I hope everyone had a safe and happy holiday season and is ready to start the 2018 year with AMHCA with a bang!
Thank you all for all your hard work on behalf of AMHCA in 2017 at the national level and state level, and I look forward to an exciting 2018 and working with you as we expand our capacity to address the needs of our members -- and promote your interests on many levels. We could not accomplish our goals without your significant contributions on so many programs and issues.
We strive to be the go-to organization for clinical mental health counselors (CMHC’s) for advocacy, education and promotional opportunities, leadership and collaboration.
Our goal was to exceed your expectations in 2017 to enhance the profession of clinical mental health counseling through the activities highlighted in our mission.
This letter to the AMHCA membership highlights the work we have done on your behalf in 2017 and the investments we have made with your hard-earned membership dollars as well as plans for the future to address your needs.
On that note, this year has been incredibly busy and exciting.
- Advocacy, Advocacy, Advocacy
Earlier this year, AMHCA restructured its public policy and advocacy group with a carefully planned reorganization process. The objective and intent was to achieve greater functional and fiscal efficiency, and adapt to a rapidly evolving public policy & legislative landscape. With a new Administration and Congress in place, we believed that mental health public policy, health care financing and delivery at the federal level, required a reboot of our Government Relations’ activities.
We have increased our monitoring of key legislative & regulatory issues affecting the clinical mental health counseling profession and providing new services. We proceeded to engage Guide Consulting Services to assist us in our lobbying activities and increase our presence on Capitol Hill.
As part of our reboot of GR activities, we have implemented a “Strategically Focused Four-Part Strategy on Medicare Recognition of CMHC’s” that included:
- Increasing clinical mental health counseling’s profile in Congress through strategic meetings to achieve Medicare reimbursement for CMHC’s.
- Modifying the messaging and substantive arguments used on Capitol Hill.
- Utilizing legislative alternatives such as by adding CMHC’s within Medicare Reimbursement to access to ACOs, APMs and other new delivery mechanisms.
- Enhancing AMHCA’s Member grassroots activities by coordinating with several bodies to strategically execute “Call your Congressman” action alerts through Member Management Systems, Grassroots Advocacy Supports, and Social Media.
- Raising the Profile of Clinical Mental Health Counseling:
Working with our consultant, we have held nearly 100 individual meetings with MoC’s and their Congressional staff such as their Legislative Directors, as well as Members on the Committees of legislative jurisdiction, e.g., Senate Finance Committee .
The meetings were designed to familiarize Congressional staff with AMHCA’s Medicare Provider Recognition efforts to pass “Seniors Mental Health Access Improvement Act (SMHAIA)” – S. 1879 and HR 3032 – educate staff on the attributes, roles and needs of mental health counseling, and the needs of end users – namely your clients. We pitched to – and continue to do so – MoC’s and staff on including provisions from “Seniors Mental Health Access Improvement Act (SMHAIA)” within legislative vehicles and/or accelerating the committee review/markup process.
On July 25th, AMHCA sponsored a major panel and legislative briefing on “The Need for Medicare Access to Mental Health Care in Rural America: A Crisis in the Making for Seniors and People with Disabilities.
An array of new materials was developed for this event including new facts sheets, infographics, PowerPoints and general resources.
On July 26th and 27th, we tapped into the large AMHCA membership and coordinated during the Leadership Forum a Hill Fly-in Day for AMHCA Members. Hill Days provide an effective way to both further engage AMHCA Members as well as garner large congressional sponsorship. Due to this action we picked up several new sponsors to House Bill 3032. Experience shows that well-coordinated constituent pressure on MoCs yields positive results in moving legislation.
We arranged 80 meetings on July 27th,(on top of the 100 individual meetings conducted by AMHCA staff working with our Coalition partners) and developed new talking points for AMHCA members, and used portions of our Leadership Forum to train AMHCA Members.
- Modifying our Messages
Previous talking points and substantive arguments concerning our Medicare Advocacy bills have been very powerful, including suicidality amongst seniors and lack of access to mental health services in rural counties and need to expand the mental health workforce for Medicare beneficiaries.
We have significantly modified and augmented messaging to tap into the economic cost savings argument that is often helpful in persuading MoC’s. To pivot around this changing policy environment, we added and shifted to arguments for CMHC recognition by emphasizing:
- The incidence rate of co-morbid medical/surgical chronic diseases and mental health disorders (i.e. clinical depression), and
- The economic cost of untreated mental illnesses among seniors.
So in turn, the underlying AMHCA’s argument has been three-fold this past year:
1.) Merit-Based Incentive Payment Systems (MIPS), Alternative Payment Models (APMs) and Accountable Care Organizations (ACOs) cannot effectively meet their savings goals without vigorously treating mental health disorders in the Medicare patient population.
2.) In order to address these threshold economic and clinical realities, the Medicare Mental Health workforce must be expanded to include CMHC’s.
3.) CMHC Medicare reimbursement is a “value added” benefit that would both improve clinical outcomes for seniors with chronic diseases – and augment integrated care systems – while helping the new MIPS, APM and ACO programs control overall costs.
