Clinicians Call Cuts In Medicaid Group Therapy Rate Shortsighted
August 27, 2015
The Department of Vermont Health Access will cut in half the amount that Medicaid pays for group therapy sessions starting next year. Many of the state’s most vulnerable patients will be negatively impacted, according to clinicians and advocates.
Group therapy is a less expensive and clinically effective treatment option for people dealing with substance abuse problems, mental or behavioral health problems. It is also used to help abuse or trauma victims, sex offenders and troubled youths, experts say.
In addition to the payments being halved in January, the length of therapy sessions that can be billed to Medicaid was shortened in July. That could lead social service agencies and private practices to reduce or eliminate group therapy programs.
“Clinically, (cutting group programs) is a terrible idea. Financially, it might be our only option,” said Margaret Joyal, director of outpatient services for Washington County Mental Health Services.
State officials say the decision was necessary to comply with federal regulations and intense pressures on Vermont’s Medicaid budget.
Gov. Peter Shumlin has directed all state agencies and departments to level-fund their budgets and look for savings where they can. At the same time, Vermont’s Medicaid program is facing an estimated $40 million budget shortfall.
“The cut was based on money,” DVHA Commissioner Steven Costantino said in an interview Thursday. The greatest pressure on Medicaid’s budget is increased caseload, he said. Eligibility for the program was expanded as part of the Affordable Care Act, and now roughly one-third of low-income Vermonters receive some form of Medicaid.
Medicaid’s payment rates for group therapy dropped from $61 per patient for a 90-minute session to $41 for a one-hour session in July. Starting in January, the rate will be $20.50 for one-hour sessions. The cut will save the Medicaid program an estimated $1 million next year.
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NASW-VT Statement on DCF Shooting
August 10, 2015
The Vermont Chapter of the National Association for Social Workers (NASW-VT) expresses its heartbreak and sympathies after tonight’s fatal shooting of a Department for Children and Families (DCF) employee.
Employees of the Department for Children and Families do immensely difficult work with children and families experiencing complicated and often extreme hardship. Every day, these workers do their best to navigate sometimes-impossible challenges in an environment of scarce resources. This work helps ensure the safety and wellbeing of communities throughout Vermont.
While we know that incidents such as these have been known to occur to child protection workers across the country, it is impossible to prepare for or fathom the devastation that a crime such as this causes. NASW-VT expresses our deepest sympathies to the family of the victim of this crime. We stand in proud solidarity with child protection workers across Vermont and across our country in the wake of this unspeakable violence.
Eilis O'Herlihy, NASW-VT Executive Director
In Lieu of flowers, please consider making a donation to one of the organizations listed below in honor of Lara Sobel.
Patten: Social Workers
August 14, 2015
DCF social worker Lara Sobel was gunned down in a cowardly act, allegedly by a mother who lost custody of her child.
I am a social worker. I was a child protection social worker and I’ve taught them at all stages of professional growth for the last ten years.
As the state emerges from the shock of recent events we ask the inevitable questions. Why did this happen? How could this have happened? And the most critical question to our collective grief and growth: how can we make sure this never, ever happens again?
We need to stop suggesting that more training is the solution. Social workers are heavily trained. To be part of the profession, you have at least a bachelor’s degree that includes a minimum of 400 hours of supervised field experience. Many social workers have a masters, which requires at least 900 hours of field experience.
Add to that on-the-job training and continuing education, optional certifications and licensure requirements, training is not the issue.
If not training, then what is the issue? It’s a wicked problem. The term wicked is used to describe problems that are resistant to definition and resolution because of interdependencies across multiple domains.
Such is the case with recent events. Our response to this tragedy needs to include much more than just security protocols.
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