Much of the news we report here comes from Beth Powell of the American Mental Health Counselors Association.  Beth is as well informed regarding the national issues that effect our profession and we appreciate her alerts!
www.amhca.org; 800-326-2642, x105; bpowell@amhca.org

FIND AND CONTACT YOUR U.S. AND STATE SENATORS AND REPRESENTATIVES BY CLICKING HERE

IMPORTANT!!!

The Senate is about to vote on broad tax relief extension legislation which includes mental health and addictive disorder parity provisions!  The parity provisions are the result of long, careful negotiations and the passage by both the House and Senate of landmark parity bills (H.R. 1424 / S. 558) earlier this Congress.  A vote is expected either today (Thursday, 9/18) or tomorrow.  

ACTION NEEDED:  Call your Senators to ask them to VOTE FOR the tax extenders legislation, including the mental health parity provisions.  

SUGGESTED MESSAGE:  “I’m calling to ask the Senator to vote for the tax relief extension legislation, and the important mental health parity provisions included in the legislation.  American with private health insurance deserve the same parity of insurance coverage for mental and addictive disorders that members of Congress and all other federal employees get.”  

As always, be sure to leave your name and postal address with the Senator’s staff person, and feel free to share your individual concerns regarding the lack of health insurance parity for coverage of mental health services.  All Senate offices can be reached by calling the U.S. Capitol Switchboard at 202-225-3121, and asking for a particular Senator’s office.  To find out who your Senators are, go to http://capwiz.com/counseling, and enter your zip code in the space provided. 

Mental Health Services Should Be More Accessible in Primary Care Settings

A multi-agency report released on July 23, 2008 , proposes strategies to overcome barriers associated with the reimbursement of mental health services provided in primary care settings, and recommends that non-physician practitioners under Medicare and Medicaid be reimbursed, particularly in underserved and urban areas.

The report was issued by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Health Resources and Services Administration (HRSA), and the Centers for Medicare & Medicaid Services (CMS), three agencies within the Department of Health and Human Services.

“The actions identified in this study are practical as well as achievable,” said Terry Cline, Ph.D., administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). “Improving access to timely and targeted mental health services in primary care settings can improve patient health and compliance with treatment.”

Mental health service consumers, practitioners, providers, researchers and government officials have identified seven barriers and made suggestions for action aimed at alleviating the barriers to the reimbursement of mental health services in the primary care setting.

The main priorities and actions recommended in the conclusions of the report, Reimbursement of Mental Health Services in Primary Care, include the following:

·         Increase leadership collaboration at the federal and state levels among government policymakers in Medicare, Medicaid, primary care, and mental health to ensure clarity in policies, rules, and procedures, and to promote the provision and reimbursement of mental health services in primary care settings;

·         Broadly disseminate clarified policies and procedures to patients, payers, practitioners, providers, and managers of care;

·         Provide technical assistance and education to states, practitioners, providers, and managed care organizations;

·         Encourage flexibility in state Medicaid benefit designs to cover mental health services in primary care settings, modeling changes based on best practices achieved through existing state Medicaid waivers;

·         Increase payment for professional services by non-physician practitioners under Medicare and Medicaid, particularly in underserved rural and urban areas;*

·         Implement policies at the state level for appropriate reimbursement of telemedicine services; and,

·         Provide reimbursement for mental health prevention and screening services.

*The report provides information about the reimbursement status of professional counselors under Medicare and the report recommends that non-physician practitioners under Medicare and Medicaid be reimbursed, particularly in underserved and urban areas.

The full report is available on the Web at http://download.ncadi.samhsa.gov/ken/pdf/SMA08-4324/SMA08-4324.pdf.

Calls Needed on Mental Health Parity

The American Mental Health Counselors Association (AMHCA) and the American Counseling Association (ACA) have for years been working with Congress to require health plans to cover mental health disorders and drug and alcohol addiction on par with physical illnesses.

AMHCA and ACA invite their members to call their Senators and Representatives about mental health parity legislation.

