September 8, 2022

As those of you who have attended the CSWA webinars on the Social Work Compact know, there is one more week to send your comments to the Council of State Governments on the draft document. Please visit the CSWA website to see information on the Social Work Compact.

To see the whole draft document, please visit https://compacts.csg.org/compact-updates/social-work/.

To send comments on the draft document, please visit https://www.surveymonkey.com/r/socialworkcompact.

The final date for sending comments is close of business on September 16, 2022.

Let me know if you have any questions.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

September 2, 2022

On August 5, 2022, the Association of Social Work Boards (ASWB) published data on pass rates for the Clinical Social Work Examination, which it oversees, as well as data on the other three levels of social work licensure (2022 ASWB Exam Pass Rate Analysis for Social Work Licensing Exams [aswb.org]). Publication of this initial data was long overdue. The noted disparities in pass rates, which vary by almost 40% for white and Black social workers were striking. Here CSWA provides historical context and suggestions for steps ahead.

History of Clinical Social Work Licensure

The clinical social work examination has been the national standard for independent clinical practice since 1950 when ASWB (formerly AASWB) began creating examinations and states began licensing clinical social workers (formerly called psychiatric social workers), beginning with California. As clinical licensure became the norm over the next 54 years (the last state to achieve licensure was Michigan in 2004), the profession established a general standard for licensure based on four elements: 1) obtaining an MSW at an accredited school of social work; 2) having 2-3 years of supervised experience, post-MSW; 3) passing the ASWB Clinical Examination; and finally, 4) having a social work licensure law approved by each state legislature and overseen by each state’s Board of social work. All four areas have different oversight mechanisms and little connection to each other. Correspondingly, there are no two states that have the exact same standards.

There is now a nationwide patchwork system which makes transferring licensure from one state to another problematic. The Council on Social Work Education (CSWE) has overseen schools of social work, but the standards for doing the work that leads to an MSW are quite elusive. Similarly, specific standards for supervised experience vary widely across the states.

Clearly, clinical social work is a young profession. LCSWs were approved to provide psychotherapy through Medicare in 1965, yet, there has been much fragmentation in the field. Efforts to standardize and integrate all parts of clinical social work were understandably set aside by stakeholder organizations in favor of creating licensure in all states and jurisdictions and achieving vendorship for clinical social workers.

Next Steps

There has been a widespread condemnation of ASWB for withholding information about the pass rates and/or being indifferent to the way that the clinical exam has yielded disparate pass rates for BIPOC and older clinical social workers. CSWA is in discussions with the new ASWB Executive Director, Stacey Hardy-Chandler, PhD, about the ways that ASWB, CSWA, and other stakeholders can work together to improve not only the clinical examination, but also the collective preparation of pre-licensed social workers to ensure an equitable exam experience. To this end, ASWB has also issued a statement about their intentions following the release of their report, which includes the following:

Need for the Clinical Examination

CSWA is aware of strong opinions of many, including LCSWs, that the clinical examination should be eliminated. There are three key reasons that CSWA does not support this idea:

1. In order to practice independently, LCSWs need to substantiate they have sufficient expertise to practice psychotherapy independently. The examination is a primary means of assessing that ability.

2. Passing the examination is written in to each states’ and jurisdictions’ laws and regulations.

3. The Social Work Compact, currently in development, which would allow LCSWs more flexibility to work in states with a multi-state license, will require LCSWs to pass a national examination.

Summary

CSWA believes that ASWB is now poised to attend to the inherent inequities exposed in the ASWB Clinical Examination process. We hope to work with ASWB toward that goal and encourage others to do so as well. Additionally, CSWA will press forward to advocate for meaningful integration of our education programs and licensing boards, efforts that can significantly impact ways the clinical examination is approached and regarded.

Contacts:

- Kendra Roberson, PhD, LICSW, CSWA President

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

August 6, 2022

Earlier yesterday I sent you the BetterHelp statement which said that they were ending their connection to CareDash.

