed in 3 major metropolitan areas reported seeing more first-time users of safety-net programs than in the previous year. A large number of nonprofits saw an increase in requests for help with food needs (78.4%), utility bills (64.9%), and mortgage or rent payments (57.3%). Eighty percent of nonprofits saw an increase in clients evicted from their homes as a result of foreclosure.3 Many suburban communities, especially those that are older and suffering from disinvestment, likely lack the capacity to keep up with the increasing demand for social services. Even before the economic downturn of the past few years, services in high-poverty suburbs lagged behind those in cities. Allard observed that between 1990 and 2000, suburbs with significant increases in poverty rates had far fewer service providers than did central city areas facing similar growth in poverty rates.4 The suburban providers are also scattered over large areas and are not easily accessible by public NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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transportation. In addition, individuals in need of assistance, particularly first-time clients, may not be aware of available services. A Regional Approach

Food pantries in suburban areas are facing large increases in demand for assistance. Capital Area Food Bank of Texas. Although philanthropic support has been particularly valuable for filling the gaps in services to the poor and increasing service providers’ capacity to provide a social safety net, most philanthropic efforts have been concentrated in cities. Sarah Reckhow and Margaret Weir note that highpoverty suburbs receive fewer grant dollars per poor person than do central cities and suburbs with lower poverty levels.5 Unlike dense central cities, which typically fall under the jurisdiction of a single local government, suburban areas commonly consist of many jurisdictions that provide varying levels of social services. These smaller governmental entities may lack the resources to support their nonprofit service providers as well as the capacity to compete for federal funds. Suburban governments can find it difficult to coordinate programs

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An Electronic Newsletter for the NASW Washington State Chapter and services across jurisdictions, leading to redundancy as already stretched municipalities attempt to recreate similar services.6

As nonprofits, philanthropies, and local governments face the dual challenges of growing need and limited resources, these groups are using regional and cross-sector collaborations to meet this rising demand. Reckhow and Weir identify four strategies that philanthropies typically invoke to meet the challenges of suburban poverty: support existing regional organizations, create new regional organizations, foster regional collaborations and networks, and establish new suburban community foundations.7 The diverse and flexible role philanthropies play in supporting and facilitating these partnerships makes them particularly important. Philanthropies with a large regional network can galvanize action and, in some cases, directly support the program costs of the response. Allard and Roth underscore this point by describing the regional influence of locally based community foundations, which “have significant convening power and are able to bring together a diverse group of community leaders.�8 Allard and Roth also observe that sharing resources by forming partnerships with other social service providers allows suburban nonprofits to improve service delivery and the local economy. Edward W. Hill and others point to the important NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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role of public-private partnerships in promoting economic development efforts that expand the tax base and increase employment opportunities in declining communities.9

Residents of the Village of Olympia Fields, a south suburb of Chicago, participate in an interactive workshop organized as part of Homes for a Changing Region, an initiative led by the Metropolitan Mayors Caucus and Chicago Metropolitan Agency for Planning. The following examples illustrate some of these strategies in action in two regions with severely distressed suburbs: the Chicago and Philadelphia metropolitan areas. Local governments, nonprofits, philanthropic foundations, and businesses in these areas are adopting regionwide responses and forging cross-sector collaborations to address the foreclosure crisis, the affordable housing needs of the lowincome population, and general economic redevelopment. A Community Foundation as Catalyst

