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

New Legislation to Increase Slots for CMHCs at the VA

AMHCA moved one step closer in June to its goal of increasing VA employment opportunities for mental health counselors. In June, Sen. Jon Tester (D–Mont.) introduced S.1155, the Rural Veterans Mental Health Care Improvement Act, which is designed to “cultivate a VA mental health workforce that better addresses the needs of veterans.” This translates into new legislation that would add mental health counselors and marriage and family therapists as participating health professions in the VA’s flagship recruitment program, the VA Office of Academic Affiliations’ Health Professionals Trainee Program. The legislation authorizes VA clinical education and training programs to develop more mental health professionals. 

AMHCA worked with a small coalition of counseling and marriage and family therapy groups to encourage Sen. Tester (shown left) to introduce the legislation. Our primary message is that mental health counselors and marriage and family therapists make up 40 percent of the overall independent practice behavioral health workforce, and they often practice in rural and underserved areas that lack other mental health providers. 

Sen. Tester’s statement supporting the legislation calls attention to the VA’s employment of fewer than 200 of these two professional groups among a behavioral health workforce of more than 23,000. Currently, exclusion from the Health Professionals Training Program compounds VA underutilization of these critical professions, which often gives priority to hiring former interns as permanent staff. AMHCA and its coalition partners strongly support Sen. Tester’s new bill to address VA’s chronic shortages of mental health professionals and to kick-start hiring of our two professions. 

We are now working to build support for the legislation among other Senate offices. In addition, AMHCA members will be asked to promote the new bill in their lobbying visits to the U.S. Capitol during our Annual Conference in July. 

Progress for Counselor Coverage Under Medicare Is Slow

Congress is still moving slowly with Medicare legislation to address the physician fee formula. AMHCA and our coalition partners hope to include our provider status bill, S.562, in this larger Medicare package addressing physician fees. 

The primary driver for Medicare legislation this year is to address a long-delayed, but necessary, correction in Medicare’s outpatient payment methodology for physicians and all independent practitioners. 

During June, two House Committees with jurisdiction over Medicare drafted language to replace the unsustainable physician payment formula, but the Senate Finance Committee to date has failed to release any bill language. AMHCA expects that the Senate’s consideration of its Medicare legislation will not begin before September, when we hope to have our bill attached by the Finance Committee. 
AMHCA urges members to follow our Medicare provider status legislation and to show support for the profession.

In the House of Representatives, our support for provider status is more problematic. AMHCA continues to seek a House Republican to introduce the House version of our bill. Generally, GOP offices need to hear more support for the benefits of the legislation. We continue to hear from chapters that passage of Medicare provider status is more critical than ever because healthcare reform plans are getting under way in the states, and the lack of provider status for mental health counselors is an impediment to participation under key reform models. 

AMHCA’s Annual Conference attendees will visit House and Senate offices in July to support passage of this bill. Background materials for Medicare action are available on AMHCA’s website.  

Budget Sequestration Talks

In other news, Congress has not initiated bipartisan talks for another round of budget sequestration that takes effect in October, when the new fiscal year begins. The Obama administration anticipates a $109 billion cut in the new federal fiscal year, up from $85 billion in cuts that occurred in March of this year. 

Complicating matters in the fall, there are fewer ways to lessen the impact of another sequester after easier cuts were made in the last six months of the current fiscal year.
For the latest information on all of our congressional activities, follow our updates on AMHCA’s Facebook page or AMHCA's Public Policy web page.