Welcome!

 

A site for social workers and other professionals interested in new developments for patient care. Enjoy!

Courses!

Suicide Assessment, Intervention, and Management

The “Professional Will”  – Solo Practice and Group Practice

Pediatric Head Trauma 1.5 CEU

Teletherapy and Documentation 2.0

Social Work and KY Law 3.0

Next Ethics Webinar – Sept 8

A self-study course is available!

LCSW Supervision for New Supervisors in KY Law

The 6 hour course is required for new supervisors. LCSWs who have two years of practice can become supervisors in KY. 

Next Webinar is Oct 21, 2022 –  “Go to Courses” to register!

A Self Study course is ready!

State Compact for Social Workers

The initial draft of model legislation for state compact for social workers has been released. States who join the compact will allow social workers to work in those states without necessarily being licensed in the state. Read more about it by using the following links.

NASW page                       National Center for Interstate Compacts

 

Social workers lead the way in telehealth

Telehealth was somewhat on a the radar prior to the COVID-19 pandemic, but the onset of the pandemic led to growth on a scale not previously seen and remains high even with the focus on “returning to normal.” One of the most notable findings in the new study is the steady dominance of mental health conditions as the most common telehealth diagnosis category throughout the pandemic. COVID-19 has had a profound impact on mental health, and access to telehealth services has helped to meet the persistent demand for mental health services. This is demonstrated increases in the share of telehealth claims in mental health conditions, and the emergence of CPT 90837 (60-minute psychotherapy) as the top telehealth procedure code nationally and in all regions from March 2021 through November 2021. A key notable is that from February 2022 to Apirl (may not completed as yet), social workers became the most common specialty used for telehealth in the West,
a position they already held in every other region. Given that the most common telehealth service clinical social workers provide is psychotherapy, it is not surprising that CPT 90837 (60-minute psychotherapy), the leading procedure code nationally and regionally. We have lived the moments and movement of history in mental health services.

National Suicide Prevention Lifeline and 988

Effective July 16, 2022, The National Suicide Prevention Lifeline Transitions will be using the designated three-digit code 988. The 1-800-273-TALK (8255) is still being used and some areas are already using 988. The New Social Worker has an article or you can read more here.

Telehealth report

A report from Kaiser Family Foundation highlights that mental health and substance use services by telehealth have remained elevated whereas other outpatient care use by telehealth have declined. The demographics of users is shown in the graph. Reed the article here.

DSM 5 TR

DSM-5-TR will be published in March 2022 and features the text updates based on current scientific literature. The TR version includes a new diagnosis ,called prolonged grief disorder, clarifies modifications to the criteria for more than 70 disorders.  There are additions of ICD-10-CM symptom codes for suicidal behavior and nonsuicidal self-injury.  The updates to descriptive text for most disorders are based on extensive review of the literature. In addition, DSM-5-TR includes a comprehensive review of the impact of racism and discrimination on the diagnosis and manifestations of mental disorders. The manual will help improve diagnoses, treatment, and research. It has been 9 years since the 2013 edition of the DSM-5 was published. Historically, the DSM has been revised every 5 to 7 years.

Have you heard?

Effective Jan 1, 2022, CMS changed the definition of POS code 02, the one we’ve been using for telehealth, and introduced a second telehealth POS code 10.

POS 10: Telehealth to a client located at home (does not apply to clients in a hospital, nursing home or assisted living facility)
POS 02: Telehealth to a client who is not located at home

Wait! Don’t go rushing off to start using the new codes immediately. Not all health plans are ready to accept the new POS codes. Check with the payer. Some have informed providers of the new codes but haven’t clearly given the green light to use them yet.

Even Medicare states they aren’t accepting the new codes yet. They plan to start on 4/1/22 for dates of service from 1/1/22. However, they may push this back depending on the Public Health Emergency. You will need to wait for further instructions. In the meantime, Medicare is still asking that you use the POS code 11 for telehealth as you would have used if the session had been in person (e.g., 11 for office).

For the complete list of POS codes, click here.

The Consolidated Appropriations Act of 2021 established new requirements for providers to protect consumers from surprise medical bills. These requirements are collectively referred to as “No Surprises” rules. The goal is of protect clients from unexpected bills for healthcare services, such as charges for out-of-network emergency care. Many of its provisions do not apply directly mental health providers. However, beginning January 1, 2022, mental health providers will be required by the federal law to give uninsured and self-pay clients a good faith estimate of costs for services that they offer, when scheduling care or when the client requests an estimate.” Read my blog post for more details and sample forms.

Telehealth study

An App to detect concussions

This study found that sociodemographic characteristics and age were dominantly associated with the success or failure of a telehealth video visit. When policy makers debate expanding telehealth coverage, consideration of patient support, equity, and abrasion must be kept in mind to make certain that already underserved patients are not left even further behind. Underserved patients may become disproportionately challenged by decreases or cutbacks surrounding insurance coverage or reimbursement for telephone-based services, threatening to worsen health care disparities. Coverage of telephonic services is now being allowed by Medicare but may be temporary. This study demonstrates the importance of audio-only services and how it can improve accessibility and equity across the age and ability spectrum. A broader understanding of the variability, associated factors, and learning curves for telemedicine may help guide the next phase of optimization and refinement of telemedicine as a primary medium for health care.

Expanding Use of Telehealth and Other Telecommunications Technologies for Behavioral Health Care

The final rule makes significant strides in expanding access to behavioral health care  ̶  especially for traditionally underserved communities  ̶  by harnessing telehealth and other telecommunications technologies. In line with legislation enacted last year, CMS is eliminating geographic barriers and allowing patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders.

