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News surrounding Social Work Profession

Montana court OKs doctor-assisted suicide
Gov mulls privately run Medicaid
New Laws Expand Mental Health Coverage
A Malpractice Insurance Primer

NASW Montana Chapter News

Professional Life on the Edge: A conference addressing the important changes of our profession

Who can say they have not increased their Montana conference prices since 2006? NASW Montana can; we recognize that Montana social workers, professional counselors, and psychologists’ reimbursements and salaries have remained stagnant and have actually declined over the past 4 years.

You can’t afford to miss the important new information presented in this two-day gathering of like-minded professionals who face the same dilemmas you confront daily. The networking alone is worth the price—and you’ll go home with 12 credits of continuing education. Please see Conference Brochure for more information.

Coming Soon: NASW Montana developing Online CE Institute. How it will help meet many of your CE Needs!!

What is the Online CE Institute
The Montana Online CE Institute will be a new option for licensed behavioral health professionals in Montana to earn continuing education credit. It is an online catalog of continuing education courses that will be pre-approved by Montana’s Board of Social Work Examiners and Professional Counselors. NASW Montana Members will receive discounts for the course(s) they take.

How can you help!
The courses populating the Institute’s virtual catalog will be based, in part, upon interests expressed by Montana’s Social Workers, Professional Counselors and Marriage and Family Therapists. We are currently in the final stages of development; NASW Montana will soon be sending out a survey to all NASW members, LCSWs, LCPCs, and MFT’s to determine what course topics are of interest to you. In addition, requests for specific presenters or courses are welcome, as NASW Montana will make an effort to acquire the desired content. In short, we strive to create a catalog of valuable courses that Montana’s behavioral health professionals will find relevant, and your participation is sought. All of the courses will be discounted for members of NASW Montana. We believe that the online CE Institute is a great opportunity for Montana because it creates easier access to high quality CE courses certified in Montana.

Building on the Positive: 2nd Annual Opportunity to Sponsor a Social Work Student as a NASW Member!

Due, in large measure, to the generosity and commitment of our members, NASW Montana now has 503 members!
Did you know:

Although Montana now has five Undergraduate and Graduate Social Work Schools and Programs, with a combined enrollment of nearly 350 students, NASW-Montana student member numbers had been dramatically decreasing from 2005-2009?
The average NASW Montana member is over 51 years and has been a member for nearly 11 years?

Did you know that since September 2009:

NASW Montana’s membership went from 447 to 503 members a 12.5% increase!
But the number of student and transitional (post graduation) members increased from 61 to 97 members a 59% increase!

As a result of the NASW Montana Student Membership Recruitment Drive we are starting to bring in the next generation of Montana Social Workers! Our members generously sponsored 35 new members during the sponsorship drive.

Your NASW Montana Membership Committee is asking you, one of our loyal regular members, to consider “sponsoring” a Social Work Student’s NASW membership for one year. The cost to you would be only $48, or about ¼ the cost of a regular NASW membership and your Social Work Student will receive all the benefits of full membership!

Moreover, after graduation, NASW student members enter a generous three-year transitional period that features reduced dues of $94 in years one and two, and $143 in year three. BSW students enter a two-year transitional period. However, without a previous student membership, Social Workers cannot participate as transitional members. Regular membership annual dues are $190, so it pays for them to join as students and take advantage of NASW’s optimal transitional rates.

When Social Work students join NASW, half of their membership dues support our Montana Chapter. Your Montana Chapter is committed to being our Social Workers’ foremost “COMMUNITY OF PROFESSIONAL SUPPORT.” We want them to reap the benefits of local membership and help the Montana Chapter continue to be a strong fighter for our profession!

How it works…Please let us know if want to sponsor a Montana Social Work Student’s NASW membership. If so, we will “match” you with a student, preferably one close to where you live. We will provide you with the student’s name, email address and phone number. We will ask you to send us a check for $48 made out to NASW and we will forward the student’s application and your check to NASW. Students will be sponsored on a first-come, first served basis.

