Counseling Today, Washington Update

Counselors claim major victory

Scott Barstow December 15, 2006

The counseling profession took a significant step toward full recognition under federal law with passage of legislation establishing licensed professional counselors as mental health specialists within the Department of Veterans Affairs (VA) health care system. Passage of the legislation took place literally in the final hours of the 109th Congress in December. The language establishing explicit recognition of counselors was included as part of the Veterans Benefits, Health Care and Information Technology Act of 2006 (S. 3421), along with other provisions designed to improve veterans’ access to necessary health care services. 

The American Counseling Association has worked for years, along with the American Mental Health Counselors Association, to remove the glass ceiling for licensed professional counselors working in the VA. Although the agency has long employed rehabilitation counselors at its facilities to help veterans adjust to life after service, it had yet to recognize licensed professional counselors as full-fledged mental health professionals. The Veterans Health Administration is heavily dominated by clinical social workers and, previously, licensed professional counselors were ineligible for the same clinical and supervisory positions open to social workers. This situation created an uneven playing field at the VA, with relatively inexperienced social workers being hired and promoted for mental health specialist positions over eligible and often better trained and more experienced licensed professional counselors. Licensed marriage and family therapists have been in the same position and now will also be recognized under the language included in S. 3421.

The Senate approved language establishing explicit recognition of licensed professional counselors as part of the Veterans Health Care Act (S. 1182) in December 2005. Following passage of S. 1182, ACA and AMHCA focused on getting the House Veterans Affairs Committee to adopt the same language. This effort led to the May 2006 introduction of stand-alone legislation, the Veterans Mental Health Care Access Improvement Act (H.R. 5396), which focused solely on establishing recognition of licensed professional counselors and marriage and family therapists within the VA health care system. It was important that Rep. Jerry Moran (R-Kan.), a member of the House Veterans Affairs subcommittee on Health, and Rep. Michael Michaud (D-Maine), the ranking minority member of the subcommittee, introduced the legislation. Thanks in large part to the grassroots support of ACA members, the legislation gained an additional 20 co-sponsors from both parties.

Although the support enjoyed by H.R. 5396 was encouraging, it would have mattered little without the passage of veterans legislation by Congress. For months, the House Veterans Affairs Committee appeared poised to approve veterans legislation, including the counselor recognition language. But despite a committee-held hearing on veterans mental health issues, movement on the legislation appeared stalled because of disagreements on other issues concerning veterans. In the closing hours of the session, however, House and Senate members reached a compromise that led to passage of a new bill, S. 3421. The House passed the bill on Dec. 8, and the Senate followed suit in the early-morning hours of Dec. 9, minutes before the 109th Congress officially ended. President George W. Bush was expected to sign the bill into law shortly after Counseling Today went to press..

“This is a huge win for us, and I’m proud that this happened on my watch,” said ACA President Marie Wakefield. “The passage of this legislation is particularly timely. Given all of the polytrauma experienced by the veterans returning from Iraq, it’s extremely important that we have as many licensed professional counselors and certified rehabilitation counselors as possible available to work for the VA. There are thousands of returning vets with severe disabilities, emotional and readjustment problems, and PTSD (post-traumatic stress disorder).” AMHCA President Gail Mears described the legislation as “a significant step forward for our profession and for consumers.” 

ACA Executive Director Richard Yep was also encouraged by the final outcome and acknowledged persistent advocacy efforts as key to finally attaining the legislative victory. “I know it can be hard to see why advocacy by your national organization is so important on a day-to-day basis when breakthroughs aren’t always happening,” he said, “but this kind of victory shows what’s possible with sustained hard work and why it’s so important to keep pushing.” 

AMHCA Executive Director and CEO Mark Hamilton said, “The inclusion of licensed mental health counselors by the VA and the quality of services they provide will make it easier for those who served our nation and who are in need of mental health services to get the health care they need. Passage of this legislation could not have been achieved without the longtime collaborative efforts of AMHCA and ACA.”

Counselors involved in the effort to gain VA recognition also applauded the news. “With the record number of returning veterans who are suffering mental health issues and their families needing resources, opening up options is essential,” said Cynde Collins-Clark, a licensed professional counselor who was named 2006 Oklahoma Mother of the Year for her work on behalf of veterans, including her son. “Each mental health credential has a place in the healing of veterans and their families, and the expertise of LPC s and LMFTs will add richly to the resources.”

Gary Felhoelter, a counselor at a VA facility in Louisville, Ky., said, “This passage will give so many others new hope and motivation. I have not felt such a high in so many years. I am so proud of ACA and their legislative folks who kept fighting despite the many setbacks.”

While counselors certainly have reason to celebrate this milestone victory, the legislation will not take effect immediately. The VA (perhaps in conjunction with the Office of Personnel Management) will first need to develop proposed regulations to implement provisions of the new law. Upon their completion, the proposed regulations will be published in the Federal Register for public comment. After the comment period ends, the VA will consider the public’s recommendations in the course of developing a final rule. Consideration of public comments and development of the final version of the regulations could take anywhere from one month to half a year or longer. When ready, the final rule will be published in the Federal Register. 

Due to the unpredictable nature of the regulatory process, it is impossible to state with any certainty when the new law will take effect. ACA will be tracking the process closely, however, and will work with the VA and the Office of Personnel Management to develop the regulations. Information regarding developments on this issue will be posted on ACA’s website at www.counseling.org/publicpolicy, on the ACA government relations e-mail list and in future issues of Counseling Today.

It is hoped that recognition within the newly passed veterans legislation will make it easier to achieve the counseling profession’s other goals for recognition under federal programs. These goals include gaining independent practice authority within the TRICARE health services program for active-duty military personnel and their dependents, and coverage under the Medicare program covering older Americans and Americans with disabilities.

ACA congratulates the many counselors who took part in the effort to push for full recognition within the VA. Major legislative victories are made possible by grassroots support, and this accomplishment would not have been possible without your help. Thank you!

For more information on this issue, contact Scott Barstow with ACA’s Office of Public Policy and Legislation at 800.347.6647 ext. 234 or via e-mail at sbarstow@counseling.org.