4/28/2008
Calls Needed to Senators on Medicare
Last December Congress left for the year having passed a few nominal reforms to the Medicare program. One of those reforms postponed a 10% cut in physician reimbursement for six months. However, a lack of time and available money prevented the Congress from passing any substantial reforms to many of Medicare?s antiquated policies.
Unfortunately the six month deferral will end this June 30th and there is still a shortage of money available for funding substantial Medicare reforms.
The Senate has been in negotiations since the beginning of the year to affect a further delay of the physician pay cut. The American Medical Association (AMA) has warned that if Congress fails to stop the 10% cut, many physicians may not continue to treat Medicare beneficiaries.
The American Mental Health Counselors Association (AMHCA) and the American Counseling Association (ACA) have been pushing hard all year to make sure that Medicare?s mental health benefit includes coverage of licensed mental health counselors. Nevertheless, it is becoming increasingly likely that Congress will only be able to agree on a minimum package to delay the impending pay cut, still leaving many important reforms left undone.
Senators will only be able to push for Medicare coverage of counselors if they know it is your priority. Counselors are encouraged to contact their Senators and ask them to cosponsor S. 921, the Seniors Mental Health Access Improvement Act. Congress will not pass Medicare coverage of counselors this year without your help and involvement.
TAKE ACTION:
All Senate offices can be reached by calling the U.S. Capitol Switchboard at 202-224-3121 and asking for the Senator?s office. To find out who your Senators are, go to www.senate.gov and click on your state in the upper right hand corner as indicated.
Call your Senator and tell him or her:
Licensed Professional Counselors have training equivalent to Medicare?s current master?s level providers.
Medicare coverage of counselors is one of the most cost-effective ways of increasing access to mental health services.
You would like the Senator to cosponsor S. 921
You would also like the Senator to tell Senator Max Baucus (D-MT, Chair of the Senate Finance Committee) to include Medicare coverage of counselors in the upcoming debate on Medicare legislation.
Below you will find a list of Senators who have already co-sponsored S. 921; counselors should call and thank them for their support.
Sen Barrasso, John [WY]
Sen Boxer, Barbara [CA]
Sen Brown, Sherrod [OH]
Sen Durbin, Richard [IL]
Sen Johnson, Tim [SD]
Sen Landrieu, Mary L. [LA]
Sen Lieberman, Joseph I. [CT]
Sen Lincoln, Blanche L. [AR]
Below is a list of Senators who have cosponsored S. 1605, the Craig Thomas Rural Hospital and Provider Equity Act of 2007. These Senators know how important LPCs are to rural areas; so, thank them for their support and ask them to also cosponsor S. 921.
Sen Barrasso, John [WY] Sen Bingaman, Jeff [NM]
Sen Cantwell, Maria [WA] Sen Coleman, Norm [MN]
Sen Collins, Susan M. [ME] Sen Domenici, Pete V. [NM]
Sen Dorgan, Byron L. [ND] Sen Enzi, Michael B. [WY]
Sen Hagel, Chuck [NE] Sen Harkin, Tom [IA]
Sen Inhofe, James M. [OK] Sen Inouye, Daniel K. [HI]
Sen Johnson, Tim [SD] Sen Klobuchar, Amy [MN]
Sen Landrieu, Mary L. [LA] Sen Lincoln, Blanche L. [AR]
Sen Murkowski, Lisa [AK] Sen Murray, Patty [WA]
Sen Nelson, E. Benjamin [NE]
Sen Pryor, Mark L. [AR]
Sen Roberts, Pat [KS]
Sen Rockefeller, John D., IV [WV]
Sen Salazar, Ken [CO]
Sen Smith, Gordon H. [OR]
Sen Snowe, Olympia J. [ME]
Sen Stabenow, Debbie [MI]
Sen Tester, Jon [MT]
Sen Thune, John [SD]
If you have any questions or comments, please contact Beth Powell, American Mental Health Counselors Association, 800-326-2642 x105 (bpowell@amhca.org) or Peter Atlee, American Counseling Association, at 800-347-6647 x242 (patlee@counseling.org).
Beth Powell
Director, Public Policy and Professional Issues
American Mental Health Counselors Association
The only organization working exclusively for mental health counselors
801 N. Fairfax Street, Suite 304
Alexandria, VA 22314
Phone: 703-548-6002, ext. 105
800-326-2642, ext. 105
FAX: 703-548-4775
Website: www.amhca.org
E-mail: bpowell@amhca.org
4/9/2008
Urge Congress to Act This Year to Pass Strong Parity Legislation
A key legislative goal for the American Mental Health Counselors Association (AMHCA) continues to be the enactment of legislation to end insurance discrimination for the treatment of mental health and substance abuse disorders.
