UMHCA Legislative Updates April 2023 

UMHCA’s Legislative & Public Policy Committee (LPPC) was extremely active during the recent legislative session and continues to advocate for our profession year-round both in Utah and nationally. This year some major legislative changes occurred and we want you to understand the impact of these changes in your work and professional development. Please reach out to lppc@umhca.org if you have any questions and if you would like your voice heard as we prepare for the 2024 legislative session and continue to work with legislators join our committee! 

House Bill 166 

The Utah Legislature passed House Bill 166 which amends the Mental Health Professional Practice Act that governs the licensing for Associate Clinical Mental Health Counselors (ACMHCs). The amended act has two primary provisions:

• ACMHCs hours required for direct supervision with an approved supervisor have been reduced from 100 hours to 75 hours
• The minimum time requirement of two years prior to obtaining full licensure has been eliminated, DOPL is adding a rule to an 18-month time frame 

HB 166 Impact for ACMHC’s 

Decreasing the supervised practice time to less than 2-years and 75 supervision hours is one of the lowest standards for full licensure in the United States. ACMHCs and ACMHC supervisors should be aware of the following: 

• Supervisors are not required to sign off to recommend full licensure for any ACMHC who has not demonstrated the ability to practice competently and ethically. This is an ethical and liability responsibility of the supervisor to protect the safety and health of the public.
• Supervisees may request more time with supervised practice from their supervisor if they do not yet feel prepared for independent practice. 
• ACMHCs should be aware that if they apply for full licensure before two years or with less than 100 hours of supervision (de facto national standards) there may possibly be untended consequences. Currently, it is likely that this decrease may impact the ability to be eligible to bill for Medicare reimbursement and commercial insurance, participation in the Counseling Compact, Privilege to Practice, and portability of licensure to other states.
• • Medicare Reimbursement: The Federal Mental Health Access Improvement Act (H.R.432) passed by Congress allows Marriage and Family Therapists (MFTs) and Mental Health Counselors to be reimbursed under Medicare. The Centers for Medicare & Medicaid Services (CMS) will establish the rules and requirements for those eligible to bill for Medicare reimbursement for both those over 65 and those with Medicare eligibility disabilities. The current draft indicates that CMHC’s eligible to be Medicare providers must have 2-years of supervised practice. The rules will be established this year so that the law can be implemented on January 1, 2024.
  • The Counseling Compact has been passed in Utah and several other states. The Counseling Compact Commission this year is likewise establishing the rules and requirements for fully licensed Clinical Mental Health Counselors to participate in the Privilege to Practice across state lines. It is likely that some states will require 2-years of supervised practice. 
  • To be eligible and paneled with Tricare 100 hours of supervision and 2-years of supervised practice are required. 
  • Many states require 2 years of supervised practice prior to full licensure. If you are considering relocating or becoming licensed in another state, UMHCA recommends that you contact the licensing body of that state. 

Supervisor Considerations. Supervisors of ACMHCs should review the ethical and legal liabilities for approving full licensure for any individual who is not fully qualified to practice competently and ethically. Supervisors are not under any state injunctions to prematurely approve ACMHCs if there are public health or safety concerns. Supervisors should also consider completing a supervisor training program.

HB 166 Summary. UMHCA strongly urges ACMHCs and supervisors to consider the impact of these changes to full licensure under the Mental Health Professional Practice Act as well as any rules that DOPL may subsequently publish.

HB 228 Unprofessional Conduct Amendments 

Further defines conversion therapy for minors and what “conversion therapy” includes. The therapist’s intent must NOT be to change a sexual identity or sexual attraction of a minor client. As long as the intent is NOT to change, a therapist should feel safe to discuss options with the client that align with the clients’ values and wants. 

It is imperative that we as therapists seek supervision when we feel unclear or unqualified when meeting with particular clients. We are lucky in the state of Utah to have such an array of therapists willing and able to meet with our LGBTQ+ community. So, whether it’s reaching out to a fellow professional to seek supervision on issues or referring to a more qualified professional, our ethical obligation is to provide the best quality care to our clients.

SB 16 Transgender Medical Treatments and Procedures Amendments

This bill takes away ALL gender-affirming medical treatment for transgender adolescents. Therapists will no longer have medical options to help their clients or refer them to. It will be imperative that therapists seek supervision if they are unclear on how to support a transgender minor client. We will still be able to talk with our clients about their mental health as related to their gender dysphoria and will need to explore other options with them to address their needs. These options may include topics such as gender expression (hair, makeup, name), resources for parents, support groups, or voice training.

Learn more about the legislative work UMHCA is engaged in at our upcoming annual conference on May 11^th & 12^th. Also, the LPPC’s Jessica Black, LCMHC will be presenting the UMHCA Brown Bag next week (April 12^th) on Legislative 101. 

DSM-5-TR is here

The DSM has been revised and is available. Some may wonder what the changes are to the "texts revisions." Best bet? Read it for yourself. Still, some of us like a summary and here are a few options for you to understand what the new revision contains.

According to medscape, "The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), which is not a full revision, only includes one new condition, Prolonged Grief Disorder." and "the goal of the Text Revision was to allow a thorough revision of the text, not the criteria," Paul Appelbaum, MD, chair of the APA's DSM Steering Committee, told Medscape Medical News."

Here are some links to help you with more...

• https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2022.03.3.28
  
• https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets
  
• https://psychcentral.com/news/dsm-5-updates-2022#Emphasis-on-gender-inclusive-language
  
• DSM-5-TR Fact Sheets (psychiatry.org)
  
• DSM-5 Update: What's New? (medscape.com)
  
• Special Report on DSM-5-TR—What Social Workers Need To Know - SocialWorker.com

The LPPC committee would like to draw your attention to a bill of particular import on the Senate Health and Human Services Committee roster. HB 283 - Mental Health Professional Licensing Amendments, sponsored by Rep. Thurston, proposes the reduction of clinical hours required for licensure among CMHCs, MFTs, and CSWs from 4,000 to 3,000. There are no amendments to any other licensure requirements for mental health professionals at this time. If you would like to review the full text of this bill, you may access that here. This bill was passed in the House and transferred to the Senate on 2/15/2022.

Learn more here

Dear Mr. Logsdon: 

The Utah Mental Health Counseling Association (UMHCA) fully endorses passage of the Counseling Compact by state legislatures. UMHCA advocates for over 1200 licensed clinical mental heatlh counselors in Utah who are licensed to assess, diagnose, and treat mental disorders. 

UMHCA endorses the Counseling Compact because it provides for: 

 Greater individual and family access to mental health services offered by licensed counselors 

 Consistently high standards of public health safety in the participating 

states 

 Continuity of care for patients when patients or counselors relocate or travel to other states 

 Military personnel and spouses to maintain their licenses to practice when relocating 

 Increased mobility for fully licensed clinical mental health counselors 

 State licensure that is preserved and strengthened in the respective participating states 

After reviewing the proposed Counseling Compact legislation, UMHCA recommends compact adoption. The compact maintains standards of public safety while adhering to state ethical and legal mandates. UMHCA urges its members to engage state legislators in supporting the passage of the Counseling Compact. 

If I can be of further support, please contact me: 

Sincerely, 

Anna Lieber, CMHC, NCC/CCMHC 

UMHCA Statement For Isabella “Izzy” Tichenor

The Utah Mental Health Counseling Association (UMHCA) Board is deeply saddened by the death of Isabella “Izzy” Faith Tichenor, age 10, who died by suicide on November 6, 2021. According to her mother, Izzy was the victim of ongoing racially and disability-based bullying at her school. This tragic event occurred several weeks after a report from the Department of Justice identified a consistent pattern of racial harassment toward Black and Asian American students within Izzy’s school district.

UMHCA is an organization committed to addressing disparities in the access to and quality of mental health care services for individuals who have been marginalized based on historical and ongoing systemic injustice, like racism. Tragedies like Izzy’s death amplify the importance of our profession in providing mental health support and suicide prevention resources for individuals, families, and communities who are often under-served and experience a lack of safety in their neighborhoods due to prejudice and hate. Izzy’s suicide also punctuates the compounded stress the global pandemic has on the lives for Black, Indigenous, and People of Color (BIPOC) who are disproportionately affected by the confluence of racism in the economic, education, medical, and mental health systems.

