Public Health Committee
March 29, 2021
Submitted by: Stephen Wanczyk-Karp, LMSW
On behalf of the National Association of Social Workers, representing over 2,300 members statewide we offer these comments and recommended changes to raised bill 1086.
SECTION 1
Section 1 (b) we have a technical change that may actually belong in one of the technical revision bills. Line 12 & 13 lists “an independent social worker certified pursuant to chapter 383a” (CISW). The title independent social worker was used from 1985-1995 until the clinical licensure of social workers was codified into statute. The CISW was at that time changed in statute to Licensed Clinical Social Worker (LCSW) however we now see that this did not happen for Section 19a-14c of the CGS. The correct title needs to read “Licensed Clinical Social Worker pursuant to chapter 383a. We recommend that only the LCSW and not the Licensed Master Social Work (LMSW) be in the statute.
The bill eliminates section (c) that requires a reassessment of the minor’s situation that would continue to require treatment without parental or guardian notification, involvement or consent. Practice standards for social work calls for parental/guardian involvement unless such involvement will be detrimental to the minor, in which case the social worker will work towards creating a safe environment and will encourage the minor to involve parents or guardians. We find that requiring a reassessment of whether the minor should continue to be treated without parental/guardian notification, involvement or consent is a reasonable provision that protects both the minor and the provider. We do not support elimination of this requirement to reassess the minor’s circumstances, however recommend that the up to 12 sessions, instead of 6, be allowed before requiring the reassessment. Six sessions are a very short period whereas doubling the amounts of sessions is a more reasonable period of time of treatment.
SECTION 2
This section calls for physicians, physician assistants and APRNs to perform a mental health examination on a patient at the time of the patient’s annual physical exam. We have concerns as to such a mandate without any further guidance. First of all, we are not convinced that these providers are adequately trained in mental health. Secondly, the questions of what the actual examination tool will be, who will develop it, and whether age and ethnicity will demand various assessment tools need to be specified. Thirdly, what happens if the examination determines that mental health treatment is appropriate and needed? Will the provider be required to maintain an up-to-date list of community-based resources? Will the provider be required to refer the patient? Section 2 simply leaves too many unanswered questions for us to support it at this time. We recommend that the Public Health Committee work on ways to incentivize and advance the provision of integrated health care where physical and mental health providers are collaborating within the same practice setting.
We thank the Public Health Committee for consideration of this testimony and recommendations.
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