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In the Chicago metropolitan region, a community foundation has served as a catalyst for a concerted response to the growth of suburban poverty and the recent economic downturn. The most visible sign of the economic strain experienced in the Chicago suburbs is continued, alarming growth in foreclosure filings. By 2010, foreclosure filings, at more than 37 per 1,000 mortgaged properties, surpassed the national average of 22 per 1,000 mortgaged properties. Foreclosure filings were also rising faster in the suburbs than in the city; that same year, South Cook County had more than 50 filings per 1,000 mortgaged properties.10 The geographic concentration of foreclosures leads to serious long-term problems. Concentrations of foreclosures negatively affect a neighborhood’s property values, and vacant or blighted houses lead to neighborhood disinvestment and increased vulnerability to crime. As families abandon their homes, local jurisdictions are faced with the repercussions; housing vacancies and blight strain municipal resources and destabilize local economies.11 In Cook County, foreclosures caused housing values to decline by an estimated $13 billion, and municipalities stood to lose as much as $34,000 per foreclosure because of maintenance costs and loss of tax revenue.12 NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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The foreclosure crisis in this region came at the end of a decade that saw a significant rise in suburban poverty rates. Between 2000 and 2008, the number of poor people in Cook County, which includes Chicago, increased by 7.4 percent. Although the city’s numbers remained basically flat, some suburbs saw their low-income populations increase by more than 50 percent.13 Population gains, in tandem with accelerated poverty rates, greatly intensified the demand for a housing and economic overhaul, but the area lacked a mechanism for coordinating the effort. “Unlike a major city like Chicago, where the entire department of housing has expertise, suburban communities sometimes have a part-time mayor, a part-time city council, and a small staff,” says Ngoan Le, vice president of program at the Chicago Community Trust, a regional community foundation. “The capacity to address the foreclosure crisis is limited.”14 The Trust, with its in-depth knowledge of the region, close community ties, and significant financial resources, was well positioned to coordinate a regional response to the foreclosure crisis. In 2008, the Trust collaborated with the nonprofit Neighborhood Housing Services of Chicago and the Federal Reserve Bank of Chicago to form the Regional Home Ownership Preservation Initiative (“Regional Preservation Initiative”).

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The Regional Preservation Initiative’s key concerns are counseling and legal aid, refinancing and financial products, foreclosed and vacant property, and related research. The initiative is a regional extension of the city of Chicago’s Home Ownership Preservation Initiative (“Preservation Initiative”), which has assisted troubled urban borrowers since 2003. Michael Berry of the Federal Reserve Bank of Chicago explained that the Preservation Initiative “offered many valuable lessons and best practices, but…was not able to fully address what had become a broadbased, metropolitan problem requiring cross-jurisdictional cooperation.”15 The Regional Preservation Initiative’s priorities were aligned with those of the Making Homes Affordable program and the American Recovery and Reinvestment Act, two federal responses to the housing and economic crisis. Seeing an opportunity to leverage more resources and partners to resolve foreclosure issues, the Regional Preservation Initiative set out to maximize the resources provided by these programs, initiating an “unprecedented partnership of governmental, nonprofit, and private sector organizations.”16 The Regional Preservation Initiative is a coalition of more than 100 individuals at 70 organizations that deal with foreclosures. These stakeholders convene to share information and NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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strategies for assisting homeowners. The individual organizations (some of which receive funding from the Trust) manage initiatives consistent with the Regional Preservation Initiative’s objectives, in partnership with dozens of other participating community groups, nonprofits, and businesses.17 The Trust fills funding gaps where needed and helps facilitate collaboration. To fight the foreclosure crisis on multiple fronts, the Trust contributes to a county fund that sends outreach workers door to door to encourage distressed homeowners to participate in the foreclosure mediation program.18 The Trust also underwrites research on program outcomes, and other partners in the Regional Preservation Initiative provide counseling and legal assistance to distressed homeowners.19 The Trust not only financially assists nonprofits battling the foreclosure crisis on the ground but also has matched private contributions for direct services to those affected by foreclosures. The Trust helped call attention to and coordinate regional responses to the housing crisis and develop regional plans for economic development in an effort to promote job creation and more directly counter the effects of suburban poverty. Because individual local governments have only a limited ability to forestall the effects of poverty triggered by the foreclosure crisis, the Trust initiated an interjurisdictional collaboration among

