by
Joseph Peters
| Jan 06, 2023
Christa Butler:
Welcome to The Voice of Counseling from the American Counseling Association. I'm Christa Butler, co-hosting with Emily St. Amant. And joining us today is Brian Banks, the Chief of Government Affairs and Public Policy for the American Counseling Association, who is here to talk about the Mental Health Access Improvement Act.
Christa Butler:
On December 23rd, Congress passed the Mental Health Access Improvement Act and it was signed into law by President Biden. This bill allows LPCs and MFTs to enroll as providers in the Center for Medicare and Medicaid Services as Medicare providers. Brian, thank you so much for joining us to speak on this monumental milestone for professional counselors, marriage and family therapists, and of course the clients that we serve.
Brian Banks:
Thank you for having me.
Christa Butler:
Yes, and thank you for joining us again. We're going to hop right in. Can you give us a Cliff Notes version of the Mental Health Access Improvement Act that just passed and all of the work that yourself and the GAPP team have been doing to get us to this point?
Brian Banks:
Absolutely. Now, at the very end of this congressional session, meaning the end of 2022, Congress was tasked with passing what they call an omnibus bill. That means it's a bill that's focused on funding government programs. Everything's in there from state grants, information for the Department of Defense, schools, healthcare and of course mental healthcare. ACA, at the American Counseling Association, we were fortunate enough to have our bill included in this package. Now, when the bill was included in the package, it doesn't mean that it was going to stay within the package. And so our members, counselors across the nation, other organizations, we came together and continued to advocate literally late into the night to ensure that we stayed in the bill.
Brian Banks:
And lo and behold, on December the 23rd, the bill came up for a vote. It was passed and the Mental Health Access Act finally became a reality for licensed professional counselors and marriage and family therapists. So what does this mean? The short version of this is it means that counselors and MFTs will be able to become Medicare providers and help Medicare clients, thus receiving reimbursement for their services. And within Medicare, it's just not those that are 65 years and older, but there's also people that are considered disabled that are eligible for Medicare services.
Christa Butler:
Absolutely. And so with the passing of this bill, it will improve access to services for older adults as well as individuals who have a disability. So you mentioned LPCs. Let's talk about who LPCs are and what we do, who we help as professional counselors? I'm an LPC myself. And so when I think about LPCs, what comes to mind for me is obviously that we're mental health professionals. We hold an independent license or practice at the state level. And so having your license, pretty much attest that you've met the minimal requirements that are set forth by the governing sanctioned entity of the state to practice at the state level.
Christa Butler:
And I want to make it clear that if you don't have the title of LPC, that does not mean that you're not eligible to practice with the benefits of the Mental Health Access Improvement Act. So counselors have different titles in each state. And so that might be an LMHC, LCPC or LPCC. It really depends on your state. And so I want to make it clear to everyone tuning in that your title does not negatively affect your eligibility to practice or to enroll as a provider. And then of course, as a professional counselor, we're required by law in every state, the District of Columbia, Puerto Rico, Guam, and US Virgin Islands to be licensed in order to legally practice as professional counselors.
Emily St. Amant:
Yeah. And LPCs like Christa and myself, we really have a focus on wellness throughout the lifespan. So with this enactment, we are actually able to work with the people we are trained and passionate about helping and serving, which includes people over 65 and people who have disability benefits. So this is an incredible opportunity for us to finally be able to get reimbursement for our services and to work with those populations. And we've worked with people in lots of different settings. I think people think private practice, maybe people think of school counselors, but we really work in all different places, including hospice, hospitals, the carceral system, treatment programs, et cetera.
Emily St. Amant:
So this really gives us the opportunity to finally be able to work with us, people that need not only treatment for a mental health disorder, but people that are adjusting to different phases in life. You don't have to have a mental health diagnosis to work with a professional counselor. We're here to help people with various transitions and different stressors and goals that they have in their life to help them succeed and be healthy and flourish. So this really came at a very crucial time because we are in a mental health crisis. So we have a shortage of clinicians, mental health clinicians. So Brian, can you tell us a little bit more about how this bill will help those who need access to the support of counselors? How will this help them get access to that support they need?
Brian Banks:
This bill is a big deal, Emily. I'm glad you asked that question. I'm not exaggerating when I say the passing of this bill will save lives. The Substance Abuse and Mental Health Service Administration, we often hear the term SAMSA informs us that one in five Americans live in the mental health access shortage area. In the shortage areas, you will almost always find a mental health counselor. In the outdated 1989 law, mental health counselors were not able to assist older Americans and the disabled. Statistics show that older Americans or senior citizens and disabled want assistance, but when it's not available, they pass on it.
Brian Banks:
And this may lead to increased stress, anxiety, ER visits, being admitted to hospitals and more. In some cases it leads to what someone would label as destructive behavior and abusive medication use, which could potentially lead to suicides or attempts at suicide. With counselors now having a full seat at the table, it would increase access to quality care and allow for current clients that age into Medicare to remain with a trusted provider. And it would also allow additional people to have options, more options, and choice of who they would like to see. So again, this is a big deal. It comes at a great time. It's well overdue, but we're now here and so we're excited to continue moving this forward.
Christa Butler:
We're very excited to continue moving this forward. And of course, I'm sure a lot of counselors want to know when can we start? How long until folks can start working with clients who have Medicare?
Brian Banks:
Now, don't be mad at me because I don't make the rules, but I do understand them. Now on January 1st, 2024 providers can begin to enroll in the program. The reason for this is that CMS will need one year to update their internal systems and technology to begin accepting licensed professional counselors as Medicare provider. Though this process is slow, it is necessary that CMS gets it right the first time. We don't want them to delay. And CMS will work with ACA through this process to ensure that it's done right and they're supportive of the profession. ACA will also host trainings to help counselors navigate the CMS system. Once we have all that appropriate information, we'll be short to get it out to everyone on a consistent basis.