Montana NASW PACE announces support of 12 Legislative Candidates for November general election

The Montana PACE Committee is pleased to announce the slate of candidates we are supporting financially and through endorsement. We encourage all NASW members to review the biographical information we have made available for your review by clicking on each candidate’s name to help you make an informed voting decision. Thank you to all the committee members and to John Wilkinson for their support and participation. Remember to vote, as this year is a very critical election year that may impact our state and country for years to come.

We are also looking to replace a number of committee members. If you are interested please contact myself or John Wilkinson. I am happy to speak with anyone interested, to provide more information and answer any questions.

Accepted endorsement and Montana NASW PACE financial contribution:

Pam Ellis HD 47	$160
Dave Wanzenried SD 49	$160
Jennifer Pomnichowski HD 63	$160
Kathleen Galvin-Halcro SD 13	$160

Candidates accepting endorsement only/no financial contribution:

Sheila Hogan HD 77
Dennis Getz HD 38
Margaret “Margie” MacDonald HD 54
Wanda Grinde HD 48
Trudi Schmidt SD 22
Mike Menahan HD 82
Pat Noonan HD 73
Chuck Hunter HD 79

Candidates endorsed in PRIMARY and accepted funds:

Mary Caferro SD 40	$160 (Won!)
Jean Price HD 21	$160 (Won!)
Bethany Latiecq HD 65	$160 (Lost)
Lindsay Love HD 25	$160 (Won!)

NASW Montana Clinical Supervision Task Force Formed, Meets 3 Times

NASW MT President, Margaret Watson, announced the formation of the Clinical Supervision Task Force. The response to her invitation to members to participate has been gratifying, and has had 3 teleconferences on July 20, August 19, and September 28.

Montana NASW members interested in helping new MSW’s gain access to quality clinical supervision are confronting an unexpected challenge to the profession. The Chapter’s Clinical Supervision Task Force began meeting last summer to assess the state of clinical social work supervision and advise the chapter board on the role that NASW should play as the organization that “defines best practice, promotes, develops and protects the social work profession” in Montana. The Task Force is chaired by Margaret Watson, Chapter President. Over 20 NASW Montana members have participated in the Task Force’s teleconferences thus far.

In late summer our Executive Director, John Wilkinson, was informed by staff of the Board of Social Work Examiners that the licensing board is considering amending the regulations to allow up to one half of the pre-licensing supervision for clinical social workers to be provided by licensed clinical professional counselors. This apparently is in response to difficulty for some employers in providing supervision by licensed clinical social workers. Chapter staff responded by mapping the distribution of licensed counselors and social workers and found the professions fairly evenly distributed throughout the state. This proposal raises a number of concerns for NASW, among which is the value of the Montana clinical social work license for members whose careers take them to other states. Only three other states currently allow for any supervision by counselors in preparation for clinical social work licenses. The Chapter will keep members informed of opportunities to examine and respond to this and other licensing concerns in the coming weeks.

The next major Chapter effort to support the provision of quality clinical supervision in Montana will be the information, training and discussion at the annual conference November 19 and 20 in Bozeman. We urge interested members to attend the conference and plan to attend a Saturday luncheon meeting to provide input for the Task Force and Chapter Board. Interested members are welcome to notify Margaret Watson or John Wilkinson if you are willing to join the Task Force as well. Among the areas in which the CSTF will be advising the Chapter Board and providing volunteer action are the following:

      A. Respond to Licensing Board proposal to include LCPCs as pre-license supervisors for clinical social workers
      B. Promote and provide training in clinical supervision
      C. Support licensing Board in spelling out qualifications for clinical supervision

Review licensing Board request to NASW regarding pre-license “permits” (with Social Action/Policy)
Encourage NASW chapter members to apply for and maintain national credentials (e.g., Diplomate in Clinical Social Work)
Inform employers of clinical social work supervision standards and resources
Develop vision statement for process of assuring national standards for clinical social work supervision in Montana

-Submitted by Margaret Watson, NASW MT President and Clinical Supervision Task Force Chair

News surrounding Social Work Profession

Montana court OKs doctor-assisted suicide

By Kevin B. O’Reilly, American Medical News staff, amednews.com

For 10 years, Oregon stood alone as the state with a legal physician-assisted suicide process. But two other states now allow the practice.

