ACA Members on Capitol Hill During the 2019 Institute for Leadership Training
The Government Affairs team advocates for you and your profession on issues ranging from Medicare reimbursement to portability to school counseling funding. Adding your voice makes our message stronger. Join us by contacting your representatives on issues that matter to you.
January 6, 2021
More Funding for Mental Health Services in HHS Appropriations Bill
Over the holidays, Congress passed the Labor, Health and Human Services, and Education (L-HHS-E) Fiscal Year (FY) 2021 appropriations bill, included as Division H of the omnibus Consolidated Appropriations Act, 2021. The legislation includes $858,314,430 in funding for HHS, an increase of $72,987,166 over the FY 2020 enacted amount. Below, please find relevant items included in the L-HHS-E Explanatory Statement.
Centers for Disease Control and Prevention (CDC)
- Mental and Substance Use Disorder Workforce Training Demonstration: Within the total for Behavioral Health Workforce Education and Training, through the Health Resources and Services Administration (HRSA), the agreement includes $29,700,000 for the Mental and Substance Use Disorder Workforce Training Demonstration program. Within this total, the agreement includes an additional $3,000,000 for new grants to expand the number of nurse practitioners, physician assistants, health service psychologists and social workers trained to provide mental and substance use disorder services in underserved community-based settings that integrate primary care and mental and substance use disorder services, which may include establishing, maintaining or improving academic units or programs to support those activities, as authorized under section 760 of the Public Health Service Act.
- Suicide Prevention: The agreement includes an increase to continue to utilize data and evaluations to inform ongoing programmatic efforts to prevent suicide, specifically in vulnerable populations and subgroups among which suicides are increasing. These data will be used to inform community-based suicide prevention efforts. The Centers for Disease Control and Prevention (CDC) is encouraged to expand their emergency department syndromic surveillance project on suicidal behavior to provide near real-time data and to continue to explore data, methods, and research that advance our understanding of suicide and suicidal behavior. The agreement recognizes CDC's work to establish a comprehensive suicide prevention program and directs CDC to continue the implementation and evaluation of these targeted, comprehensive, community-based suicide prevention strategies to reduce risk for suicide, and to evaluate their impact, especially among high-risk populations. The agreement also directs CDC to enhance the completeness of data to capture mechanisms of death and support research and evaluation projects to understand the pathways and mechanisms that contribute to suicidal ideations and attempts.
Substance Abuse and Mental Health Services Administration (SAMHSA)
- Certified Community Behavioral Health Clinics: The agreement includes a $50,000,000 increase in funding.
- Mental Health Block Grant: The agreement includes a $35,000,000 increase for a new five percent set-aside of the total for evidence-based crisis care programs as directed in House Report 116-450.
- National Suicide Prevention Lifeline: The agreement includes an increase and requests that SAMHSA provide a report to the Committees on Appropriations of the House of Representatives and the Senate within 180 days after enactment of this Act on the level of funding required to meet the needs of the Lifeline, including updated data on suicide rates and attempts. In addition, SAMHSA is directed to provide a report to the Committees on Appropriations of the House of Representatives and the Senate and post such report on SAMHSA' s website within 180 days of enactment of this Act detailing call and text volume over the past three years as applicable. The report shall also include an assessment of whether other services such as emails, videos, or other digital modes of communications would improve service of the Lifeline. As SAMHSA considers expanding this service, the agreement encourages SAMHSA to leverage existing infrastructure to the extent practicable. The agreement further urges SAMHSA to provide specific training programs for counselors to increase competency in serving at-risk youth through the utilization of existing specialized resources.
- Suicide Prevention: The agreement includes increased funding to expand and enhance access to suicide prevention resources of the Suicide Lifeline, the Zero Suicide program, the Garrett Lee Smith Youth Suicide Prevention State Grants Program and the Garrett Lee Smith Suicide Prevention Resource Center.
- Infant and Early Childhood Mental Health: The agreement includes an increase for grants to entities that are in different stages of developing infant and early childhood mental health services. The agreement directs SAMHSA to allocate a portion of the increase for technical assistance to existing grantees, to better integrate infant and early childhood mental health into State Systems.
- Mental Health Awareness Training: SAMHSA is directed to continue to include as eligible grantees local law enforcement agencies, fire departments, and emergency medical units with a special emphasis on training for crisis de-escalation techniques. SAMHSA is also encouraged to allow training for veterans and armed services personnel and their family members.
National Institutes of Health's National Institute of Mental Health
- State of Bereavement Care: The agreement is aware of research indicating that individuals and families suffer severe health, social and economic declines following the death of a loved one-be it a child, sibling, spouse, or parent. The agreement encourages OMH, ACF, CDC, CMS, HRSA, IHS, NIH and SAMHSA to examine their activities to advance bereavement care for families, including prevalence of bereavement events and the details of those events (what relationships are impacted, how the loved one died and at what age), risk factors and associated health events or outcomes, biological or physiological changes in wellbeing, and what interventions or programs could help functional coping or adaptive processing.
