March 27, 2020
The government is temporarily easing HIPAA enforcement regarding teletherapy tools. How can social workers use the new flexibility, and still comply with ethical and legal standards?
Normally, HIPAA requires providers to use fully compliant video platforms and to enter a Business Associate Agreement (BAA) with the platform provider (e.g., Skype for Business; Updox; VSee; Zoom for Healthcare; Doxy.me; Cisco Webex Meetings; Amazon Chime; GoToMeeting; and Google G Suite Hangouts Meet)*. This is still the best practice.
However, during the COVID-19 emergency, you may use any other "non-public facing" video chat apps (e.g., Facebook Messenger, Apple FaceTime, Skype, Google Hangouts)* and omit the BAA, without facing HIPAA violations. These platforms use end-to-end encryption to safeguard protected health information or PHI.
When using these tools, you must:
- Enable all available encryption and privacy modes when using those applications.
- Obtain informed consent for telemental health, including notice of potential privacy risks.
- Remember that legal and ethical privacy and confidentiality rules still apply to telemental health.
- Practice only within your area of competence.
- Be aware of cultural and socioeconomic differences among clients and how they may use electronic technology. Assess cultural, environmental, economic, mental or physical ability, linguistic, and other issues that may affect the delivery or use of these services.
- Consider a client's right to self-determination.
* NASW does not currently endorse any video platform. These examples are provided by the U.S. Department of Health and Human Services.
Please note that this information does not constitute legal advice and is provided for educational and informational purposes only; it is not a substitute for advice of counsel.
March 25, 2020
How will the proposed federal stimulus packages affect social workers and their clients?
As you may know, the White House and Congress have in the last two weeks moved swiftly to enact legislation to respond to the COVID-19 pandemic. They are currently negotiating a third legislative package, which is projected to include $2 trillion+ in economic stimulus and aid measures. The Senate bill is the Coronavirus Aid, Relief, and Economic Security Act or the "CARES Act" (S. 3548). The House bill is the Take Responsibility for Workers and Families Action (H.R. 6379). Bipartisan negotiations will continue over the coming days.
NASW issued an action alert on March 23 to mobilize members around this developing relief package. Specifically, we want Congress to make sure it provides:
- Support for child welfare, mental health and behavioral health providers who are providing essential services to new and existing clients.
- Sufficient relief to poor and working-class families, including access to paid leave and long-term unemployment benefits.
- Immediate access for child welfare, mental health and health care workers to vital personal protective equipment.
- Access for Medicare beneficiaries to telehealth services using phones that are audio-only and do not have video chat apps. Last week NASW and the American Psychological Association sent a joint letter to Congress to Congress urging Medicare to reimburse audio-only telehealth services during the pandemic.
- Charitable nonprofit eligibility for loan and other economic relief, as these entities are on the front lines responding to the crisis.
NASW also is a member of the Coalition on Human Needs, which sent a letter to Congress around our urgent priorities for the legislative package now under consideration. NASW participates in this and many other coalitions working to promote equitable relief packages.
March 23, 2020
Is NASW working to change national policies affecting social
workers and their clients during the coronavirus pandemic?
NASW is committed to supporting
you and the clients you serve during this unprecedented public health
crisis. We are working on all fronts to respond in a way that best
reflects our shared social work values. In an
NASW statement issued on March 20, we are pleased with the
recent federal actions taken to provide economic relief as well as new
healthcare services to combat the pandemic.
We are especially pleased with
the significant expansion of telehealth in Medicare, given that older adults
are the most vulnerable to the virus. Teletherapy can now be done via
cell phone, with clients in their own home, using everyday video chat apps.
Our next big advocacy goal is to
get reimbursement approved for audio-only telephone sessions. A letter
was sent to Congress last week, and many of our 55 chapters are taking similar
action to secure this expansion for Medicaid and commercial payers.
We are pleased that so many of
you can join our free March 23 webinar about these changes. Due to overwhelming
interest, registration for the live webinar filled within 24 hours. If you were
unable to register, you can access the recording of the event through the
NASW CE Institute,
where it will remain free to members. We will post it as quickly as