AMHCA, ACA, and other mental health advocates have been pushing hard since 2001 to enact full mental health parity, and victory is finally within reach. Following the Senate’s historic passage of S. 558 by unanimous consent in September, and House passage of H.R. 1424 on March 5, informal negotiations commenced.  Mental health providers across America should contact their Representative and Senators NOW to urge their support for successfully concluding this process.  Senate and House leaders must continue to work together to reconcile differences between the versions and produce a bill that can pass both chambers before the end of the year. 

Background:

With suicide claiming some 30,000 lives each year in this country, health benefit barriers still block millions of Americans from getting needed mental health and substance-use treatment. Given the critical need for Congress to lift those discriminatory barriers, and a limited number of legislative days to do so, there is profound urgency to forge a compromise on mental health parity legislation that will not only yield strong protections but will also pass both chambers. We applaud initial steps to reach that compromise, and call on Senate and House leaders to move quickly to ensure enactment of a strong mental health parity law this year.

Failure to pass a parity bill in 2008 would further delay relief for millions of American families who face discrimination now.  It would also place the issue directly in the path of a potential health care policy tornado in 2009 – health care reform – with no assurance that our issue would receive the attention it needs.

Targets: All Members of the House of Representatives and Senate.

Action: All AMHCA and ACA members, and others interested in this issue, are urged to call your Representative and Senators by using the toll-free Parity Hotline, 1-866-PARITY-4 (1-866-727-4894). (The Parity Hotline reaches the Capitol switchboard, which can connect callers to their Members of Congress). Please be sure to leave your name and address with the staff member to make it clear that you are a constituent.

Message:

The Legislation: Both S. 558 and H.R. 1424 expand the Mental Health Parity Act of 1996 by prohibiting group health plans from imposing treatment or financial limitations on mental health benefits that are different from those applied to medical/surgical services. The legislation applies only to group health plans already providing mental health benefits and exempts plans sponsored by small businesses of 50 or fewer employees.

E-News from Washington

Vol. 08-08

February 13, 2008

Congress to begin work on Medicare in the coming months

This past December Congress passed and the President signed S. 2499, legislation that extends the State Children's Health Insurance Program (SCHIP) through March 2009 and delays impending pay cuts to Medicare physicians through June 2008.

After the House passed substantial Medicare reform legislation (H.R. 3162—the CHAMP Act) in August, the Senate began work on similar legislation. Unfortunately, as the end of 2007 approached, the Senate ran out of time to pass any significant reforms to the program and, instead, was forced to pass "bare-bones" legislation (S. 2499) to do little more than delay looming physician pay cuts, which, due to limited available funding and time, will only last for six months.

The short-term nature of S. 2499 means that Congress will have to pass further Medicare legislation before the June 30, 2008 or face the possibility that many physicians will stop accepting Medicare patients.

Staff for the Senate Finance Committee have been engaged in informal discussions on future Medicare legislation for the past few weeks, and are expected to begin addressing specific provisions in March after the Congressional Budget Office announces its new funding baselines for 2009.  An aide to Senator Blanche Lincoln (D-AR), sponsor of S. 921, believes that a bill will be introduced sometime in April, noting that the Senator Max Baucus (D-MT), Chair of the Finance Committee, is dedicated to taking significant action on Medicare this year.

Continuing work on Medicare legislation means that Congress will have another chance to expand Medicare's provider base by including professional counselors in the program.  Representatives from AMHCA and ACA will be visiting Senate offices in the next few months to ask Senators to co-sponsor S. 921 and work to include Medicare reimbursement of counselors in any broad Medicare legislation. 

Counselors are encouraged to write/call/email their legislators and ask them to do the same.  All Senate offices can be reached by calling 202-224-3121 and asking for your Senator's office.  In your message to the Senator, please consider including the following points:

Members of the Finance Committee will be influential in drafting this legislation, so counselors in Montana, West Virginia, North Dakota, New Mexico, Massachusetts, Arkansas, Oregon, New York, Michigan, Washington, Colorado, Iowa, Utah, New Hampshire, Maine, Arizona, Kentucky, Idaho, Kansas, and Nevada are especially encouraged to call and may be receiving a second email specifically tailored to these Senators.

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]

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).

E-News from Washington

Vol. 08-04

January 24, 2008

House Passes Inmates' Mental Health Bill

On Wednesday, January 23, 2008, the U.S. House of Representatives passed, by voice vote, H.R. 3992, the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act, legislation to improve mental health services for inmates and improve training for law enforcement officers.