If you have questions or would like to become involved in ACA’s advocacy efforts, please contact the ACA Government Affair and Public Policy team at email@example.com.
November 12, 2020
On November 9, 2020, the Medicare Payment Advisory Commission (MedPAC) held a public meeting on the expansion of telehealth in Medicare. During the meeting, MedPAC staff discussed the following:
- Expansions and flexibilities granted to telehealth in Medicare—which will expire upon the end of the public health emergency (PHE)
- Policy options for extension of certain policies
- Various policy options to expand the use and availability of telehealth in Medicare to MedPAC commissioners
Click here to view the full presentation. For more information, please contact firstname.lastname@example.org.
November 2, 2020
U.S. DEPARTMENT OF HOMELAND SECURITY
COUNSELORS NAMED ESSENTIAL DURING NATIONAL EMERGENCIES
The Cybersecurity and Infrastructure Security Agency, has named counselors as essential to the critical infrastructure of the United States of American during national crisis.
The U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) has the responsibility of ensuring essential critical infrastructure workers have the ability to work during COVID-19. CISA works with a variety of federal, state, and local agencies, as well as the private sector to issue an advisory list of essential personnel.
The purpose of the list is to provide state, local, tribal, and territorial officials an essential services list to ensure communities continue to function during disasters, including public health and safety, as well as economic and national security. Though states are not required to adhere to the list provided by CISA, it is clear that counselors are an integral part in supporting the countries needs in a time of crisis.
CISA’s most recent list includes a variety of professionals including counselors that work in, or fall into the following categories:
- Rural Health Clinics
- Community Mental Health Clinics
- Federally Qualified Health Centers
- Residential and Community-Based Providers
- Religious Nonmedical Health Institutions
- Crisis Counselors
- Domestic Violence Counselors
- Behavior Specialist
- Substance Abuse-Related Counselors
- Peer Support Counselors
- Telehealth Services
- Guidance Counselors
- Mental Health Professional (Education)
The list provided by CISA is advisory only, and not a federal directive. The list is also not an exclusive list of critical infrastructure sectors. The American Counseling Association (ACA) has worked with CISA to educate them on the role of the counseling profession. It is important that counselors are aware of this development, you are part of the essential personnel needed during this crisis.
Due to the work of ACA, several of the categories above were added to the list. CISA issues a new list monthly and ACA will continue to monitor and provide updates as we obtain them. Your local and state legislators should be aware of this list and call on you for your expertise during these difficult times. If they haven’t, please reach out to them and let them know you are available to assist in emergencies when needed. If you need assistance in reaching out or have questions, please e-mail email@example.com.
October 28, 2020
Medicare Coverage for Opioid Use Disorder Treatment
And a friendly reminder that we are still fighting for full coverage.
Thanks in part to your advocacy efforts, H.R.6, the SUPPORT for Patients and Communities Act, commonly referred to as “The SUPPORT Act” was signed into law October 2018. This landmark legislation includes critical provisions to increase and strengthen our workforce; standardize the delivery of addiction medicine; cover addiction medicine; and expand access to high-quality, evidence-based mental health care. The SUPPORT Act also expands the definition of allowable mental health care services under provision B to include LPCs operating within certified Opioid Treatment Programs (OTP) for the purpose of Opioid Use Disorder (OUD) treatment.
The Centers for Medicare and Medicaid Services (CMS) retained language within the SUPPORT Act that would benefit LPCs in a proposed rule related to Medicare payments. Specifically, the language would enable any LPCs or Licensed Mental Health Counselors (LMHC) working in an Opioid Treatment Program (OTP), with clients suffering from opioid use disorder, to provide counseling services without any disruption to the bundled payments received by the OTP since January 1, 2020.
Due to the passage of H.R.6, Medicare offers new bundled payment options to help you treat patients with Opioid Use Disorder (OUD):
- Office-based OUD treatment, including management, care coordination, psychotherapy, and counseling activities. Learn about treatment billing.
- Treatment provided by enrolled Opioid Treatment Programs (OTPs). Services include medication (like methadone and buprenorphine), counseling, drug testing, and individual and group therapy. We cover counseling and therapy services in person and virtually. Refer your patients to Medicare-enrolled OTPs to get started.
Learn more about our efforts to combat the opioid epidemic.
