A few points we would like to make clear:
1. If LARA's proposed rules go into effect before HB 4325 is signed by the governor, then LLPCs and LPCs will not be able to diagnose or use counseling techniques - it will be illegalfor LLPCs and LPCs to diagnose and use counseling techniques.
a. This means LLPCs and LPCs will not be able to bill under someone else (as has been done in the past) because you will not be able to use counseling techniques (conduct mental health therapy).
b. If the legislature passes HB 4325 into law after LARA's proposed rules take effect it will nullify the rules.
2. If HB 4325 is signed by the governor (before LARA's proposed rules go into effect), then law will clearly define our scope of practice among other things (supervision, etc.), and LLPCs and LPCs will be able to practice mental health therapy in the same way they have for decades (since 1989). Passing HB 4325 will negate the need for LARA's rules.
3. Our focus now and over the coming weeks must be to influence legislators to move HB 4325 quickly to Governor Whitmer. Please be thoughtful/diplomatic about what you write on public sites. Stay focused on the goal of contacting legislators.
4. If at all possible, attend and speak at the public hearing on LARA's proposed rules on October 4th. This is imperative. We want a large volume of testimony on record. IF IT IS IMPOSSIBLE FOR YOU TO BE PRESENT, PLEASE SEND WRITTEN TESTIMONY. Written comments must be submitted by 5:00 pm on October 4th to the following email: BPL-BoardSupport@Michigan.gov Tell the Board of Professional Licensing how this will hurt your clients, and the financial/career crisis this will cause you and your business or the business you work for. The hearing is being held at the G. Mennen Williams Building Auditorium, 525 W. Ottawa St., Lansing, MI 48893 and starts at 9am.
5. Please join MMHCA - your memberships fund the essential lobbyist we have employed to help move HB 4325 through the system. MMHCA is the only organization funding a government relations professional who is working on HB 4325. Go to our mobile friendly website to donate and/or join. www.mmhca.org .
6. Use this living excel document to easily access legislators' contact information and action steps all in one place. Tremendous thanks to Benjamin Reisterer for creating and maintaining it. https://docs.google.com/spreadsheets/d/1fkuYQciUwYXhj32iaK1e_75dFTxwYv1M2N8D8XssvAM/edit?usp=drivesdk&fbclid=IwAR1FCcxgdSz8XFOqJa4az0Lsuw837kPIBOas3i_U1wIibLzl3IJ0iI8bCUY
7. Read MMHCA's September newsletter for more information and to access important documents via links.
8. Many people still don't know about this dire situation. OUR ABILITY TO PRACTICE OUR PROFESSION IS AT STAKE! Tell every graduate student, LLPC and LPC you know about this information asap. Have them sign up to receive MMHCA emails like this one (go to mmhca.org/articles/and at the bottom of the September newsletter is a button to sign up to be on the mailing list).
9. Dr. Sara Sue Schaefer will be presenting on October 1, 2019, at the Kalamazoo YWCA in their lower multi-purpose room. This is a very important meeting to attend from 7:00pm to 8:30pm. The presentation will also be live streamed on the Facebook group Michigan LPCs for HB 4325 & Against LARA SOP Changes - Counselors & Allies.
Dr. Sara Sue Schaefer has been instrumental in working on this issue for many years. She will be presenting about what we can say and do at the hearing on October 4th to further our cause. The YWCA is located at 353 East Michigan in Kalamazoo.
10.MMHCA has a Facebook page you can follow as well. It's called Michigan Mental Health Counselors Association.
11.Please do the following (use the excel document link in #6 for contact information):
a. Continue contacting Governor Whitmer and encourage support of HB 4325.
b. The Ways and Means committee meets about HB 4325 on Wednesday, 10/2/19. Contact the committee members about how urgent it is to pass the bill out of committee asap so it can move to the House of Representatives for a vote.
c. Contact Senate Majority leader Mike Shirkey via phone and email to respectfully request that he support HB 4325 and bring it to the Senate for a full vote as quickly as possible once the bill gets to the senate. Explain that HB 4325 does NOT expand LPCs' scope of practice, it only solidifies what we have already done for over three decades.
d. Contact the Speaker of the House Representative Lee Chatfield and urge him to put the bill up for a vote WITHOUT AMENDMENTS as soon as possible.
e. Keep the language simple when contacting legislators e.g. "HB 4325 puts into law what has been the practice for 30 years." Educate the senators about the current situation.
f. Letters to the editor and news coverage are great and noticed by legislators.
g. Remember - all the contact information you need is in the excel document here:
Keep up the outstanding advocacy for our license, our colleagues and our clients. It is an honor to be side by side with you in this effort.
