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Social Workers and Disaster Relief Services
The NASW policy statement, Disasters, states that social
workers are “uniquely suited to interpret the disaster context,
to advocate for effective services, and to provide leadership in
essential collaborations among institutions and organizations” (NASW,
2003). In the aftermath of Hurricane Katrina social workers are
responding to the call to provide disaster assistance in the affected
areas, primarily Louisiana , Mississippi , and Alabama . While
NASW recognizes that social workers who practiced or lived in those
areas have also been affected personally and professionally by
the disaster, the focus of this Legal Issue of the Month article
is on the legal and ethical issues for social workers who provide
services to the hurricane survivors.
Social workers should note that guidelines, requirements, working
conditions, and administrative support for volunteering under the
auspices of specific organizations, programs, or government agencies
may vary. Interested social workers should investigate the details
of volunteer arrangements carefully and plan accordingly. Information
that is available about licensure requirements for social work
volunteers is presented here, and varies from state to state. Federal
programs have other standards for participation as health care
professionals.
Waiver by HHS of In-state Licensure and Other Federal Requirements
Pursuant to a Presidential Declaration of a major disaster in
Florida, Alabama, Mississippi, Louisiana, and Texas, Secretary
of HHS Michael Leavitt declared a public health emergency. Leavitt
issued a statement on September 4, 2005 waiving the requirement
that healthcare workers be licensed in the state where they are
providing services related to federal programs, as long as they
hold a valid license to practice in another state. These, and other
provisions are waived “ only to the extent necessary to ensure
that sufficient health care items and services are available to
meet the needs of individuals enrolled in the Medicare, Medicaid
and SCHIP programs and to ensure that health care providers that
furnish such items and services in good faith, but are unable to
comply with one or more of these requirements as a result of the
effects of Hurricane Katrina, may be reimbursed for such items
and services and exempted from sanctions for such noncompliance,
absent any determination of fraud and abuse” (HHS, September
4, 2005). The waiver also temporarily lifts certain provisions
of the HIPAA Medical Privacy Regulations relating to notification
of family members and friends, requests for restrictions on confidentiality,
and the requirement to provide a Notice of Privacy Practices. To
review the complete details of the statement, see references below.
State Social Work Board Licensure Standards for Disaster Volunteers
Alabama
The Alabama Board sent a request for an order from the Governor
permitting an exemption to the usual licensure requirements for
volunteer social workers entering the state. Volunteer social workers
placed in Alabama should receive information from the agency responsible
for their placement, as these groups are in contact with the Board.
Updated information about this will be posted on the Alabama Board’s
Web site, referenced below.
Louisiana
The Louisiana State Board of Social Work Examiners has provided
up-to-date information concerning the licensure requirements for
volunteer social workers entering the state who are licensed to
practice other states. As of September 8, 2005 the Louisiana Board
had published the following statement:
Social workers actively licensed in other states that want to
assist others that have been affected by the hurricane can practice
in Louisiana , for a maximum of 60 days, without applying for a
license under La. R.S. 37:2722.C. This statute reads as follows, “An
individual licensed to practice social work in another jurisdiction
who is providing services within the scope of practice designated
by such license and in response to a disaster declared by the appropriate
authority or governor of the state may, upon prior written notice
of the board, provide such services in this jurisdiction for a
period of time not to exceed sixty consecutive days per year without
applying for a license. The practitioner who provides services
under this Subsection shall be deemed to have submitted to the
jurisdiction of the board and be bound by the laws of this state.”
While the statute allows a person to work up to 60 days in the “state
of emergency” the Governor declared the state of emergency
from August 26 th through September 25 th which is less than 60
days. Therefore, a person that is licensed in another state
could only provide services during the time that the emergency
is declared.
Those that are accepting permanent employment in Louisiana ,
must be credentialed by the Louisiana State Board of Social Work
Examiners within 120 days of accepting employment.
Additional information about Louisiana social work licensure renewals
and verification is provided on the NASW-LA Web site, noted below.
Renewals
The board accepts renewals through November
30th without penalty. All
renewals postmarked on or after December 1st are subject to a late
renewal fee. Renewal forms can be downloaded from the board’s
website under “Forms and Lit.” If you did not
have your renewal postmarked by August 31, 2005, we do not consider
your social work credential lapsed or inactive.
Verifications
Verification of your social work
credential can be obtained from this site at “Database Search.”
Mississippi
As of this writing, the Mississippi Board has not yet developed
standards for licensure for out-of-state social work disaster volunteers
who enter Mississippi. Interested social workers may contact the
board directly using the contact information provided on the Web
site, referenced below.
Texas
Although the Texas State Board of Social Work Examiners does not
provide an exemption from licensure requirements, it is processing
requests for licensure on an expedited basis for social work evacuees
and for social work volunteers seeking to activate their licenses
or to enter the state in order to assist hurricane survivors who
have arrived in the state (NASW-TX). According to the Texas Board,
these expedited requests are being processed in one day, in many
instances.
Licensure and Liability Issues for Federal Volunteers
The U.S. Department of Health and Human Services Office of the
Surgeon General and the Office of Public Health Emergency Preparedness
has posted an Internet notice indicating a particular need for
social work volunteers in the areas affected by Hurricane Katrina.