The leadership at UMHCA sends our heartfelt condolences to Izzy’s family. We wish to recognize our BIPOC colleagues who are numerically underrepresented in the state of Utah and who are deeply affected by the racial injustices they and their BIPOC clients experience; it is a collective trauma. We send our support to our Black colleagues and communities who are grieving and who must mourn the loss of another Black life. UMHCA wants to encourage all Clinical Mental Health Counselors to seek out the educational, professional, and ethics training needed to provide culturally responsive services to their BIPOC clients. As a professional community, we must work together to cultivate cultural fortitude and multicultural competencies, which will allow us to courageously support and advocate for our clients as well as for our colleagues. UMHCA is committed to creating opportunities for multiculturally oriented dialogue, professional development, and resources with these priorities in mind.

Here are some resources and training opportunities: 

Liveonutah.org

•https://utahsuicideprevention.org

•https://healthcare.utah.edu/uni/programs/safe-ut-smartphone-app/

•https://zerosuicide.sprc.org/about

•www.sprc.org

•https://suicidology.org/ 

•http://www.mentalhealthamerica.net 

•https://afsp.org

 •https://veterans.utah.edu/training-workshops/ 

•https://livethroughthis.org/

•https://www.sprc.org/resources-programs/calm-counseling-access-lethal-means

•https://www.nctsn.org/  

 Counseling on Access to Lethal Means - Utah (CALM-Utah)

o    Flyer attached.

o    www.train.org/utah

·         Collaborative Assessment and Management of Suicidality (CAMS)

o    Flyer attached.

o    Registration: https://utahdhs.iad1.qualtrics.com/jfe/form/SV_ewE3gomcwtJpaD4

·         Trauma-Informed Approach Training

o    Trauma Informed Approach Training | DSAMH

• Mental Health Professional Practice Act rule changes effective November 10, 2020. The rule changes impact: Clinical Mental Health Counselors, Marriage & Family Therapist, Substance Use Disorder Counselors, and Social Workers.
  

  Utah State Bulletin: https://rules.utah.gov/publicat/bull_pdf/2020/b20201001.pdf

  Key Changes: 

• 1.       Supervisors & supervisees are required to enter into a supervision contract and must be kept on file with the supervisor.
• 2.       Supervisors are required to submit a Verification of Supervision for Post Graduate Mental Health Practice Hours from to the Division.  https://dopl.utah.gov/cmhc/verify_supervised_experience.pdf
• a.      The form can be found on DOPL dopl.utah..gov  SW, CMHC, MFT and SUDC website’s by going to “Licensing”, then “Additional Forms”
• 3.      Regardless of how long you have been supervised, you will need to turn in this form to the Division
• 4.      DOPL will inform the Supervisor via letter that the form has been received and the supervisor may proceed with supervision. If the supervisor does not qualify, DOPL will contact both the Supervisor and Supervisee.

• 5.       There are new profession-specific Supervision for Post Graduate Mental Health Practice Hours forms (on DOPL website)ACMHC https://dopl.utah.gov/cmhc/cmhc_supervision_for_post-graduate_mental_health_practice_hours.pdf

• 6.      Previous hours obtained under supervision before the rule change will be accepted. Supervision hours documented on the old form prior to the rule change will still be accepted.
• 7.      Clinical Mental Health Counselors are now required to take the NCE & NCMHCE exams for full licensure.
• National Counselor Examination (NCE). The registration and administration of this exam is processed through the National Board for Certified Counselors (NBCC). To register for this exam, please visit the link below
• Exam Registration
• NCE Candidate Handbook
• National Clinical Mental Health Counselor Exam (NCMHCE). The registration and administration of this exam is processed through the National Board for Certified Counselors (NBCC). To register for this exam, please visit the link below

• ·  Exam Registration

  ·  NCMHCE Candidate Handbook

• 8.       All Continuing Education can be found in the Mental Health Professional Practice Act Rule.

