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THE NEW SOCIAL WORKER® Social Work E-News
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Issue #102, May 12, 2009
Don’t Miss—Chat TONIGHT May 12, 9 p.m. Eastern Time at http://www.socialworkchat.org – Topic: Private Practice Nuts and Bolts, with host Mila Tecala
EDITOR’S EYE
Dear Social Work Colleagues,
Welcome to Issue #102 of the Social Work E-News! This e-mail newsletter is brought to you by the publisher of THE NEW SOCIAL WORKER magazine, SocialWorker.com, SocialWorkJobBank.com, and other social work publications.
May marks the observance of Mental Health Month, National Foster Care Month, National Teen Self-Esteem Month, and Older Americans Month, among others! Also, special weeks and days this month include Older Americans Mental Health Week (May 24-30), National Women’s Health Week (May 10-16), and HIV Vaccine Awareness Day (May 18). Coming in June: Gay and Lesbian Pride Month, International Men’s Month, and Professional Wellness Month.
In observance of Women’s Health Week, I am asking you to join me in the Woman Challenge. I have created a team especially for social workers…The New Social Worker’s Woman Challenge Team. See article under “Features” below.
It’s Mental Health Month. I recently saw the movie, The Soloist, and am now reading the book. This story fits right in with Mental Health Month, as it is a true story of how mental illness changed one’s man life. Want to read the book with me? Join my new book club! See article under “Features” below.
In today’s economic climate, some social workers and other therapists are turning to collection agencies. What do you think about this practice? John Riolo has written an article on this, which appears in the “Features” section.
Don’t forget—the Spring issue of THE NEW SOCIAL WORKER is now available on our Web site! Go to http://www.socialworker.com to read the articles from this issue in Web format. You can also download this issue (and others) of THE NEW SOCIAL WORKER magazine in PDF format FREE at http://www.socialworker.com/home/component/remository/Download/TheNewSocialWorkerMagazine/TheNewSocialWorkerVol.16No.2(Spring2009)/
You can now go to http://www.socialworker.com/home/menu/Subscribe/ and subscribe (free) to receive an e-mail reminder and table of contents of each issue of THE NEW SOCIAL WORKER magazine when it is available.
In the Spring 2009 issue of THE NEW SOCIAL WORKER, we introduced our new technology columnist, Karen Zgoda, who writes the “SW 2.0” column. See her first column, a review of CaringBridge.org, at: http://www.socialworker.com/home/Feature_Articles/Technology/CaringBridge%3A_A_Valuable_Tool_for_Social_Workers_and_Those_With_Critical_Illness/
You can read THE NEW SOCIAL WORKER’s blog at: http://blog.socialworker.com – T.J., Karen, and I are posting on the blog. Please be sure to leave your comments. You can also subscribe to receive new blog posts by e-mail or in a feed reader. We recently added a “Share” button on our blog, too, so you can easily e-mail our blog posts to friends or share them on Facebook, Twitter, and a variety of other social media.
And…you can follow THE NEW SOCIAL WORKER on Twitter, too! Go to http://www.twitter.com/newsocialworker to read our latest updates and follow us, so you don’t miss out on anything! We tweet new social work job postings, new blog posts, and more!
The Social Work E-News has 26,100+ subscribers, and thousands of social workers (and people interested in social work) visit our Web sites. If you like our Web sites, The New Social Worker, and the Social Work E-News, please help us spread the word! Tell a friend, student, or colleague to visit us at http://www.socialworker.com, where they can download a PDF copy of the magazine, become our fan on Facebook, participate in discussions, and lots more.
Until next time,
Linda Grobman, ACSW, LSW
Publisher/Editor
THE NEW SOCIAL WORKER®
mailto:linda.grobman@paonline.com
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IN THIS ISSUE
Words From Our Sponsors
Features
Job Corner/Current Job Openings
Letter to the Editor
News & Resources
On Our Web Site
In Print
Newsletter Necessities
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WORDS FROM OUR SPONSORS
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NEED BOOKS OR GIFTS? The publisher of THE NEW SOCIAL WORKER has some great books that make great gifts for yourself or someone else. Give the gift of Days in the Lives of Social Workers, The
All of our books are available through our secure online ordering system at:
http://www.socialworker.com/home/blogsection/Publications/
You can also download our catalog in PDF format at:
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FEATURES
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Aggressive Debt Collection – Is it the Answer in Today’s Economic Climate?
