Public Policy

NOTE: Author of this Article is Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
(Website named April Young as Author becasue she is the one who posted it.)

The Department of Veterans Affairs (VA) has issued qualification standards formally recognizing licensed professional counselors as mental health specialists within the Veterans Health Administration.  The standards, released internally to VA staff late on September 28th, and available online at http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=507&FType=2, are the culmination of years of work by ACA, the American Mental Health Counselors Association (AMHCA), and the National Board for Certified Counselors (NBCC) to open up mental health provider jobs within the VA to professional counselors.  This is a landmark step forward for the counseling profession as well as an important means of expanding the pool of mental health service providers available to meet the large unmet treatment needs of our nation’s veterans.

 The new standards set categories and criteria for employment within the VA.  The standards establish several levels of employment within the

GS-101 series for counselors—entitled “Licensed Professional Mental Health Counselors” (LPMHC)—similar to and on par with the positions currently in place for clinical social workers:
GS-9    Licensed Professional Mental Health Counselor (Entry Level – for individuals with a graduate degree in counseling but who have not yet become licensed)
GS-11   Licensed Professional Mental Health Counselor
GS-12   Licensed Professional Mental Health Counselor Program Coordinator
GS-12   Licensed Professional Mental Health Counselor Supervisor
GS-13   Licensed Professional Mental Health Counselor Program Manager
GS-14   LPMHC Program Manager Leadership Assignments

The regulations require counselors to have a master’s degree in mental health counseling or a related field from a program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACREP).  Examples of related mental health counseling fields include, but are not limited to addiction counseling; community counseling; gerontology counseling; marital, couple, and family counseling; and marriage and family therapy.  If not yet licensed and hired at the GS-9 level, a VA counselor must become licensed at a date set by her or his supervisor.  Failure to become licensed within two years from the date of appointment will result in removal from the GS-101 LPMHC series and may result in termination of employment.  Once licensed, counselors must maintain a valid and unrestricted license to independently practice mental health counseling, which includes diagnosis and treatment.
 
While it is the last formal step in the VA employment process, it will take time for counseling positions to be posted on http://usajobs.gov or http://www.vacareers.va.gov,  and for counselors to be appropriately recognized within the VA health care system.   ACA, NBCC, and AMHCA are continuing to work with the VA on implementation of the new position descriptions and their use by VA facilities, as well as on obtaining the adoption of the standards by the federal Office of Personnel Management (OPM) for their use throughout the federal government.  We will also be suggesting minor modifications to the standards, and monitoring their implementation to ensure that licensed professional counselors are being adequately recognized for—and hired in—mental health specialist positions within the VA.
 
To help us ensure the process is working, we strongly encourage counselors to contact us to share their experiences in seeking positions within the VA under the new standards.  Please share your experiences with me at the e-mail address below. 
 
If you have questions about your eligibility for VA positions, please contact the human resources staff at your local VA office.
 
On behalf of ACA, thank you for your interest, your support, your patience, and your service.

NOTE: Author of this Article is Scott Barstow
Director of Public Policy & Legislation
American Counseling Association

(Website named April Young as Author becasue she is the one who posted it.)

Senate Bill Introduced on TRICARE Independent Practice Authority

The counseling profession took a significant step forward with the introduction of Senate legislation (S. 3371) that will make it easier for TRICARE beneficiaries to see a professional mental health counselor.  TRICARE is the health care system for service members and their dependents, and licensed professional counselors are the only mental health professionals still required by law to see beneficiaries following physician referral and under physician supervision.

Senators Joseph Lieberman (I-CT), Claire McCaskill (D-MO) and Susan Collins (R-ME) jointly introduced the “TRICARE Mental Health Care Access Act,” S. 3371 to allow licensed professional counselors to independently treat and diagnose TRICARE beneficiaries.  The American Mental Health Counselors Association, the American Counseling Association and the National Board for Certified Counselors applaud the senators for sponsoring this legislation, as it is a much-needed step forward in giving TRICARE beneficiaries better access to highly skilled outpatient mental health professionals.  Our three organizations are working closely together to gain the enactment of legislative language providing counselors independent practice rights as part of this year’s National Defense Authorization Act (NDAA).