Emily St. Amant:
Okay. Yeah, I think that's a great call out too because I think there's a lot of things that need to be sorted out. We don't have the answers yet because those things don't exist yet. So those are going to be created and we hope that people will stay tuned because we're going to have more episodes about the Medicare bill for counselors and more resources to help people understand how to make this work for them. So looking forward to supporting our membership with that.
Emily St. Amant:
And going back to this has been a long battle, some could say. That's been going on for decades to get this to finally happen and we did not do this in isolation. So can you speak to the grassroot effort that helped this finally get passed?
Brian Banks:
Absolutely. From my understanding, ACA has been at this for 11 years. I've been at this for three years and nine months. There are others that have worked on this for a couple decades and there's been progress every single year, but not the ultimate goal. And one thing I'll say that I found when I came to ACA is that our grassroots was not as strong as we've needed it to be. When I say grassroots, I mean the people, counselors, friends, families, colleagues, college professors, the list goes on. They made a huge difference in this efforts. They attended congressional meetings, whether it was virtual or in person at home in their home state. They attended town hall meetings and they talked about the counseling profession. They talked about why Medicare reimbursement was important not just to counselors but to the state. There were letters to Congress, they participated in our hill briefing and for the first time ever we had a counselor actually address... I'm sorry, not a counselor, I want to get this right.
Brian Banks:
For the first time ever we had a client, a Medicare client, address Congress, which was awesome. That's never happened before. ACA was able to find someone that's located in Ohio and she spoke very highly of Medicare and what it can do, but she also spoke about what it's not doing and that pulled on the heartstrings of a lot of members and helped us move in the right direction.
Brian Banks:
Now I'll admit, our advocacy was really good. We had some record breaking numbers. However, we can do better moving forward. I believe a hundred percent we have to get things done over the next couple years. There's a lot to get done over the next couple years and I believe that the counselors will help us reach those goals. If the counselor community is strong, anything can potentially happen for this profession. I want to make this really clear because I don't think counselors understand this. Counselors have a lot of power. The power has been shown, the legislators are relying on counselors and we have to take advantage of the counselors' expertise as we move forward in implementing Medicare as well as other programs that we're working on here at ACA.
Christa Butler:
I want to also highlight that when it comes to maintaining membership at ACA, this is one of the benefits that your membership helps to move projects forward with. And so this isn't the only thing that ACA is working on. Of course, we have the Interstate Counseling Compact that we're also working on, and many other projects that our GAPP team is working on as well. And so Brian, can you tell us what are other projects, is the American Counseling Association working on to support the mental health of every American as well as the counseling profession?
Brian Banks:
Absolutely. There's a lot that we're working on, and I know we don't have time to go through the entire list, so I would encourage the listeners to visit the ACA website at www.counseling.org to learn about all we're doing. But now what I'll tell you is about the counseling compact. We're working on that. It's a high priority for ACA to continue moving that forward. We have 17 states that are already part of the compact. So it has been extremely successful. We're continuing to work with our elected leaders to fully implement 988, which is the suicide and crisis lifeline. It takes money to run that line. So we want to make sure states have the money and the resources and that can move it forward at a high level. We also want to make sure that they are funding the resources for school and career counselors. So we're always pushing with the Department of Education and other committees to ensure that the funding and resources are there to help the people that are in need.
Brian Banks:
And we have a focus on immigrant mental health and we would love to see counselors being allowed to work within the US Public Health Service Commission Corps as well as the Army Medical Corps. That's a big deal. That's a place where counselors are not. Other professionals are there, we're not there. And the military knows that they have an access problem as well. They're working on it. They're aware of our ask and we're going to continue pushing forward. So hopefully this time next year, we'll be doing another podcast to say that our members can now become commissioned officers within the military, within the public health services.
Emily St. Amant:
Yeah, you are very busy and we can't thank you all enough for the work that you do on behalf of counselors. Because us counselors, I think so much of who we are and what we do is supporting the people around us. So having someone advocating for us so we can take better care of our clients so we can have a better impact and more reach to serve our communities. It's just, you help me help you. That the work that y'all do is just it's incredible. And again, like you said, it's going to save lives and it's going to enable people to really be able to make more of a difference. So for those that are interested in learning more about how to get involved, what are some places for them to go? Some things that they can do to get involved with the advocacy work here at the ACA?
Brian Banks:
They can always shoot us an email at advocacy@counseling.org. We'd love to hear from counselors, whether they're members or not, and they can go try our website. Again, it's www.counseling.org. Go to the government affairs section and you'll see just about everything that we're working on there. If you have information to share with us or something is happening in your state, that's a policy or government affairs issue. Don't sit on it. Let us know. We can help you advocate. We do trainings for people. So just let us know if you want a training and we can come to your community or do a virtual training to ensure that you have all the tools in your toolbox to effectively meet with your leaders, whether they're elected officials or appointed officials, we can help you move forward.
Emily St. Amant:
Wonderful. Thank you so much for joining us today, Brian. And thank you again for all that you and your team do for counselors. And thanks to our listeners for joining in today. Make sure you are subscribed to the Voice of Counseling on Apple and Google Podcasts and that you follow us on social media because again, this is not the end here. We've got lots more. We've got several other episodes and resources coming your way. So make sure you give us a follow to stay in touch and to stay updated. And to join the ACA to get all the access to exclusive member benefits, check out our website counseling.org. We hope everyone has a great day.
Christa Butler:
ACA provides these podcasts solely for informational and educational purposes. Opinions expressed in these podcasts do not necessarily reflect the view of ACA. ACA is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information and resources provided in this program. This program is Copyright 2023 by the American Counseling Association. All rights reserved.