By John A. Riolo, Ph.D.
These days one hears regularly about people who have amassed staggering debt and are so deep in the financial hole that there appears to be no way they can get themselves out of debt. They may have mortgages that are worth more than their house, or they may have lost a job or run up debt resulting from medical or health care needs.
It’s understandable that some of these people will seek therapy to cope to deal with the stress of mounting debt that can take a toll on marriages and families. But what happens when the therapy itself adds to their debt and compounds their stress?
To the average working family, psychotherapy is not cheap. Even when provided by social workers who tend to charge less than other disciplines or even if some offer reduced fees, bills can mount up. Clients lucky to have insurance coverage are in a better situation, but there are often still deductibles and co-payments. We can argue that is why we need national health insurance. But even if we achieve that goal, there will still most likely be deductibles and co-payments, and of course, we don’t have national health insurance now.
In this economy, many of our clients—but also many of us—are hurting. Many social workers and psychotherapists are feeling the effects of this recession, also. One does not have to look far to find colleagues who face the very same difficulties of debt, foreclosure, and even bankruptcy.
Therefore, if our clients owe us money for our services, do we not have every right to collect what is due? Of course we do. In fact, in some cases we have a legal obligation to collect what is due. For example, we may not waive or fail to make a good faith effort to collect a patient’s co-payment or deductible except for documented and extraordinary reasons of hardship. This would be insurance fraud. But what is a reasonable and good faith effort in collecting fees, be they co-payments, deductible, or the balance?
Whenever this question is discussed among social workers and other therapists, the question of using collection agencies comes up. Is it ethical to use a collection agency? Is it true that if a social worker or other therapist uses a collection agency that doing so will increase the chances of a patient filing a malpractice suit or licensing board complaint against them? Or, as some social workers have claimed, is this a myth perpetrated by lawyers and risk managers who have a vested interest in creating fears of litigations to sell books and CE courses on ethics? Where, they ask, are the actual cases of therapists being sued as a result of using a collection agency, inferring that if there is not a direct correlation it must be okay.
The odds are that there are few, if any, licensing board complaints or litigations accusing clinicians of contracting with collection agencies, because in and of itself, that is not illegal or unethical. So even if a patient made such a charge, it would unlikely be heard.
There is ample evidence, however, that turning debt over to a collection agency can trigger a complaint or litigation. Dr. Ofer Zur, a psychologist who has also represented clinicians at licensing board hearings, states, “We have known the answer for that for decades. When (some) ex-clients are being harassed by a collection agency, they call the licensing boards and complain NOT about the collection, but about other things that involve sub-standard care—unfair change in fees, bad treatment, etc. Such complaints are often traumatizing to most therapists and can take years to resolve.”
Dr. Bryant Welch, a psychologist and attorney, stated he would not go so far as to say to never use them, but in calculating the cost-benefit analysis, one must consider that it can precipitate a complaint for an unrelated matter. Thus, if it is a small sum of money and/or the patient is potentially litigious, I would definitely not do it. Whether there is liability for illegal methods used by the collection agency is very fact dependent, but it is certainly a risk.
Social work ethics expert Frederic Reamer tells audiences of continuing education workshops, students, and others REPEATEDLY that fee disputes are high-risk territory and may trigger a complaint about other issues (e.g., alleged failure to treat properly, boundary violations). His standard advice is to handle fee disputes delicately, diplomatically, and skillfully; practitioners should do their best to avoid enraging clients/former clients with regard to fees.
It’s virtually unanimous among experts that using a collection agency is simply dangerous and may hardly be worth the risk.
Why, then, would debt collection trigger such a seemingly strong response from some patients that they would go so far as looking for things to file complaints to licensing boards about us? Are they borderline patients? Some might be, but not necessarily. To understand their motivation, we need to examine what happens how collection agencies collect debt.
First, the clinician often sees only a very small amount of return on debt turned over to collections. The most successful collection agencies rarely collect more than 50% of all debt, and they often keep a substantial percentage of what they collect. So a clinician is lucky to see much more than 25% of what was owed and, as often as not, nothing at all.
