Legislative Action Center

Bipartisan Bill to Improve Mental Health Care Supported by Hagan Approved by Senate Committee

Hagan is original co-sponsor of the legislation

April 10, 2013


Chris Moyer 202-379-8421

Hannah Smith 202-407-5177


Washington, DC – U.S. Senator Kay Hagan, a member of the Senate’s Health, Education, Labor and Pensions (HELP) Committee, announced today that a bipartisan bill to improve access to mental health services for young people was passed by the HELP Committee this morning with her support. The Mental Health Awareness and Improvement Act will also increase awareness, prevention and early identification of mental health conditions.

“Addressing the threat of violence in our schools requires a comprehensive approach. Increasing access to mental health services for young people is a critical part of our efforts to prevent tragedies like the one that took place in Newtown from happening again,” Hagan said.  “This bipartisan legislation increases support for schools to help identify troubled students and connect them with the services they need. By strengthening our mental health system, we can save and improve lives in North Carolina and around the country.”

The Mental Health Awareness and Improvement Act makes targeted improvements designed to advance Federal efforts to assist states and local communities in addressing mental health needs. The legislation reauthorizes and improves programs administered by the Departments of Education and Health and Human Services related to awareness, prevention and early identification of mental health conditions.

For more information about the bill, please click here.

In addition to Hagan, original cosponsors of the bipartisan legislation include HELP Committee Chairman Tom Harkin, Ranking Member Lamar Alexander, and Senators Al Franken (D-MN), Mike Enzi (R-WY), Michael Bennet(D-CO), Lisa Murkowski (R-AK), Tammy Baldwin (D-WI), Pat Roberts (R-KS) and Johnny Isakson (R-GA).


Bill to Reduce Student-to-Counselor Ratio: Help Get Co-Sponsors for the Student Support Act

Please click HERE for more information.

Please review the attached document for information on Education bills (P-12) that may have direct implications for counselors.

ACA UPDATE: Department of Veterans Affairs (VA)

American Counseling Association

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/
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.

ACA UPDATE: Good News / Bad News on Federal School Counseling Support

American Counseling Association

There is good news on federal support for school counselors and school counseling services!

According to recent statements by the U.S. Department of Education (ED), funding under the stimulus bill (the American Recovery and Reinvestment Act of 2009) can be used to save school counselors’ jobs. The stimulus bill includes billions of dollars in funding to shore up state budgets and avoid staff cuts, and constitutes the biggest one-time federal investment in K-12 education ever. ED staff have stated that stimulus funds disbursed to states through the State Fiscal Stabilization Fund, Individuals with Disabilities Education Act (IDEA), and Title I programs can be used to support school counselor positions.

ACA urges school counselors to educate their colleagues, administrators and officials—at the school, district and state levels—to use these stimulus funds to save school counselors’ jobs and their crucial services. Many school administrators and staff are not aware that stimulus funding can be used in this fashion.

Unfortunately, there is also some potentially bad news to report. The administration has released its fiscal year 2011 budget request to Congress, and is proposing to eliminate the Elementary and Secondary School Counseling Program (ESSCP) and other targeted initiatives. In their place, ED proposes a new “Successful, Safe, and Healthy Students” program that would establish measurements to enable States, districts, schools, and partners “to assess the need for, direct the provision of, and provide the resources and supports necessary for safe, healthy, and successful students.”

While ACA supports the stated goals of the proposed program, we are very concerned about the potential elimination of ESSCP, as it is the only program devoted to supporting school counseling programs and services. School counseling does not yet enjoy the recognition and support it deserves in state and local education agencies, making it important for federal education policy to provide a dedicated funding stream to create and expand school counseling programs.

In 2009, school districts in 29 states serving nearly 430,000 students obtained new grants to establish or expand school counseling programs and services in schools.

Congress will have the last word on ED’s proposals, and ACA is working with partner organizations to ensure school counselors are heard at the federal level and that ESSCP is maintained. But we need your voices! Please send your school counseling success stories to Dominic Holt at dhot@counseling.org or call Dominic at 800.347.6647 x 242.

Your advocacy makes a difference! Thank you so much!

ACA UPDATE: Federal Government Releases Mental Health/Substance Abuse Parity Regulations

American Counseling Association

The federal government has issued regulations to require parity of health insurance coverage for mental health and addictive disorder services, realizing a long sought-for goal of ACA and the rest of the behavioral health advocacy community. No longer will health insurance companies be allowed to use separate and unequal treatment limits and cost-sharing requirements to restrict use of mental health—and, for the first time, addictive disorder—services. The regulations implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

The regulations were released Friday, January 29th, and will apply to health plan years beginning on or after July 1, 2010. The regulations were issued as an ‘interim final rule,’ meaning that minor modifications may be made following the comment period, which ends May 3rd.