 

Reflex is a smartphone app developed by startup brightlamp. The app takes a video recording of a person’s eye to gauge a reaction called pupillary light reflex. The user holds the smartphone camera up to an eye and taps the screen. A light flash initiates a response from the pupil. The response can be an indicator of a concussion. A retrospective clinical review of patients has been completed and the results of the study have been published in Life, a peer-reviewed journal of life sciences.

Place of service codes

Effective January 1, 2022, and available to Medicare April 1, 2022

As of September 2021, CME has issued a new CPT code modifiers, two of which are relevant to telehealth CPT code billing. Medicare telehealth services practitioners use “02” if the telehealth service is delivered anywhere except for the patient’s home. If the patient is in their home, use “10”. For telehealth, the 95 modifier code is can also be used. Check with your MAC or insurance carrier.

Man Therapy started in Colorado to prevent suicide in men aged 24-65 and has grown into more. The fictitious Dr. Rich Mahogany (an actor) is featured in the videos. Take the Head Inspection!

A first responder’s perspective!

Zoom is caught - Again!

The FTC has forced Zoom into a settlement about its laxed and misleading security practices. The settlement begs the question of Zoom being safe for telehealth.

Practice across state lines

Practice across state lines for Veterans Administration Health – Mental Health
and careers for social workers.

Sharing reopening resource from NASW!

OCR Levies Fines for Failing to Grant the Right of Access

The HIPAA Right of Access gives patients, or their designated personal representative, the right to request a copy of their medical records. Under this provision, healthcare providers must provide timely access to medical records, stating that requested records must be provided within 30 days of the request.

Beth Israel Lahey Health Behavioral Services (BILHBS), the largest provider of substance abuse and mental health services in eastern Massachusetts, was issued a $70,000 fine for failure to provide timely access to medical records requested by a patient’s personal representative. They are also subject to one year of monitoring by OCR and must implement a CAP.

Dignity Health, doing business as St. Joseph’s Hospital and Medical Center (“SJHMC”), has agreed to take corrective actions and pay $160,000 to settle a potential violation of the HIPAA Privacy Rule’s right of access provision.  SJHMC, based in Phoenix, Arizona, is a large, acute care hospital.

On April 25, 2018, OCR received a complaint from a mother alleging that beginning in January 2018, she made multiple requests to SJHMC for a copy of her son’s medical records, as his personal representative.  SJHMC provided some of the requested records, but despite the mother’s follow up requests in March, April, and May 2018, SJHMC did not provide all of the requested records. OCR initiated an investigation and determined that SJHMC’s actions were a potential violation

of the HIPAA right of access standard.  As a result of OCR’s investigation, SJHMC sent all of the requested medical records to the mother on December 19, 2019, more than 22 months after her initial request.

King MD, a small psychiatric services provider based in Virginia, was issued a $3,500 HIPAA violation fine for failure to provide timely access to medical records. They are also subject to two years of monitoring by OCR and must implement a CAP.

Wise Psychiatry, PC, a small psychiatric services provider based in Colorado, was issued a $10,000 HIPAA violation fine for failing to provide a personal representative with access to his minor son’s medical records. They are also subject to one year of monitoring by OCR and must implement a CAP.

All Inclusive Medical Services, Inc. (AIMS), a multi-specialty family medicine clinic based in California, was issued a $15,000 HIPAA violation fine for refusing to give the patient access to her medical records. They are also subject to two years of monitoring by OCR and must implement a CAP.

Housing Works, Inc., a non-profit healthcare organization based in New York City, was issued a $38,000 HIPAA violation fine for failing to provide a patient with his records. They are also subject to one year of monitoring by OCR and must implement a CAP.

Total fines: $256,500

Zoombombing

Most everyone now knows that Zoom has experienced a huge increase in customers and security issues were revealed.  Zoom has pushed out some updates and is working on their issues.  Here are some tips that can help.

Tips to stop Zoombombing

Stay Healthy!

COVID-Net is an open-source model written in Jupiter notebook (Python).  COVID-Net was developed by Linda Wang and Alexander Wong at the University of Waterloo and the AI firm DarwinAI in Canada. COVID-Net was trained on chest x-rays using 5,941 images taken from 2,839 patients with different lung conditions, including bacterial infections, non-COVID viral infections, as well as COVID-19. The accuracy rate of the neural network model is 83.5%.  

Emotional Health Assistant

Using on the latest scientific research and artificial intelligence, Youper monitors a users’ emotional health with quick personalized conversations to help one improve their emotional health.  The app features personalized meditations along with the ability to track mood and monitor emotional health. As users communicate with the chatbot, it will learn more about them and refine the experience in order to tailor to their needs.

From their Privacy Notice:

“We DON’T collect or store medical information or Protected Health Information (PHI), defined under the US law as any information about health status, provision of health care, or payment for health care that is created or collected by a Covered Entity and can be linked to a specific individual.”

An app that can hear an ear infection!

Ear infections are not typically diagnosed by using a smartphone until now. Scientists have developed a smartphone app to detect middle ear fluid by using the microphone and speaker of a phone to emit sound and analyze its reflection back from the eardrum. The smartphone system did better than a commercial acoustic reflectometry system in detecting middle ear fluid.   The importance is that the patient’s parent could easily operate the app without formal medical training.

Artificial Intelligence Can Detect Depression in Children

The University of Vermont reports the development of a machine learning algorithm to detect depression in young children. 

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