Now I am pleased to send you the news that CareDash is backing off their harmful stance toward clinical social workers in private practice, as well. While there are still some problems to be resolved, CareDash has 1) stopped their deliberate confusion about LCSW availability; 2) removed their “book an appointment” option which directed potential patients away from LCSWs who were not part of the CareDash network; and 3) clarified that their information comes from the NPI list of clinicians and has nothing to do with the quality of those clinicians. 

I am fairly certain that the outstanding response of CSWA members to the demeaning policies of CareDash had a major impact on their decision to back off their original stance. Thanks to all of you for your great contributions to this effort.

CSWA will continue to insist on the rights of all LCSWs in private practice to have access to all patients who want to see them without interference by any external organizations.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

August 5, 2022

Here is a link to an article published today in Bloomberg Law today about the CareDash situation which mentions CSWA:

https://www.bloomberg.com/news/articles/2022-08-05/shadow-profiles-from-therapist-directory-spark-startup-backlash?sref=yqJvNODh

Keep sending your complaints to your state consumer protection agencies and the FTC.

Let me know when you have sent them, as always.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

August 4, 2022

Update on CareDash

Here is an update on the CareDash/BetterHelp fiasco. Many members complained to CareDash and received the following form letter:

Sarah (CareDash)

Aug 2, 2022, 15:43 ADT

Hello,

Thanks for reaching out to CareDash! As a mental health provider, we understand your concerns regarding the importance of protecting your privacy and would be happy to help remove any personal information. We permit the redaction of a personal phone number or address and can flag profiles as retired or deceased, as needed. However, CareDash's policy is not to remove a profile since this information is of the interest to the general public.

While we provide information on healthcare providers and practices by aggregating information from various public sources, such as the NPI Registry, it is most important to us that you and your practice are appropriately represented on CareDash. The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.

We'd be happy to help you update your profile to ensure you and your practice are appropriately represented on CareDash. We permit the redaction of a personal phone number or address and can flag profiles as retired or deceased, as needed.

We've created this guide on how you can protect your privacy: https://www.caredash.com/articles/how-health-care-providers-can-protect-their-privacy. At CareDash, we're deeply committed to protecting the privacy of providers and keeping our data accurate, so please let us know if we may be misrepresenting you or your practice in any way in order for us to correct it immediately. The easiest way to ensure your data stays up-to-date is for you to take control of your profile by claiming and updating it on CareDash. Please follow the simple instructions here: https://www.caredash.com/portal.

Lastly, please visit the NPI Registry to edit the source of the public information we use: https://npiregistry.cms.hhs.gov. Many sites use this data and you may have accidentally placed personal information when registering for your NPI. Our team will periodically update our data to match what's in the NPI Registry if you choose not to claim and update your profile today. Please check back in a few weeks for your changes to be in effect.

Kind Regards,

Sarah B.

CSWA regards this letter as disingenuous, since the issue is not just where CareDash found all our information, the NPI list, but how they are using it to restrict access to our services. CSWA has also discovered that CareDash is connected to Teledoc and Nufit Media, which we are looking into.

Several members suggested that CSWA consider filing lawsuits against CareDash. We are exploring this possibility with attorneys, are examining what the legal issue or issues might be (restraint of trade, kickbacks, possibly) and are determining the feasibility of filing a lawsuit (class action, through attorneys general, etc.). In addition, we are working with PsiAN to send a letter to the FTC.

Several members have reported that they sent letters to NPR and other groups that use BetterHelp as a sponsor objecting to the policies of CareDash and BetterHelp.

Please continue to send your individual letters to your state attorney general and the FTC about your objections to CareDash and BetterHelp policies. They have already made a difference in Maryland where the consumer protection department at first refused to look into the situation but changed its mind after a flood of complaints.

I will be sending weekly updates about the progress being made and/or new actions to be taken. Thanks to the over 300 members who let me know they have sent messages on the subject. Please continue to let me know if you have done so.

I also urge you to join the discussion in the comments at this link.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

July 30, 2022

LCSWs at Risk: CareDash and BetterHelp

CSWA would like to call to your attention a duplicitous practice which a company called CareDash is engaging in. CareDash has partnered with BetterHelp to drive potential patients to CareDash or BetterHelp affiliated therapists. It has gathered information about thousands of LCSWs and other clinicians to direct them to CareDash or BetterHelp affiliated clinicians without the permission of the non-affiliated LCSWs listed.

