The National Association of Social Workers

NASW Vermont Chapter Legislative Agenda 2005

I.) Economic State of Vermont Fiscal Budget The state of Vermont budget establishes the economic and fiscal priorities that impact every resident of Vermont. As such, NASW-VT recognizes that the budgeting choices reflected in tax policy and social spending directly impact the just and equitable allotment of the state's resources for all citizens of Vermont. Position Statement: NASW-VT supports budgeting polices that promote economic justice and social well being for all members of our state, especially those most at risk: children, the elderly, people in poverty, and those who are physically and emotionally challenged. The budget should support full employment and alternative work patterns, livable wages, and the meeting of the intrinsic human needs of all Vermonters, including access to health and mental health care, sound nutrition, housing, education, and support for the care of dependents. Livable Wages (Background information from the Vermont Livable Wage Campaign, http://www.vtlivablewage.org). According to the Peace & Justice Center's Livable Wage Campaign, the minimum wage of the state of Vermont needs to be raised to $11.49/ hour (as of January 15, 2005 this number will be adjusted to reflect the most current data; please refer to the web site above for the most current information), a livable wage for a single person with no dependents, and indexed to match inflation over time. A livable wage is an hourly wage or annual income sufficient to meet a family's basic needs including food, housing, childcare, transportation, healthcare, clothing, household and personal expenses, and insurance (Kahler& Hoffer, 1997). Approximately 42% of the Vermont labor force (119, 510 workers) is earning considerably less than they need to provide for their individual basic needs. At least half of working Vermonters do not earn enough to support a traditional, nuclear family (Worker's Center, 1999). The minimum wage in Vermont is $7.00 an hour. This is still not a livable wage. The Vermont Livable Wage Campaign believes that the legislature should increase the minimum over several years until it is equal to the livable wage for a single person, while simultaneously working on bringing down the cost of living (i.e. health care, housing, and childcare). Finally, the Vermont Livable Wage Campaign encourages the Joint Fiscal Office to continue calculating the cost of basic needs and the equivalent livable wage for the next five years until 2010. Position Statement: NASW Vermont Chapter supports legislation that would provide a livable wage for all Vermonters based on the figures of the Peace & Justice Center's Livable Wage Campaign. Temporary Assistance for Needy Families: Welfare Reform Coming up on the fifth year of TANF, if a family has been receiving cash payments, they will be denied federal financial support. It is expected that many children and families will plunge further into poverty without any safety net. In some cases, it must be recognized, that there is a combination of personal responsibility and economic system failure (Social Work Speaks). Position Statement: NASW Vermont Chapter recognizes the need to maintain a safety net to protect the most vulnerable individuals and therefore supports policies and practices that strengthen a collaborative response to circumstances of poverty. NASW VT opposes all punitive policies and practices against TANF recipients, such as full family sanctions and family caps (i.e. five year life-time cash payment). NASW VT supports efforts that focus on the economic causes of poverty, provide long-term opportunities through post-education and vocational training for low income people and recognize the crucial role substance abuse, domestic violence, mental/health issues and illiteracy play in the lives of some TANF recipients. Homelessness & Housing NASW Vermont Chapter recognizes the socioeconomic factors of poverty that contribute to homelessness, and values the need for adequate and quality housing as a fundamental and basic human right. NASW VT also recognizes the lack of affordable housing within the state. Position Statement: NASW Vermont Chapter supports legislation that will increase access and availability of adequate low and moderate- income housing, and reductions in the social and economic conditions that contribute to poverty and homelessness.

