COVID-19: Legal Considerations for Social Workers Resuming In-Person Services
By Anne B. Camper, JD, General Counsel
© May 2020. National Association of Social Workers. All rights reserved.

In the early days of the Covid-19 public health emergency, many private clinical practices were closed or shifted to the delivery of clinical health care services via technology (virtual service). This was required or facilitated by emergency orders by many state and local governments. As these governments begin the process of reopening, many social workers are considering when and how to resume their own in-person service to clients. Common questions are addressed below from a legal perspective, to provide general guidance to social workers. Please be sure to review the companion article, Covid-19: Practice Guidelines for Reopening Social Work Practices, which focuses on issues such as Covid-19 infection prevention and control when providing in-person services.


​Click here to read the full article.


Changes for Interns under 491 

Updates for Interns Doing Telehealth

For the purposes of preparing for, responding to, and mitigating any effect of COVID-19, on April 3, 2020, the Board held an emergency meeting to discuss emergency rule 64B4ER20-24, Florida Administrative Codes. This rule allows registered interns to provide telehealth services during the next 90 days if they establish and adhere to the following:

  • The registered intern has a qualified supervisor and maintains a qualified supervisor for the duration of the application of this rule; and
  • The registered intern has a written telehealth protocol and safety plan in place with their current qualified supervisor which includes the provision that the qualified supervisor must be readily available during the electronic therapy session.


The emergency rule also allows qualified supervisors to utilize face-to-face electronic methods (including telephone only communication) to conduct all supervision sessions for internship hours.

For the filed emergency rule language, please 
click here.

For further information regarding telehealth, please 
click here.

Please click the link for the Emergency Order allowing out of state mental health professionals to offer services in Florida during the COVID-19 pandemic. 
http://flhealthsource.gov/pdf/DOH-EO-20-003.pdf

Pearson VUE Suspends Testing

As of April 6, 2020, Pearson VUE has suspended testing until May 1, 2020. If your test is scheduled for April 17-30, Pearson VUE will contact you directly about rescheduling. Visit our COVID-19 page for more details about registering and scheduling exams: 
https://www.aswb.org/covid-19

Medicare 


COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
 
PROVISIONS OF INTEREST TO SOCIAL WORKERS IN HEALTH CARE SETTINGS
Including hospitals, long term care & rehabilitation facilities, community health centers, home health, hospice, nephrology, psychiatric or ID inpatient facilities, etc.
 
Complete Document: COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers


https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf 
 
The following blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration. For general information about waivers, see Attachment A to this document.


These waivers DO NOT require a request to be sent to the 1135waiver@cms.hhs.gov mailbox or that notification be made to any of CMS’s regional offices.


Practice Alert: Medicare Telehealth Psychiatric CPT Codes Used by Clinical Social Workers


With the emergence of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has temporarily expanded its telehealth policies on an emergency basis under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. During the waiver period which began March 6, 2020, cost-sharing may be reduced or waived and clinical social workers (CSWs) may seek reimbursement for telehealth psychotherapy services furnished via telehealth to patients whether they are in their home or in an outpatient setting such as an office, assisted living facility, or nursing home. For telehealth services, CSWs will also be reimbursed at the same rate as an in-person service. 


Click here to read the full Practice Alert.


The CARES Provider Relief Fund Payment Attestation Portal is now available through hhs.gov/providerrelief

As a reminder, you must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Payment Portal will guide you through the attestation process to accept or reject the funds. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions.

Details from the original April 10 notification email are provided below for your reference.

Above all, thank you for your tireless efforts during this critical time. To help sustain these efforts, President Trump is providing support to healthcare providers fighting the COVID-19 pandemic. The President signed the bipartisan CARES legislation that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. Recognizing the importance of delivering funds in a fast and transparent manner, the Department of Health and Human Services (HHS) is distributing $30 billion of the relief funds immediately. These are payments to healthcare providers, not loans, and will not need to be repaid.

Who is eligible for funds from the initial $30 billion?
Billing entities who received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. Your organization qualifies and you will automatically receive payment soon.

How are payment amounts determined?
Providers will receive a portion of the initial $30 billion distribution based on their share of total Medicare FFS reimbursements in 2019. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.

How will payments be distributed?
HHS is partnering with UnitedHealth Group to deliver funds. You will receive payment within two weeks via Automated Clearing House (ACH). The automatic payments will come via Optum Bank with “HHSPAYMENT” as the payment description. Payments to practices that are part of larger medical groups will be sent to the group’s central billing office. All relief payments are made to provider billing organizations based on their Taxpayer Identification Numbers (TINs).

What action should I take?
Within 30 days of receiving the payment, you must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions. Terms and conditions can be found on
hhs.gov/providerrelief.

Whom can I contact for more information?
For additional information, please visit
hhs.gov/providerrelief or call the CARES Provider Relief line at (866) 569-3522.

Thank you for all you are doing to support and protect the American people during this difficult time.