The regulations do not contain any provisions regarding individual types of practitioners, but focus instead on the broader issue of how health plans devise their benefits packages. Under the regulations, private group insurance plans covering 50 or more people will no longer be able to use treatment limitations or financial requirements for mental and addictive disorder care that are not also used for substantially all other covered services.

The regulations prohibit the use of both quantitative and non-quantitative types of treatment limitations on treatments. Thus, health plans will be prohibited from using both arbitrary numerical visit limits, and different preauthorization or utilization review procedures, for mental and addictive disorder services. The regulations apply the parity requirements to six separate components of a health plan: inpatient in-network care, outpatient in-network care, inpatient out-of-network care, outpatient out-of-network care, emergency care, and prescription drug coverage.

The regulation also prohibits the use of separate annual deductibles for mental and addictive disorder treatment coverage. Plans must use a single, combined annual deductible for all medical/surgical, mental health, and substance abuse care.

ACA will post more information regarding the parity regulations shortly, on our website. In the meantime, please contact me at sbarstow@counseling.org should you have any questions.

ACA ALERT: Ask Your Representative and Senators to Pass Health Care Reform!

American Counseling Association

The current U.S. health care ‘system’ is no longer sustainable. Health insurance premiums are rising faster than inflation (not to mention wages!), more and more businesses are choosing not to provide coverage for their employees, tens of millions of Americans don’t have coverage, and the U.S. spends roughly twice as much on health care per person as most developed nations while getting worse outcomes.

With both the House and the Senate having passed comprehensive reform bills, our nation has never been closer to establishing a framework for a health care system to provide near-universal coverage. At the same time, the counseling profession has never been closer to achieving independent reimbursement under Medicare, the nation’s single largest health insurance program. Both of these goals have been long-standing priorities for the American Counseling Association. The House-passed health care bill (H.R. 3962) includes Medicare coverage of counselors, and while the bill passed in December by the Senate (H.R. 3590) does not, it is our understanding that Senate offices are increasingly receptive to approving Medicare coverage of counselors. The health reform legislation is our best chance for making this happen.

We are very close to achieving an historic step forward, for both counselors and their clients, and we need House and Senate members to finish the job. We encourage counselors to call their Representative and Senators to ask them to vote for comprehensive health insurance reform, to enact such legislation this year, and to include Medicare coverage of counselors in the legislation.

The consumer organization Families USA is encouraging health care advocates to use a toll-free phone number they’ve set up, 1-800-828-0498, to call the U.S. Capitol Switchboard and ask members of Congress to enact comprehensive health insurance reform—like the bills passed by the Senate and House last year—as soon as possible. When the operator answers, ask to speak to your Representative, and when connected to your Representative’s office identify yourself as a constituent, and tell the staff member you want the Representative to vote for real health care reform. Please also convey your support for improving Medicare beneficiaries’ access to outpatient mental health services by establishing Medicare coverage of licensed professional counselors in the legislation.

Thank you for your help!

For more information or for questions, contact:
Scott Barstow
Director of Public Policy and Legislation
American Counseling Association
5999 Stevenson Avenue
Alexandria, VA 22304
703.823.9800 x234
703.405.9711 (cell)
703.823.0252 (fax)
800.347.6647 x234
703.823.6828 TDD

NCCA is proud to work with other statewide organizations to advocate for our clients. As a member of The Coalition, NCCA seeks to make sure our clients continue to have the services they need. Here is an article that appeared in the current issue of Behavioral Health demonstrating how NC mental health reform is impacting our clients.

The Coalition surveys impact of funding cuts

(1/7/2010) Press Release

Raleigh, NC — The Coalition, a group of 40 statewide organizations advocating together to meet the needs of North Carolinians living with mental illness, developmental disabilities, and the disease of addiction, launched an online survey in December seeking to capture the impact of budget cuts to the mental health, developmental disabilities, and addictive disease system and those it serves and share the information with policymakers. There are separate surveys for those who get services and supports, those employed delivering services, and those who operate organizations providing services. “Our aim is to look at cuts from many perspectives: the parent who has heard their child’s support hours will be cut, the individual who fears they will lose needed treatment, the employee who has been laid off, or the CEO who is cutting wages and closing programs due to lack of funds,” says Jennifer Mahan, The Coalition Chair.

