Keeping Up With The Counseling Profession: Current Issues on the National Level

David Kaplan ACA Chief Professional Officer Art Terrazas ACA Director of Government Affairs 2014 AASCB Conference

Things we might talk about Professional Identity Counselor Education Accreditation Key legislation Practice Issues Ethical Issues

Things we might talk about Professional Identity Counselor Education Accreditation Key legislation Practice Issues Ethical Issues

Dr. William Glasser

Professional Identity

20/20: A Vision for the Future of Counseling

The 20/20 consensus definition of counseling

Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.

The 20/20 Building Blocks to Portability Project

Building Blocks to Portability The task was to develop: A consensus licensure title to recommend to all state licensing boards A consensus scope of practice to recommend to all state licensing boards Consensus education requirements to recommend to all state licensing boards

The delegates reached consensus on the licensure title!

Licensed Professional Counselor

And the Scope of Practice! future-of-counseling/current-activities Open the sample endorsement letter future-of-counseling/current-activities

Some Key Elements Individual, group, couples, & family counseling Promote mental health wellness, development across the lifespan, crisis intervention and the diagnosis and treatment of mental disorders Consultation and program evaluation Supervision Ability to practice independently

TWO OUT OF THREE AIN’T BAD! What about the licensure education requirements?

Where does 20/20 go from here?

Counselor Education Accreditation

The next CACREP standards revision has begun Slated for 2016

Draft # 2 public comment period ends 1/10/14 Review the draft and give feedback at:

More evolutionary than revolutionary “Clarify, Simplify, and Unify”

Three significant proposals By July 2020, all entry-level programs, including: – career counseling – school counseling – postsecondary counseling be comprised of 60 credit hours

Clinical Rehabilitation Counseling added as a specialty Student Affairs and College Counseling specialty becomes Postsecondary Counseling

Important accreditation news CACREP and CORE have become corporate affiliates CORE will jointly implement the new CACREP Clinical Rehabilitation Counseling specialty

Alternative Counselor Education Credentialing

Masters in Counseling Accreditation Council (MCAC)

Initial MCAC programs U of Albany (mental health counseling) U of Massachusetts, Boston (mental health counseling & school counseling)

THE COUNSELING PSYCHOLOGIST VOL. 41, NO. 5, JULY 2013 Psychology & counselor education accreditation

Articles Quality of Master’s Education: A Concern for Counseling Psychology? Looking to the Future – The role of Master’s Programs in Counseling Psychology Integrating Master’s Education in Counseling Psychology for Quality, Viability, and Value Added Legitimizing and Reclaiming Master’s Training and Education in Counseling Psychology: An Urgent Concern

Contributing to the ambivalent relationship of counseling psychology to masters training… -Jackson & Scheel, p.676

In some situations, the master’s training programs were developed …to help fund the doctoral training program. -Palmer, p.703

In some cases, master’s programs help pay the bills for doctoral education…in difficult economic times, counseling psychology doctoral programs without master’s programs may be easier to cut -Jackson & Scheel, p. 687 & 688

To maintain CACREP accreditation when budget cuts are required, deans and other administrators…may prioritize master’s over doctoral programs since master’s training is less expensive than doctoral training. -Jackson & Scheel, p.682

…such developments do threaten counseling psychology programs… -Jackson & Scheel, p.682

The new MCAC accreditation standards may serve to promote a new direction for counseling master’s education…consistent with core values and contributions of counseling psychology -Jackson & Scheel, p. 681

It is questionable…whether we will be able to avert eventual professional annihilation…as a profession we are experiencing THE RECKONING -Palmer, p. 701 & 704

Legislative Issues

VA hiring of LPCs TRICARE certification of mental health counselors Medicare coverage of LPCs Federal education spending “Religious freedom of expression” legislation Major Issues We’re Following

VA (Non-)Hiring of LPMHCs April 2012 – VA Office of Inspector General report: For half of first-time patients, MH evals took about 50 days As of August 2012, total number of LPCs hired as mental health clinicians within the VA nationwide: 29 Number of VA LPMHC positions posted in 2012: 58 Number of VA social worker positions posted: 1,563

ACA Has… Written to VA Secretary Eric Shinseki, and met repeatedly with multiple VA staff Met with White House staff Met with members of Congress, and worked with them to draft letters to the VA Our goals: Our goals:   Encourage passage of S 1581, which includes a provision to open up VA paid traineeships to counselors   Have VA central office light a fire under local VA directors to hire more counselors

VA & counselors: What you can do Check if you’re curious about VA positions. If (surprise!) you find one not open to counselors, contact the HR person to ask that it be opened to counselors, and copy ushttp://USAJobs.gov Contact your Senators and ask that they 1) Vote for S and 2) write to the VA to direct them to: – –Broaden the eligibility criteria for LPMHC positions, and instruct VA facilities to open more positions to counselors Share copies with/direct Q’s to Art Terrazas at

now through 2014 TRICARE requirements: now through 2014 Licensed counselors must: have a master's or higher-level degree “from a mental health counseling program of education and training* and either – Pass the NCE or NCMHCE (for CACREP-accredited degrees) OR – Pass the NCMHCE (for regionally-accredited degrees) have 2 years/3,000 hours of supervised clinical practice, "provided by a mental health counselor” * For at least CACREP degrees, this is interpreted by DoD to mean only degrees with the title of “mental health counseling” or “clinical mental health counseling”

beginning 2015 TRICARE independent practice requirements: beginning 2015 Licensed counselors must: have a CACREP degree pass the NCMHCE same 2 years/3,000 hours of supervision as previous slide Independent practice only. Practice under physician referral and supervision will no longer be allowed.

TRICARE Mental Health Counselor Certification Requirements: Possible Barriers  Having a degree title other than “mental health counseling” or “clinical mental health counseling”  Not having passed the NCMCHE  Not having 2 years/3,000 hours of supervision under a licensed professional counselor (not psychologist, social worker, etc.)  Not having a CACREP-accredited degree

Comparing the federal standards AgencyMaster’s degree…ExamSupervision Dept. of Veterans Affairs …in mental health counseling or related field from CACREP program, Ph.D. not recognized -- TRICARE (after 2014) …from a mental health counseling program of education and training accredited by CACREP NCMHCE2 years/3,000 hrs, 100 hrs face- to-face, meets AMHCA guidelines Army SAP…in counseling from a program accredited by CACREP NCMHCE-- Medicare bill (S. 562 & HR. 3662) In mental health counseling or a related field -- 2 years post- master’s

Medicare and Counselors For the first time since 2009, we have TWO Bills! S. 562 and HR.3662 call for Medicare to reimburse Licensed Professional Counselors. We need you to call your Senators and Representatives to ask them to support these bills!

Q: Will Medicare require CACREP degrees?  The House and Senate have each passed Medicare coverage of LPCs/MFTs twice, without ever including CACREP requirement  HHS declined to require even regional accreditation of psychology degrees, said nothing about CSWE when writing regulations for psychologist/SW Medicare coverage  Starting 1/1/2014, Affordable Care Act (ACA) prohibits discrimination against state-licensed providers  HHS is incredibly busy implementing ACA, doesn’t have time to start second-guessing state licensure requirements  Requiring CACREP degrees would defeat the goal of expanding access to outpt. MH services, especially in rural and underserved areas A: Most likely not

Our best hope: Our best hope: getting a lot of cosponsors on S. 562 & HR. 3662, to build momentum for passage.

Affordable Care Act – Provider Non-Discrimination Provision takes effect January 1, 2014 “Sec * Non-Discrimination in Health Care. (a) P ROVIDERS.—A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.” * of the Public Health Service Act

Practice Issues

DSM-5 Licensed counselors eligible for participation in DSM field trials for the first time

Current DSM-5 Issues Adjusting to the disappearance of the multiaxial system Vague wording has increased confusion Autism as a spectrum Expanding criterion into the normal range

Current DSM-5 Issues Adjusting to the disappearance of the multiaxial system Vague wording has increased confusion Autism as a spectrum Expanding criterion into the normal range

DSM-5 Tools ACA Webinars ( DSM-5: Navigating the New Terrain (6 hours) DSM-5 Specifics, Drilling Down With the New Diagnostic Tools (2 hours) ACA Book ( *DSM-5 Learning Companion for Counselors

New HIPPA Regulation Extending HIPPA to billing services, document storage companies & other business associates Clients can now request health records in electronic form Mitigating and informing clients about security breaches

Ethical Issues

The 2014 ACA Code of Ethics

Who is on the ERTF? Jeannette Baca Janelle Disney Perry Francis (Chair) Gary Goodnough Mary Hermann Shannon Hodges Lynn Linde Linda Shaw Shawn Spurgeon Richard Watts Michelle Wade Erin Martz (ACA staff) David Kaplan (ACA staff)

Timeline highlights Task force appointed Summer of 2011 Initial call for member input Fall 2011 Draft composed April Call for draft feedback May 2013 Draft revised based on input June-December 2013 Final draft presented to ACA Governing Council March 2014

ERTF Areas of Focus Social media The imposition of counselor personal values When is a client a client? Removing the end of life exemption Fee splitting

How licensure board members can keep up with current national issues ACA Connect Read Counseling Today Read CT online Read ACA e-News Subscribe to the ACA blogs Visit affairs/public-policy ! affairs/public-policy

Visit the ACA Facebook page Follow ACA on Twitter Subscribe to counseling listservs (cesnet, counsgrads, icn, etc.) Use Google alerts Ask Art or David

Let’s schmooze!

Keeping Up With The Counseling Profession: Current Issues on the National Level