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the area’s suburbs.20 The southern suburbs, the areas of Illinois hardest hit by the foreclosure crisis, cover a large area with 42 municipalities. The foreclosure crisis triggered a significant decline in property values in this area, with some municipalities seeing drops of up to 30 percent in the past year. In a 2008 effort spearheaded by the intergovernmental agency South Suburban Mayors and Managers Association (“Mayors and Managers Association”), many of the suburbs decided that, with their small staffs and limited resources, few of them could compete for — or effectively invest — federal funding on their own. “It’s kind of counterintuitive as an elected official to put time into proposals you may not get dollars out of this time,” says Robin Snyderman, vice president of community development for the Metropolitan Planning Council, a lead Regional Preservation Initiative partner that, along with the Metropolitan Mayors Caucus, worked with the municipalities to build consensus for collaboration.21 Later, 19 suburbs from the Mayors and Managers Association formed the Chicago Southland Housing and Community Development Collaborative (“Collaborative”) to apply for federal funds as a group instead of competing with one another for resources. The Trust provided funding for the Collaborative to hire a housing director to apply for grants and work on behalf of NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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the member suburbs. Eleven Southland communities were awarded $8.9 million in Neighborhood Stabilization Program funds.22 Awards ranged from $80,000 to $1.7 million per community and funded the rehabilitation and redevelopment of foreclosed properties.23 The relationships that have resulted from collaboration, facilitated by the Trust and other groups, paved the way for additional collective efforts. Members of the Collaborative are combining redevelopment efforts around existing 19 South Chicago suburbs formed a Collaborative to apply for federal funds as a group instead of competing with one another for resources. 19 rail lines to connect housing to mass transit and jobs. The Southland communities obtained a grant to implement an initiative called Green TIME Zone, which promotes job creation to circumvent suburban poverty. The first phase of the initiative will prepare 60 acres of land for redevelopment, creating 720 new or rehabilitated energy-efficient units of workforce housing over 5 years. The communities are also standardizing ordinances to make it easier for developers to operate in the region.24 The Trust’s early support of the Collaborative helped build the capacity to execute these ambitious redevelopment plans. And “without the Regional Preservation Initiative, we’re not sure that the south suburbs would

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have been able to leverage as much federal, state, or philanthropic support to develop a coordinated plan,” says Le.25

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illustrate the role that public-private, cross-sector partnerships can play in revitalizing older, distressed inner-ring suburbs through job creation and mixedincome housing development.

The city of Chester worked with the nonprofit Boys and Girls Club to open a new recreation center to expand opportunities for young people. Before and after photos of the Wellington Heights development in Chester, Pennsylvania illustrate improvements in a distressed neighborhood that now offers affordable homes for first-time buyers. Cross-Sector Partnerships While the older suburbs of Chicago are using regional, interjurisdictional solutions to address growing poverty levels, Chester, Pennsylvania seeks strategies that will work for a small, distressed city of 33,972. Chester is located in a region with a relatively strong economy.26 The city is challenged to capitalize on the potential of its local advantages, recent economic development projects, and institutional assets to address the difficulties facing the city and its residents. Its efforts NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

Located approximately 13 miles southwest of Philadelphia along the Delaware River, Chester was one of Philadelphia’s first suburbs. In the 1950s Chester began losing its once thriving shipbuilding and automobile manufacturing industries. This economic shock triggered a downward spiral of long-term population decline, disinvestment, concentrated poverty, and a decreasing tax base, which together compromised the city’s ability to combat any one of these issues.27 Today, Chester struggles with a poverty rate of 36 percent, nearly 3 times the national rate, exacerbated by an unemployment rate that has nearly tripled between 1970 (5.2%) and 2008– 2010 (15.1%).28 The severe nature of Chester’s economic distress was a major reason it was chosen as one of

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the Obama administration’s Strong Cities, Strong Communities initiative pilot cities — the only noncentral city selected. Contrasting demographic and socioeconomic trends in Philadelphia from 1970 to 2000, Nancey Green Leigh and Sugie Lee found that inner-ring suburbs in the Philadelphia metropolitan region were at the wrong end of a widening gap in economic prosperity. Income disparities stemmed from gentrification of the downtown and inner-city area and the economic and residential growth of outer-ring suburbs. At the same time, the inner suburbs experienced stagnating and declining population growth, deteriorating housing, and a rising proportion of minority and low-income households.29 Chester’s experience was consistent with the Leigh and Lee study: a 40 percent population loss occurred between 1970 and 2010; most of the housing stock began to deteriorate, as 65 percent of total housing units were constructed before the 1950s; and the city’s minority population grew from 68 percent in 1990 to 84 percent in 2009.30 By 1995, Chester’s future seemed grim. Having been identified by the state as a distressed municipality, Chester’s public schools were in receivership, its Community Development Block Grant (CDBG) program funds were impounded for five years, its redevelopment agency had been dissolved, and its public housing management was troubled.31 NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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The city responded by creating a quasigovernmental agency, the Chester Economic Development Authority (“Authority”), to administer economic development, housing, and community development services. This action retained valuable leadership, secured effective management, and created some protection from politics while still being under city control.32 This restructuring appears to have paid off; Chester has attracted $1.64 billion in public and private investment in the past 15 years, with the Authority playing an important role in the community’s redevelopment.33 Cross-sector partnerships between the local government, local anchor institutions, nonprofits, and other businesses have been key to Chester’s revitalization efforts. Two HOPE VI projects that were initiated in 1996 mark the turning point in the city’s efforts to address long-term community decline. HOPE VI brought investment, publicprivate partnerships, mixed-income housing, and neighborhood improvement. The city took advantage of the momentum and the change in public perception caused by the housing projects to combat disinvestment.34 Today, the Authority is working to stabilize the population by advancing homeownership for low- and middleincome residents while redeveloping blighted neighborhoods. In addition to renovating the older housing stock, the