The 110th Congress has fewer than five legislative weeks remaining to complete its work if it adjourns as planned for the upcoming presidential and congressional elections. This short time frame leaves limited time for final action on mental health and substance abuse parity legislation.
AMHCA needs your help to keep the heat on Congress to enact this historic legislation. The American public supports ending insurance discrimination, and it is time for Congress to ensure that those who need services can receive them. For far too many years, we have heard promises of action, and now Congress is poised to make mental health and substance abuse parity a reality.
Because of the grassroots efforts of AMHCA and the advocacy of allies across the country, the U.S. House of Representatives took a historic step in passing H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act, on March 5, 2008. Two members of Congress, Reps. Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), shared their stories of recovery and led the successful, bipartisan effort to secure passage of the bill, which passed by an overwhelming vote of 268 to 148. On September 18, 2007, the U.S. Senate passed S. 558, the Mental Health Parity Act, by unanimous consent.
House and Senate negotiators will soon begin efforts to reconcile differences between the two bills passed by each chamber.
What you can do: AMHCA encourages its members to call their two Senators and Representative and ask them to support enactment of mental health and substance abuse parity legislation this year.
The U.S. Capitol Switchboard can be reached by calling 202-224-3121 and can connect you to your Senators and Representative?s offices. If you do not know the name of your elected officials, go to www.congress.org and enter your zip code in the upper right hand corner. Please be sure to leave your name and address with the staff member to make it clear that you are a constituent.
Suggested Message for your Senators and Representative: ?As a constituent and a Licensed Professional Counselor (or your specific state title), I?m calling to express my strong support for the enactment of mental health and substance abuse parity legislation this year. Now that the House and Senate have passed their bills, millions of Americans are depending on the 110th Congress to put aside their differences and reach a bipartisan agreement. Please work with your colleagues to ensure that a strong mental health and substance abuse parity bill is sent to the President for his signature.?
Thank you for making calls these advocacy calls on this important issue. If you have any questions or would like more information, please contact Beth Powell of AMHCA at 1-800-326-2642 x105.
Beth Powell
Director, Public Policy and Professional Issues
American Mental Health Counselors Association
The only organization working exclusively for mental health counselors
801 N. Fairfax Street, Suite 304
Alexandria, VA 22314
Phone: 703-548-6002, ext. 105
800-326-2642, ext. 105
FAX: 703-548-4775
Website: www.amhca.org
E-mail: bpowell@amhca.org
Mark your calendar now: July 17-19, 2008
AMHCA?s Annual Conference at the Town & Country Resort in San Diego, CA
3/31/2008
MMHCA and LPC Victory Committee Members,
I'm happy to report that our bill that includes LPCs in the definition of 'mental health professional' in Dept. of Mental Health statutes, HB 1791 has passed the House as a consent bill on Thursday. It will now be sent to the Senate where we have an identical companion bill, SB 1177, on the consent calendar. It appears that these bills are well on their way to becomng law. The net effect of these bills will be to give the community mental health centers that serve as administrative agents of DMH the flexibility to use their LPC staff for assessments of those who might be in need of an involuntary detention in DMH due to their danger to themselves or others. This should enhance the position of LPC in the CMHCs and reinforce those agencies in their willingness to hire and utilize our profession.
Our diagnosis bills, SB 1109 and HB 1792, continue to be viable but need a lot of good things to happen through the rest of the session. SB 1109 is a bit further along in that it was voted out of committee on a 6-0 do pass recommendation with some substitute language that defines options for acceptable training for those LPCs that use diagnosis and were licensed prior to 2007. We are looking at substitute language for our House bill to more adequately define those options and I expect we'll learn more about its prospects for a vote of the committee where it was heard next week. All in all we are much further along this session than we have been in the past but we still need everyone to be in touch with their legislators to help them move along.
Thanks,
Dan Holdinghaus, MA, LPC
MMHCA Executive Director
mmhca@mmhca.net
www.mmhca.net
800-341-3363 voice and fax
573-205-9529 cell
1/29/2008
MMHCA has filed two bills in the House with Wayne Cooper as our sponsor. Your active support through contact with your Representatives will help us along the way through this session. I'll be sending you more information as the bills move through the process but at this early stage it looks like we will get an early hearing date when they are assigned to the Special Committee on Professional Registration. If you have Thursdays in February available to travel to Jefferson City you might want to pencil in those dates because there is a good chance our hearing in the House before the PR committee will be on one of those dates.
