CMS Rule Criticized by NASW

— Heidi Sfiligoj, News Staff


New changes to personnel requirements for social work jobs in hospice settings went into effect on Dec. 2, but not without garnering criticism from NASW.

In a July 7 letter to Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, NASW Executive Director Elizabeth J. Clark opposed the final rule for the Medicare Hospice Conditions of Participation. The rule defines personnel qualifications for social workers as having an MSW with one year of experience or a bachelor's degree in social work, psychology, sociology or other related field, as well as one year of experience. Past regulations mandated an MSW or BSW.

"NASW is extremely disappointed with these newly amended personnel qualifications for social work . . . [T]he critical nature of end-of-life care necessitates intensive interventions requiring the expertise of a qualified professional social worker," Clark wrote.

The new rule further states that anyone with a bachelor's degree doing hospice social work, whether they have a BSW or a baccalaureate degree in another field, has to be supervised by a qualified MSW. This does not apply, however, to BSWs who were hired by hospices before Dec. 2.

According to the rule, the supervising MSW must be an active adviser and supervision may occur in person, over the telephone, or through electronic communication. The rule does not specify, however, how frequently supervision should be provided or how long it should last.

NASW sent an earlier letter to CMS in 2005, when the proposed rule was up for public comment. "Hospice workers should be licensed and trained at the master's level . . . NASW opposes any designation of a social worker that includes bachelor's-level workers in a discipline other than social work," Clark wrote in the 2005 letter.

"We maintain that MSWs and BSWs have a body of knowledge, skills and competence distinct from graduates of non-social work programs and that such preparation is essential to ensure quality hospice care," the July 7 letter concluded.