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Authority uses HOME Investment Partnerships program (HOME) funding to subsidize new developments to meet the existing demands of potential firsttime homebuyers. But because of the city’s depressed housing market, the cost of building a new home is substantially higher than its sales price.35 “We make up the difference in price so [homebuyers] can build equity and break the cycle of poverty,” said Lisa Gaffney, housing director for the Authority.36 CDBG entitlement grants and HOME funds allow the city to plan for the long term and attract other sources of funding. Wellington Heights, a multiphase housing development that began 10 years ago, provides an example of how the city improved the quality of public housing stock while creating new opportunities for potential homebuyers. Wellington Heights replaced 122 parcels in a distressed neighborhood with 92 new affordable houses for first-time homebuyers. CDBG funds totaling $1.4 million over the first few years leveraged additional funding for later phases from state and local governments, philanthropic organizations, and the private sector.37 Public and Collaboration

Nonprofit

Sector

The Authority also collaborates with the Chester Community Improvement Project (“Improvement Project”), a NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

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nonprofit community-based organization that leveraged HOME funds with philanthropic dollars to revitalize a neighborhood on the east side of Chester. The neighborhood — reborn as the East Gateway Triangle — had been in decline since the mid-1990s.38 In 2005, the Improvement Project received an $89,500 planning grant from the Wachovia Foundation to develop a comprehensive revitalization plan for the neighborhood. The Improvement Project gathered residents, community groups, and local businesses to work on the plan, and a 5-year, $750,000 grant from the foundation followed in 2007.39 With housing as the platform, the Improvement Project provides lowincome residents with access to needed services — from mortgage counseling to adult education programs — previously unavailable in east-side neighborhoods. Grants from a group of philanthropic organizations added services that could improve poor residents’ economic wellbeing.40 To complement the new services with neighborhood improvements, the Authority funds the Improvement Project with HOME money to buy groups of houses in particularly distressed blocks, gut-renovate them, and sell them to low-income, first-time homebuyers. Since 2000, five such properties in East Gateway Triangle have been renovated and sold, and four more are currently in progress.41 Partnering With Anchor Institutions

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Many older suburbs are home to postsecondary schools and medical facilities, institutions that are deeply rooted in the community and major employers of skilled, knowledgeable workers. Finding themselves surrounded by blight and deterioration, many such “anchor institutions” invest in revitalizing their neighborhoods.42 The city of Chester partners with two such anchor institutions in the community, Crozer-Chester Medical Center and Widener University, through the Institute for Economic Development (“Institute”), a corporate-driven nonprofit. Since 2010 some of the Institute businesses, including Widener and Crozer-Chester, have helped their employees purchase homes through the Walk to Work Program. Homebuyers receive $5,000 from their employers and are eligible for an additional $10,000 from the city for downpayment and closing costs; workers who remain with their employers for 5 years keep the money.43 “Having employees [live] locally makes them more reliable because they don’t have long distances to travel,” says David Sciocchetti, executive director of the Authority. “Conversely, it supports the city by having people with good jobs buying homes in neighborhoods.” Over the past 18 months, workers have purchased 17 homes through the program.44 Conclusion

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The ongoing economic crisis is expected to increase suburban poverty in U.S. metropolitan areas as resources grow more scarce.45 With fewer service providers available, nonprofits and philanthropies are struggling to adapt, and many suburban municipalities lack the capacity to implement solutions. Stakeholders are seeking and testing strategies to address the demand for safety net services in the suburbs and to connect low-income suburban populations to services, jobs, and housing opportunities. Regional and cross-sector collaboration is a strategy being tested widely on the ground — as in the Chicago suburbs and in Chester, Pennsylvania — that has the potential to address the challenges of a changing geography of poverty. As this type of experience in collective problem solving accrues, communities build more capacity to weather these stresses. Related Information: Why Anchor Institutions Matter 1.