In a recent posting by AMHCA, they state:

Congress Passes Landmark VA Mental Health Counselor Bill September 24, 2020   Yesterday, the House of Representatives approved S. 785, sending a major VA mental health and counseling bill to President Trump for signature.  The bill is the most significant new legislation for the counseling profession in over a decade and a tremendous advancement for mental health counselors working for the federal government, and particularly the Department of Veterans Affairs. This historic legislation directs the U.S. Office of Personnel Management to create the first ever federal government classification for mental health counselors, referred to as an Occupational Series. The Series will allow counselors to work in federal government agencies under the title of mental health counselor instead of generic Series that apply to many professions. Social workers and psychologists have had their own Occupational Series for decades and it is past time counselors have the same level of recognition. Creation of an Occupational Series for mental health counselors has been a top federal priority for national counseling organizations for many years and is a hard won success. S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, also takes several steps to increase the hiring, training, and advancement of mental health counselors within the Department of Veterans Affairs (VA). The bill requires the Comptroller General of the United States to prepare a study on staffing levels of mental health counselors and marriage and family therapists. The study will identify “impediments to carry out the education, training, and hiring of mental health counselors and marriage and family therapists”, as well as a “description of the objectives, goals, and timing of the Department with respect to increasing the representation of such counselors and therapists.” The bill also creates scholarships for counselors interested in working for the VA Readjustment Counseling Program.AMHCA lobbying firm, Bergman Strategies, worked closely with Members and staff from the Senate and House Veterans Affairs Committees to develop and advance this important legislation. AMHCA was the only counseling organization to help shepherd this bill through both chambers, but partnered with the American Association for Marriage and Family Therapy / California Association of Marriage and Family Therapists.    S. 785 was introduced by Senators Jon Tester (D-MT) and Jerry Moran (R-KS), the Ranking Member and Chairman of the Senate Veterans Affairs Committee (SVAC). These Senators are long-term champions for increased recognition of mental health counselors, Senator Moran having introduced the original House bill that opened the VA to the profession in 2006. The SVAC passed the bill in December 2019, but the bill really started to gain steam when it passed the Senate on August 5, 2020.  AMHCA and AAMFT/CAMFT lobbyists had been working with the House Veteran Affairs Committee (HVAC) on companion legislation, but efforts intensified after Senate passage. Representative Jahana Hayes (D-CT) introduced H.R. 8145 on September 1, a standalone bill that matched the counselor components in S. 785. The legislation was included in a September 10 hearing and September 17 markup. House Veterans Affairs Committee Chairman Mark Takano (D-CA) and his staff showed strong commitment to the counselor legislation and ensured that it was maintained throughout the process. S. 785 will be sent to President Trump for signature. The legislation requires creation of the counselor Occupational Series within one year from enactment. There is no timeframe for the Comptroller report on VA staffing, but it must be reported to the House and Senate Committees within 90 days of completion. The passage of legislation to create an Occupational Series for mental health counselors is a tremendous success for the counseling profession and AMHCA is proud to have played such a pivotal role in its achievement. The Series will increase federal government recognition and hiring of mental health counselors. S. 785 will also expand employment and training of mental health counselors within the VA, a long-term priority of the association. AMHCA wants to thank Senators Tester and Moran, as well as Representatives Takano, Brownley, and Hayes for their commitment to this important legislation.

ABOUT THE REPORT    AMHCA.ORG       CONTACT DOWNLOAD FOR FREE Beyond a Perfect Storm – How Racism, Covid-19, and Economic Meltdown Imperil Our Mental Health Based on the AMHCA report, nearly 41 percent of adults nationally are reporting that they are suffering from a mental health disorder -- or about 103 million adults in the U.S.     Download the Report for Free Enter your information and we will send you the report. DOWNLOAD NOW What you'll find inside   Read  AMHCA's Press Release "The confluence of events this year has created a 'perfect storm' that has swamped the mental health and well-being of all people, and especially those who identify as Black Americans," said Angele Moss-Baker, President of the American Mental Health Counselors Association and one of the report's co-authors. "The resulting tsunami of mental health concerns requires a comprehensive and integrated policy response with intentional, culturally responsive policy and practices to reduce the negative impacts of racial trauma, discrimination, and oppression while promoting short- and long-term mental health and well-being."