Introduction of S. 3371 comes on the heels of a recently released Institute of Medicine (IOM) report that recommends independent practice of mental health counselors in TRICARE.  The Institute of Medicine’s report, titled “Provision of Mental Health Counseling Services under TRICARE,” was conducted pursuant to a request by Congress contained in the National Defense Authorization Act for Fiscal Year 2008.  The IOM panel recommended granting independent practice authority for counselors who have:

   1. A master’s (or higher) degree in mental health counseling from a program accredited by the Council for Accreditation          of Counseling and Related Education Programs (CACREP);
   2. Obtained state licensure in mental health counseling at the “clinical” or highest level available;
   3. Passed the National Clinical Mental Health Counselor Examination (NCMHCE); and
   4. Have a well-defined scope of practice sufficient to permit a counselor to see TRICARE beneficiaries absent primary            care physician supervision and referral.

Representatives Tom Rooney (R-FL) and Mike McMahon (D-NY) introduced a similar bill, H.R. 3839, last October.  The Rooney-McMahon legislation would let any counselor participating in the TRICARE program practice independently, just like clinical social workers and marriage and family therapists have done for years.  The legislation is currently being cosponsored by Reps. Bordallo (GU), Courtney (CT), Israel (NY), Jones (NC), Kilpatrick (MI), McMorris Rodgers (WA), Rodriguez (TX) and Shuster (PA).

AMHCA, ACA, and NBCC are working with members of the House and Senate Armed Services Committees to gain adoption of legislative language based on H.R. 3839 and S. 3371 as part of the defense authorization legislation being considered over the coming weeks.  We urge counselors to contact their representatives to ask them to cosponsor H.R. 3839, and to contact senators to ask for cosponsorship of S. 3371.  The more cosponsors we have on the legislation, the greater our chances of establishing independent practice authority for as many counselors as possible within the TRICARE system.

For more information, contact Scott Barstow with ACA’s public policy office, at 800-347-6647 x234, email: sbarstow@counseling.org.

Posted 4-06-10
The Health Insurance Reform Bill, signed into law by President Obama in March 2010, unfortunately does not include language to establish Medicare reimbursement of licensed professional counselors.  The language did not make it into the final version of the Reform Bill due to a need to further reduce prospective federal spending.  ACA continues to support the health insurance reform legislation, and encourages counselors to express their support to their members of Congress. However, we are continuing to push for enactment of counselor Medicare reimbursement legislation later this year. Counselors can help in this effort by asking members of Congress to cosponsor H.R. 1693 and S. 671. These bipartisan bills focus solely on establishing Medicare coverage of licensed professional counselors and marriage and family therapists

The 2010 Colorado Legislative Session concluded on May 12th drawing to close a session mixed with budget shortfalls and contentious legislation.  There were several important pieces of mental health legislation that passed through the Capitol in 2010 that will affect the mental health profession.

Two pieces of legislation addressed when information is reported by and how information is transmitted back to a mandatory reporter.  SB10-066 sponsored by Senator Hudak(D-Jefferson) and Representative Levy(D-Boulder) clarified language around mandatory reporting of child abuse and neglect if the victim is 18 years or older at the time of disclosure.  The reporting requirement still applies if the reporter still has reason to believe the perpetrator is subjecting any other child currently under 18 years of age to abuse or neglect.  SB10-152 sponsored by Senator Newell(D-Arapahoe) and Representative Gagliardi (D-Jefferson) requires county departments to provide follow-up information to a mandatory reporter after a report is made.  Within 30 calendar days after receipt of a report of suspected child abuse or neglect from a mandatory reporter, a county department shall provide the following information to the mandatory reporter in his or her professional and offical role in maintaining the child's safety:

(A) THE NAME OF THE CHILD AND THE DATE OF THE REPORT;

(B) WHETHER THE REFERRAL WAS ACCEPTED FOR ASSESSMENT;

(C) WHETHER THE REFERRAL WAS CLOSED WITHOUT SERVICES;

(D) WHETHER THE ASSESSMENT RESULTED IN SERVICES RELATED
TO THE SAFETY OF THE CHILD;

(E) THE NAME OF AND CONTACT INFORMATION FOR THE COUNTY
CASEWORKER RESPONSIBLE FOR INVESTIGATING THE REFERRAL; AND

(F) NOTICE THAT THE REPORTING MANDATORY REPORTER MAY
REQUEST ADDITIONAL INFORMATION WITHIN NINETY CALENDAR DAYS
AFTER THE COUNTY DEPARTMENT RECEIVED THE REPORT AND
INFORMATION CONCERNING THE PROCEDURE FOR OBTAINING ADDITIONAL
INFORMATION.