2.

3. 4.

Scott W. Allard and Benjamin Roth. 2010. “Strained Suburbs: The Social Service Challenges of Rising Suburban Poverty,” Brookings Institution; Sarah Reckhow and Margaret Weir. 2011. “Building a Stronger Regional Safety Net: Philanthropy’s Role,” Brookings Institution; Emily Garr and Elizabeth Kneebone. 2010. “The Suburbanization of Poverty: Trends in Metropolitan America, 2000 to 2008,” Brookings Institution. Elizabeth Kneebone, Carey Nadeau, and Alan Berube. 2011. “The Re-Emergence of Concentrated Poverty: Metropolitan Trends in the 2000s,” Brookings Institution, 8–10. Allard and Roth,13. Scott Allard. 2004. “Access to Social Services: The Changing Urban Geography of Poverty and Service Provision,” 1; Allard and Roth, 16; Laurie E. Felland, Johanna R. Lauer, and Peter J. Cunningham. 2009.

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An Electronic Newsletter for the NASW Washington State Chapter 5. 6. 7. 8. 9.

10.

11.

12. 13. 14. 15.

16.

17. 18. 19. 20.

21. 22.

23. 24.

25. 26. 27. 28.

29.

“Suburban Poverty and the Health Care Safety Net,” Center for Studying Health System Change, 6. Reckhow and Weir, 9. Allard and Roth, 7–8. Reckhow and Weir, 14–5. Allard and Roth, 23. Edward W. Hill, Kathryn W. Hexter, Brian A. Mikelbank, Benjamin Y. Clark, and Charles Post. 2011. “Revitalizing Distressed Older Suburbs,” What Works Collaborative, 21. Chicago Community Trust, Federal Reserve Bank of Chicago, and Neighborhood Housing Services of Chicago. 2009. “Regional Home Ownership Preservation Initiative Action Plan: Addressing the Foreclosure Crisis in the Chicago Metro Area,” 15; Internal document provided by the Metropolitan Planning Office. G. Thomas Kingsley, Robin Smith, and David Price. 2009. “The Impacts of Foreclosures on Families and Communities: A Primer,” Urban Institute. Ibid., 16. Brookings Institutution. 2010. “Factsheet: Suburban Chicago.” Interview with Ngoan Le, September 2011. Michael Berry. 2009. “RHOPI Perspectives: The Federal Reserve Bank of Chicago,” Profitwise News and Views, 3. Roberto Requejo. 2009. “RHOPI Perspectives: The Chicago Community Trust,” Profitwise News and Views, 5. Ibid. Interview with Ngoan Le, October 2011. Circuit Court of Cook County, Illinois. 2011. "Mortgage Foreclosure Mediation Program: Report and Update,” 23. Chicago Community Trust, Federal Reserve Bank of Chicago, and Neighborhood Housing Services of Chicago. Interview with Robin Snyderman, October 2011. Interview with Ed Paesel, executive director of the Chicago Southland Housing and Community Development Collaborative, October 2011; interview with Janice Morrissey, director of housing initiatives for the Collaborative, October 2011. Internal document provided by the Chicago Southland Housing and Community Development Collaborative. Internal PowerPoint slides provided by the Chicago Southland Housing and Community Development Collaborative. Interview with Ngoan Le. Hill et al. Correspondence with Lisa Gaffney, October 2011; Interview with Lisa Gaffney, October 2011. U.S. Census Bureau. 2008–2010 American Community Survey, 3-Year Estimates; HUD USER. State of the Cities Data Systems Census Data, 1970. Nancey Green Leigh and Sugie Lee. 2005. “Philadelphia’s Space In Between: Inner-Ring Suburb

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

30.

31.

32. 33. 34. 35.

36. 37. 38. 39. 40.

41. 42.

43. 44. 45.