The survey is a short questionnaire that asks if they know someone who has lost services, had services reduced, or is worried this will happen, then asks what kind of services, demographics about the person filling out the survey, and where the services are provided. The surveys for employers and employees are similar, but focus on loss of employment, wages, and the impact on the delivery of services.

Jennifer Mahan, who also works as Director of Policy for the Mental Health Association in North Carolina, has already seen her organization lay off 160 staff that provided direct services to people with mental illness. “Services are being cut across the board and we wanted to show that people are being affected now, and not wait until we have reports a year from now that shows the harm of these cuts. As a coalition that has advocated for increased funding for MHDDSAS since 1991, we must make it clear to lawmakers and budget writers that these cuts are hurting people.” The survey can be filled out again if the status of the person changes from fearing loss of services to actually having hours or services cut. The information is collected monthly and the survey will be available online until June 30th, 2010.

In the first month of the survey there have been over 590 individuals who have responded. Of those responding, 22.7 percent indicated that all of their services were lost; 54.4 percent reported their services have been reduced; and 22.9 percent are worried about losing all of their services or having them reduced in the future. According to Vicki Smith, Executive Director of Disability Rights NC, “The impact of the economic crisis of the lives of individuals is no longer a possibility but a reality for hundreds of people.”

Extension of Provisionally Licensed Providers Delivering Reimbursable Outpatient Therapy Services Billed Through the Local Management Entity (LME)

The purpose of this communication is to announce that the deadline for provisionally licensed providers delivering outpatient therapy as a reimbursable service under Medicaid and state funds and billed through the LME has been extended to June 30, 2010. Our Divisions will continue to pay for services delivered by provisionally licensed individuals billed through LMEs under codes H0001, H0004, and H0005 until that date.

As outlined in Implementation Update #32, the LME may chose to provide this service on behalf of the provisionally licensed professional. If the provisionally licensed professional is employed by an agency, the agency must develop a contract directly with the LME to do this billing for them. If the provisionally licensed professional works independently, they should contact their licensure board prior to developing a contract with the LME to ensure compliance with each profession’s Scope of Practice.

In addition to providing outpatient services billed through an LME, there are various other means for provisionally licensed professionals to obtain the clinical experience required by their licensing boards. These include:

  • providing outpatient Medicaid services working with a physician using Medicaid’s Incident To policy (see the March 2009 Medicaid Bulletin);
  • providing Enhanced MH/DD/SA services as the Qualified Professional (QP) in order to receive family and community based clinical experience; and
  • serving as the “Licensed Professional” in the Intensive In-Home service.

American Counseling Association

VA to Request New Occupational Category for Counselors

ACA and AMHCA are pleased to announce that the Department of Veterans’ Affairs (VA) has approved the establishment of a new occupational category, or categories, for licensed professional counselors and marriage and family therapists working within the VA’s Veterans Health Administration (VHA) health care system. The move is a step toward implementation of Public Law 109-461, the “Veterans Benefits, Healthcare, and Information Technology Act of 2006,” which established explicit recognition of both mental health counselors and marriage and family therapists within the VHA. Until the VHA’s endorsement of a new occupational category, it was unclear if counselors and marriage and family therapists would be considered merely subcategories of an existing occupational category for a different profession.

Establishment of an occupational category for professional counselors has been a key objective for ACA and AMHCA in implementation of the law. Federal occupational categories are developed by the Office of Personnel Management (OPM), but only at the request of federal agencies such as the VA. Creation of an occupational category will mark a key step in achieving recognition of the profession, although the process is likely to take another year or more.

The VHA’s announcement of the new occupational category came after the House Veterans’ Affairs Committee—which has direct jurisdiction over the agency—wrote to Secretary Eric Shinseki urging the VA to “move quickly” to establish regulations enabling counselors and marriage and family therapists to “work to their full potential within the VA.” The letter also stated that federal job classifications for each of the professions should be established, “in order to recognize their status as full-fledged, independent mental health professions.”

The House Veterans Affairs Committee letter was developed and promoted jointly by ACA, AMHCA, and the American Association for Marriage and Family (AAMFT). Our three organizations—recently joined by the California Association for Marriage and Family Therapy (CAMFT)—have been working closely together to push for implementation of P.L. 109-461. Our organizations’ close collaborative working relationship with AAMFT and CAMFT will increase our effectiveness in pushing for new occupational categories for each profession, and for continued progress by the VA and Congress in expanding the role of counselors and marriage and family therapists in serving our nation’s veterans.

Peter Atlee
Legislative Representative
American Counseling Association
ph 703-823-9800 x242 | 800-347-6647 x242