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Q: What is the Federal Guideline for social work coverage in an Medicare-approved dialysis facility?

A: The regulations state that a qualified social worker is one with a masters degree in social work from a CSWE-approved program with clinical specialization. The only exception to this is if the social worker was hired by the dialysis clinic one year prior to the enactment of the regulations (9/76) and the social worker had experience as a social worker before then. In the case of the grandfathered non-MSW, he/she must have established a consultative relationship with a qualified social worker. The same requirement exists for dialysis and transplant facilities.

More and more research is showing the link between mental health and outcomes. CNSW has a letter that was received years ago from the director of BSW training that says that BSWs are generalists and are not trained to provide counseling. MSW training consists of 2 years of post-graduate classwork and practicum experience. Social workers, by regulation, are supposed to do psychosocial assessments, casework and groupwork (counseling), patient care planning with members of a multidisciplinary team, and help patients and families access community resources. The federal regulations do not say anything about many of the tasks that social workers have been assigned inappropriately.

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