In addition to expanding existing grants available under the Mentally Ill Offender Treatment and Crime Reduction grant program created in 2004, H.R. 3992 authorizes an additional $35 million annually in fiscal years 2008-2013 for four new grant programs focusing on the treatment of female prisoners who are mentally ill, coordination of the treatment of mentally ill prisoners, screening, identification and assessment of mentally ill inmates, and coordination of post-release services.

The purpose of the legislation is to encourage mental health and criminal justice systems to work together in devising new, more effective ways to assist the mentally ill. Demands for grants available through this program have far exceeded their availability. In 2006, for example, only 27 (11%) received funding out of 250 submitted grant applications from states and communities.

The Senate has not acted on a companion measure (S 2304) introduced in November of 2007.

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.

E-News from Washington

Vol. 08-08

February 13, 2008

Congress to begin work on Medicare in the coming months

This past December Congress passed and the President signed S. 2499, legislation that extends the State Children's Health Insurance Program (SCHIP) through March 2009 and delays impending pay cuts to Medicare physicians through June 2008.

After the House passed substantial Medicare reform legislation (H.R. 3162—the CHAMP Act) in August, the Senate began work on similar legislation. Unfortunately, as the end of 2007 approached, the Senate ran out of time to pass any significant reforms to the program and, instead, was forced to pass "bare-bones" legislation (S. 2499) to do little more than delay looming physician pay cuts, which, due to limited available funding and time, will only last for six months.

The short-term nature of S. 2499 means that Congress will have to pass further Medicare legislation before the June 30, 2008 or face the possibility that many physicians will stop accepting Medicare patients.

Staff for the Senate Finance Committee have been engaged in informal discussions on future Medicare legislation for the past few weeks, and are expected to begin addressing specific provisions in March after the Congressional Budget Office announces its new funding baselines for 2009.  An aide to Senator Blanche Lincoln (D-AR), sponsor of S. 921, believes that a bill will be introduced sometime in April, noting that the Senator Max Baucus (D-MT), Chair of the Finance Committee, is dedicated to taking significant action on Medicare this year.

Continuing work on Medicare legislation means that Congress will have another chance to expand Medicare's provider base by including professional counselors in the program.  Representatives from AMHCA and ACA will be visiting Senate offices in the next few months to ask Senators to co-sponsor S. 921 and work to include Medicare reimbursement of counselors in any broad Medicare legislation. 

Counselors are encouraged to write/call/email their legislators and ask them to do the same.  All Senate offices can be reached by calling 202-224-3121 and asking for your Senator's office.  In your message to the Senator, please consider including the following points:

Members of the Finance Committee will be influential in drafting this legislation, so counselors in Montana, West Virginia, North Dakota, New Mexico, Massachusetts, Arkansas, Oregon, New York, Michigan, Washington, Colorado, Iowa, Utah, New Hampshire, Maine, Arizona, Kentucky, Idaho, Kansas, and Nevada are especially encouraged to call and may be receiving a second email specifically tailored to these Senators.

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]

E-News from Washington

Vol. 08-04

January 24, 2008

House Passes Inmates' Mental Health Bill

On Wednesday, January 23, 2008, the U.S. House of Representatives passed, by voice vote, H.R. 3992, the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act, legislation to improve mental health services for inmates and improve training for law enforcement officers.

In addition to expanding existing grants available under the Mentally Ill Offender Treatment and Crime Reduction grant program created in 2004, H.R. 3992 authorizes an additional $35 million annually in fiscal years 2008-2013 for four new grant programs focusing on the treatment of female prisoners who are mentally ill, coordination of the treatment of mentally ill prisoners, screening, identification and assessment of mentally ill inmates, and coordination of post-release services.

The purpose of the legislation is to encourage mental health and criminal justice systems to work together in devising new, more effective ways to assist the mentally ill. Demands for grants available through this program have far exceeded their availability. In 2006, for example, only 27 (11%) received funding out of 250 submitted grant applications from states and communities.

The Senate has not acted on a companion measure (S 2304) introduced in November of 2007.

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.

E-News from Washington

Vol. 08-12

March 6, 2008

House Passes Historic Parity Legislation!

