Counseling Today, Features

Protecting consumers and licensed counselors

Angela Kennedy February 14, 2008

Last June, Counseling Today reported on efforts by the Oregon Coalition for Consumer Protection and Choice in Mental Health Care to persuade state lawmakers to address issues related to the quality and availability of mental health services. The legislation being pushed by the coalition (H.B. 2687) urged consumer protection against unlicensed and unregulated mental health care providers who set up practice and call themselves counselors. It also pushed for third-party reimbursement for licensed professional counselors and licensed marriage and family therapists. Unfortunately, after earning approval by the Oregon House, the bill didn’t make it through the state Senate Ways and Means Committee.

Now, however, after a promising revision to the legislation, an exposé by the state’s largest newspaper and some strategic maneuvering, the coalition, composed of members of the Oregon Mental Health Counselors Association, the Oregon Counseling Association and the Oregon Association for Marriage and Family Therapy, may finally have the support it needs.

“Our purpose is to educate the public, disseminate practical information and protect the public, because in Oregon, you can practice and say that you are a counselor without having a license,” explains Art Tolentino, a licensed mental health therapist who is an active member of the coalition. “We are trying to change that so we can protect the title of counselor — (make it so) the only way you can say that you are a counselor is to have a license, be registered as an intern or be certified as a drug and alcohol counselor.”

In November, the Oregon House Committee on Human Services and Women’s Wellness selected the revised Consumer Mental Health Protection and Choice bill (formerly H.B. 2687) as its only bill to send to the House floor. Because of the time constraints involved with the supplemental session of the Oregon Legislative Assembly this month, legislators restricted themselves to a relatively small number of noncontroversial bills that were supported by a committee, says coalition member and licensed professional counselor Mary Lou Brophy.

Preceding the House committee’s selection of the bill championed by the coalition, Majority House Whip Peter Buckley (D-Ashland), chair of the House Education Committee, presented the key rationale for the legislation. Buckley was one of the original sponsors of H.B. 2687. In addition, Marcus Berglund, president-elect of the Oregon Association for Marriage and Family Therapy, provided strong and clear testimony in favor of the bill, while Brophy walked the committee through three changes made to the former version of the legislation:

  • Omitting the proposed paid investigator position within the Oregon Board of Licensed Professional Counselors and Therapists
  • Allowing certified alcohol and drug counselors to be included on the list of those who may use the word counselor/counseling in their titles
  • Adding wording to protect interns who registered with the state licensing board
  • Despite those changes, the overall purpose of the original bill was not compromised, according to Brophy, because the revised version still focuses on four key elements:
  • Improved consumer protection: State boards should verify the qualifications and regulate the practice of mental health care providers, including unlicensed providers. Currently, there is no safety net to protect the public against fraudulent, unqualified business people working or promoting themselves as “counselors.” Offenders will face a $2,500 civil penalty.
  • LPCs and LMFTs are fully qualified: The required training for LPCs and LMFTs meets or exceeds that of other professionals in the mandated provider pool. Therefore, LPCs and LMFTs should be compensated equally. Current Oregon law already requires insurers to pay for mental health services provided by physicians, psychologists, clinical social workers and nurse practitioners.
  • Mental health needs are going unmet: Because LPCs and LMFTs are currently being discriminated against and not allowed third-party reimbursement, public access to mental health services are significantly limited.
  • Insurance company provider panels have too much power: Insurers trump state laws and professional licensing boards by solely determining who is and is not competent to provide mental health services. By restricting access to mental health care via provider panels, insurers are, in effect, restricting the supply of counselors and therapists.

Gaining momentum

Late last fall, Brophy met with Rep. Suzanne Bonamici (D-Washington County), vice-chair of the House Consumer Protection Committee, and reviewed a feature article and subsequent editorial and letter that appeared in The Oregonian, the state’s largest newspaper. The initial article focused attention on the Oregon Coalition for Consumer Protection and Choice in Mental Health Care’s cause by reporting on several “counselors” (two being social workers and one an LMFT) whose Oregon licenses had been revoked, but who were still practicing. The legislative activities of the coalition were also given ample coverage as the article investigated consumer vulnerability in mental health care. Brophy says the articles helped the coalition gain merit not only with lawmakers, but also with the general public and potential consumers.

Adds Tolentino, “It’s been a long struggle for counselors and MFTs to get parity or vendorship in Oregon. Recently, the coalition has become more powerful and is now being recognized by the state Legislature and other mental health professional organizations.” However, not all of the publicity on LPCs and LMFTs has been positive or supportive. Several professionals currently mandated as mental health service providers under insurance plans have been vocal in questioning the scope of practice of LPCs and LMFTs. Tolentino believes this is a strategic approach to keep counselors from achieving parity.

Explains Brophy, “The Oregon Psychological Association is really fighting us this time around. They have put out so much misinformation, and we have been busy correcting it.”

“They are arguing that LPCs and LMFTs are working beyond their scope of practice,” Tolentino adds. “To be able to be reimbursed by insurance companies, they claim that, by law, you have to be able to diagnose and treat your client. That is their contention.”

In December, Tolentino and other coalition members met with officials from the Oregon Board of Licensed Professional Counselors and Therapists to persuade them to defend counselors publicly and to back the coalition’s efforts for third-party reimbursement. In January, the board released a position statement saying that LPCs and LMFTs are working within their scope of practice and are qualified to diagnose and treat mental health cases. The board disseminated the statement to other mental health professional licensing boards, associations and agencies in an effort to erase any doubt about the qualifications of LPCs and LMFTs.

“Additionally,” Brophy says, “we have hired a lobbyist, because it was recommended that we have one on the Senate side in particular. Last time, we won the House with a vote of 51 to 7, but were defeated in the Senate.”

“Now that we have the support of our licensing board, and with all these things coming together, I think we will be successful,” Tolentino says. “It really is a great bill that will ultimately protect the consumer. When passed, the consumer will know for certain that all counselors are licensed and regulated.”

Brophy adds that it’s vital for the profession as a whole for counselors to investigate and stay current on state policies that protect not only themselves, but also their clients. The Oregon State Legislative Assembly Supplemental Session commences Feb. 4. If the Consumer Mental Health Protection and Choice bill passes, the new law will have an effective enactment date of July 1.

Angela Kennedy is a senior writer at Counseling Today. Contact her at Letters to the editor: