Federal:

From NYMCHA Metro Chapter

The Counselor Accessibility Reform and Expansion for Soldiers Act, or CARES Act, the bill would allow anyone covered under Tricare to have the same access to mental health care professionals that many people covered under private insurance enjoy today... another key issue in suicide preventiion — access to professional counselors.  Click for complete article.

 

 

From AMHCA

 

The Time is Now to Champion Your U.S. Senators’ Support of Medicare Reimbursement in Final Health Bill



Yesterday, the Senate Finance Committee passed its own health care reform version out of the Finance Committee by a 14-9 vote. Senator Olympia J. Snowe of Maine was the only GOP Senator to vote in favor of sending America’s Healthy Futures Act of 2009, the Senate Finance Committee’s health care reform bill, to the floor. In the next few days, the Senate Finance bill will be melded together with the Senate HELP bill, a health reform bill passing out of the late Senator Kennedy’s Health, Education, Labor & Pensions Committee earlier this summer. The Congressional Budget Office will be scoring the Senate’s melded Finance and HELP bill. Once the bill has been scored, the final Senate bill will be debated on the Senate floor.



None of the Senate bills currently include Medicare reimbursement of licensed mental health counselors/licensed professional counselors. Of the two committees in the Senate with jurisdiction over health care, only the Finance Committee has jurisdiction over Medicare. It is possible that Senator Lincoln’s bill, S. 671, which was offered as one of over 500 amendments to the Senate Finance Committee, but was not formally offered and was not included in Chairman Baucus’s final bill, may be offered on the Senate floor. AMHCA, in conjunction with other organizations representing the interests of licensed mental health counselors and licensed marriage and family therapists, is meeting with Senator Lincoln and other Senators’ staff to chart the course for possibly getting S.671, what has become known as Senator Lincoln’s D3 Finance Amendment, into the Senate bill, before any conferencing of final House and Senate bills takes place by leadership in the House and Senate.



It’s not too late to urge your U.S. Senators to champion inclusion of Medicare reimbursement of licensed mental health counselors in the final Senate bill. Please contact your Senators’ offices by going to www.senate.gov, clicking on your Senators’ names, getting to the Senators’ web pages, and then clicking on the “Contact Us” icon. Calls to the Senators’ offices, both in the District and in Washington, DC, as well as District meetings with your Senators’ staff members are needed now more than ever. Medicare reimbursement of licensed mental health counselors has been included in Section 1308 of H.R. 3200. Ask your Senators to support inclusion of the Section 1308 provision in H.R. 3200, also known as S.671, in the Senate’s final legislation.



Expanding Medicare’s pool of eligible providers to include licensed mental health counselors and licensed marriage and family therapists in a Senate bill is presently a ripe issue. If S. 671 does not get offered as an amendment to the Senate bill, Medicare eligibility as part of a Senate bill will become a moot issue. We will simply be putting all of our chances for inclusion in a final health care bill behind the House’s efforts in getting Section 1308 of H.R. 3200 included, as part of the conferencing process which will take place between the House and Senate, after the Senate puts forth a final bill. AMHCA does not want to put all of its eggs in one basket; you can help us disperse the eggs! Please reach out to your Senators now and let them know, whether or not they support other major components in the health care legislation, such as a public option, support for expanding mental health access to Americans via Medicare reimbursement of licensed mental health counselors is of paramount importance to you and the Medicare beneficiary population. With the Senate Finance Committee having passed a bill out of its committee, your focus should be on the entire Senate populace.



Numerous moderate and conservative House Democrats have been intently watching the Senate Finance Committee. Many of these members remain skeptical of a public option, which is included in the House bill, H.R. 3200, but not included in the Senate Finance bill, as well as the House bill’s higher price tag. If the Senate bill becomes the vehicle that makes it to President Obama’s desk for a signature, it must include Medicare reimbursement of licensed mental health counselors. Inclusion of the provision in the House bill is simply not enough to ensure the eligibility of licensed mental health counselors and licensed marriage and family therapists as Medicare eligible providers. The fight for Medicare eligibility must be taken up in the Senate; please do your part to put Medicare reimbursement of counselors on your U.S. Senators’ radar screen, as an issue of importance to his or her constituency.









Julie A. Clements, J.D.

Director of Legislative Affairs

American Mental Health Counselors Association

The only organization working exclusively for mental health counselors

801 N. Fairfax Street, Suite 304

Alexandria, VA 22314

Phone: 800-326-2642 X 105

FAX: 703-548-4775

Website: www.amhca.org

E-mail: jclements@amhca.org

 

New York State:

This is the bill that will fix some of the unintended consequences of
our licensure law. Please contact your local legislator ASAP and urge
them to co-sponsor it.

*S.5921/A.8897 Key Points*

At the request of the New York State Education Department’s Office
of Professions, Senator Toby Stavisky and Assemblyman Gary Pretlow
introduced S.5921/A.8897 in June. This legislation is the result of
months negotiations with mental health groups such as New York
Association of Marriage and Family Therapists.

In short, the bill:

1) provides a process for the registration of entities that seek to
employ licensed professionals to provide services in the areas of
social work, mental health practitioners, and psychology.

2) allows the Department to accept experience that would otherwise
meet all requirements for licensure (supervisor qualifications,
duration, frequency, etc.) in a setting that was not authorized under
the original law. This would address the many individuals who
completed experience in a setting that was subsequently determined to
lack authority for providing services;

3) establishes a work group of stakeholders to identify and address
issues related to the licensure and practice of the professions,
including any recommendations on clarification or continuation of the
registration process for entities;

4) extends and expand the exemption from licensure under Article 154
(social work) and 163 (mental health practitioners) until July 1,
2011, to include programs funded, operated, regulated or approved by a
broader list of government entities; and

5) extends the exemption from licensure under Article 153
(psychology) until July 1, 2011 for programs funded, operated,
regulated, or approved by OMH, OMRDD, OASAS, OCFS, local social
service and mental hygiene districts (same language as current law).

Members should contact their local legislators to urge them to
co-sponsor S.5921/A.8897 and vote in favor of the measure.

 

The time for enhanced recognition of LMHCs is now. Urge your federal legislators to support S.671 and H.R. 1693, legislation that, if enacted, will allow you as a Licensed Mental Health Counselors (LMHC) to be reimbursed at 75 percent of the Medicare allowable rate for the outpatient services you provide to seniors.

Today, health care comprises almost 20 percent of the United States's gross domestic product (GDP). In the next few weeks, legislators on the Senate Finance and House Ways and Means Committees will come together to decide how to restructure this significant chunk of U.S. GDP.

  • Notify your legislators, via e-mail letters or phone calls to their DC and state district offices, of the need for LMHC Medicare reimbursement.
  • Explain how Medicare reimbursement of outpatient psychotherapy services will benefit Medicare eligible seniors and the mental health care needs of society in general.

President Obama has asked congressional leaders to have a major health care reform bill on his desk by October; key congressional leaders have indicated that they will begin marking up health care reform bills in mid-June. Legislators are attuned to the fact that changes to the health care system will impact everyone. Please let them know how Medicare reimbursement will affect you and the senior population in your locale. Go to www.senate.gov to find contact information for your U.S. Senators and to www.house.gov to find contact information for your U.S. Representatives. Download a list of members of the key committees voting on this legislation.

Please stress to your legislators who sit on these committees our need for their possible cosponsorship and, at a minimum, their support of S. 671/H.R. 1693.

Why should your federal legislators support
LMHC Medicare Reimbursement bills, S. 671 and H.R. 1693?

Lack of Access to Mental Health Services – Fully 50 percent of rural counties in America have no practicing mental health providers that are currently covered under Medicare. However, many of these mental health shortage areas have well-educated and experienced LMHCs who desire to deliver outpatient mental health services to the senior population but are obstructed by Medicare's current lack of reimbursement.

Medicare Inefficiency – Medicare has proven to be a very inefficient purchaser of mental health services, choosing to fund a disproportionate share of more costly inpatient mental health services, rather than less costly, preventive outpatient mental health services. An American Psychiatric Journal study on private health insurance recipients' mental health care purchases evidences that increased availability of outpatient treatment for mild to moderate mental health disorders, like depression and anxiety, can result in as much as a 30 percent decrease in mental health costs expended by private insurers and their insured population.

Underserved Minority Populations – In a report by the United States Surgeon General entitled "Mental Health: Culture, Race, and Ethnicity," it was noted that "striking disparities in access, quality, and availability of mental health services exist for racial and ethnic minority Americans." Minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders. Many minority communities have a shortage of mental health providers, like clinical psychologists and clinical social workers, whose services are covered by Medicare.

Education and Training Comparable to Covered Social Workers – Today, LCSWs with education hours and training hours comparable to LMHCs receive reimbursement under Medicare for outpatient services they provide to Medicare insured clients. LMHCs, like clinical social workers, have a minimum of a Master's degree, thousands of hours of counseling experience and direct client contact, and passage of a clinical examination.

Please contact AMHCA's Director of Legislative Affairs, Julie A. Clements, J.D., at (703)-548-6002 X 105 or via email at jclements@amhca.org, if you have further inquiries.

 

DRAFT LETTER TO CONGRESS
Please use this text as a template and personalize as you see fit.

May____, 2009

The Honorable_______
____House/Senate Office Building
Washington, DC 20510

RE: Please Co-Sponsor S. 671/H.R. 1693:
The Seniors Mental Health Access Improvement Act of 2009.