II.) HEALTH & MENTAL HEALTH CARE Reflecting the national trend in which more people have no or inadequate insurance, health care coverage in Vermont also is now and may well continue to be shrinking and threatened in some important respects. One scenario of great concern would be the converting of Medicaid payment to a block grant. In addition, the fact that the number of elders and poor people is growing in the state is likely to further strain all Vermont resources. For example, number of both V-Script and Children's Health Fund recipients is down, in part because of tighter eligibility regulations. Medicare & Prescription Drugs Because Vermont traditionally has had good coverage for its elders, the impact of the new Medicare Drug Bill to be implemented in 2006- where more generous Medicaid or other co-insurance benefits will be replaced by the often smaller Medicare benefits- may be especially negative in this state and certainly will need to be monitored during the 2005 legislative session. Medicaid For individuals on Medicaid, the issue of paying premiums rather than co-payments at receipt of service continues to be complicated, especially because of the threat of losing coverage due to late or non-payment. Also, the ideas of raising premiums or cutting services are threats that need constant monitoring. Universal Health Care Although a direct, single payer plan is not likely to be proposed in the Vermont Legislature during 2005, a grassroots business focused effort through Coalition 21 is moving forward as an important citizens' initiative to reform health care in this state and move towards universal coverage. Position Statement: NASW VT supports the ideal of universal health care for all, as well as any reasonable movements in that direction. We recognize that health care in the U.S. is in a state of crisis because of rapid growth in both costs and number of people lacking any or adequate services. Particularly we support the maintenance and improvement of Medicaid and Medicare benefits for children, adults, families and elders in order to ensure equitable access to services for critical and long-term health issues, substance abuse treatment, vision and oral care. We also support expanded prescription drug coverage that is affordable for all Vermonters who need it and especially encourage our state to work towards bulk purchase of medications in order to reduce and regulate prices. End of Life Care Social workers regularly deal with quality-of-life issues and choices related to life and death as advocates for the rights of individuals, as providers of mental health services, and as workers in hospitals, hospices, nursing homes and crisis centers. Social workers have requested guidelines that are compatible with professional and personal ethics, legal parameters, and respect for client self-determination. In acknowledging and affirming social work's commitment to respecting diverse value systems in a pluralistic society, end of life issues are recognized as controversial because they reflect the varied value systems of different groups. Consequently, NASW-VT does not take a position concerning the morality of end of life decisions, but affirms the right of the individual to determine the level of his or her care (Social Work Speaks 2003-06). Position Statement: NASW VT believes health care, advanced directives, and end of life decisions are the province of individuals in consultation with medical professionals, families and significant others. Patients at the end of life ought to be able to make informed decisions and to assert dominion over their own personhood with regard to pain management and personal health matters, as they deem necessary. Reproductive Choice and Health Issues Position Statement: NASW Vermont's position concerning issues related to reproductive health and choice is based in our professional principle of self- determination. Every individual (within the context of his or her value system) must have the choice whether or not to participate in reproductive health services. Adolescents and adults should have access to a range of social and health services including, but not limited to, comprehensive sexual education, contraception and pregnancy testing, fertility enhancement, treatment of sexually transmitted diseases, emergency contraception, family planning, sterilization, abortion and all other reproductive health services. In addition women should also have access to case management, pregnancy options counseling, family counseling, adoption counseling, prenatal care, birthing services and postpartum follow-up and support. Mental Health NASW VT will review the expected proposal regarding the current State Hospital with an eye on the needs and rights of consumers, as well as the impact on Vermont's overall mental health system. It is clear that reforms are needed to provide care that is more effective, humane, and aligned with the state's commitment to community based treatment. It is expected that any proposal will require sustained and substantially increased financial support to the Community Based Mental Health system. Designated agencies in this system have experienced a decline in resources in recent years as a result of inadequate public funding, inflation, rising health care costs, and caseload growth, as well as the growing strain on the Medicaid budget. Further, there is a growing demand for mental health services for people in correctional facilities, for the elderly, and other diverse populations such as refugees, which at present are seriously under met. It is imperative that the State provide adequate funding to support the existing services in this system, while also responsibly funding any growth in services needed to reorganize services for some of the state's most vulnerable populations. Of particular concern is the underpayment of the mental health workforce that has led to retention issues in the designated agencies. Position Statement: NASW VT will support legislative efforts to adequately fund the Community Based Mental Health System and promote the creation of additional services where there are gaps. NASW VT also supports collaboration among the legislature, the Division of Mental Health, the Department of Health and community based groups in planning for mental health service delivery in the future.

III.) FAMILIES Quality Childcare in Vermont Position Statement: NASW Vermont Chapter supports legislation that increases the availability, the quality and the consistency of childcare in the state of Vermont through such measures as increasing state subsidies for childcare, increasing wages of childcare professionals, and encouraging childcare facilities in Vermont to seek national accreditation. Paid Family Leaves NASW Vermont Chapter recognizes the strength of the family as the primary agent of socialization. It also recognizes the importance of flexibility in balancing both economic and social responsibilities, as both a parent and a provider, to the family. Position Statement: NASW Vermont Chapter supports legislation that would offer employer paid compensation to allow workers to be able to afford to provide for their family members during an episode of necessary and needed care.

IV.) AGENCY OF HUMAN SERVICES RESTRUCTURING Position Statement: NASW VT believes that social workers have been presented with the opportunity to become a powerful tool in the restructuring process of AHS. Therefore, based in part, on the Agency's new focus of a "client-centered model," trained, professional social workers become a "natural fit" because of their existing knowledge, skills, values, and prior understanding of the Agency's successes, failures, and barriers. Consequently, it is the hope of NASW VT to enhance the position and profession of social work within AHS by remaining an active partner in the process, and secondly, to validate the profession via "research and outcome studies that demonstrate the effectiveness and cost/benefit of hiring trained social workers" (Social Work Speaks, 2003, p. 78).