NASW Issue Update

April 3, 2006

 

Issue:              Civil rights

Position:          Support antidiscrimination bills expanding the jurisdiction of the Human Rights Commission to protect gays, lesbians, bisexuals, and trans-gender individuals.

History:          House Bill 1515 was passed by the House of Representatives in 2005 by a vote of 61-37, but died on the Senate floor by the vote of 24-25.

Status:            This year, House Bill 2661 passed the House 60-37, passed the Senate 25-23, and was signed into law by Governor Gregoire 1/31/06, with an effective date of 6/8/06.  However, Tim Eyman filed both an initiative and a referendum on 1/30/06 to allow Washington voters to either uphold or overturn this new law in November.

 

Issue:              Expanded access to health care services

Position:          Support expanded access to health care for low-income individuals, particularly children’s health, Medicaid, and Basic Health Plan coverage.

History:          In the budgets passed by the Legislature in 2002 and 2003, more than 32,000 slots were cut from the state’s Basic Health Plan, over 40,000 children saw their eligibility cut from Medicaid, and additional low-income children were anticipated to lose benefits due to premiums being charged to their families.  In her first act as the new Governor, Christine Gregoire administratively rescinded the premiums on low-income children covered by Medicaid and streamlined the eligibility process, and the Legislature provided funding for restoration of a portion of the immigrant children who lost Medicaid coverage.  However, the supplemental operating budget proposed by Governor Gregoire in December 2005 did not propose any expansions to access to health care services.

Status:            There were several legislative successful legislative efforts to further restore or expand coverage, in which NASW was a very active participant:

·        Basic Health Plan:  The budget passed by the Legislature and signed by the Governor (SB 6386) included $15.6 million for an additional 6500 slots to the BHP, expanding coverage to a total of 106,500 persons;

·        Children’s Health:  The budget passed by the Legislature and signed by the Governor (SB 6386) included $10.9 million for coverage of 12,890 children per month beginning in July 2006, increasing to 14,000 per month in October 2006;

·        Prescription Drugs:  The budget passed by the Legislature and signed by the Governor (SB 6386) included $18.2 million for covering the Medicare Part D medication copays for “dual eligible” low-income clients covered by both Medicare and Medicaid;

·        Medicaid Premiums:  House Bill 2376, rescinding statutory authority for the state to charge premiums on children covered by Medicaid, passed the House by a vote of 74-34, and the Senate by a vote of 34-11, and was signed by the Governor, thus enacting into statute the policy established by Governor Gregoire by executive order in 2005 and funded in the 2005-07 biennial budget; 

·        “Fair Share” health care coverage (SB 6356 / HB 2517):  Would have required employers with more than 5000 employees in Washington to provide health insurance coverage to all of their employees on a pro-rated basis, or else be charged by the state for the cost of providing such insurance through public programs.  Died 2/14 in both the Senate and House Rules Committees, but the Governor announced 2/16 that she was committed to working with stakeholders to pass a “perfected” bill in 2007.

·        Small business health insurance partnership (HB 2572):  Passed House 57-41, substantially revised by the Senate, but ultimately the House version passed the Senate by a vote of 25-23, and the bill has been signed by the Governor.  In addition, $625,000 was included in the budget (SB 6386) for the Health Care Authority to use to establish the program and prepare for funding of enrollment in 2007.  The program, once enrollment begins, will involve a 40% premium subsidy for employees of those small employers who are also willing to pay 40% of premium for their employees who are 200% of FPL or below, leaving 20% of the cost to employees for a plan actuarially equivalent to the BHP.

 

Issue:              Budget

Position:          Support adequate funding to restore cuts to health and human services programs, including appropriating a fair share of the $1.5 billion state budget surplus to this budget category.

History:          37% of the cuts made during the 2002-04 budget cycles were to health and human services programs, causing crises of access to a wide array of services.  In addition, in 2005 the Legislature and DSHS made changes to the fashion in which Medicaid mental health services were distributed, causing a drop in funding from anticipated and needed levels in several counties, including King, Pierce, and Spokane.  This resulted in an actual or anticipated reduction of services for low-income persons in need of mental health services in these counties.