However, to the client who is the subject of debt collection, a number of adverse things occur. First, they can expect to receive dunning letters and phone calls that under the best of circumstances feel harassing. It would be understandable if they got angry about the person(s) who initiated the process.
The other thing it will do is wreak havoc with the client’s credit rating. That is the well known credit score that will determine if you can obtain credit for a mortgage, car, and so forth. and what interest rate you will have to pay if you get it. When one has debt turned over to collections, one can guarantee dunning and that it will have a negative impact on obtaining future credit. If little else, we have learned as a nation in our current economic crisis that whether we are a bank, an organization, an individual, or a family, credit is like life’s blood. Therefore, if we take any action that will have a negative impact on a client’s ability to obtain credit, we are potentially putting them and their family in peril, and they may interpret our action as a betrayal.
The above is true even if the collection agency acts legally and appropriately. However, for relatively small amounts of debt of which we at best will see only a fraction of what was owed, is it worth the damage? Clinicians have reported turning over debt of $200 and often less to collections. That means, at best, they might actually see $50-100, if the collection agency is successful. There is one documented case of a not-for-profit agency turning over a debt of $12.68 to a collection agency.
Legal? Yes. Ethical? Questionable. Appropriate, No!
The above is when the collection agency is acting legally and by their own ethical standards. But, can collection agencies be relied upon to act ethically even by their own standards, let alone ours? Can we even count on them to act legally?
Apparently not, according to an NBC Dateline exposé conducted by investigative reporter Chris Hanson. On March 27, 2009, Dateline aired a show depicting some of the disreputable tactics that, despite laws to the contrary, are common in the debt collection industry. These tactics include harassing phone calls at all hours, embarrassing calls to family members and employers, calls by agents impersonating law officers and attorneys, and threats that included one woman being asked if she knew what it felt like to be raped.
Hanson used hidden cameras to document collection agents admitting to tactics such as the above and claiming that the chances of getting caught was minimal. When the head of the trade association of collection agencies was shown the tapes, she expressed shock, but admitted that complying with the law was an apparent problem for the industry. This would be like Betsy Clark of NASW being forced to admit that a substantial number of social workers were dishonest.
Even if one did find a collection agency that acted legally and responsibly, debt is a commodity. Like mortgages, it can and often is sold to third parties for collection. That makes it virtually impossible for a clinician to have any assurances that debt they turn over to collection agencies will be handled in a manner that respects the dignity of the client.
It then becomes understandable why clients might feel betrayed by their therapists and then reexamine their entire treatment and perceive other evidence of bad treatment. They are not necessarily borderline, but may be simply hurt and angry and fight back in any way available to them.
A question for another article is why any therapist would allow debt to mount up in the first place. It’s bad clinical and ethical practice.
John A. Riolo, Ph.D., is the editor of Civil Discourse Blog, The Insider, Your Advocate Online, Law and Ethics In Mental Health , and Listen to The Insider Podcast Series.
Read this article on THE NEW SOCIAL WORKER’s Web site at: http://www.socialworker.com/home/Feature_Articles/Professional_Development_%26_Advancement/Aggressive_Debt_Collection_%96_Is_it_the_Answer_in_Today%92s_Economic_Climate?/
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Women’s Health & the Woman Challenge
This week, May 10-16, is Women’s Health Week. You can read all about it at: http://www.womenshealth.gov/whw/
One aspect of the observance of Women’s Health Week is the kick-off of the Woman Challenge, which is a campaign to encourage women to get at least 2½ hours of moderate intensity aerobic activity per week. The challenge lasts 8 weeks, beginning May 10. (Okay, it already started, but it’s not too late to catch up! Actually, the site gives you the option to start at a later date.)
I signed up for the challenge myself yesterday. So, here’s my challenge to you.… Go to http://www.womenshealth.gov/woman/woman-challenge/ and register for the challenge. Then click “Join a team” and find “The New Social Worker’s Woman Challenge Team.” Sign up for our team and join the challenge with me! (If you can't find the team, let me know, and I'll send you an invitation.)