Washington voters in November 2008 passed a ballot initiative legalizing aid in dying. Then in December 2008, Montana Judge Dorothy McCarter ruled that state homicide laws unconstitutionally restrict terminally ill patients’ right to dignified deaths.

The judge’s ruling took effect immediately, meaning that as of AMNews press time in mid-December, Montana physicians could prescribe lethal doses of medicine to mentally competent terminally ill patients, without fear of criminal prosecution. The court decision does not apply to other states.

"The Montana constitutional rights of individual privacy and human dignity, taken together, encompass the right of a competent terminally ill patient to die with dignity," McCarter wrote in her 1st Judicial District Court opinion.

Defending state law, Montana Attorney General Mike McGrath had argued in a motion for summary judgment that "unless and until Montanans’ legislature decides to start down the rarely traveled path toward a regulated regimen of physician-assisted suicide, the court should refuse to blaze a trail."

Washington voters in November 2008 passed a ballot initiative legalizing aid in dying.
After the ruling, McGrath filed a motion to stay the decision, pending an appeal to the Montana Supreme Court.

Kathryn Tucker, co-counsel for the plaintiffs in the case, said she would file a motion opposing a stay. She said patients’ rights should not be put on hold for a Supreme Court decision that could take up to a year. Tucker added that a Montana-type legal strategy could be pursued in other states.

"We would look for a place where they have a constitution with an explicit privacy clause, then we’d look to whether that’s been interpreted by the state supreme court in a way that is protective of individual privacy and autonomy," said Tucker, director of legal affairs for Compassion & Choices, a Portland, Ore.-based death-with-dignity advocacy group. "Any state where they have both of those factors would be one where this claim might well succeed."

Mixed reactions in medicine

One of the plaintiffs in the case was Robert Baxter, a 75-year-old with leukemia. He was sleeping when his family received news of the decision, according to news accounts. He never awoke, dying of natural causes before learning of the ruling. Four physicians also are plaintiffs.

Kathryn Borgenicht, MD, who was not a party to the suit, supports the decision. The Bozeman geriatrician and hospice medical director said legal aid in dying will open up end-of-life conversations and could be good for a small number of patients who value controlling how they die.

"When they are dying, the three things [patients] are looking for are comfort, control and dignity," Dr. Borgenicht said. "We’re really good about providing comfort, we’re OK about dignity, and control is the one thing we’re really struggling with."

American Medical Association policy opposes physician-assisted suicide because the practice is "fundamentally inconsistent with the physician’s role as healer." Officials with the Montana Medical Assn. said the organization has no policy on doctor-aided dying and will not file an amicus brief when the case is appealed.

The AMA usually does not join state litigation unless the state medical society asks for help. MMA officials said they had no plans to request the AMA to file a brief. MMA President Kirk L. Stoner, MD, said the society would get involved only if its members or the Supreme Court asks it to weigh in.

Physician-assisted suicide "is not something we’ve discussed recently," Dr. Stoner said. "We don’t have a real reason to get involved right now. There are bigger fish to fry."
Gabor Benda, MD, a Bozeman family physician, said he was "deeply dismayed" by the judge’s ruling.

"I do not think that physicians should ever be put in the position of helping someone to commit suicide or end their life," Dr. Benda said. "We should basically confine ourselves to the job of the healing art, as well as of keeping people comfortable."

The print version of this content appeared in the Jan. 5, 2009 issue of American Medical News.

Gov mulls privately run Medicaid

By Mike Dennison, Helena Independent Record State Bureau

The Schweitzer administration is considering a test run of having a private, managed-care firm run Medicaid, the state’s $900 million health care program for the poor.
Top state health care officials confirmed late last week that they’re preparing a possible request for companies to bid on a contract early next year to manage Medicaid in a five-county area that includes Helena and Great Falls.

Anna Whiting Sorrell, director of the state Department of Public Health and Human Services, said the managed-care “demonstration project” would cover all Medicaid patients in the five-county area. The program could save money and improve health care quality for patients, she said.“We know that other states are doing it; we’re trying to figure out how it would work in Montana,” she said.