Status:            Health care:  As noted above, funding for a number of major health care programs was provided in the 2006 supplemental operating budget (SB 6386).

Mental health:  In order to ameliorate the lowering of expected funding in

several counties, and to invest in new methods of distributing funding and

services, the Legislature appropriated and the Governor signed significant new

resources:

·        $2.5 million to Pierce and Spokane Counties to settle lawsuits against the state over the billing of those counties for beds at Western State Hospital;

·        $450,000 for “evidence-based” children’s mental health pilot projects at UW School of Medicine;

·        $11.2 million ($22.1 million with federal match) to increase RSN funding by 3.5% for RSNs over the state average in per-capita costs, and to bring all RSNs under the state average up to the average;

·        $30.8 million and 182 new FTEs to open five new temporary wards at Western State Hospital (and the open discussion of an additional $31 million needed in the 07-09 biennium), and efforts to prevent and eventually reduce WSH placements through improved use of program for active community treatment (PACT) teams and other enhanced community resources.  PACT development and initial implementation received an additional $2.3 million.

General assistance:  The 2005 Legislature ordered DSHS to implement

management strategies to decrease GAU expenditures by $18 million in the

2005-07 biennium, due to that level of shortfall in program funding.  However,

because of caseload decreases, the actual shortfall by 2006 was shown to be

only about $5 million, all of which was funded in the 2006 supplemental

operating budget, theoretically rescinding the required DSHS management

strategies, though we are still awaiting DSHS confirmation of this assumption.

Low-income housing / homelessness:  House Bill 2418 authorizes a total of

$21 million in new resources for additional low-income housing and related

services, funded through the 2006 supplemental capital budget (SB 6384).

New funding is provided in the following fashion and distribution:

·        $6.8 million for Housing Trust Fund projects previously approved but not funded due to insufficient resources;

·        $1.0 million for housing vouchers, including emergency, temporary housing vouchers for homeless persons and victims of domestic violence;

·        $4.5 million for weatherization of low-income households;

·        $850,000 for housing for persons with developmental disabilities;

·        $500,000 for shelters and other housing for victims of domestic violence;

·        $3.0 million for farmworker housing;

·        $200,000 for manufactured / mobile home landlord-tenant conflict documentation and resolution;

·        $4.0 million for the Washington Families Fund (formerly the Homeless Families Services Fund); and

·        $150,000 for home-buyer assistance for individuals and communities with language access barriers.

Nutrition:  The 2006 supplemental operating budget provides a $2 million increase for school breakfast and summer food programs statewide, resulting in at least an additional 15,000 students receiving free school breakfasts.  Washington is the first state in the country to eliminate the co-pay for reduced-price school breakfasts statewide.

Work First:  The supplemental operating budget (SB 6386) allocated $51.1 million to balance the “TANF box”. In addition, DSHS developed new regulations governing changes to Work First, including various efficiencies, caseload reductions, and full-family sanctions for a total expected savings of $36 million. No changes are proposed to time limits or to child care. The most major change is the “full-family sanction” policy.  Currently, a Work First recipient who fails to fully participate (i.e. satisfy all the work requirements) receives a family sanction that causes them to lose 40% of their cash grant. This sanction is meant to encourage the parent to follow all the job requirement rules. Governor Gregoire had chosen to implement a new policy of full-family sanctions for less than full participation. This means that a family would lose 100% of their monthly cash grant.   SSB 6628 would have preserved the child safety net by eliminating full-family sanctions, instead leaving in place the present partial sanction, and assigning a protective payee, that is, a designated person or agency to pay for the basic needs of the household. The remaining funds would have been held to provide for the needs of children in the household. While SSB 6628 was not passed by the legislature this session, the feedback from advocates convinced Governor Gregoire to delay the implementation of full-family sanctions from July 1, 2006 until March 1, 2007, to allow the legislature the opportunity to address the issue during the 2007 Legislative Session.  Public hearings will be held on the sanctions on April 4. 

 

Issue:              Protection of consumer access and freedom of choice in mental health providers

Position:          Support retention of “every category of licensed health care provider” provision in state insurance law.