If the LCSW is not affiliated with BetterHelp, CareDash will say that there is no way to connect with them through CareDash, without directing them to the website of the LCSW, or noting that this is an active licensed clinical social worker. CareDash receives a commission for all patients referred to BetterHelp.

CareDash also has its own list of LCSWs which they will only use for referrals if an LSCW affiliates with them. These practices could significantly reduce the ability of patients in gaining access to LCSWs who are not connected to CareDash or BetterHelp. Please note that if you are not on the CareDash list, patients will be directed to BetterHelp. CareDash at this point refuses to take anyone off their list who is not officially connected with them or BetterHelp.

There is little doubt that the CareDash list has been compiled from public lists such as NPI, insurers, and others, then made to look as if the LCSWs listed are not being artificially limited by CareDash.

Here is what CareDash said about me:

About

Laura W. Groshong LICSW (she/her) is a clinical social worker in Seattle, WA.

For new and existing patients, please see recommendations on how to schedule an appointment with Laura Groshong online. As a clinical social worker, she may specialize in Anger Management and Anxiety, in addition to other issues.

Laura Groshong got her license to practice in Washington.

If you want to see Laura Groshong, please contact her to book an appointment. You can also see how she compares to other clinical social workers in Seattle or get matched to an online therapy provider.

When anyone clicks on “schedule an appointment” or “book an appointment” they get the following message: “Laura Groshong has not provided a way to schedule online through CareDash. However, you could get connected with an online therapist or chat with our virtual assistant to get help finding a therapist.” There are then over 1000 mental health clinicians listed as “the best” clinicians in the Seattle area, all sponsored by BetterHelp, many of which offer 20% discounts for the first month.

Here is what CSWA recommends each member do to protect your practice:

1. Go to CareDash.com and see if you are listed as a member. Unless you are working for BetterHelp and want to remain on the CareDash list, send a complaint to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. You will need the CareDash corporate address which is 614 Massachusetts Ave., Ste 400, Cambridge, MA 02139, and the BetterHelp corporate address which is 990 Villa Street, Mountain View, CA 94041.

2. You may also file a complaint with your state attorney general consumer protection department. To find the location of your state’s consumer protection department go to https://www.consumerresources.org/file-a-complaint/.

3. A template for sending a complaint is found below:

I am a Licensed Clinical Social Worker writing to inform you that a company, CareDash, is unfairly restricting my practice as a clinical social worker. They have listed my professional information on their website without my permission and refer anyone who checks my name to another company, BetterHelp, or to their own list of clinicians. I do not wish to work with CareDash or BetterHelp. CareDash refuses to take my name off their list, claiming it is public information. Thus, CareDash is falsely marketing my services to generate online traffic for BetterHelp or itself, ultimately resulting in the selection of BetterHelp’s participating providers or its own, rather than me. This is a restriction of trade that should be stopped immediately.

CSWA encourages all members and affiliated societies to file complaints with the appropriate state and/or national organizations. Please let me know when you have done so.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

July 29, 2022

H.R. 4040, THE ADVANCING TELEHEALTH BEYOND COVID–19 ACT OF 2021

A bill passed the House yesterday which would allow Medicare to cover LCSWs and other mental health professionals for telemental health services until 2024, including audio only treatment. Additionally, the requirement that patients be seen in person every six months was eliminated. The vote was 416-12.

This is a huge win for CSWA, clinical social work, and all of the groups in the Mental Health Liaison Group that worked to get this bill passed. The bill now goes to the Senate where it is likely to pass, as long as it is brought to a vote.

All CSWA members should send the following message to their senators at https://www.senate.gov/senators/senators-contact.htm?OrderBy=state&Sort=ASC: “I am a member of the Clinical Social Work Association and a constituent. Please ask Speaker Schumer to bring H.R. 4040, The Advancing Telehealth Beyond Covid-19 Act of 2021, to a vote. Many patients struggling with mental health problems will be unable to get the help they need unless this bill is passed by the Senate. Thanks for your support on H.R. 4040.”

