Congress Passes Landmark VA Mental Health Counselor Bill

This is great news for Counselors in Michigan!

September 24, 2020

Yesterday, the House of Representatives approved S. 785, sending a major VA mental health and counseling bill to President Trump for signature.  The bill is the most significant new legislation for the counseling profession in over a decade and a tremendous advancement for mental health counselors working for the federal government, and particularly the Department of Veterans Affairs.

This historic legislation directs the U.S. Office of Personnel Management to create the first ever federal government classification for mental health counselors, referred to as an Occupational Series. The Series will allow counselors to work in federal government agencies under the title of mental health counselor instead of generic Series that apply to many professions. Social workers and psychologists have had their own Occupational Series for decades and it is past time counselors have the same level of recognition. Creation of an Occupational Series for mental health counselors has been a top federal priority for national counseling organizations for many years and is a hard won success.

S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, also takes several steps to increase the hiring, training, and advancement of mental health counselors within the Department of Veterans Affairs (VA). The bill requires the Comptroller General of the United States to prepare a study on staffing levels of mental health counselors and marriage and family therapists. The study will identify “impediments to carry out the education, training, and hiring of mental health counselors and marriage and family therapists”, as well as a “description of the objectives, goals, and timing of the Department with respect to increasing the representation of such counselors and therapists.” The bill also creates scholarships for counselors interested in working for the VA Readjustment Counseling Program.AMHCA lobbying firm, Bergman Strategies, worked closely with Members and staff from the Senate and House Veterans Affairs Committees to develop and advance this important legislation. AMHCA was the only counseling organization to help shepherd this bill through both chambers, but partnered with the American Association for Marriage and Family Therapy / California Association of Marriage and Family Therapists.

S. 785 was introduced by Senators Jon Tester (D-MT) and Jerry Moran (R-KS), the Ranking Member and Chairman of the Senate Veterans Affairs Committee (SVAC). These Senators are long-term champions for increased recognition of mental health counselors, Senator Moran having introduced the original House bill that opened the VA to the profession in 2006. The SVAC passed the bill in December 2019, but the bill really started to gain steam when it passed the Senate on August 5, 2020.

AMHCA and AAMFT/CAMFT lobbyists had been working with the House Veteran Affairs Committee (HVAC) on companion legislation, but efforts intensified after Senate passage. Representative Jahana Hayes (D-CT) introduced H.R. 8145 on September 1, a standalone bill that matched the counselor components in S. 785. The legislation was included in a September 10 hearing and September 17 markup. House Veterans Affairs Committee Chairman Mark Takano (D-CA) and his staff showed strong commitment to the counselor legislation and ensured that it was maintained throughout the process.

S. 785 will be sent to President Trump for signature. The legislation requires creation of the counselor Occupational Series within one year from enactment. There is no timeframe for the Comptroller report on VA staffing, but it must be reported to the House and Senate Committees within 90 days of completion.

The passage of legislation to create an Occupational Series for mental health counselors is a tremendous success for the counseling profession and AMHCA is proud to have played such a pivotal role in its achievement. The Series will increase federal government recognition and hiring of mental health counselors. S. 785 will also expand employment and training of mental health counselors within the VA, a long-term priority of the association. AMHCA wants to thank Senators Tester and Moran, as well as Representatives Takano, Brownley, and Hayes for their commitment to this important legislation.

House Committee Passes Mental Health Counselor Medicare Legislation

James Blundo MMHCA Executive Director and a member of the AMHCA Public Policy and Legislation Committee and Midwest Director on the AMHCA Board of Directors worked along with Dr. Sarah Sue Schaffer and Dr. Jeremy Norwood to gain support from three Michigan members of the US House of Representatives.
The Three US Reps from on the Energy and Commerce Committee were contacted to request their support HR 945. Upton, Walberg, and Dingell all considered our request to vote for the bill. It passed out of the committee unanimously on Wednesday September 9, 2020.
David Bergman Legislative Affairs Consultant for AMHCA was extremely helpful to us in identifying and helping with talking points.
This is a huge victory for counselors in Michigan and the 140,000 mental Health Counselors in the Untied States. The struggle is far from over, but this is a great move forward.
Please participate in the Call to Action and thank Michigan’s members of the Energy and Commerce Committee of US House.

September 9, 2020

Today, the House Energy and Commerce Committee approved HR 945 in an historic vote supporting Medicare coverage for the counseling profession. While this legislation has passed both the House and Senate twice over the years, never before has the bill been voted on as a standalone measure rather than part of a broader package.