AMHCA released a major report today on the number of Americans reporting mental health distress over the last few months.  Please see our new study – Beyond A Perfect Storm – How Racism, Covid-19, and Economic Meltdown Imperil Our Mental Healthand our press release on the study.

Based on the AMHCA report, nearly 41 percent of adults nationally are reporting that they are suffering from a mental health disorder -- or about 103 million adults in the U.S.

The AMHCA study is based on surveys developed by the U.S. Census Bureau, Centers for Disease and Prevention, and the National Center for Health Statistics. For more information, please see the link below to a key table through the Census Bureau Pulse Survey.

https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

Please scroll through the chart and you will find specific information by your state as well. For your convenience, we also have listed the percentage of adults reporting mental health disorders by AMHCA State Chapter below.

For more information about the study, please contact me at 703-548-4474

State                   % Reporting Mental Health Disorders

AL                        33.9

AR                       43.5

CT                        35.1

DC                       36.1

FL                        40.5

GA                       40.0

IA                         37.8

ID                         45.5

IL                          43.2

IN                         42.0

KY                        26.6

LA                        43.1

MA                       35.2

MD                       39.3

ME                       37.8

MI                         40.7

MO                       37.9

MS                       48.0

MT                       36.0

NC                       39.5

ND                       33.8

NH                       40.7

NJ                        37.6

NM                       47.5

NY                       41.1

OH                       37.1

OK                       44.1

PA                        31.8

RI                         44.5

SC                       42.3

SD                       35.4

TN                        43.6

TX                        35.5

UT                        37.8

VA                        38.3

VT                        33.2

WA                       43.8

WV                       37.0

Joel E. Miller
Executive Director and CEO
American Mental Health Counselors Association (AMHCA)

For Immediate Release
Jan. 31, 2019

CONTACT: 
Barrasso Press Office (Barrasso) – (202) 224-6441
Miranda Margowsky (Stabenow) – (202) 224-1437

Barrasso, Stabenow Introduce Bipartisan Mental Health Access Improvement Act

Bill will expand access to mental health services for our nation’s seniors.

WASHINGTON, DC –Today, U.S. Senators John Barrasso (R-WY) and Debbie Stabenow (D-MI) reintroduced the Mental Health Access Improvement Act (S. 286). The bill would allow America’s seniors access to marriage and family therapists (MFTs) and licensed mental health counselors (LMHCs) through Medicare. By providing these mental health professionals the opportunity to participate in the Medicare program, this bill expands the number of mental health providers available to our nation’s seniors.  

“As a doctor, improving access to mental health care is an important personal priority of mine. I am proud to once again join with Senator Stabenow to introduce the Mental Health Access Improvement Act,” said Barrasso. “This bipartisan legislation expands the number of mental health providers working in the Medicare program. This will make it easier for our nation’s seniors, especially those living in rural areas, to get the care they need closer to home.”

“One in five Americans struggle with some kind of mental illness and older Americans are no exception,” said Stabenow. “Our bill makes it easier for seniors to have access to the mental health care they need.”

U.S. Representatives Mike Thompson (D-CA-05) and John Katko (R-NY-24) introduced the companion bill to S. 286 in the House of Representatives. 

In the United States alone, 20 percent of individuals ages 55 and older experience some type of mental health concern. According to the Health Resources and Services Administration, there are more than 5,000 Mental Health Professionals Shortage Areas in the United States, and half of all counties in the U.S. have no practicing psychiatrists or psychologists. Seniors in rural communities are the most adversely affected by these shortage areas. 

The Mental Health Access Improvement Act lifts restrictions on certain mental health professionals that bar them from billing Medicare. This will increase access to existing mental health professionals and allow them to treat America’s seniors.

Utah Mental Health Counselors Association