Are you up for the challenge? It’s always more fun and motivating as a group. And as social workers, we know that self care is so important. It appears that men are welcome to join the challenge, too! Let’s see what we can do when we join together as a group of social workers. I’ll report on the team’s progress in a future e-news.
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The Soloist—and introducing…Linda’s New Social Worker Book Club!
By Linda May Grobman, ACSW, LSW
The movie The Soloist, starring Jamie Foxx and Robert Downey, Jr., premiered on April 24. I went to see it the first night it was in the theaters. I had heard about this true story of homelessness, mental illness, music, and friendship about a year or so ago on NPR. Steve Lopez, a columnist for the LA Times, happened upon a homeless man one day…a homeless man playing a 2-stringed violin. When he learned that the man, Nathaniel Anthony Ayers, had once been a student at Juilliard (the prestigious
It took time for Ayers to open up to Lopez, and as he did, his story unraveled to reveal a once-promising young musician who, in his early 20s, began to show symptoms of serious mental illness.
Once Lopez’s column on Ayers was published, the public response to it was incredible. People began to offer to help Ayers in different ways, and Lopez’s relationship with Ayers transformed into something deeper than that typical of a columnist and his subject.
This story is just so wonderful on a lot of levels. And the movie isn’t just a movie…there is also a nonprofit foundation in Ayers’ name to support arts programs for people with mental illness. (See http://www.naayers.org.) There is a Web site associated with the movie that encourages the public to learn and do more about the issues this story entails. (See http://www.takepart.com/thesoloist/.) A number of people in the movie were actual homeless people, playing themselves. You can go online and find out more about the real Nathaniel Anthony Ayers, and you can read the original articles written by Lopez in the LA Times. NAMI has developed an entire Web site devoted to Ayers’ story, as well, at http://www.nami.org/soloist.
I was intrigued by this story and I am now reading the book, The Soloist, by Steve Lopez. Want to read it with me? It will be the first selection for what we’ll call “Linda Grobman’s The New Social Worker Book Club.” Go to Amazon and get it for only $3.99. (This link will take you directly to The Soloist’s page.) Let me know if you are reading it, and I’ll let you know when we have set up a time and place to discuss it online!
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Older Americans Month By the Numbers: May 2009
A meeting with the National Council of Senior Citizens resulted in President John F. Kennedy designating May 1963 as Senior Citizens Month, encouraging the nation to pay tribute in some way to older people across the country. In 1980, President Jimmy Carter’s proclamation changed the name to Older Americans Month, a time to celebrate those 65 and older through ceremonies, events, and public recognition.
37.9 million
The number of people 65 and older in the
By 2050, the projected population of people 65 and older is 88.5 million, or 20% of the total projected population. By midyear 2009, the world population 65 and older is projected at 518 million, with that number increasing to 1.6 billion by 2050.
Median 2007 income of households with householders 65 and older is $28,305, statistically unchanged, in real terms, from the previous year. The poverty rate for people 65 and older in 2007 was 9.7%, statistically unchanged from 2006. There were 3.6 million seniors in poverty in 2007, up from 3.4 million in 2006. The median net worth for families in 2004 whose head was between 65 and 74 was $190.100.
Jobs
5.8 million
Number of people 65 and older who were in the labor force in 2007. Projections indicate that by 2016, the number will reach 10.1 million.
Living Arrangements
Sixty-five percent of people 65 and older in 2007 lived with relatives. Another 27 percent lived alone, while 5 percent lived in group quarters and 2 percent in a household with nonrelatives. In addition, 6 percent lived in their children’s home.
One and a half million people 65 and older lived in nursing facilities in 2007. These residents comprised 4 percent of all people in this age group.
Population Distribution
Nation
73
The number of men 65 and older on July 1, 2007, for every 100 women in this age group. For those 85 and older, it drops to 48 men per 100 women.
5.5 million
The number of people 85 and older in the
96,548
Estimated number of centenarians in the
601,000
Projected number of centenarians in the
For more information, see http://www.census.gov.
If you are interested in working with the older adult population, check out Linda Grobman and Dara Bergel Bourassa’s book, Days in the Lives of Gerontological Social Workers.