AMHCA Legislative Affairs consultant, David Bergman, posted an advocacy update in the AMHCA community today.

Energy and Commerce Committee Chairman Frank Pallone, Jr’s (D-NJ) opening remarks described HR 945 as “bipartisan legislation that would improve access to mental health providers in the Medicare program by covering mental health counselor and marriage and family therapist services.”

The sponsors of HR 945, Congressmen Mike Thompson (D-CA) and John Katko (R-NY), fought hard for inclusion of the legislation in the markup. They worked closely with committee staff and Members to build support for passage. Energy and Commerce Health Subcommittee Chairwoman Anna Eshoo (D-CA) also pushed for the bill, speaking on its behalf at the markup calling it a “blessing” and stating that “passage is a priority to me.” The Committee reported the bill to the full House by voice vote.

The future of HR 945 in this Congress is difficult to forecast. There are limited legislative workdays before Members leave for campaigning in October, although there is expected to be a post-election lame duck session that may provide additional opportunity. Further, a Senate calendar packed with COVID relief legislation and annual appropriations is offering little room for movement of our Senate companion bill, S. 286.

While the President’s signature cannot be guaranteed in the 116th Congress, this historic vote shouldn’t be underestimated. There remain paths for passage this year, and even if success is elusive, the Committee approval strengthens the chance for approval in the next Congress when mental health legislation is anticipated.

AMHCA thanks all members and leaders who contacted your Representatives in support of HR 945. We wouldn’t have been successful without your efforts and urge you to keep up the good work when we make our next push. We also encourage you to contact your Representatives, particularly our champions, to thank them for their support.

You can use the following link to find your Representative with email and phone numbers:

Find my Representative

 

Latest Executive Orders (EO) that affect LLPCs, LPCs and other licensed mental healthcare providers

Dear MMHCA members and allies,

The following is information about the latest Executive Orders (EO) that affect LLPCs, LPCs and other licensed mental healthcare providers. The information is up to date as of 9/4/20.

Executive Order 2020-175 replaces EO 2020-97. Its title is “Safeguards to protect Michigan’s workers from COVID-19.” In EO 2020-175 under number 9. Healthcare it states “Outpatient health-care facilities…must: (k) Employ telehealth and telemedicine to the greatest extent possible.” It remains the licensed Counselor’s decision if a client cannot be seen via telehealth and must be seen face to face instead, but clearly requires we use telehealth “to the greatest extent possible.” That being said, there are absolutely a variety of legitimate reasons why a client would need to be seen in person. MMHCA does recommend if you are seeing clients in person that you document why the client cannot be met with via telehealth. The rest of section 9. Healthcare in this EO details procedures that must be followed if a client/patient needs to be seen in person. EO 2020-175 was signed 9/3/20 and can be viewed here: https://content.govdelivery.com/attachments/MIEOG/2020/09/03/file_attachments/1535444/EO%202020-175.pdf

Executive Order 2020-177 was also signed 9/3/20. EO 177 extends the State of Emergency to October 1, 2020. https://content.govdelivery.com/attachments/MIEOG/2020/09/03/file_attachments/1536731/EO%202020-177%20Emergency%20declaration.pdf

EO 2020-176 replaces EO 160 and 162. Its title is “Safe Start.” The first item in this directive reinforces the directive from the EO it replaces concerning the fact that work that can be done remotely “must” be done remotely. In two regions, 6 and 8 (which are defined on page 10 of the EO) where Covid 19 is under better control, the order says “should” work remotely rather than “must.” EO 2020-176 can be viewed here: https://content.govdelivery.com/attachments/MIEOG/2020/09/03/file_attachments/1535448/EO%202020-176.pdf

EO 2020-153 replaces EO 147. Its title is “Masks” and can be viewed here: https://content.govdelivery.com/attachments/MIEOG/2020/07/17/file_attachments/1498115/EO%202020-153%20Emerg%20order%20-%20Masks%20-%20re-issue.pdf

EO 2020-138 replaces EO 86 and is titled “Encouraging the use of telehealth services during the COVID-19 emergency” and can be viewed here: https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-533221–,00.html

Below are several other links you may find helpful.

You can receive immediate updates from the State of Michigan about new executive orders by going to https://www.michigan.gov/coronavirus    Under “press releases” subscribe to “news releases from state emergency operations center”.

The State of Michigan has the following list of resources regarding mental health during Covid-19: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_99557—,00.html

The CDC document “Using Telehealth to Expand Access to Essential Health Services during the COVID-19 pandemic” can be viewed here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

“As the pandemic continues, healthcare systems must balance the need to provide necessary services while minimizing risk to patients and healthcare personnel (HCP).” (from the Centers for Disease Control and Prevention website)

We will do our best to keep you updated and informed.