We are introducing a new bill this year, HB 1791 which can be tracked at:
http://www.house.state.mo.us/billtracking/bills081/bills/HB1791.HTM
This bill is being offered with the support of the Dept. of Mental Health and is a simple bill to add LPCs to the DMH definitions of "mental health professional". We expect this to be a non-controversial bill that should have good prospects of passage.
Our other bill is HB 1792 which can be viewed at:
http://www.house.state.mo.us/billtracking/bills081/bills/HB1792.HTM
This bill is our bill to add the term diagnosis to the LPC statutes. For the most part it is identical to last session's bill but we have added language to the end of the bill that would require that if an LPC were brought to a disciplinary hearing for their license or brought to a civil or criminal court proceeding that addressed a diagnosis they made then that LPC would be required to offer evidence that they had been adequately trained in some way to be make a diagnosis. We have listed several common ways that one might acquire the skills to do diagnostic assessments.
Please contact your Representative and ask for their support of these two bills. You can get contact information and find your representative on this page:
http://www.house.state.mo.us/content.aspx?info=/bills081/member/memmail.htm
Attached is a rationale sheet that you can use in regards to HB 1792 and we'll be providing you with more information as the session progresses.
ScopeofPracticeRationale.pdf
1/19/2008
For many years, the American Counseling Association (ACA) and the American Mental Health Counselors Association (AMHCA) have been working collaboratively to remove the physician referral requirements under which mental health counselors must practice for TRICARE, the Department of Defense (DOD) managed health care program for active duty service members and their families, retirees and their families, and survivors.
ACA and AMHCA have made some progress. The conference report for the 2008 National Defense Authorization Act (NDAA) includes language instructing the Department of Defense (DOD) to contract with the Institute of Medicine or a similar organization to carry out a study of the training and licensing of mental health counselors. The report also requires DOD to issue regulations outlining training credentials that would allow mental health counselors to practice independently under TRICARE.
The House of Representatives passed the conference report for the NDAA by a vote of 370 to 49 on December 12, 2007. On December 14, 2007, the Senate followed suit by voting 90 to 3 to adopt the conference report. Unfortunately, due to an unrelated provision, President Bush used a "pocket-veto" to kill the legislation. When Congress is in session, any unsigned bills become law after seven days. However, if Congress is out of session, any bills that are not signed after seven days expire (this is referred to as a "pocket-veto"). A decades-long dispute between the Legislative and Executive branches has led some to question the President's constitutional right to use "pocket-veto" in this particular situation, and Congress may act to override the action.
Should the veto be upheld, ACA and AMHCA will have an opportunity to lobby for stronger provisions affecting the work of mental health counselors operating in the TRICARE program before the revised bill is drafted. Details: Peter Atlee. Telephone: 800/347-6647, Ext. 242 or Email: patlee@counseling.org.
*source: http://www.counseling.org
1/2/2008
E-News from Washington
Vol. 07-79
December 21, 2007
TRICARE language included in final Defense Authorization bill
For many years, the American Mental Health Counselors Association (AMHCA) and the American Counseling Association (ACA) have been working collaboratively to remove the physician referral requirements under which mental health counselors must practice under TRICARE, the Department of Defense (DOD) managed health care program for active duty service members and their families, retirees and their families, and survivors.
TRICARE covers physicians, psychologists, and the three master?s level mental health professionals: mental health counselors, clinical social workers, and marriage and family therapists. TRICARE regulations establish strict licensure, education, and training, requirements for all covered mental health professionals, but LMHCs are the only providers who are not allowed to practice independently. To receive mental health services from a mental health counselor, beneficiaries must first obtain a physician referral, and services must be supervised on an ongoing basis by the physician.
The physician referral and supervision requirement was removed for clinical social workers in 1982 and for marriage and family therapists in 1990. Despite having similar levels of training and expertise, licensed mental health counselors continue to labor under physician referral and supervision more than 17 years after this requirement was removed for other providers. The referral and supervision requirement also presents unnecessary roadblocks to servicemembers and their families accessing mental health care.
DOD remains opposed to independent practice authority for licensed mental health counselors practicing under TRICARE. TRICARE Management Authority (TMA), the agency within DOD that manages the program, has repeatedly stated that mental health counselors do not have adequate training to provide independent services, and have pointed to the diversity of counseling requirements and licensing statutes as a means to block our efforts.
On May 17, 2007, the House of Representatives passed their version of the Fiscal Year 2008 National Defense Authorization Act (H.R. 1585), and for the third time in as many years, included a provision to allow mental health counselors to practice independently under TRICARE. The provision was once again sponsored by Rep. Robin Hayes (R-NC), a member of the House Armed Services Committee.