Practice Alert: ATTENTION CLINICAL SOCIAL WORKERS:

Medicare Revises Telehealth Place of Service and Modifier Codes During COVID-19


The Centers for Medicare and Medicaid Services announced on April 3, 2020, revisions for telehealth place of service (POS) and modifier codes.  The revisions will allow clinical social workers (CSWs) to be reimbursed at the same rate as an in-person service.


Click here to read the full Practice Alert.


Medicare Webinar Available On-Demand 

The recording of the Medicare webinar "Key Developments in Medicare Telehealth Options during COVID-19" presented last Monday is
available on-demand.  

The recording is available free of charge to NASW members. Please feel free to share. 

Telehealth


Regulatory Provisions for Social Work Emergency Responders and COVID-19 Policy Actions as of 4.8.2020.


Select a state, province, or territory


The following jurisdictions have emergency provisions regarding social work licensure related to the COVID-19 public health emergency. If a state is not listed, there are no provisions specific to the the public health emergency at this time.


​Click here to read more.

Telehealth and Social Work in Florida during the Coronavirus Pandemic 
by  Katharine Campbell, PhD, LCSW  


For many social workers navigating the challenges of the public health needs with the needs of clients and personal care can be difficult. Using technology can be a great asset that is being recommended by many including agencies, funders and insurances. 

This brief is designed to outline basic concepts that need to be addressed in the use of technology. This is in no way designed to be an all inclusive or in-depth document; rather, an outline to encourage practitioners to explore their own needs and resources as well as options for care. Additionally, it is recommended to stay up to date via
https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus. 

When discussing the use of technology it is important to understand some basic terminology. Often telehealth and teletherapy are used interchangeably, both referring to any type of therapeutic communication with a client via a third-party platform. Legally state definitions vary on use of language such as telehealth vs telemedicine, there is also telepsychiatry, teletherapy and telepractice. 

Click here to read the full article. 

Practice 


NASW Practice Alert on Medicaid & COVID-19


A new NASW Practice Alert Medicaid Considerations to Support Communities During COVID-19 Public Health Emergency has been posted to the Health Practice Tools page and will be shared on NASW’s COVID-19 Resource Pages. 

During the COVID-19 crisis, states are leveraging the Medicaid program to expand health insurance coverage, respond to the health needs of individuals, and ease practice restrictions. These measures inform social work services, and they support efforts to minimize health risks for providers and clients. With varied responses at the state level, best practices are emerging and informing advocacy opportunities.


NASW National Website COVID-19 Resources 

The NASW National website has excellent resources for the coronavirus: "Social Work Response to the Coronavirus Pandemic." You will find resources on:

  • The coronavirus;
  • Preparing your practice;
  • Supporting clients;
  • Helping people in special populations;
  • Telehealth;
  • Ethics consideration;
  • Self-care;
  • Answers from our CEO, and
  • Education and the workforce.


Click here for more information and resources. 

Advocacy 

Update on Access to Health Care  for Immigrants and Their Families 

National Immigration Law Center


In this difficult time, we want to provide some reminders about access to health care for immigrants and their family members, including new funding that Congress recently made available for coronavirus testing. 


Click here to read the full update.


Petition to Governor Ron DeSantis to Protect Farm Workers 

Floridians are calling on Governor Ron DeSantis to immediately take all the possible steps, along with the local and federal government, to protect farmworkers in Immokalee from the COVID-19 pandemic. 

Click here for more information and to sign the petition. 

Florida Safety Net Advocacy Coalition
by 
Florida Policy Institute 

As Florida's response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress passed the 
Families First Corona virus Response Act to address, at least in part, the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic.

Click here to learn more

Implications of Coronavirus (COVID-19) to America’s Vulnerable and Marginalized Populations 

Click here for a comprehensive overview and analysis of the COVID-19 pandemic on several major vulnerable populations. The overview also references issues such as the 2020 Census and the 2020 Elections that could be disrupted if the virus continues to spread.  There is added resource information and background to help to contextualize the problem.


Findhelp.org


If your clients need food assistance, help paying bills, legal advice & other free or reduced cost programs, including new programs for the COVID19 pandemic you can direct them to findhelp.org

You enter in your zip code and in connects you with companies that provide aid based on the type of aid needed.

Child Welfare


Florida Coalition for Children - Good resources and information during COVID19: https://flchildren.starchapter.com/FCC_COVID_19_Response


Self-Care 

Staying Mentally Healthy during a Pandemic

By Darryl Webster, MSW, LICSW

As a clinical social worker and former doomsday thinker in my youth, I grew up thinking all sorts of negative and catastrophic thoughts that stressed me out.

I thought I was going to die from all kinds of maladies. These thoughts and my inability to cope caused me to suffer from anxiety disorders and depression in my twenties. I have been on both sides – stressed and supporting those who experience stress.

These are challenging times for us all, particularly, it is stressful for the 40 million Americans diagnosed with anxiety disorders in the United States and hundreds of millions worldwide with depression. 


Click here to read the full article.


COVID19 RESOURCES

Join NASW today! 1-800-742-4089