Best wishes to you always,

MMHCA Public Policy Committee, and MMHCA Leadership Team

Selecting A Supervisor Training Program

SELECTING A SUPERVISOR TRAINING PROGRAM

By: James Blundo Executive Director MMHCA

As Executive Director of MMHCA with many years of counseling experience I want to address the issue of Supervisor Training. It is extremely important that you pick wisely. I have observed several inquiries on Facebook about the selection process of finding your best options for training.

Evaluate the Investment.

Here are some important considerations to think about when making a decision about what training is the best for you. The Michigan Board of Counseling Rules specify what supervisor training must include.  It is important that your training program meet these requirements.  They can be found in Rule. 333.1757 (2).  Be aware that the current Rules were written for the 1988 law, and a new set of rules is currently being promulgated for the 2019 law.

Evaluate the Trainer.

Is the trainer willing to provide a list of people who have taken the training so that you can contact them and ask about the training?  This approach usually yields more significant information when you select someone from a list to ask questions of rather than simply relying on testimonials and revues. Will this program truly prepare you for the new role you are taking on as a supervisor?

Evaluate the Program.

Beyond just providing a training to meet training requirements to be a supervisor, what added value does the program provide? It might surprise you to know that there are no particular requirements in the Rules concerning who can provide this training.  There is no requirement that someone providing supervisor training has actually done supervision.  There is no requirement that the trainer be licensed as an LPC. Because Licensure laws and supervision requirements vary from state to state, you will probably want to make sure that your trainer is licensed to practice in Michigan and is a qualified supervisor in Michigan.  

Questions to ask about the trainer:

How long has your trainer been licensed to practice in Michigan?  You can go to the verify a license section on the LARA website (https://www.michigan.gov/lara/0,4601,7-154-89512—,00.html) to see when your trainer’s license was issued.

How long has your trainer provided supervision in Michigan?

How do they meet the requirements to be a supervisor?  Michigan Rules require that supervisors provide their supervisees with a statement detailing how they meet the requirements to be a supervisor. Don’t hesitate to ask your trainer for a copy of this statement.

What supervision credentials does your trainer hold?  The national credential for supervisors is the Approved Clinical Supervisor Credential (ACS).  The MITS credential for Michigan supervisors designates a qualified supervisor with training that needs Michigan requirements.  The Center for Credentialing and Education, which issues the ACS credential, provides a link to National Board for Certified Counselors (NBCC) ACEP (Approved Providers of Continuing Education.)

https://www.nbcc.org/search/acep_by_state?statecode=MI.

Other resources related to your decision making:

MI Administrative Code(s) for Licensing and Regulatory Affairs – Bureau of Professional Licensing

Licensed Professional Counseling Rule/Law regarding LLPC Supervisors’ trainer/training

I hope you will consider membership in MMHCA. We have great action plans for your future as an LLPC/LPC.  Please join our 1000 plus members.

See our website for information and to join or renew.

 www.mmhca.org

New Study Shows More Than 100 Million Americans Will Suffer A Mental Health Disorder This Year

Confluence of Racism, COVID-19, and Economic Crisis Results in Massive Wave of New Anxiety and Depressive Disorders, and Immense Trauma

NEWS PROVIDED BY 

American Mental Health Counselors Association 

Aug 24, 2020, 07:14 ET

ALEXANDRIA, Va., Aug. 24, 2020 /PRNewswire/ — The American Mental Health Counselors Association (AMHCA) announced today the release of a major report — “Beyond a Perfect Storm: How Racism, COVID-19, and the Economic Meltdown Imperil Our Mental Health,” that calls for a response to the fact that over 40 percent of Americans now have an anxiety disorder and depression. By comparison, in 2019, only 8 percent of adults had symptoms of anxiety disorder and 6 percent had symptoms of a depressive disorder.

Americans are suffering from mental health disorders on a scale rarely seen before, due to a perfect storm of systemic racism, the COVID-19 pandemic, and economic turmoil. By the end of 2020, more than 103 million adults in the United States will suffer mental health disorders, according to the new report.

“The confluence of events this year has created a ‘perfect storm’ that has swamped the mental health and well-being of all people, and especially those who identify as Black Americans,” said Angele Moss-Baker, President of the American Mental Health Counselors Association and one of the report’s co-authors. “The resulting tsunami of mental health concerns requires a comprehensive and integrated policy response with intentional, culturally responsive policy and practices to reduce the negative impacts of racial trauma, discrimination, and oppression while promoting short- and long-term mental health and well-being.”