James Blundo MMHCA Executive DirectorNapoleon Harrington MMHCA PresidentMMHCA Public Policy CommitteeAcuitas LLC, the MMHCA Retained Lobbyist
Next MMHCA Board Meeting
MMHCA Members are invited to attend the next MMHCA Board meeting on Friday, October 18th, at 10:00 am. Location is Ashland Theological Seminary in Southfield. Guest speaker includes Andrea Cascarilla from Acuitas LLC. Must RSVP to attend, contact jamesblundo@att.net.
Frequently Asked Questions:
HB 4325 and LARA's Proposed Counseling Rule Changes
by
MMHCA Retained Lobbyist Andrea CascarillaLegislative Director
What rules changes is LARA proposing?
The actual text of LARA's proposed rule changes may be found here. To be clear, some of the proposed rule changes are not contentious and make necessary and appropriate updates. Others related to R338.1751 and R338.1757 are a cause for serious concern.
First, LARA is recommending the repeal of virtually all the rules that define a licensed professional counselor's scope of practice under R338.1751. These are the current rules that have been recognized as part of a counselor's scope since they were first promulgated after the passage of the Licensed Professional Counselor statute in 1988. Instead the department insists these definitions should apply only to the educational preparation of counselors and not to counseling practice.
Second, LARA is also pursuing the repeal of the rules identifying the requirements for providing counseling supervision (R338.1757), one of which is specific training in supervision. This training is a national standard for professional counseling.
What would the impact of these changes be?
R338.1751:
Included in the repeal of the definitions in the rule is the practice of "counseling techniques" and the related ability to "diagnose and identify the problem". Without these and numerous other definitions, the counseling scope of practice will be severely restricted.
These changes in scope also put Michigan's LPCs in violation of the American Counseling Association's Code of Ethics (E.5.a. Proper Diagnosis), which requires the proper diagnosis of a client's mental disorder before treatment and could subject them to permanent expulsion from the profession.
Under Michigan's public health code, LPC's are legally required to comply with their professional code of ethics. They will be violation of this statute. Ultimately, these rule changes will prohibit Michigan's 10,000 licensed professional counselors from continuing to practice in the state and leave hundreds of thousands of residents without the treatment they need.
Additionally, insurance companies will no longer cover services of LPCs as a diagnosis is required for reimbursement.
R338.1757:
If this rule regarding counseling supervision requirements is rescinded, counselors who provide supervision without training would be practicing in violation of the ACA's Code of Ethics (F.2.a Supervisor Preparation).
Furthermore, LPCs who received their supervision in Michigan may not be eligible for licensure in other states because their supervisor would not be qualified in the state to which the counselor is moving.
Why is LARA proposing these changes?
The Attorney General's office raised concerns a few years ago as to whether the counseling rules were properly aligned with the counseling statute, questioning whether the rules exceed the statute. Since LARA only has the authority to promulgate rules, not change statute, they have proceeded with the only option available to resolve this concern: repeal the rules in question.
What is the status of the proposed rule changes?
Despite the unanimous objections by the Board of Counseling, on July 18, 2019, LARA filed a formal request for rule making and submitted its draft rules. The associated Regulatory Impact Statement for the proposed rule changes was filed on August 28, 2019.
This action triggered the setting of the required public hearing, which is scheduled for Friday, October 4 at 9:00 am at the G. Mennen Williams Building Auditorium located at 525 W. Ottawa Street in Lansing, Michigan.
After this public hearing, the rules can be certified, and a report submitted to the Joint Committee on Administrative Rules (JCAR). JCAR, a legislative body, has just 15 session days to review the rules. Their only course of action if they object is to introduce legislation within another 15 days to repeal them. After the JCAR review is completed, the LARA Director can adopt the rules.