Information posted by HHS states that volunteers in this program
will have an unpaid, temporary “federal employee” status,
and that licensure in any state will qualify a social worker to
practice in any area where the unpaid temporary employee is deployed.
HHS states that workers will “ be eligible for coverage under
the Federal Tort Claims Act for liability coverage and Workman’s
Compensation when functioning as HHS employees” (HHS, 2005).
These provisions apply specifically to the volunteer program organized
under the auspices of HHS, noted in the reference below. Volunteers
have the opportunity to submit applications online.
Client Confidentiality During Disaster Relief
According to the recently-issued HHS bulletin, HIPAA permits
disclosure without client consent for a number of purposes during
emergency situations, including provision of treatment, notification
of relatives and family members, to prevent imminent danger, and
to publish facility directories.
The standard permitting disclosure of confidential information
to prevent imminent harm is similar to the standard in the NASW
Code of Ethics, which permits disclosure to prevent serious,
imminent, and foreseeable harm to the client or other identifiable
individual. The HIPAA standard is as follows:
IMMINENT DANGER. Providers can share patient
information with anyone as necessary to prevent or lessen a serious
and imminent threat to the health and safety of a person or the
public -- consistent with applicable law and the provider’s
standards of ethical conduct (HHS Office of Civil Rights, 2005).
Social workers providing assistance during periods of emergency
will need to take into account the surrounding circumstances to
determine whether the ethical standards have been met in instances
where it is not possible to obtain client consent to disclosure.
NASW and Disaster Relief
The NASW Foundation has created a Social Worker Disaster Assistance
Fund to receive contributions to assist social work colleagues
in the areas affected by Hurricane Katrina (NASW, 2005). NASW’s
National Office has been communicating regularly with chapters
on the Hurricane Katrina aftermath and the needs of NASW members.
Two key publications are available from the NASW Press: Pocket
Guide to Essential Human Services, and When Their WorldFalls Apart,
Helping Families and Children Manage the Effects of Disasters.
Many NASW Chapters have organized to provide timely information
and opportunity for social workers interested in providing disaster
assistance, such as offering opportunities for social workers to
participate in Red Cross training programs. Some chapters have
initiated standing committees to address relevant disaster related
issues. For example, the Massachusetts Chapter has a Social Work
Disaster Resource Network (SWDRN) Committee, formed after the events
of September 11, 2001 , that provides a focus for disaster relief
education, planning, and activities (NASW-MA).
Conclusions
Social workers responding to the call for disaster relief services
should be aware of the various legal and regulatory requirements
applicable to their practice when working outside the usual areas
of professional services. Notably, applicable licensing requirements
must be reviewed and social workers should follow the Code of Ethics
and practice guidelines to provide professional services within
their areas of competence. Where necessary, social workers should
seek training and guidance in order to provide competent emergency
and disaster relief services.
References
-
- National Association of Social Workers. (2003). Disasters. Social
work speaks: National Association of Social Workers policy
statements, 2003–2006 (6th ed., p.83). Washington,
DC: NASW Press.
- National Association of Social Workers (2005). NASW Foundation
establishes a social work disaster assistance fund [Online].
Retrieved from http://www.socialworkers.org/swdrf/letter.asp on
September 12, 2005.
-
- National Association of Social Workers, Louisiana Chapter (2005). NASW-LA
chapter HurricaneKkatrina information - 09/08/05 [
Online]. Retreived fromwww.naswla.org on
September 12, 2005.
- National Association of Social Workers, Texas Chapter (2005). Hurricane
Katrina relief efforts, emergency licensing information [Online].
Retrieved from http://www.naswtx.org/Katrina.htm#Emergency_Licensing_Information on
September 12, 2005.
-
- U.S. Department of Health & Human Services (2005). Health
care professionals and relief personnel worker page [Online].
Retrieved from https://volunteer.ccrf.hhs.gov/ on
September 12, 2005 .
- U.S. Department of Health and Human Services Office for Civil
Rights ( September 2, 2005 ). Hurricane Katrina bulletin: HIPAA
privacy and disclosures in emergency situations [Online].
Retrieved from http://www.hhs.gov/ocr/hipaa/KATRINAnHIPAA.pdf on
September 12, 2005.
-
- U.S. Department of Health & Human Services ( September 4, 2005
). HHS declares public health emergency for Hurricane Katrina [Online].
Retrieved from http://www.hhs.gov/katrina/ssawaiver.html on
September 12, 2005 .
Key State Social Work Boards
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The information contained in this Web
site is provided as a service to members and the social work
community for educational and information purposes only and
does not constitute legal advice. We provide timely information,
but we make no claims, promises or guarantees about the accuracy,
completeness, or adequacy of the information contained in
or linked to this Web site and its associated sites. Transmission
of the information is not intended to create, and receipt
does not constitute, a lawyer-client relationship between
NASW, LDF, or the author(s) and you. NASW members and online
readers should not act based on the information provided
in the LDF Web site. Laws and court interpretations change
frequently. Legal advice must be tailored to the specific
facts and circumstances of a particular case. Nothing
reported herein should be used as a substitute for the advice
of competent counsel.-
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