In addition to threatening Americans’ physical health and economic stability, the coronavirus pandemic has caused high levels of emotional distress throughout the country. The levels are so high in fact that the report’s co-authors believe the country faces an imminent national mental health crisis—unless Congress, states, and local communities act. Undeniably, U.S. society is in a collective state of traumatic distress.

The AMHCA report lays out a series of vitally needed policy changes that can mitigate the mental health crisis. Crucial changes include federal legislative initiatives that would recognize clinical mental health counselors and marriage and family therapists in the Medicare program. This one change alone would enable Americans with mental health conditions to access both in-person and virtual services in a timely fashion and at reasonable rates.

Read the complete report at: https://www.amhca.org/publications/reports/beyond-perfect-storm

Reprint compliments of:  Michigan Mental Health Counselors Association (MMHCA) 

Governor Whitmer Signs Executive Directive Strengthening Enforcement of COVID-19 Orders to Save Lives

Yesterday’s Executive Order has been further clarified. This reinforces MMHCA’s advice given previous to yestereday’s order. Seeing clients face to face needs to be the exception in order to comply with these orders.
If you see someone in person, be able to defend your decision to do so. There are circumstances where this is the best way to work.
If you can see them on doxy.me or on another HIPPA compliant remote method, please do so.
I would highly recommend using Dr. Larry Pfaff’s Tutorial on our website. You will find it under the news tab.  It will help you in the decision making process. Go to:  https://mmhca.org
Please read the Governor’s Executive Order from July 31st on our website  and the one below issued August 4th.

FOR IMMEDIATE RELEASE

August 4, 2020  Contact: Press@Michigan.gov

Governor Whitmer Signs Executive Directive Strengthening Enforcement of COVID-19 Orders to Save Lives 

LANSING, Mich. — Governor Whitmer signed Executive Directive 2020-08 today to direct state departments and autonomous agency heads to review allocation of their resources to ensure that enforcement of COVID-19-related laws is a priority, such as limitations on capacity and the requirement to wear a mask when entering a Michigan business. Cases have risen over the past month—from a rolling seven-day average of about 15 cases per million on in mid-June, the low point since the peak last April, to about 50 cases per million in late July.

Without effective enforcement, Michigan will move backwards, causing individuals, businesses, and the economy to suffer. The governor’s directive therefore requires state departments and agencies to ensure that enforcement of COVID-19-related laws receives the priority that fighting a pandemic demands. Under the directive, directors and agency heads should assign elevated priority to enforcement of COVID-19-related laws in categories of establishments where transmission is well-documented, including but not limited to nursing homes, meat processing plants, and agricultural housing.

“Ensuring these executive orders are enforced across the state will protect Michigan families, small businesses, and the first responders on the front lines of this crisis,” said Governor Whitmer. “This fight is not over yet. During the month of July we saw an increase in positive COVID-19 cases in every region of the state. By allocating the appropriate and needed resources, we can continue to save lives and ensure we don’t have to move backward.”

Executive Directive 2020-08 requires departments to consider violations of law when determining eligibility for licensing. This includes any violation of relevant COVID-19 executive orders or epidemic orders. If a state department or agency becomes aware of non-compliance under the law they must consider it to be presumptive evidence of a “public health hazard” or “imminent and substantial hazard to the public health” and take appropriate steps to mitigate any risk to public health and safety. This includes, but is not limited to, suspension of a license or cessation of operation of a food establishment.

Ensuring the governor’s executive orders are enforced is necessary to slowing the spread of COVID-19 and saving lives. The Michigan State Police will enforce violations of these COVID-19 related laws, such as executive orders and DHHS epidemic orders, in the same manner as any other violation of law, applying their discretion as appropriate. Departments and agencies who become aware of a violation must share that information with relevant licensing authorities, and collaborate on enforcement to ensure efficiency and effectiveness.

To view Executive Directive 2020-08, click the link below:

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Amended Governor’s Safe Start Orders effective date: July 31, 2020

MMHCA Alert for Mental Health Counselors

Amended Governor’s Orders effective date: July 31, 2020

EXECUTIVE ORDER No. 2020-160

Amended Safe Start Order

Rescission of Executive Orders 2020-110, 2020-115,

                                                               2020-120, 2020-133, and 2020-143

Below is a direct link to the Governor’s orders.

https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-535195–,00.html

MMHCA wanted to make sure that you were aware of the Governor’s latest Executive Order No. 2020-160.  A link is included for your information and review.  Please note the first directive in this order:

  1. Remote work. Any work that is capable of being performed remotely (i.e., without the worker leaving his or her home or place of residence) must be performed remotely.