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Evolution,” Opolis: An International Journal of Suburban and Metropolitan Studies, 1:1, 13–32. Kathryn W. Hexter. 2011. “Revitalizing Older Suburbs: Public Policy Options for America’s Older Low-Capacity Suburbs,” presented at the Suburbs and the 2010 Census Conference, George Mason University; U.S. Census Bureau. State and County QuickFacts, Chester City, Pennsylvania; U.S. Census Bureau. 1990 Decennial Census, Summary Files 1,3. Abt Associates. 2003. “Exploring the Impacts of the HOPE VI Program on Surrounding Neighborhoods,” 14. A public housing authority with a Public Housing Management Assessment Program score of less than 60 percent has problems in major areas of management operations and is designated as troubled; Chester’s score was 35. Hill et al. City of Chester, Pennsylvania (www.chestercity.com). Accessed 25 October 2011. Abt Associates, 28. “Homebuyer Assistance Program.” Chester Economic Development Authority (http://www.ceda.cc/what_do/housing/hap.php). Accessed 23 October 2011. HOME funds are awarded annually as formula grants to participating jurisdictions. HUD establishes HOME Investment Trust Funds for each grantee, providing a line of credit that the jurisdiction may draw on as needed. The program’s flexibility allows states and local governments to use HOME funds for grants, direct loans, loan guarantees or other forms of credit enhancement, rental assistance, or security deposits. Interview with Gaffney. Ibid. Internal document provided by the Chester Community Improvement Project. Interview with Annette Pyatt, executive director of the Chester Community Improvement Project, October 2011. “About Us.” College Access Center of Delaware County (www.collegeaccessdelco.org/about_us.htm). Accessed 26 October 2011. Interview with Pyatt. Radhika K. Fox and Sarah Treuhaft. 2006. “Shared Prosperity, Stronger Regions: An Agenda for Rebuilding America’s Older Cities,” PolicyLink and Community Development Partnerships’ Network, 67–77. Interview with David Sciocchetti, October 2011; Interview with Gaffney. Interview with Sciocchetti. Kneebone et al, 19.

The views and opinions expressed in this article are those of the author and do not necessarily represent the views and opinions of NASW Washington State Chapter. This article is reprinted with the permission of the author, HUD.gov, U.S. Department of Housing and Urban Development Secretary Shaun Donovan.

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

Clinical Social Workers and 5010: Frequently Asked Questions Since the release of the recent Practice Perspective, Clinical Social Workers Be Aware: Version 5010 is Coming (Fall, 2011), many clinical social workers have contacted NASW with questions. This Practice Perspective responds to frequently asked questions by NASW members who are preparing for compliance with the 5010 deadline of January 1, 2012. Members with additional questions may send an e-mail to mcoleman@naswdc.org. Q. What is 5010? A. Simply stated, 5010 is a new requirement for use of HIPAA electronic transactions and is a software update to the formerly used 4010. Q. How do I know if I am required to use 5010? A. Clinical social workers who use HIPAA electronic transactions in their solo or group practice are required to convert to 5010. Q. What are HIPAA electronic transactions? NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

A. HIPAA electronic transactions include the use of a computer involving the transfer of information for one or more of the following items: • Transmission of health claims • Payment and remittance advice • Eligibility status • Health claim status • Verification of insurance benefits • Referral certification and Authorization • Coordination of benefits Q. If I do not use a computer in my practice to conduct electronic transactions, am I required to use 5010? A. No, you will only be required to convert to 5010 if you use electronic transactions. Q. If I have not converted to 5010 by January 1, 2012 and file an electronic claim, what will happen? A. Your claim may be denied for payment. Q. Will I be able to obtain online treatment authorizations if I have not converted to 5010 by January 1, 2012? A. No, the information may not be available to you. Q. Is a delay expected in the implementation of 5010? A. The Center for Medicare and Medicaid Services has announced there will be no delay. Q. I use a billing service, clearinghouse, or other covered entity to bill for me. Does 5010 apply to them?