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Youth in Foster Care Need Extra Public Support in Recessionary Times
May is National Foster Care Month
Today there are nearly 500,000 children and youth in
Each May, National Foster Care Month provides an opportunity to focus public attention on the plight and potential of children in foster care, as well as teens aging out. The child welfare community is calling on every citizen to do something positive that will change a lifetime for a child or young adult in foster care -- as foster parents, volunteers, mentors, employers, or in other ways.
If nothing changes in the
Thousands of dedicated foster families, caring individuals, and organizations already support young people in foster care. Thanks to these unsung heroes, many formerly neglected or abused children and teens will safely reunite with their parents, be cared for by relatives, be adopted by loving families, and/or make a successful transition to independent living.
Communities are urgently seeking many more unsung heroes to come forward for our nation’s most vulnerable children so they may realize their full potential. Across the country, people are:
Resources
Several national organizations provide advocacy and critical support for foster youth, including:
Casey Family Programs
Children’s Rights
Foster Care Alumni of America
Foster Family-based Treatment Association
FosterClub
National Association of Social Workers
National Foster Care Coalition
National Foster Parent Association
Orphan Foundation of America
Voices for America’s Children
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JOB CORNER
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Opportunity of a Lifetime - Social Work in
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NEW MASTERS LEVEL GRADUATES ARE WELCOME! Location:
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MILESTONES RANCH
Seeking dynamic, motivated, dependable, and experienced LCSW to help grow beautiful state of the art dual diagnosis treatment center in
Seeking that special person!!!
E-mail deeamige@aol.com or phone 818-879-9110.
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Find more jobs for new grads and experienced social work practitioners at http://www.socialworkjobbank.com, THE NEW SOCIAL WORKER’s online job board and career center. We are proud of the fact that this site was chosen as one of 350 (out of 40,000+ employment sites) to be included (for the third consecutive time) in Weddle’s Recruiter’s and Job Seeker’s Guide to Employment Web Sites 2007/2008. Post your confidential resume at http://jobs.socialworkjobbank.com/c/resumes/resumes.cfm?site_id=122
If you or your agency are hiring social workers, don’t forget to post your jobs on SocialWorkJobBank.com. Please check the SocialWorkJobBank “products/pricing” page at http://jobs.socialworkjobbank.com/r/jobs/post/index.cfm?site_id=122 for job posting options and SPECIAL offers.
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There are 1,071 jobs currently posted on SocialWorkJobBank.com. Check it out today.
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LETTER TO THE EDITOR
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Dear Editor:
I was fortunate enough to have worked with the Missionary Brothers of Charity shelter for families in
Maintaining the status quo is not easy during times of significant financial unrest and instability. But there is one significant ballot choice that looms on the horizon that, if approved, may decide the fate of hundreds of thousands of vulnerable citizens. The May 19, 2009, special election will allow voters to decide what will be best for those suffering from mental illness. They will decide to dismantle a program by borrowing $226.7 million this year to help balance the state’s budget and would reverse significant provisions of the MHSA in the future.
The Mental Health Services Act has proven to be successful. Proposition 1E would put all of our 200,000 (6 out of 100) California citizens who rely on public services in not only a no-win situation, but would leave them in a world of dangerous survival-of-the-fittest with few options for desperately needed care.
As President of the California Mental Health Director’s Association Wayne Clark explained, “Successful community mental health programs save state dollars in health care, homelessness services, law enforcement, and corrections costs over the long run.” This proposal would change the face of mental health funding for years to come.
Proposition 1E would literally close the door on people in our community who simply would have no other options for their survival. We would return to an antiquated system where costly hospitalization, homelessness, and imprisonment are the only choices for the mentally ill. The consequences would be unimaginable to these good citizens. Institutionalization would become a fact of life where choice is no longer an option for them. We will be placing our friends and family members in the unsafe position of “back to the future,” essentially turning back the clock on the remarkable progress of Prop 63 that has been made over the last five years for those in need of mental health services.
It would simply be wrong to assume that this misguided proposal can help right our financial woes by shifting our current budget problems on to the backs of those who can least afford it. Children, adults, and older citizens will no longer thrive in an environment of limited choices. I urge everyone with vision to let people who want to improve the quality of their lives have a fair shake. All of us can help give them that chance come May 19th.
I urge a “NO” vote on Prop 1E.
James McChesney Ranson
MSW Candidate