When would the proposed rules take effect?
The rules changes were written with immediate effect. Given the above timeline these proposed rule changes could be in effect as early as November of this year immediately rendering Michigan's 10,000 licensed professional counselors unable to diagnose and, therefore, unable to legally practice in our state.
What can be done to oppose the proposed rule changes?
Any member of the public may comment in opposition of the proposed rules changes at the October 4th hearing. Written comments may also be submitted electronically any time before 5:00 pm on October 4th to BPL-BoardSupport@Michigan.gov
What organizations are opposing the proposed rule changes?
The following are some of the organizations that have expressed opposition to LARA's proposed rule changes:
MMHCA (Michigan Mental Health Counselors Association)
CMHAM (Community Mental Health Association of Michigan)
MHA (Michigan Hospital Association)
MPCA (MI Primary Care Association)
MATCP (MI Association of Treatment Court Professionals)
MPFFA (MI Professional Fire Fighters Association)
ACA (American Counseling Association)
MCA (Michigan Counseling Association)
NBCC (National Board for Certified Counselors)
MASW (MI Association of Social Workers)
MSCA (Middle School Counselors Association)
Central Michigan University
Eastern Michigan University
Oakland University
Spring Arbor University
University of Detroit-Mercy
Wayne State University
Western Michigan University
Hope Network
Pine Rest
MI AFSCME
Oakland County
How do the proposed rule changes relate to HB 4325?
The proposed rules are the administrative response to the Attorney General's question as to whether the rules align with the statute. HB 4325 is the legislative response.
What does HB 4325 do?
HB 4325, sponsored by Rep. Aaron Miller (R-Sturgis), would codify into statute the existing rules that have come into question instead of repealing them. This preferred solution allows counselors to maintain their ability to properly diagnose and treat individuals with mental and emotional disorders. The bill also makes a number of technical updates to the 30+ year old law.
Does HB 4325 change the scope of practice for licensed professional counselors?
No. It maintains the scope of practice that has been in placed since the Licensed Professional Counselor law was passed in 1988.
Does HB 4325 change who is eligible to be licensed as a professional counselor?
No. It maintains that only those with the education and training in the diagnosis and treatment of mental and emotional disorders and meet the standards of the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) are eligible for licensure.
What is the status of HB 4325?
HB 4325 (S-3) was passed unanimously out of the House Health Policy Committee on September 19, 2019. The bill has been referred to the House Ways and Means Committee. A hearing and vote is expected on October 2. The bill will then be sent to the full House of Representatives for a vote.
How would the passage of HB 4325 affect the proposed rules?
HB 4325 negates altogether the need for LARA's proposed rule by resolving the Attorney General's question. It would nullify the proposed rules if they were to go into effect.
Who is supporting HB 4325?
To date the following organizations have formally taking a position supporting HB 4325, and many more are expected to as future opportunities in the legislative process allow:
MMHCA (Michigan Mental Health Counselors Association)
MPCA (MI Primary Care Association)
MATCP (MI Association of Treatment Court Professionals)
NBCC (National Board for Certified Counselors)
MASW (MI Association of Social Workers)
MSCA (Middle School Counselors Association)
Central Michigan University
Eastern Michigan University
Oakland University
Spring Arbor University
University of Detroit-Mercy
Wayne State University
Western Michigan University
Hope Network
A few related other facts:
Our nation is facing a mental health crisis and there simply aren't enough counselors and other mental health professionals to meet the burgeoning demand for services, according to a recent analysis by the U.S. Health Resources & Services Administration (HRSA).
HRSA estimates nationally we need to add 10,000 providers in each of seven separate mental healthcare professions by 2025 to meet the expected growth in demand.
In Michigan there are nearly 1.4 million adults with mental illness and 67,000 youth suffering from a major depressive episode. The majority of these individuals are not receiving the care they need.
Costs are the reason nearly half of the adults are not receiving the treatment they need. Mental health counselors are uniquely qualified to meet the challenges of providing high quality care in a cost-effective manner.