This directive clearly says must, not should.  It will require all LPCs and LLPCs to examine their practice carefully.  If, in their clinical judgment, they determine that any client, for clinical reasons, needs to be seen in-person, this should be carefully and thoroughly documented as to why they have chosen to violate the order.  Such documentation is not only clinically indicated, but will serve to protect the LPC should issues arise from this decision.

Dr. Larry Pfaff created a tutorial to assist mental health practitioners in deciding which clients need to be seen in-person, as well as the proper protocols for practicing this way at this time. CLICK HERE to view his tutorial.

Please note that this executive order continues to give us permission to do supervision virtually.

The following is the portion of the Governor’s order that impacts health providers directly.

“Acting under the Michigan Constitution of 1963 and Michigan law, I find it reasonable and necessary, for the reasons outlined above, to order:

  1. Remote work. Any work that is capable of being performed remotely (i.e., without the worker leaving his or her home or place of residence) must be performed remotely.
  1. Workplace safety. Any business or operation that requires its employees to leave their home or place of residence for work is subject to the rules on workplace safeguards in Executive Order 2020-161 or any order that may follow from it.
  1. Individual responsibility. Any individual who leaves his or her home or place of residence must:

(a) Follow social distancing measures recommended by the Centers for Disease Control and Prevention (“CDC”), including remaining at least six feet from people from outside the individual’s household to the extent feasible under the circumstances; and (b) Follow the rules described in Executive Order 2020-153 or any order that may follow from its governing masks.”

House Committee Considers H.R. 945 – Urgent Action Requested to Contact Your Congressional Representative

Some News with Regards to Medicare Reimbursement to Mental Health Counselors!

On June 30, the Health Subcommittee of the House Energy and Commerce Committee held a legislative hearing that included H.R. 945, which provides Medicare reimbursement to mental health counselors. The Heath Subcommittee hearing on “High Anxiety and Stress: Legislation to Improve Mental Health During Crisis” considered 22 bills to improve both quality and access to mental health care in America.

This historic hearing was the first time that counselor Medicare legislation was evaluated as a stand-alone measure. All previous congressional action included our legislation as a piece of a broader health care package. During the hearing, Congressman Morgan Griffith (R-VA) strategically highlighted the significant benefits of H.R. 945.

The Energy and Commerce Committee is expected to hold a markup of a selection of these mental health bills in the future. It is critical that H.R. 945 be included in list of bills for markup. To ensure that happens, Representatives need to hear from mental health counselors in their district about the importance of including our bill.

We urge you to contact your Representative this week and ask him/her to include H.R. 945 in the House Energy and Commerce markup of mental health legislation.

Use the link below to find your Representative with email and phone numbers:

Find my Representative

Sample message for call or email [please fill in bracketed sections]:

I am a mental health counselor from [city/state]. I urge Representative [___] to request inclusion of H.R. 945 in the Energy and Commerce Committee markup of mental health legislation. H.R. 945 authorizes licensed mental health counselors to provide mental health and addiction services to Medicare beneficiaries. H.R. 945 ensures that 40% of the mental health workforce is available to deal with the behavioral health crisis that is being created by the COVID-19 pandemic. Access to care was a key priority of the Energy and Commerce Committee’s legislative hearing and H.R. 945 was the only bill that expanded the clinical workforce to meet the growing demand. I urge Rep. [____] to increase the availability of behavioral health services by requesting inclusion of H.R. 945 in the Energy and Commerce Committee markup of mental health legislation. Thank you for your consideration.

Governor Reissues the Emergency Order 2020-138 for Telehealth!

Below is the correct posting for the Governor’s new executive order on Telehealth.

EO 2020-138 Emerg order – telehealth – re-issue

MMHCA would like to highlight two parts of what the governor orders at the end:

Number 5 which references the law requiring that the provider be licensed in Michigan to provide Telehealth to Michigan residents and relaxes this requirement while the state of emergency is in place.

Number 7 (b) which defines “healthcare providers” As including health professionals licensed under article 15 of the public health code which includes LPC’s. This addresses the question that seems to be asked a lot, “does this include us?”

We have included two other pieces of information: MCL 500.3476, The law requiring that providers of telehealth to Michigan residents be licensed in Michigan CLICK HERE, and the definition of telehealth in the public health code CLICK HERE.

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