History:          Since 1995, all health insurance plans must cover the services of “every category of licensed health care provider” for those services that are covered by the insurance plan.  For example, if the plan covers mental health services, it must cover services by all categories licensed mental health professionals within the scope of their licensed practice.  It does not require contracting with every provider who desires to contract with the health plan, just every category (which can mean, in practice, just a single practitioner).  Insurance companies, Association of Washington Business, and National Federation of Independent Business continue to lobby heavily to remove this provision from state law, as well as other insurance mandates including the mandatory offering of mental health coverage, as part of their efforts to lower the cost of health insurance for employers.  However, a coalition of health care professionals (including NASW) has been successful in thwarting these efforts each year since 1995, and documenting that provider choice and access (such as covering mental health services by licensed social workers rather than only psychiatrists) actually results in lower costs.

Status:            House Bill 3310, when introduced, required studies of mandated health care benefits, as well as efficacies of various forms of treatment mandated by Washington statutes.  However, the bill was eventually amended to be much more sweeping and negative in its inquiry, and the bill subsequently died.

 

Issue:              Medicaid coverage of master’s-level mental health professionals

Position:          Support House Bill 2113, House Bill 2803, and Senate Bill 5919

History:          Both HB 2113 and SB 5919 were introduced into the respective health care committees in 2005, but neither received a public hearing.

Status:            In 2006, HB 2803 was introduced, to expand the type and number of mental health professionals from which Medicaid clients can receive services.  There was a public hearing in the House Health Care Committee, but further action was not taken on the bill, in favor of a request for a $1 million pilot project proposed by DSHS to allow master’s-level mental health professionals to treat clients of the General Assistance program (which does not currently include mental health benefits).  However, the funding for the pilot project was not included in the final budget that passed the Legislature.

 

Issue:              Social worker classification

Position:          Support establishment of a tiered Social Worker classification including only those with licensure (BASW, new MSW grad, LICSW, and SW Supervisor)

History:          Department of Personnel is moving to reclassify all job classes, pursuant to public sector collective bargaining legislation passed in 2002, and will be addressing the social work classification (among many others) during 2006 - 07.

Status:            Rep. Ruth Kagi has provided us substantial assistance in our efforts to get this reclassification conducted to our specifications, and she also would like to see special categorization and compensation for front-line CPS workers.  She helped convene a meeting last summer with the director of the Department of Personnel, DSHS’ human resources director, and Governor’s staff to propose this option.  Subsequently, representatives from NASW were able to meet with DSHS Secretary Robin Arnold-Williams and her staff, to discuss our needs and request the desired changes, and a meeting is scheduled with Department of Corrections Secretary Harold Clarke.

 

Issue:              Protection of social workers from harm

Position:          Support House Bill 3122

History:          HB 3122 was introduced in response to the near-fatal assault of a CPS worker by a client.

Status:            HB 3122 adds child protective, child welfare, and adult protective service

workers to the list of persons of whom stalking constitutes a class C felony, when the person is being stalked in retaliation for some act performed in the course of the person's official duties or to influence the person's performance of their official duties.  The legislation also reimburses child protective, child welfare, and adult protective service workers who are injured on the job, for uncovered sick leave.  It passed both House and Senate unanimously, and was signed into law by the Governor on March 17.

 

Issue:              Other human services

Position:          Support protection of current human services programs, as well as support new policies and programs improving services to low-income persons in need.

Status:            There were many other bills of potential interest to NASW, and a couple of

those in which we were closely involved include:

·        Birth – Three:  House Bill 1107 passed both the House and Senate unanimously, and awaits action by the Governor.  This legislation requires school districts to utilize state funds to provide or contract for early diagnosis, intervention and treatment for developmental disabilities in infants and children up to age 3, by September 1, 2009. 

·        Foster Youth:   House Bill 2002 allows 50 foster youth per year, beginning in 2007, to remain in foster care (with state support) in furtherance of higher or vocational education.  HB 2002 passed the House 97-1, and the Senate 45-0, and awaits action by the Governor.