This year, through the combined efforts of AMHCA and ACA, we were able to gain the support of Sen. Claire McCaskill (D-MO), a member of the Senate Armed Services Committee, who championed our cause and who has promised to remain dedicated to passing the provision for as long as she remains in the Senate. Although Sen. McCaskill encountered opposition from DOD and the staff of the Senate Armed Services Committee on obtaining a committee vote on an amendment to grant independent practice authority to counselors, she did make progress in securing support for our cause. Sen. McCaskill was able to collect the signatures of 15 Senators from across the country on a letter in support of removing the restrictions on mental health counselors under TRICARE.
The Senate, on October 1, 2007, passed their version of the Defense Authorization Act by a vote of 92 to 3. The Senate bill did not address the referral and supervision requirement for TRICARE participating mental health counselors. Following final action in the Senate, the legislation was then sent to a conference committee, where differences in the bills passed by the House and Senate were resolved.
The conference report on H.R. 1585 requires DOD to issue regulations outlining training credentials that would allow mental health counselors to practice independently under the TRICARE program. AMHCA and ACA are hopeful that counselors who meet those criteria may be granted independent practice authority under TRICARE shortly. The conference report also includes language instructing DOD to contract with the Institute of Medicine or a similar organization to carry out a study of the training and licensure of mental health counselors. We expect the study to help build a strong case for independent practice authority of all professional counselors practicing under TRICARE upon completion in March 2009.
On December 12, 2007, the House of Representatives passed the conference report by a vote of 370 to 49. The Senate, on December 14, 2007, adopted the conference report by an overwhelming vote of 90 to 3. President Bush is expected to sign the bill into law the week of December 24, 2007.
AMHCA and ACA are currently working with the offices of Senator Claire McCaskill (D-MO) and Senate Armed Services Committee Chairman Carl Levin (D-MI) to ensure that regulations are issued in a timely manner and that there is a strong and fair study.
Medicare reform legislation is cut short.
On August 1, 2007 the House of Representatives passed milestone legislation to reform the Medicare program, including augmenting the program?s mental health benefit. H.R. 3162, the Children Health and Medicare Protect (CHAMP) Act of 2007, included Medicare coverage of counselors as well as a reduction in the 50% co-payment for mental health services.
The Senate spent the next few months attempting to draft its own Medicare reform legislation. Driven by the need to delay impending pay cuts for physicians, Senate Finance Committee staff worked to assemble a package that would be acceptable to both parties and, at the same time, address some of the problems that Medicare is currently facing.
Democrats and Republicans were in negotiations late into December, but a potential veto threat from President Bush caused those negotiations to break down. The administration pledged to veto any Medicare legislation that affected the Medicare Advantage program or raised taxes, which were, unfortunately, the only two available sources to fund reforms.
On December 18, the Senate passed a bare bones package of Medicare reforms. S. 2499, the Medicare, Medicaid, and SCHIP Extension Act of 2007, addressed the upcoming physician pay cuts and funds the State Children?s Health Insurance (SCHIP) Program through March of 2009. The House, in turn, passed the legislation on December 19 and the President has appears poised to sign it.
Due to constraints on time and money, S. 2499 did not include Medicare reform provisions espoused by AMHCA and ACA and was only able to increase physician reimbursements for 6 months. Fortunately, while the bill did not include coverage of counselors, the short term physician pay fix means that Congress will have to take another shot at Medicare before next June. We are hopeful that the second round of Medicare negotiations will be more fruitful and will yield us the opportunity to include counselor reimbursement in Medicare legislation in the second session of the 110th Congress.
Department of Veterans Affairs making progress in implementation of LMHC law.
Just over one year ago, the President signed S. 3421 into law, allowing the Department of Veterans Affairs (VA) to hire mental health counselors. The VA has spent this past year reviewing the law and beginning its implementation. The VA recently began an Occupational Study of the counseling profession to determine the how LMHCs can best be utilized in the care of veterans. According to a source in the Human Resources Department of the VA the study should take, a couple of months.
Upon completion of the study, the VA will determine whether to write a new qualification standard (job description) for counselors or to adapt an existing standard. AMHCA and ACA are advocating for the creation of a new qualification standard in order to ensure the recognition of LMHCs as a distinct profession and not just an extension of an existing one. As both options are likely to take similar amounts of time, the creation of a new qualification standard will yield more substantial results for counselors.
