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Legislative Update
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Medicare Momentum Builds, and Outlook Is Good for VA Mental Health Counselor Training 

By James Finley, Associate Executive Director and Director of Public Policy

Congress has just reached its scheduled mid-point for the year, so this is a good time to assess what legislation may actually pass by year-end. 

The largest health measure of the year likely to move forward is reform of Medicare’s physician fee schedule. This legislation would provide a long-delayed, but critical change in Medicare’s outpatient payment methodology for all independent practitioners. 

During May, both the Senate Finance Committee and the House Ways and Means Committee considered very costly preliminary plans to replace the unsustainable physician payment formula. Support for physician payment reform has grown this year because the Congressional Budget Office greatly reduced the estimated cost of legislation. 

Senate Finance Committee Chair Max Baucus (D–Mont.) said recently that the goal of the legislation is “to pay physicians and other healthcare providers in a way that results in high-quality, affordable care for seniors.” Lawmakers are seeking a methodology to transition Medicare away from its current fee-for-service approach into a system that rewards provider service quality and efficiency. 

Let’s Push for the Profession to be Recognized by Medicare This Year

Congress rarely advances Medicare legislation of any type, and AMHCA views the fee legislation as the only good vehicle to carry our provider status bill, S.562. AMHCA urges its members to learn about our Medicare provider status legislation (see link below) and show their support for the profession. Most urgently, AMHCA seeks a House Republican to introduce a House version of the bill. 

AMHCA has heard from several of its chapters that passage of S.562 is more critical than ever because health reform plans are already under way in their own states. States such as Maine and Massachusetts have reported that passage of S.562 is vital to ensure provider status for mental health counselors to participate in state reform models. Some chapter leaders tells us that practice opportunities for clinical mental health counselors will be restricted under reformed systems if the profession is not recognized by Medicare. 

We ask each AMHCA member—particularly those with a Republican Representative or Senator—to contact their legislators and urge them to support S.562. Background materials for Medicare action are available on AMHCA’s website.  

VA Employment for Mental Health Counselors

Increasing VA employment opportunities for mental health counselors remains a top AMHCA priority in this Congress. The annual budget and appropriations bills are now at center stage in congressional discussions, and we have our eye on training opportunities in veterans programs. 

The VA will be spared from spending cuts, so AMHCA would like to increase opportunities for mental health counselor training in VA-sponsored internships. AMHCA has targeted new funds for VA clinical training because this budget is growing, and other mental health professions already tap the agency as a major source of training support. 

AMHCA is very concerned that in 2006 mental health counselors were granted VA provider status, but very few positions have opened up since then. We believe that agency hiring has been slow due to entrenched personnel who resist hiring mental health counselors.

AMHCA and its coalition partners representing both counselors and marriage and family therapists have collaborated this year in making rounds to VA committee members to press our case for trainee funds. Our key point is that both professions combined equal less than one percent of the VA behavioral health workforce, but they represent almost 20 percent of the overall mental health workforce in the private sector. 

AMHCA advocates that increasing the supply of financial stipends for mental health counselor interns at a level equivalent to those provided to the other mental health professions in the VA trainee-support program will help increase agency hiring for years to come. We are receiving positive feedback from our Hill supporters and are optimistic we can leverage more hires through this route. Agencies outside Defense, Homeland Security, and the VA are in far more funding trouble this year. Republicans leaders in the House are seeking large spending reductions in many domestic agencies for the coming year. 

Topping the cuts list is the Department of Health and Human Services, which faces a 17 percent reduction, on top of cuts already made by this year’s sequestration order. Spending by SAMHSA (the Substance Abuse and Mental Health Services Administration), NIMH (the National Institute of Mental Health), and HRSA (the Health Resources and Services Administration) includes programs sustaining healthcare workforce training and mental health research. All of these are in the crosshairs of major spending reductions for the new fiscal year, which begins Oct. 1. 

For the latest information on all of our congressional activities follow our updates on Facebook or on AMHCA’s website.