LEGISLATION
S. 604—the “Seniors Mental Health Access Improvement Act of 2011"
Sponsor: Senator Ron Wyden (D-OR)
Cosponsors:
Senator John Barrasso (R-WY)
Senator Mark Begich (D-AK)
Senator Daniel K. Inouye (D-HI)
Senator Richard Durbin (D-IL)
Senator Sherrod Brown (D-OH)
Senator Tim Johnson (D-SD)
Senator Barbara Boxer (D-CA)
LATEST INFORMATION
Bipartisan legislation has been introduced in the Senate to establish Medicare reimbursement of licensed professional counselors and marriage and family therapists. As with previous versions of the legislation, the “Seniors Mental Health Access Improvement Act of 2011,” S. 604, would cover only medically-necessary outpatient mental health services, and would reimburse licensed professional counselors and marriage and family therapists at the same reimbursement rates, and under the same terms and conditions, as clinical social workers.
ACA strongly encourages counselors to contact their Senators to ask them to cosponsor the legislation. If one of your Senators is already listed above as a cosponsor of the legislation, please thank them.
WHAT YOU CAN DO
Please call or e-mail your Senators and ask them to cosponsor the "Seniors Mental Health Access Improvement Act of 2011," S. 604. (Only Senators can cosponsor legislation introduced in the Senate.) Let your Senators know that this same legislation was passed by the Senate in both 2003 and 2005, and that private sector health plans have been covering counselors for many years.
You can find out who your Senators are by visiting the ACA internet legislative action center at http://capwiz.com/counseling and entering your zip code in the box indicated. Senators and Representatives can be reached through the U.S. Capitol Switchboard at 202-224-3121, and telling the operator which office you would like to be connected with.
Letters and emails should be addressed as follows:
For Senators:
The Honorable {full name}
U.S. Senate
Washington, D.C. 20510
Dear Senator {last name}:
BACKGROUND
Medicare is the nation's largest health insurance program, covering roughly 39 million older Americans (65 or older), and approximately 8 million Americans with disabilities. The program was established in 1965, and its mental health benefit has remained largely unchanged since that time.
Medicare has covered psychologists and clinical social workers since 1989, but does not cover licensed professional counselors. Many Medicare beneficiaries live in mental health professional shortage areas, and there are more than 120,000 licensed professional counselors across the country ready to provide needed treatment. Lack of access to outpatient mental health treatment harms beneficiaries, and contributes to overutilization of more expensive inpatient care.
Medicare coverage of counselors is not a partisan issue. The Senate passed legislation establishing Medicare reimbursement of licensed professional counselors in both 2003 and 2005, during Republican control of that chamber. The House of Representatives has also approved such language twice, in both 2007 and 2009, under Democratic control.
S. 604 will improve Medicare beneficiaries' access to outpatient mental health care in a cost-effective manner, by establishing coverage of highly-qualified LPCs. The current shortage of mental health professionals available to Medicare beneficiaries is going to get significantly worse over the coming years, as the baby boom generation enrolls in the program and current mental health service providers retire. Research shows that licensed professional counselors are proportionately more likely to work in rural and underserved areas than are clinical social workers, psychologists, and psychiatrists.
STATISTICS / FINDINGS
- The Congressional Budget Office (CBO) estimates that Medicare coverage ofboth LPCs and MFTs would cost only $100 million over 5 years, and $400 million over ten years. In comparison, total Medicare spending over the next five years is projected to be over $2.3 trillion dollars.
- An April, 2004 report by the National Advisory Committee on Rural Health and Human Services recommended to the Secretary of Health and Human Services that Medicare be amended to authorize licensed professional counselors and marriage and family therapists to provide behavioral health services to Medicare beneficiaries.
- A 2002 federally-funded study by the University of Southern Maine (USM) concluded that Medicare should cover licensed professional counselors and marriage and family therapists. The study found no basis for differentiating coverage policy between clinical social workers (already covered under Medicare) and these two provider groups based on the professions' respective state licensure laws.
- Virtually all of the rural counties in this country have a shortage of practicing psychiatrists, psychologists, and social workers, the only providers covered by Medicare (President's New Freedom Commission on Mental Health, July 2003) and about 50% of rural counties have no practicing psychologist or clinical social worker(Quality Through Collaboration: The Future of Rural Health Care, Board on Health Care Services, 2004). Allowing licensed professional counselors to be reimbursed under Medicare provides an increased choice of mental health providers and increased access to services, especially for beneficiaries in rural areas who may have to pay out-of-pocket or go without services. Due to these statistics and the qualifications of licensed professional counselors, the National Rural Health Association and the National Association for Rural Mental Health support Medicare reimbursement for licensed professional counselors.
- It is estimated that nearly two-thirds of older Americans with a mental disorder do not receive needed services. The problem is even more acute in rural and underserved areas. (Mental Health Care and Older Adults: Facts and Policy Recommendations, American Psychological Association, July, 2003)
- An estimated 50-70% of all primary care visits are related to mental health factors such as anxiety and depression (National Coalition on Mental Health and Aging, 2004)
FOR MORE INFORMATION
Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
5999 Stevenson Avenue
Alexandria, VA 22304
703.823.9800 x234
703.823.0252 fax
800.347.6647
703.823.6828 TDD
sbarstow@counseling.org
www.counseling.org