On March 5^th the House of Representatives passed comprehensive legislation requiring private health insurance plans to use the same treatment limitations and financial requirements for mental health and addictive disorder coverage as is used for substantially all other covered services. H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” introduced by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), was passed with strong bipartisan support by a vote of 268-148. (House members’ votes are listed online at http://clerk.house.gov/evs/2008/roll101.xml.) The legislation is named for the late Senator Paul Wellstone of Minnesota , a tireless advocate for Americans with mental illness.

House passage of H.R. 1424 is an historic step forward for mental health and addiction treatment advocates, and comes after years of hard work by the mental health and addictive disorder advocacy community. Although similar in many respects to legislation passed last year by the Senate, H.R. 1424 provides more consumer protections by requiring plans covering mental and addictive disorder treatments to cover the full range of disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the same range of disorders as is covered for members of Congress and all other federal employees under long-standing requirements for Federal Employee Health Benefits Program (FEHBP) policies. Unlike the Senate’s bill, H.R. 1424 also stipulates that health plan covering out-of-network services for medical and surgical benefits must also offer out-of-network coverage for mental health and addictive disorder benefits. This requirement applies for both outpatient and inpatient care.

AMHCA and ACA applaud Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) for their long, hard, heroic work in gaining House passage of H.R. 1424. During floor debate, both Kennedy and Ramstad spoke about their own personal battles with mental and addictive disorders, their treatment, and how their treatment has enabled them to lead productive lives. AMHCA and ACA also thank those counselors who took the time to contact their representative on this issue.

Attention now shifts to House-Senate negotiations to reconcile their chambers’ versions of the parity legislation. Like the business community, the Bush administration argued in favor of the weaker Senate version, issuing a statement of policy expressing opposition to H.R. 1424. Despite this, AMHCA, ACA and other mental health and addictive disorder advocates are now working to build upon the strong bipartisan support for H.R. 1424 and the unanimous passage last year of the Senate’s bill, to encourage the development and enactment of parity legislation that provides consumer protections that are as strong as possible.

For more information on this issue—or to find out how you can help—contact Beth Powell with the American Mental Health Counselors Association at 703-548-6002 x105, or at bpowell@amhca.org or Scott Barstow with ACA at 800-347-6647 x234, or at sbarstow@counseling.org.

Why Legislative Advocacy is Key to the Future of Mental Health Counseling

 Legislative activities at the federal, state and local levels affect all aspects of the mental health counseling profession. In the most fundamental terms, lack of support from policymakers may mean that mental health counselors are not included in state and federal programs. Conversely, strong support can mean the inclusion of mental health counselors in federal health programs, such as Medicare and Medicaid.

Why get involved in the legislative process? Because the profession’s future depends on the advocacy efforts of mental health counselors like you. Everyone – each mental health counselor – must play an active role in the legislative arena to improve federal policy regarding mental health counselors.

In Washington , groups such as the American Mental Health Counselors Association (AMHCA) derive part of its influence from the fact that it represents concentrations of voters, also known as constituents. Constituent pressure is a very effective tool. Legislators listen to what their constituents have to say, especially if they are visible and persistent in communicating their cause. They listen to what you have to say. Your grassroots advocacy effort can make key difference in future legislative decisions.

One of the most important actions you can take in support of your profession is to develop a good relationship with a legislator and his or her staff. Getting to know each other and helping legislators understand the role that mental health counselors play in the mental health field are the most effective ways to influence the legislative process.

 Communicating with your Legislators

As a mental health counselor, you need to develop an ongoing relationship with your member of Congress in which there is two-way communication.

Members of Congress want and need to hear from their constituents. Each legislator must consider a vast number of issues. These issues are divided among staff that is responsible for following legislative activity and constituent support for each of their assigned issues. A staff member may be responsible for 20 or more broad issues and is seldom an expert in all of them. Staff members rely on a multitude of resources to keep them knowledgeable on these issues, including groups like AMHCA and experts like you.

Mental health counselors must be proactive and offer to serve as a resource to members and their staff. You are in an excellent position to provide them with information about your profession and the role that you play in your community. Once you have developed a working relationship with the member and his or her staff, they will look to you more often and ask for your input as these issues come forward. By establishing yourself as a reliable source of information, you are improving your access to the member.