As always, please let me know when you have sent your messages.

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

July 19, 2022

July 16, 2022 was the roll-out date for ”9-8-8”, the new US network for people looking for help with suicidality or other emotional crises. This phone number is designed to be used for text or for telephone access to volunteers who will provide initial assistance to callers, then triage them to LCSWs and other licensed clinicians.

Ultimately, 9-8-8 will become the National Suicide Prevention Lifeline (1-800-273-TALK); the new number will be easier to remember and access. This older hotline will remain in effect for an as yet undetermined period of time while 9-8-8 becomes fully operational.

There is no question of need: there has been an exponential increase in suicides and suicide attempts since the pandemic began almost three years ago. Here is what LCSWs should know about the implementation of this new system.

Funding

The $400 million set aside in Federal funding for 9-8-8 is about half of what will be needed to fund the services in every state. So far, the only states that have provided the needed state funding are Colorado, Nevada, Virginia and Washington. Nine states have legislation in progress to provide this funding; 37 states have no plan to provide funding. CSWA encourages members to ask their state legislators to find the state funding for 9-8-8 so that it can be fully functional as soon as possible. To see what your state’s plan is for funding 9-8-8, go to https://reimaginecrisis.org/map/.

Current Statistics

How serious is the issue of suicide? Here are the number of suicides in the most recently recorded year, 2020:

• In 2020, the U.S. had one death by suicide about every 11 minutes
• Suicide was the leading cause of death for individuals between ages 10-34 in 2020
• Over 100,000 individuals died from drug overdoses in the nine months from April 2020 to the end of the year

While 2020 actually saw a decrease in suicides from 2019 overall (17.7%, https://suicidology.org/2021/04/02/2020data/), of grave concern is the fact that there was an increase for young adults and BIPOC communities of all ages in 2020 (https://www.webmd.com/mental-health/news/20211103/suicide-rates-2020-cdc) .

More Information

The Substance Abuse and Mental Health Services Administration has prepared a toolkit to further explain the need for 988. For FAQs and Fact Sheets, go to https://www.samhsa.gov/find-help/988/partner-toolkit. Also feel free to contact me for more information.

July 11, 2022

As you know, CSWA has been involved in the development of a Compact which would allow clinical social workers to practice in all states that join the Compact without having to become licensed in individual states. For the past 8 months, Laura Groshong, CSWA Director of Policy and Practice, and I have attended the Social Work Compact Technical Advisory Committee meetings monthly, sponsored by the Department of Defense and Council of State Governments.

A document for the Compact has been created which is now available for review by the public, including CSWA members. I encourage all CSWA members to attend one of the two webinars which will be held on July 30 at noon ET and September 8 at 3 pm ET for more detailed information on the Compact. Keith Buckhout and Matt Shafer of the Council of State Governments will be available to explain the process and answer your questions. Registration for these webinars will be on the website shortly.

Among the issues that will be addressed are:

To review the document before the webinars, go to https://compacts.csg.org/compact-updates/social-work/

To submit comments or feedback on the draft, please fill out the online survey at https://www.surveymonkey.com/r/socialworkcompact.

Please let Laura know if you have any questions and watch for an email later this week from our new Administrator, Angela Katona, regarding how to sign up for one of the two webinars.

- Kendra Roberson, PhD, LICSW, CSWA President

- Laura Groshong, LICSW, CSWA Director of Policy and Practice

July 8, 2022

CSWA members have expressed concerns about the way that companies like Betterhelp are providing a kind of mental health treatment based on texting. The lack of direct contact is cause for concern. The asynchronous nature of Betterhelp limits emotional communication.

A new article from California Healthline written by award-winning journalist Harris Meyer, has just come out and has echoed some of these concerns. The article, “Digital Mental Health Companies Draw Scrutiny and Growing Concerns”, can be found at https://californiahealthline.org/news/article/digital-mental-health-companies-scrutiny-concerns/.

Both Marlene Maheu, PhD, who presented a webinar on telemental health for CSWA, and Laura Groshong, CSWA Director of Policy and Practice, are quoted in the article.