Dear Senator/Representative_________:

I am writing to strongly urge you to co-sponsor S. 671/H.R. 1693, The Seniors Mental Health Access Improvement Act, which would establish Medicare coverage for licensed professional mental health counselors. With the exception of a recent federal law that finally equalized outpatient co-payments for mental health and medical/surgical services, the baseline Medicare mental health benefit has not been updated in almost 20 years. This inaction has consequences.

Improve Access in Rural Areas and among Underserved Minority Populations:
Approximately 77 million older adults live in 3,000 mental health professional shortage areas. Yet over 50% of rural counties have no practicing psychologists, psychiatrists or social workers. It is shocking to note that fully two thirds of rural residents with mental illness symptoms receive no treatment at all. As a direct result of this lack of access, older Americans with chronic medical conditions and major depression (nearly 2 million senior citizens nationwide) have significantly higher rates of disability than those with either condition alone. Similarly, in a report entitled "Mental Health: Culture, Race and Ethnicity," the United State Surgeon General noted that "striking disparities in access, quality and availability of mental health services exist for racial and ethnic minority Americans." A critical result of this disparity is that minority communities bear a disproportionately high burden of disability from untreated or inadequately treated mental disorders.

Making Medicare a Better Purchaser of Mental Health Care:
Inpatient psychiatric hospital utilization by elderly Medicare recipients is extraordinarily high-particularly when compared to psychiatric hospitalization rates for patients covered by Medicaid, VA, TRICARE and private health insurance. To the extent that fully one third of these expensive inpatient placements are caused by clinical depression and addiction disorders, it is strikingly clear that additional community-based mental health services provided by licensed professional mental health counselors will reduce unneeded hospitalizations.

The bottom line is the lack of access to mental health care is increasing both the burden of disability on our senior citizens and minority communities as well as the financial burden on the Medicare program. Take action today. Co-sponsor S. 671/H.R. 1693.

Sincerely,

 

TARGET LIST
The Senate Finance Health Subcommittee and the House Ways and Means Health Subcommittee have jurisdiction over S 671/ HR 1693. Help ensure that members from your states on these committees support S. 671/H.R. 1693.

Click here for a list of members of the Senate Finance Health Subcommittee and House Ways and Means Health Subcommittee.

 

Affect Public Policy

Pass S.671/H.R. 1693 -- Help LMHCs Achieve Medicare Reimbursement

Download Veterans Access Issue Brief

Keep public policy supporting you, your profession and your clients with AMHCA's powerful advocacy initiatives in Congress and state legislatures.

The Office of Public Policy and Legislation (PP&L) works with Federal and State legislatures to protect AMHCA members' interests and their right to practice throughout the United States. The PP&L Office works with AMHCA state chapters, for example, to help enact counselor licensure laws and other legislation to ensure that members maintain their right to practice. At the Federal level, the PP&L Office works with Congress and the Executive Branch to ensure that counselors are recognized in applicable federal laws; to educate policymakers about the role of mental health counselors; and to increase lawmakers' awareness about mental illness and its effects on people's lives.

AMHCA's legislative advocacy program provides grassroots support for the association's lobbying in Washington, and is necessary for the success of AMHCA's legislative agenda. To join, contact AMHCA Director of Legislative Affairs, Julie A. Clements, J.D, at jclements@amhca.org or 1-800-326-2642, ext. 105. We need your name, address, phone numbers and e-mail address. Get involved. Join Now!

 

American Mental Health Counselors Association

Public Policy and Legislation Committee
Dan Holdinghaus, LPC, Chair

111th Congress, First Session

Federal Legislative Issues

  • Enact legislation to allow mental health counselors to be reimbursed by Medicare;
  • Eliminate discriminatory physician referral and supervision requirements under TRICARE;
  • Enact legislation to ensure that that mental health counselors are fully recognized by a full range of federal programs, including the Federal Employee Health Benefits (FEHB) Program and as Department of Transportation (DOT) Substance Abuse Professionals (SAPs);
  • Monitor implementation of mental health and substance abuse parity law (P.L. 110-343)
  • Monitor federal medical records confidentiality regulations;
  • Monitor implementation of legislation recognizing state licensed mental health counselors as mental health specialists within the Department of Veterans Affairs (P.L. 109-461).

State Legislative Issues

  • Enact counselor licensure law in California;
  • Protect the rights of mental health counselors to utilize testing instruments;
  • Enact legislation to name mental health counselors as providers for state employee health benefits plans;
  • Update title laws to practice acts in applicable states;
  • Ensure that mental health counselors are named as providers for Medicaid; and
  • Enact mandatory reimbursement laws for mental health counselors.