Sorrell emphasized that the discussion is “very preliminary,” that no final decision has been made, and that federal health officials must sign off on the project, since the federal government funds at least two-thirds of Medicaid.

However, agency documents obtained by the Lee Newspapers State Bureau include a timeline that calls for putting out the contract for bid in January, signing it by next summer and implementing the project in January 2012. Department documents also reveal that state health officials have been talking for more than a year about expanding private managed care of Medicaid, including a proposal from Centene Corp., a St. Louis-based managed-care firm that operates in several Midwestern and Southern states.
Centene, a $4 billion company that has a claims-processing center in Great Falls, submitted a detailed proposal in August 2009, to extend private managed care of Medicaid across the state and to many of the program’s 90,000-plus patients.

A memo from a top state Medicaid official this August expressed strong doubts about the proposal, which Centene said could add jobs in Great Falls, improve the quality of care for patients, maintain “fee schedules” for hospitals and physicians — and save the state anywhere from $10 million to $26 million a year.

Yet sources told the Lee Newspapers State Bureau that Gov. Brian Schweitzer directed health officials to pursue managed-care options for Medicaid.
Sarah Elliott, spokeswoman for Schweitzer, said Tuesday that the governor had asked the health department “to move forward exploring ideas where citizens can best access the complicated health care industry,” and that can save taxpayer money and provide “better health outcomes.”

Deanne Lane, a spokeswoman for Centene in St. Louis, said Tuesday the company employs nearly 200 people at its Great Falls center and “welcomes any new opportunities as we continue to improve health outcomes while saving states valuable resources.”

Under managed care, a private firm would take over management of part of the Medicaid program, receiving a set amount of government money to provide services to eligible patients.
Through arrangements with patients and health care providers, such as hospitals, physicians and nursing homes, the company would “manage” care with an eye toward routing patients to lower-cost services, thus saving money. The company gets a cut of the savings.

Medical providers that would be affected by any change said this week the Schweitzer administration has not consulted with them, and that the state’s possible move toward more managed care of Medicaid is a surprise.

“We’re kind of in the dark on what the governor’s office is thinking,” said Bob Olsen, vice president of MHA, which represents most of the hospitals in the state. “There’s been no communication at all. … The only thing I can say is that we would be very interested in seeing the details of what they have in mind and how this might work.”
A leading legislator also said this week the administration should consult with the Legislature on such a significant policy move, because saving money on managed care of Medicaid would mean lower payments to health care providers, less care for patients, or both. “If you’re going to take that much money out, who’s going to get less money?” said Sen. Dave Lewis, R-Helena, the vice-chairman of the Senate Finance and Claims Committee. “They still don’t have an answer on that one. “Everybody deserves a lot more information, the Legislature and the public. If they’re going out in January (with the contract), they’re kind of fast-tracking it.”

The demonstration project considered by the department would cover Medicaid patients in Lewis and Clark, Cascade, Chouteau, Teton and Judith Basin counties. Sorrell said the area offers a good mix of urban and rural populations, to see how managed care would work in both settings. The department is reviewing the plan now, will decide soon whether to proceed, and plans to bring providers and others into the discussion, she said.

“Once we complete our review, we’ll be working closely with the providers and with the people who count on us to get their health care,” Sorrell said.
Sorrell said Centene Corp. contacted her agency last year about expanding managed care of Medicaid, but that since then, the state has spoken with other companies. But now that the state is considering putting out a managed-care contract for bid, “we’ve stopped those conversations,” she said.

In July, the Washington Post reported that Centene and other managed-care firms that specialize in Medicaid are laying the groundwork to win additional contracts, anticipating the scheduled 2014 expansion of Medicaid contained in the federal health-reform bill passed in March.
Montana officials have said the expansion could double Medicaid rolls in the state, to as many as 200,000 people.

The Post’s coverage also said managed care of Medicaid by private firms has not been without its problems, with some companies accused of undue profits by taking per-patient payments and not providing adequate care.