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An Electronic Newsletter for the NASW Washington State Chapter

A. Yes, it applies to them if they use HIPAA electronic transactions to file your claims and conduct other online transactions for you. Q. Will I be held responsible for denied online claims if a covered entity contracted by me does not transition to 5010 by January 1, 2012? A. Yes, you will. It is important that you confirm with your covered entities that they will transition to 5010 by January 1, 2012. Doing so will prevent denial of your online claims and cash flow interruptions. Q. Are clinical social workers the only group required to transition to 5010? A. No, all health care providers such as physicians, nurses, psychologists, and physical therapists who conduct HIPAA electronic transactions in their practice are also required to transition to 5010. Q. Why is the HIPAA software being changed to 5010? A. Current HIPAA software 4010 is limited in its function. Changes to 5010 include improvements that will (1) increase the number of diagnosis allowed on a claim (2)accommodate the reporting of the International Classification of Diseases, 10th Edition, Clinical Modification (ICD10-CM) codes which will be implemented on October 1, 2013 (3) enhance data collection and transmission (4) return early to clinical social workers their rejected claims requiring corrections. NASW WA Chapter Office 522 N 85th St. #B-100 Seattle, WA 98103

March 2012 Volume 2, Issue 2

Q. What steps should I take to prepare for 5010? A. Preparing for 5010 includes (1) contacting your billing service and other covered entities to determine when they will have upgrades completed and when testing can begin (2) contacting your software vendor to determine when Version 5010 will be available and ready for installation on your computer (3) using 5010 prior to January 1, 2012 to ensure that electronic transactions are working properly. Resources Coleman, M. ( 2011). Clinical social workers be aware: version 5010 is coming. Practice Perspectives. NASW Press: Washington, DC. HIPAA Insurance Reform: Modifications to the Health Insurance, Portability and Accountability Act (HIPAA): Final Rules, 74 Fed.Reg.3296. (January 16, 2009). Available online at http://edocket.access.gpo.gov/ 2009/pdf/E9-740.pdf Clinical social workers who use HIPAA electronic transactions in their solo or group practice are required to convert to 5010. Occupational Profiles: Available at http://workforce.socialworkers.org/studies/other.asp • Social Work Salaries by Gender • Social Work Salaries by Race/Ethnicity • Social Workers in Colleges and Universities • Social Workers in Government Agencies • Social Workers in Health Clinics & Outpatient Health Care Settings • Social Workers in Hospice and Palliative Care • Social Workers in Hospitals and Medical Centers • Social Workers in Mental Health Clinics & Outpatient Facilities • Social Workers in Private Practice • Social Workers in Psychiatric Hospitals • Social Workers in Schools • Social Workers in Social Service Agencies Social Work Practice Perspectives: Available at www.socialworkers.org/practice/default.asp • 2011 Medicare Changes for Clinical Social Workers • Adolescent Depression and Suicide Risk: How Social Workers Can Make a Difference • Advocating for Clinical Social Workers: Highlights of 2010 • Creativity and Aging

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

March 2012 Volume 2, Issue 2

• Dangerous Rites of Passage: Trends in College Alcohol Consumption • Domestic Violence and Human Trafficking: Double Jeopardy for Immigrant Women in the United States • Domestic Violence and Women of Color: Complex Dynamics • Engaging Young People in Their Transition Planning • Healthy People 2020: Social Work Values in a Public Health Roadmap • Opting Out of Medicare as a Clinical Social Worker • Results of 2010 Psychotherapy Survey • Support for Family Caregivers: The National Landscape and the Social Work Role • Supporting the Child Welfare Workforce to Reduce Child Maltreatment • The Medical Home Model: What Is It and How Do Social Workers Fit In? Leadership Ladders: Steps to a Great Career in Social Work Available at http://careers.socialworkers.org/ professionaldev/default.asp • From the Front Line to the Corner Office • Letting Your Voice be Heard • Managing Stress • Navigating Large Service Systems • Opening a New Private Practice • Outside the Lines: Maximizing the Flexibility of a Social Work Degree • Presenting Your Work to Others • Publishing as a Practitioner • Risk Management in Clinical Practice • Strengthening Your Writing Skills: An Essential Task for Every Social Worker • The Tech-Savvy Social Worker: Prepared for the Challenges of 21st Century Practice • The Value of Dual Degrees New Practice Standards For a complete list of practice standards, visit www.socialworkers.org/practice/default.asp • NASW Standards for Social Work Practice with Family Caregivers of Older Adults (2010) 750 First Street NE, Suite 700 Washington, DC 20002-4241 SocialWorkers.org The views and opinions expressed in this article are those of the author and do not necessarily represent the views and opinions of NASW Washington State Chapter. This article is reprinted with the permission of the author.

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

March 2012 Currents  

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