Judy Gallant, MD Legislation and Advocacy Chair

In late September, 2021, Pam Metz Kasemeyer (our Maryland lobbyist) and I met via zoom with Stanley Weinstein, Executive Director of the MD Board of Social Work Examiners (BSWE). At the meeting, we raised concerns with Dr. Weinstein that our members have expressed for a long time: slow responsiveness, apathy, unprofessional behavior and unhelpfulness of staff to inquiries; problems with applications for licensure not being acted on in a timely way; and the great contrast of Maryland’s BSWE with Boards of Social Work of other states and jurisdictions. Although our membership has been frustrated for a number of years, our discussion was also in the context of the pandemic. At that time, staff was working in a hybrid manner, coming to the office just 3 days/week, working from home the rest of the time. Prior to July, staff was working virtually 5 days/week.

What I found most illuminating was Dr. Weinstein’s discussion of how the Board operates in terms of staffing and budget. The State (Governor and Legislature) controls how much money is spent on the Boards, and the Department of Health assigns who gets hired as staff. They have only 15 staff members to deal with 18,000 applications for all levels of licensure/year. By contrast, when Dr. Weinstein began his position 7 years prior, 10,000 applications were processed by the same number of staff.

I raised the issue of denials of Continuing Education credits because of staff’s lack of knowledge of the applicability of a specific course to clinical social work. He acknowledged that one member of the CE department at that time was not a clinical social worker, and indicated that licensees can ask to go before the CE Committee if they feel an incorrect decision was made about a training they have taken. The Maryland Board of Social Work Examiners accepts continuing education units offered by Association of Social Work Boards, National Association of Social Workers, and Board Authorized Sponsors.

Dr. Weinstein indicated they were reassessing how they operate, esp. via telework, and that he would be reviewing all staffing. We agreed to stay in touch.

New Information

In December 2021, there was a cyber attack on the MD Department of Health which affected the professional licensing Boards, the hospital system and health clinics. As a result, BSWE has had additional difficulty functioning, since BSWE has been unable to use their old computers, cannot print licenses, and cannot deposit checks.  They now use a mobile hot spot from Verizon and have gotten a few new computers, but there are not enough for all staff. They are extremely frustrated that the Department of Health has downplayed this and that the public has little information about what is going on. I know several of our members have had problems with license applications, reaching the Board for other business, and have been extremely frustrated by the complete lack of responsiveness. While we know about the historical difficulties the BSWE has had with their responsiveness, this has decreased their response times even further. At this writing, we are planning to join with other organizations to write to the Department of Health and to Governor Hogan.

In early January, the Maryland General Assembly started their annual 90-day legislative session. As of this writing in February, we have submitted testimony on 11 bills, supporting the bills’ aims, but for several bills our support is dependent upon the inclusion of amendments offered.

Bills addressing insurance reimbursement

As some of you already know, Optum, the administrative services organization (ASO) that administers the delivery of specialty mental health services under the Maryland Medicaid Program, has an abysmal record of paying claims in a timely manner. Senate Bill 549 is a direct result of the inability of the State’s ASO to process claims or pay health care providers for services rendered since inception on January 1, 2020.  As a result, the Maryland Department of Health has had to resort to making advanced but estimated payments to health care providers, based on historic 2019 billing data that did not account for the impacts of the COVID-19 pandemic.  This has now placed health care providers in the precarious position of having to pay back the difference between the estimated payments and the claims amount submitted.

Senate Bill 549 requires Optum to give health care providers the tools needed to substantiate the processing of claims.  Our testimony in support of the bill argued that health care providers should not be disadvantaged due to the failure of Optum (and the State) to employ a workable billing and claims processing system.

House Bill 912 addresses health care coverage of non-participating providers. In our testimony supporting this bill, we stated: ensuring that individuals have access to critical mental health and substance use disorder treatment services continues to be an area of concern to the clinical social work community. … House Bill 912…ensures that the insured has coverage for mental health or substance use disorder services at no greater cost to the member than if the services were provided in-network by allowing an insured to go out of network if the carrier’s provider panel has an insufficient number or type of participating specialist or non-physician specialist for the required services.

Addressing issues around Health Care staffing shortages

HB 625 would establish a Commission to study the health care workforce crisis in Maryland. In our testimony supporting the bill, we emphasized the importance of examining the additional support the Department of Health could give to the Boards to assist with workloads, overhead, improved staffing and technology improvement. We expressed concern that BSWE has been unable to respond in a timely way to licensing issues of our members, which is greatly impacted by the tremendous workload the inadequate number of staff is attempting to handle.

HB 407 would authorize the Secretary of Health to declare a health care staffing shortage emergency in the State and require each health occupations board to establish processes for the issuance of initial licenses, temporary licenses, and temporary practice letters on an expedited basis for such an emergency. The bill would relax licensure standards to bolster the current health care workforce, specifically targeting (1) an applicant for an initial health occupation license; (2) an individual who holds a valid, unexpired health occupation license issued in another state; (3) an inactive licensee; (4) a retired health care practitioner; and (5) a nursing graduate. We expressed support of the bill provided that amendments would be offered that will allow the health occupation boards more discretion in how to expedite licenses.

We are currently monitoring many other bills of interest to clinical social workers in Maryland. Look for our June newsletter for final decisions on these and other bills.