New Laws Expand Mental Health Coverage

By Michelle Andrews, Kaiser Health News Oct 05, 2010

Two federal laws that provide better insurance coverage for more people with mental health and substance abuse conditions are just beginning to take effect, and advocates say the changes describe the changes as a huge win for consumers that will greatly improve treatment.

As anyone who has ever sought help for addiction, depression or any other mental illness knows, insurance coverage is often skimpier than for a physical malady. Plans typically limit the number of therapy visits they’ll pay for, and they may also impose a separate deductible for mental health and substance abuse services and require higher out-of-pocket contributions from patients as well.

Under the Mental Health Parity and Addiction Equity Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments. The law does away with different co-payments, deductibles and visit restrictions.

"These financial equalizers will be very helpful to families that have not been able to access care before," says Katherine Nordal, executive director for professional practice at the American Psychological Association.

There are some important caveats. Plans are not required to provide mental health or substance abuse coverage, however, and they can also determine that they will not cover specific disorders.

Some companies made the changes starting last January, but the regulations on parity went into effect July 1, so in most plans the changes become effective when they renew their coverage after that date, said Elaine Alfano, deputy policy director at the Bazelon Center for Mental Health Law in Washington.

The parity law - which was championed by former Sen. Pete Domenici, R-N.M., and the late Sen. Paul Wellstone, D-Minn. - doesn’t apply to plans at companies with 50 or fewer employees or to individual health insurance policies. The new health-care overhaul law, however, will pick up the slack. Under the law, health plans sold through the state-based insurance exchanges that will begin offering coverage in 2014 must include mental health and addiction benefits, and the benefits must be on a par with a plan’s medical benefits. The exchanges will be open to individuals and to small businesses with 50 or fewer employees.

Advocates say they are pleased on the whole with the new laws. But they are watching closely to see whether plans try to erect roadblocks to treatment by claiming it’s not medically necessary, for example, or requiring that someone get preapproved before receiving services, says Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness.

For the Bryan family of San Antonio, the new laws are already making a difference. Their 17-year-old son, Kevin, has had bipolar disorder since he was a child. But as he went through adolescence, Kevin became increasingly paranoid and out of touch with reality, says his mother, Chris. About three years ago clinicians determined he suffered from schizoaffective disorder, a diagnosis that led to a change in his medication and a doubling of his outpatient therapy visits to twice a week.

Unfortunately, the health plan covered only 52 outpatient therapy sessions annually, so by August or September of each year, the Bryans were paying $60 out-of-pocket each time Kevin had an appointment, or roughly $3,000 a year. "I kept making the point to the insurer that it was cheaper to cover his visits than to have him wind up in the hospital," says Chris Bryan, but nothing changed.

Under the new parity provisions, and the annual cap on visits was lifted. Now, when Kevin visits his therapist, his parents are responsible only for a $15 co-payment. He is responding well to treatment and considering going to college next year.
Looking down the road, Chris Bryan says the family may also benefit from the provision in the health-care overhaul that allows adult children to stay on their parents’ insurance plan until age 26. "We were starting to worry about how to get him coverage as an adult," she says.

Mental health advocates are particularly pleased that the health-care overhaul will also beef up coverage of preventive services, including screening for depression and alcohol misuse.

In September, the Department of Health and Human Services announced nearly $100 million in grants under the new Prevention and Public Health Fund. They include more than $20 million to help local behavioral health agencies integrate primary care into the mental health care they already provide, and another $5 million to establish a national resource center dedicated to the integration of physical and mental health care.
Integrated care is critical, say experts. The life expectancy for someone with serious mental illness is 25 percent lower than that of the average person, according to Nordal, in part because of metabolic problems resulting from the long-term use of powerful psychotropic drugs. With ongoing integrated care, the severity of chronic mental illness can be reduced and lives saved, as doctors, therapists and other health care practitioners work together sharing information to make sure their patients’ ongoing physical and mental health needs are addressed.

Of course, dealing with problems before they become chronic can be even more effective. According to the National Institute of Mental Health, half of the people with a mental illness have it by the time they’re 14. But on average, people don’t receive formal treatment for their illness until they’re 24, says David Shern, president and CEO of Mental Health America, an advocacy group.