In addition, AMHCA has prepared an array of materials including:
- General Presentation on the Special Attributes of Clinical Mental Health Counselors and Roles Under Health Care Reform;
- White Paper on Older Adults with Mental Health Conditions;
- FACT SHEET: Why Congress Should Pass Legislation to Reimburse Clinical Mental Health Counselors, and
- The Professional Identity of Clinical Mental Health Counselors
All of these documents and more can be found on our new landing page on Medicare Provider Recognition for CMHC’s
These documents make consistent arguments about the growing need for mental health care among seniors, the impending “silver tsunami” -- up to 10 million additional seniors will need mental health services in the next 20 years.
- Utilizing Legislative Alternatives to Gain Legislative Traction
The cost of the SMHAIA – CBO’s score of the bill is a thorn in our side. The lack of an offset led both bills to have a large number of Democratic co-sponsors, but few Republican supporters last year.
So we have also been supporting another option: Medicare reimbursement for CMHCs would be available to CMHC’s who participate in Accountable Care Organizations and authorized under SSA or the Alternative Payment System or other “shared-savings approaches.
- Enhancing AMHCA’s Member Grassroots Activities by Coordinating with AMHCA Platforms
Our Public Policy and Legislation (PP&L) Committee in collaboration with the AMHCA Board & Staff evaluates and develops a plan for logistical factors in motivating a grassroots advocacy effort utilizing regions, state chapters and national outlets.
The #IAM4AMHCA campaign sells our national brand, focuses on obtaining Medicare provider status for CMHC’s and tells the story of how CMHCs want to make sure that our aging and disabled population has ready access to affordable outpatient behavioral health services in both rural and urban areas of the US.
AMHCA has sent send email blasts and utilized social media to announce the launch of this coordinated, nation-wide campaign to mobilize CMHC’s in a unified effort to obtain Medicare recognition. We have emphasized key facts & statistics to highlight the critical need for this legislation and the impact it has on the profession.
Whether you are a play therapist or specialize in senior services, this issue impacts you. Ensure practitioners and legislators understand why and how.
This year, and culminating in a “Virtual Action Day”, AMHCA launched a targeted “Call Your Congressman & Congresswoman Day”. An additional Social Media Presence in 6-7 Discrete Target States and/or congressional districts was implemented.
The first set of Members of Congress that AMHCA targeted were Senate Finance Committee Members, due to their jurisdiction on Medicare and Medicaid financing policy.
We developed strategic grassroots messaging for AMCHA state-level members to encourage participation in the call-in day, including template language for list-servs and a grassroots’ advocate packet. We also identified and secured personalized Senate and House contact information for the participating AMCHA member states. We then created strategic messaging directed at the U.S. Senate and House of Representatives including call-in scripts, Facebook post samples and images, and Twitter post samples and images. We provided email and phone technical assistance to AMCHA state-level members regarding questions or concerns for the call-in day. We also coordinated with our partners: NBCC, ACA, AAMFT, CAMFT, NCBH, and ABHW
Our next steps on Medicare include:
- PP&L Committee Supporting states with more local legislative needs.
- Updating Landing Pages
- Pitching Congressional and Senate offices to ask questions and make statements during Congressional Hearings and Markups related to AMHCA legislative goals
- Identify more Coalition partners – usual and not so usual suspects – to support overall effort
- Organizing more Capitol Hill and Briefings and Meetings
- PP&L Committee & PA Committee integrating work especially on grassroots and messaging efforts.
On a separate legislative and regulatory front, we have been working very closely with several organizations like APAs, NASW, NAMI and others in support – or opposed –to Congressional bills affecting CMHC’s and the field at large like:
- Stabilizing the Individual Health Insurance Marketplace
- New Graham-Cassidy-Heller-Johnson (GCHJ) proposal (ACA Repeal)
- CONNECT for Health Act, S. 1016
- Veterans E-Health & Telemedicine Support (VETS) Act of 2017 (National Violent Death Reporting System
- Five-year Extension of CHIP Funding
- Mental Health in Schools Act
- Medicaid Coverage for Addiction Recovery Expansion (CARE) Act
- Medicare Mental Health Inpatient Equity Act.
There are a number of states and members that believe CMHCs are at odds or being hindered by other major organizations. This is not true. We have a number of legislation that is sponsored by the APAs, NASW and others, including the ACA. Our organizations are often working together and not working against one another, and we have healthy, collaborative relationships with one another. We need their support in mutual efforts and coming from a place of inclusion and cooperation, we will have a better shot of being included in pursuits we have, nationally and locally.
We work with – but we need to do more – national and local mental health departments, agencies and organizations and take the lead on any project that needs help. We meet regularly with national organizations to show we are inclusive and cooperative. At a state level it's a great selling point that our national organizations are working well together. If state chapters see that we're doing it nationally, it's going to be hard for sibling state organizations not to do the same thing. We always have to talk positive about those we are working with or potentially working with. Our grassroots efforts will excel exponentially.
AMHCA staff continues to push for more partnerships with other large organization like AARP, insurance companies and other major counseling and health related organizations. They have clout, funds, resources and their partnerships would be paramount to getting a seat at the table for larger initiatives. This will be a key priority for me in 2018.
Look for more updates from me as we keep the momentum of 2017 going through 2018.