House Passes Historic Parity Legislation!

On March 5th the House of Representatives passed comprehensive legislation requiring private health insurance plans to use the same treatment limitations and financial requirements for mental health and addictive disorder coverage as is used for substantially all other covered services. H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” introduced by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), was passed with strong bipartisan support by a vote of 268-148. (House members’ votes are listed online at http://clerk.house.gov/evs/2008/roll101.xml.) The legislation is named for the late Senator Paul Wellstone of Minnesota, a tireless advocate for Americans with mental illness.
House passage of H.R. 1424 is an historic step forward for mental health and addiction treatment advocates, and comes after years of hard work by the mental health and addictive disorder advocacy community. Although similar in many respects to legislation passed last year by the Senate, H.R. 1424 provides more consumer protections by requiring plans covering mental and addictive disorder treatments to cover the full range of disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the same range of disorders as is covered for members of Congress and all other federal employees under long-standing requirements for Federal Employee Health Benefits Program (FEHBP) policies. Unlike the Senate’s bill, H.R. 1424 also stipulates that health plan covering out-of-network services for medical and surgical benefits must also offer out-of-network coverage for mental health and addictive disorder benefits. This requirement applies for both outpatient and inpatient care.

AMHCA and ACA applaud Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) for their long, hard, heroic work in gaining House passage of H.R. 1424. During floor debate, both Kennedy and Ramstad spoke about their own personal battles with mental and addictive disorders, their treatment, and how their treatment has enabled them to lead productive lives. AMHCA and ACA also thank those counselors who took the time to contact their representative on this issue.

Attention now shifts to House-Senate negotiations to reconcile their chambers’ versions of the parity legislation. Like the business community, the Bush administration argued in favor of the weaker Senate version, issuing a statement of policy expressing opposition to H.R. 1424. Despite this, AMHCA, ACA and other mental health and addictive disorder advocates are now working to build upon the strong bipartisan support for H.R. 1424 and the unanimous passage last year of the Senate’s bill, to encourage the development and enactment of parity legislation that provides consumer protections that are as strong as possible.

For more information on this issue—or to find out how you can help—contact Beth Powell with the American Mental Health Counselors Association at 703-548-6002 x105, or at bpowell@amhca.org or Scott Barstow with ACA at 800-347-6647 x234, or at sbarstow@counseling.org.

2007 FMHCA Legislative Report

No real significant changes were made during the 2007 Legislative Session with regard to the practice of Mental Health Counseling. NASW did attempt to amend Chapter 491 with its non clinical social work title protection bill, but the bill died on the house messages calendar. The forensic mental health bill passed and amended the definition of qualified practitioner to one who practices in accordance with their practice act, replacing the old language that required the respective boards to develop a rule as to who was qualified. Representative Homan's mental health parity (mental health coverage) bill moved well in the House of Representatives, but never made it to the floor of the House and was stuck in committee in the Senate. FMHCA will continue to work with Representative Homan and others in the Senate to get this bill passed. Finally, we were able to remove some language from an adoption bill that would require an un-needed certification for mental health treatment of children in Florida's foster care and adoption system.

As mentioned earlier, NASW's attempt to protect the title of social worker died on the calendar. However, as it moved through the process we were able to amend the bill to grandfather (for ever) those who currently work in human service careers as social workers. The bill originally stated that those currently using the title would be exempt from the provisions of the bill so long as they stayed in their current place of employment. This was not acceptable and we changed it to "may use the title regardless of place of employment".

We did not push to exempt future generations of LMHCs for the following reasons:

1. Very little if any interest on the part of our membership
2. The Board felt that our political capital should be expended toward more viable issues like mental health parity and fighting statutory recognition of "certified mental health professionals".
3. Professional identity issues
4. Legislators were confused as to why 'mental health counselors' also wanted to be identified as social workers
5. Employers will likely change the title of those human service jobs to get a broader market of applicants.

House bill 1309 (a bill related to adoption) originally had some language that would require the Department of Education and the Department of Children and families to create certification for mental health treatment of children in Florida's foster care and adoption system. FMHCA argued that a certification to provide mental health services was not necessary as the programs of study for licensed mental health professionals was more than adequate to diagnose and treat mental disorders and conditions in foster children. The language was subsequently removed from the bill. The bill has passed and does provide funding for mental health services.

Over all it was a good legislative year for FMHCA. We were able to amend a couple of bills to our position and we were able to hold the gains we have made legislatively in the recent past. FMHCA and its leaders will be working hard over the summer to develop a new legislative platform. We encourage our chapters and members to let us know what your needs are so we can examine the possibility of adding your suggestions to the 2008 Legislative Platform. Thank you for your support and we look forward to hearing from you soon. For details of bills that have passed please see the following Table.

Alex Golden, FMHCA Lobbyist