Early intervention—for example, teaching kids how to manage their emotions or educating grade school teachers about effective behavior management—can be effective strategies for keeping children from developing more severe, long-term emotional problems later on, say experts. "That’s why routine screening and treatment is so important," says Shern.

A Malpractice Insurance Primer

By Christina Reardon, MSW; Social Work Today

September/October 2010 Issue Vol. 10 No. 5 P. 22
http://www.socialworktoday.com/archive/092310p22.shtml

Don’t panic. Shopping for malpractice insurance may not be as hard as you think. Here are some tips from several experts.

Insurance is a fact of life: Health insurance helps pay the bills incurred during a medical emergency. Automobile insurance helps you get back on the road after an accident. Homeowners insurance gives you the peace of mind that your belongings can be replaced in case of a fire or a burglary.

But are you adequately protecting your career as a social worker?

Although social workers rarely attract attention-grabbing lawsuits, the risk of financial and professional ruin still exists. The best protection may be to purchase malpractice coverage.

“Virtually all social workers should consider coverage, including those who might not think they need it,” says Frederic G. Reamer, PhD, a professor at Rhode Island College’s School of Social Work. “Strange things happen. Lightning can strike.”

The good news is that malpractice coverage is relatively affordable. The bad news is that thinking about insurance—let alone shopping for it—can seem like a boring chore. But there are ways to make the process go more smoothly. The following tips are compiled from information provided by Reamer and several other observers of the malpractice market.

Tip 1: Consider Whether You Need Coverage

A major mistake people make when shopping for malpractice coverage is assuming they don’t need it. There are many types of social workers other than those in private practice who could benefit from coverage, Reamer says.

For example, social workers employed in agencies often believe they are covered by their agencies’ policies. That may be true—to a point. Such coverage is there to protect the agency, and a social worker’s interests may fall by the wayside when the agency faces legal action, says Tony Benedetto, executive vice president of NASW Assurance Services, Inc., a subsidiary of the National Association of Social Workers.

“You never know where a lawsuit might lead,” he says. “You should have your own coverage to make sure your individual interests are protected.”

Social workers at risk of being subpoenaed as part of custody battles, workers compensation cases, or other legal proceedings and those who provide consultation or supervision should also consider insurance, Reamer says. Students in field placements and faculty at schools of social work should make sure they have adequate coverage, too.

“It’s important to have both an umbrella and a raincoat,” Reamer says.

Tip 2: Think About How Much Coverage You Need

Malpractice coverage comes with two liability limits. The per-claim limit is the maximum coverage you will have for any single claim. The aggregate limit is the maximum coverage you have for all claims covered by the policy.

Social workers working with managed care organizations and other third-party payers are typically required to have a policy with coverage of at least $1 million per claim and $3 million aggregate, says Margaret Bogie, a licensed insurance broker and consultant based in Chantilly, VA. This is sufficient coverage for most social workers, and providers considered lower risk or who are covered under an agency policy may be able to get by with even less coverage, Bogie says.

Tip 3: Know the Differences Between Claims-Made and Occurrence Coverage

There are two types of coverage available to social workers and other mental health professionals: claims-made and occurrence. A claims-made policy will provide coverage for alleged actions that occur during the time the policy is in effect as long as the policy is still in effect when the claim is made. The pricing for such a policy is stepped, meaning the annual premium is deeply discounted at first and will go up each year for several years to a point where the policy reaches maturity and rates level off. An occurrence policy will provide permanent coverage for claims relating to actions taken during the policy period.

Which type of coverage is best? Each has its advantages and disadvantages. The long-term protection provided by occurrence policies is good because many claims come several years after the alleged wrongdoing. However, claims-made policies are less expensive; the cost of such a policy when it matures is typically about 80% of the annual premium for an occurrence policy, Bogie says. She recommends purchasing tail coverage if you choose a claims-made policy and later decide not to renew it. Tail coverage will continue to cover claims for actions occurring during the policy period.