While it may seem like the implementation process is moving slowly, we should also note that it is moving steadily. The slow and deliberate process of implementation is meant to guarantee that counselors receive the recognition and responsibilities indicative of their education and training. A rapid process could result in the creation of a substandard job description that prevents counselors from performing at their potential.
AMHCA and ACA appreciate the service of counselors working in the VA and ask for your patience as we move forward with the implementation process, which we hope will be completed in the next year.
If you have any questions, please feel free to contact Beth Powell of AMHCA at 1-800-326-2642, ext. 105 or by e-mail at bpowell@amhca.org or Peter Atlee of AMHCA at 1-800-347-6647, ext. 242 or by e-mail at patlee@counseling.org
Beth Powell
Director, Public Policy and Professional Issues
American Mental Health Counselors Association
The only organization working exclusively for mental health counselors
801 N. Fairfax Street, Suite 304
Alexandria, VA 22314
Phone: 703-548-6002, ext. 105
800-326-2642, ext. 105
FAX: 703-548-4775
Website: www.amhca.org
E-mail: bpowell@amhca.org
Mark your calendar now: July 17-19, 2008
AMHCA?s Annual Conference at the Town & Country Resort in San Diego, CA
*source: http://www.mmhca.net
9/5/2007
Representative Wayne Cooper filed HB 554 and HB 555 on behalf of MMHCA. HB 554 mirrors language found in the statutes for psychologists and social workers that makes it illegal for governmental entities to produce policies or regulations that discriminate against LPCs for work that they are qualified to do by training and statutory scope of practice. A second bill, HB 555, will help LPCs that have complaints brought against their license by inmates in the Dept. of Corrections expunged from the public record if the complaint is not substantiated. Both of these bills were heard, duly agreed and finally passed by the legislature and signed into law by Gov. Matt Blunt on 6/30/07. They will become effective on 8/28/07 and then regulations will have to be written to implement them over the next year. Sen. Kevin Engler filed companion bills in the Senate (SB 158 and SB 159) and they were eventually combined into a larger bill, SB 272 sponsored by Sen. Delbert Scott, which was also truly agreed and finally passed. SB 272 contained language concerning other classes of licensed professionals and it was signed into law on 7-13-07.
Senator Engler also filed SB 289 to include the term diagnosis in our statutory definitions. Rep. Cooper filed its companion in the House (HB 672). SB 289 received a do pass recommendation in the Senate Committee where it was heard. HB 672 was heard by the Professional Registration Committee but ultimately neither of these bills advanced to the floor of their respective bodies for final consideration.
MMHCA will continue to work through this year to promote our efforts to finally recognize in statutory language that diagnosis is an integral part of the services offered by Licensed Professional Counselors. We look forward to reintroducing this language in the 2008 session and with the widespread support that LPCs have for this effort we are hopeful that we will see positive results next year.
*source: http://www.mmhca.net/legislativeupdate.html
7/13/2007
A bill important to all LPCs passed both the U.S. House and Senate during the waning hours of the 109th Congress. The provision, included in S. 3421, the Veterans Benefits, Healthcare, and Information Act, opens up the VA health care system to mental health counselors, increasing access to care for veterans. S. 3421 now goes to President Bush to be signed into law.
The bill, which passed the House by voice vote and the Senate under unanimous consent, includes the AMHCA and ACA provision to add mental health counselors to the list of appointed positions within the Veterans Healthcare Administration (VHA). The provision would also delineate the qualifications mental health counselors would need to be appointed to a position in the VHA.
Currently, the VA cannot hire mental health counselors at the same pay grade as clinical social workers, nor can mental health counselors apply for supervisory positions open to clinical social workers and others. Partially as a result, the VA is the largest employer of social workers in the United States, and the VA employs very few mental health counselors on a full-time basis.
The AMHCA and ACA supported provision will allow mental health counselors to be eligible for better paying jobs with a greater potential for promotion at the VA. Currently, licensed mental health counselors do not have a federal Office of Personnel Management (OPM) General Schedule (GS) occupational classification, which is necessary for a counselor to be employed by the U.S. Government. With enactment of the provision, OPM will be required to create an occupational classification for mental health counselors.
Among S. 3421's other provisions, is authorization of an additional $180 million for the provision of readjustment counseling and related mental health services provided at VA Vet Centers. The bill also adds funding to increase the number of clinicians, including mental health counselors, treating post-traumatic stress disorder (PTSD), and authorizes an additional $2 million for VA community based outpatient clinics to support the provision of mental health services. Finally, the bill expands access to bereavement counseling for immediate family members as a service to be offered at Vet Centers when a service member dies on active duty.
*source: http://www.mmhca.net/legislativeupdate.html
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