* INFORMATION DISCLOSED TO A MANDATORY REPORTER
PURSUANT TO THIS PARAGRAPH (e.5) IS CONFIDENTIAL AND SHALL NOT BE
DISCLOSED BY THE MANDATORY REPORTER TO ANY OTHER PERSON
EXCEPT AS PROVIDED BY LAW.

* UNLESS REQUESTED BY A COUNTY DEPARTMENT, A
MANDATORY REPORTER SHALL NOT HAVE THE AUTHORITY TO
PARTICIPATE IN ANY DECISION MADE BY THE COUNTY DEPARTMENT
CONCERNING A REPORT OF ABUSE OR NEGLECT.

HB 10-1226, Differential Response to Child Abuse sponsored by Representative Kefalas (D-Larimer) and Senator Spence (R-Arapahoe), created a differential response pilot program for Larimer, Jefferson, Fremont, Arapahoe, and Garfield County Department of Social Services to use in addressing intra-familial abuse or neglect cases that are deemed low or moderate risk.  The Department of Human Services will evaluate whether the program was effective in the areas of child safety, permanence, case worker satisfaction and cost effectiveness. 
 
SB10-124, Michael Skolnik Medical Transparency Act 2010 sponsored by Senator M. Carroll (D-Arapahoe) and Representative Ryden (D-Arapahoe), extends the Michael Skolnik Medical Transparency Act enacted in 2007 to additional health care professionals including marriage and family therapists, professional counselors, addiction counselors, and unlicensed psychotherapists applying for, renewing, reinstating, or reactivating a license, certification, or registration on or after July 1, 2011.The reporting requirements, as enacted in the original "Michael Skolnik Medical Transparency Act" of 2007, are modified to require all impacted professionals, including physicians, to:
 
* Report information about the education and training the person received pertaining to his or her profession;
* Provide information about other licenses, certifications, or registrations to practice the applicant's profession that were issued in the previous 10 years, rather than those issued at any time in the person's career; and
* Comply with their responsibility to report adverse actions to the appropriate regulatory body as otherwise required by law. The requirement to report the license number, type, original issue date, last renewal date, and expiration date of any other license, certification, or registration issued to the person is eliminated. In addition to the information required to be reported, an impacted professional is also permitted to submit information pertaining to relevant awards and recognitions received by the person.
* Report the location of the applicant's practice if different than the applicant's address of record
 
HB10-1360, Parole Placement for a Technical Violation sponsored by Representative Pace (D-Puebl0) and Senator Steadman (D-Denver), clarified that parole officer’s duties include helping offenders reintegrate into society.  In addition to allowing the parole board to have discretion when sending a parolee back to a corrections facility for lower risk offenders the bill creates a new option for the parole board at a revocation hearing for a parolee who is in need of treatment.  If the parole board finds the parolee would be amenable to treatment the parole board may modify the parole conditions to allow the parolee to be placed in a treatment program.
 
SB10-171, Child Protection Ombudsman Program sponsored by Senator Newell (D-Arapahoe) and Representative Gagliardi (D-Jefferson), requires the department of human services to establish and administer a Child Protection Ombudsman Program by contract with a public agency or private nonprofit organization.  The program will receive and review complaints, investigate and resolve cases when appropriate evaluate and make recommendations for the creation of a statewide grievance policy, make recommendations to improve the child welfare system, and promote best practices.

HB10-1033, Screening Brief Intervention Referral sponsored by Representative Massey(R-Chaffee) and Senators Boyd (D-Jefferson) and Schwartz (D-Alamosa) adds to the list of optional services provided to Medicaid recipients screening, brief intervention, and referral to treatment for alcohol and other substance abuse services. 

Throughout this summer and fall the Department of Regulatory Agencies (DORA) will be completing the Mental Health Sunset Review.  DORA has been meeting with each of the respected professions within the Mental Health Act.  Legislation will be introduced next session revising the Mental Health Act after DORA completes its sunset review.
 
Summary of 2010 Legislative Session provided by Mendez Consulting.