If you share space or work with other providers, you may want to look into a group policy. Such a policy may be more economical, but it could come with restrictions that you don’t want, Bogie says. For example, a group policy may not cover you when you work outside the group setting. If you do choose a group policy, Bogie recommends looking for one that offers severability of limits. That means each person covered under the policy has separate liability limits, not shared ones.

Tip 4: Examine the Stability of Each Carrier You Consider

You don’t want to be stuck facing a claim that your insurance company can’t pay. That’s why it’s important to research the insurer’s financial strength before buying a policy, Benedetto says. You can do that by dealing only with carriers with “A” ratings from an organization such as A. M. Best. Looking for such ratings will help ensure a carrier has adequate resources to pay claims and large enough reserves to survive a rash of claims.
Historical stability is important, too. An insurer with a proven track record is more likely to stick around and have the perspective needed to weather storms in the marketplace, Reamer says.

“You don’t want to take chances,” he says. “You want a reputable company that has a good bond rating, a long history, and that is going to be in your corner if the worst happens.”

Tip 5: Look at the ‘Bells and Whistles’ That Come With a Policy

There aren’t a plethora of companies that offer malpractice insurance for social workers. Among the organizations that do are NASW Assurance Services, Healthcare Providers Service Organization, and CPH & Associates. These and other carriers often try to differentiate themselves by offering extra features with their policies. Some of these extras could help you choose one policy over another.

One especially important extra is licensing board coverage, which will help cover your legal expenses in case you need to defend yourself against complaints filed or disciplinary action taken by a board. Such complaints are more common than lawsuits, and your inability to afford adequate legal counsel could cost your license and your reputation, says David Wolowitz, an attorney with McLane, Graf, Raulerson & Middleton, a law firm with offices in New Hampshire and Massachusetts.

“Social workers are not wealthy people, and I’ve seen people give up their licenses rather than fight a complaint because they couldn’t afford legal expenses,” Wolowitz says.
Bogie says other extra features to consider include premise liability, which covers trips and falls occurring in your office space, and coverage for income you lose while attending court and depositions. Many carriers offer premium discounts for part-time practitioners, first-year practitioners, and others meeting certain criteria. It also may be important to find out whether a carrier makes you pay your premium all at once, quarterly, or semiannually.

And don’t forget customer service, Benedetto says. Look at how easy or difficult it is to pay premiums, renew policies, and contact the company with questions.

Tip 6: Don’t Panic

For some social workers, even the thought of shopping for malpractice insurance invokes anxiety about lawsuits, court proceedings, and big payouts. Yet the truth is social workers are at relatively low risk of getting sued.

“[Social workers] just don’t get sued very much and are less likely to attract lawsuits,” Bogie says. “I just haven’t seen any huge damage awards with social workers.”

Social workers are considered at lower risk than other mental health professionals such as psychologists because social workers are more likely to be engaged in areas such as child welfare and case management, and only some social workers work regularly with suicidal or other high-risk clients, Bogie says. In addition, the fact that social workers cannot prescribe medications reduces their risk of a lawsuit.

Because social workers are at a relatively low risk of legal troubles, it makes financial sense to look for a malpractice policy that covers mostly or only social workers, Benedetto says.

“Your price will reflect the group that is being covered,” he says. “And if you are in a group with practitioners who are considered higher risk, eventually the rates will reflect that.”

Tip 7: Keep Yourself Out of Trouble

The best way to fight lawsuits or disciplinary action from licensing boards is to make sure they don’t happen. Social workers must recognize that the ethics violations that can get them into trouble go beyond sexual relationships with clients and other boundary violations, Reamer says. Problems also can arise over issues as varied as the management of confidential information, terminating services, not reporting abuse to protective services, and using unorthodox treatment approaches.

Continuing education requirements can provide social workers with great opportunities to learn more about ethical issues and how to manage their risk, and insurers frequently offer premium credits for social workers who take advantage of these opportunities. The fact that most states require ethics courses as part of their continuing education requirements and that the Council on Social Work Education has required more ethics education in schools of social work are encouraging signs, Reamer says.

“That more ambitious approach, I feel, is bearing some fruit,” he says.

Christina Reardon, MSW, is a freelance writer based in Harrisburg, PA.