Mental health counselors typically are effective communicators. This is important in working with clients as well as influencing policy makers. There are many options available for communicating with policy makers: letters, faxes, telephone calls, personal visits and e-mail. Logic dictates that if you are trying to influence something that is going to happen immediately, faxes and phone calls are the best option. E-mail is an option as well, especially when communicating with staff members. If you need to provide detailed information and have a longer period of time in which to work, a personal letter is more likely to get the legislator’s attention.

Keep in mind that as our issues come before Congress, it is much easier to ask a friend for something than it is to ask a stranger!

Guidelines for Communication

Whether you write, call, e-mail or visit your legislator, some basic guidelines are applicable to all methods of contact. They are:

<Identify Yourself.

Identify yourself as a constituent by providing your address and congressional district. Identify yourself as a mental health counselor and give your area of expertise. In addition, identify yourself as a member of AMHCA and your state mental health counselors association. This will further enhance your credibility and effectiveness by linking you to a broader advocacy effort.

 <Be Prepared.

Know your issue. Know the legislation you support and the impact it will have on your profession, organization or local community, and, if appropriate, on the nation as a whole. Know and use statistics and facts whenever possible. In this age of accountability, numbers matter! Keep abreast of issues through the Advocate and AMHCA’s E-News from Washington and contact us if you have any questions. Contact your state chapter for state-level advocacy assistance.  

<Be Specific.

Be specific and state the action you want the legislator to take, such as: vote in a certain manner; introduce legislation or co-sponsor a bill. If the member expresses support for your position, hold him or her to that commitment. Whenever possible, refer to a specific piece of legislation by its number.

<Be Concise.

Be concise in your written or verbal communications. Legislators and their staff have limited time to devote to any one issue. A one- or two-page fact sheet can summarize your points and is more likely to be read and filed for future reference than a 10-page document. In face-to-face meetings, highlight key issues and leave behind a fact sheet as a reminder of essential points you want the legislator to have on hand. 

 <Be Constructive.

Be pleasant, polite and use a “soft-sell” approach even if a legislator does not agree to support you in a specific instance. Do not threaten or make negative comments. You are looking for a continuing relationship and very likely will need the legislator’s support on issues in the future. In the meantime, feel confident that you have shared your information in a positive manner.

<Follow Up.

Follow legislation throughout the legislative process and be prepared to contact your legislator several times on one issue. You can contact the legislator prior to a committee vote, before a floor vote or when there is a lot of press activity on the issue. Keep the pressure on him or her through your continued contact on the issue.

<Continue the Connection.

It is important to continue developing ties with your legislator and his or her staff. In addition to contacting them about specific legislation or issues, also:

 ¨ Congratulate them on honors received or elections won. Thank them for a positive vote on your issue or on actions taken that are important to the community. 

¨ Legislators appreciate, but seldom receive, thank you letters for actions taken. Be among those who show appreciation for their support and you will be remembered!

¨ Sharing news with your legislator is an ideal way to promote your issues and to highlight the impact it has made on his or her constituents. This is an easy way to continue to develop and establish rapport with the legislator. You are also giving them information they can use to justify their support of your issue.

<Update AMHCA .

Be sure to share information regarding contacts with your federal legislators with the AMHCA Public Policy and Professional Issues staff. It is important for us to hear about your legislator’s support or opposition to issues affecting mental health counselors.

Everyone has a different comfort level and level of experience in advocacy and different amounts of time to commit to these important efforts. Regardless of your specific circumstances, there is a great need for you to participate and there are a variety of ways to get involved. Please contact Beth Powell , AMHCA’s Director of Public Policy and Professional Issues, by e-mail at bpowell@amhca.org or by phone at 800-326-2642, ext. 105 for more information about how to get involved in our advocacy efforts. If you aren’t yet a member of AMHCA, please join. And, please take the next step in advocating for your profession. TAKE ACTION.

ALMHCA still supporting FACT - Fair Access Coalition on Testing

ALMHCA has become a member of FACT because of ongoing activities regarding various state psychology boards who have been attempting to pass legislation that would greatly limit access to most quality assessment instruments from Professional Licensed Counselors and all other mental health professionals other than licensed psychologists and psychiatrists.   Read more...