Although this is a step forward toward Medicare coverage, ACA is still fighting for the full inclusion of professional counselors as behavioral health providers under Medicare. If you would like to become involved in ACA’s advocacy efforts, you can contact the ACA Government Affairs and Public Policy team at firstname.lastname@example.org
October 20, 2020
President Trump Signs Law Designating 9-8-8 as Universal Number for National Suicide Hotline
On Saturday, President Trump signed a bipartisan bill into law that will make ‘9-8-8’ the universal telephone number to reach the national suicide prevention hotline, beginning in 2022. Currently, the hotline is accessible by the 10-digit number, 1-800-273-8255 (TALK).
S.2661, The National Suicide Hotline Designation Act of 2020, which passed the House of Representatives last month after approval from the Senate and the Federal Communications Commission, will allow those seeking help to dial the three-digit number and be directed to the hotline.
The bill authorizes states to collect fees aimed at ensuring that local crisis centers will be able to support increased volume, and it also directs government health agencies to submit a report to Congress detailing strategies to improve support services for LGBTQ youth, minorities, and individuals in rural counties, who are at higher risk for suicide.
Suicidal ideation is up among young people since last year, with as many as one in four people ages 18 through 24 having seriously considered suicide in the 30 days preceding a survey released in August by the US Centers for Disease Control and Prevention (CDC). The CDC also reported that 11% of adults surveyed had seriously considered suicide in the past 30 days before they completed the survey. Among those identifying as Black or Hispanic, the numbers were worse: 19% of Hispanics reported suicidal ideation and 15% of Black Americans reported suicidal thoughts.
If you would like to become involved in ACA’s advocacy efforts and create a pathway for greater access to mental health services for those in need, please contact the ACA Government Affairs and Public Policy department at email@example.com.
October 16, 2020
California Enacts Historic Parity Law (SB 855)
The American Counseling Association (ACA) is excited to share that a broad coalition of mental health organizations, including California Counseling Association (CCA) and ACA, have successfully aided in the enactment of SB 855. This enacted legislation, authored by Senator Scott Wiener, expands state mental health parity law for fully-insured health insurance plans. The new law updates California health code in accordance with best practices and nationally recognized standards of care for mental health treatment across the full spectrum of care, including early interventions.
SB 855 also changes the following for fully-insured health plans issued, amended, or renewed on or after January 1, 2021:
- Requires plans to make coverage determinations using nationally recognized standards of care; to provide coverage for medically necessary treatment of all MH/SUDs included in the most-recent edition of the International Classification of Diseases and Related Health Problems (ICD) and the most-recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) under the same terms and conditions applied to other medical conditions.
- Defines medical necessity and medically necessary treatment for purposes of MH/SUDs by reference to generally accepted standards set by nonprofit professional associations for the relevant clinical specialties. Prior state law did not have a definition of these terms.
- Prohibits a plan from limiting benefits or coverage for MH/SUD to short-term or acute treatment and defines covered benefits to include basic health care services, intermediate services, and prescription drugs.
For health insurance carriers, the changes in the bill that are more significant are those that define medical necessity, require out-of-network care at in-network cost-sharing, and dictate review criteria. It is not anticipated that changes will impact premiums.
In addition to increasing access to care, SB 855 will reduce costs to Medi-Cal and other public programs associated with untreated mental health and substance use disorders.
For more on the enactment of SB 855, including bill language, go here.
October 16, 2020
Congressional Report Reveals Americans’ Mental Health is Worsening
The U.S. Congress Joint Economic Committee recently released a report on how the COVID-19 pandemic, coupled with economic instability, is taking a toll on Americans’ mental health. Over 90 million Americans are reporting symptoms of anxiety and depression due to fears surrounding the coronavirus. According to a survey conducted by the Center for Disease Control and Prevention (CDC), 41% of respondents are struggling with mental health issues stemming from the pandemic; and researchers from New York University’s Grossman School of Medicine suggest that the solution is increased funding for mental health as well as greater access to behavioral health services.
ACA has been advocating for greater access to behavioral health services, particularly in rural communities, through S.286/H.R.945, the Medicare Access Improvement Act of 2019. If you would like to become involved in ACA’s advocacy efforts and create a pathway for greater access to mental health services for those in need, please contact the ACA Government Affairs and Public Policy department at firstname.lastname@example.org.
October 7, 2020
Trump Administration Extends the National Health Emergency
The Trump administration is renewing the public health emergency declaration for the COVID–19 pandemic, ensuring key resources are available nationally for fighting the virus.
This is the third time Department of Health and Human Services (HHS) Secretary Alex Azar, under the Trump administration, has extended the emergency declaration, which must be renewed every 90 days. The latest renewal comes without speculation over whether the administration would let the declaration lapse. Azar announced the renewal nearly three weeks before the declaration was set to end, providing certainty to the behavioral health community.
The public health emergency declaration has been critical in providing resources so that mental health professionals can provide much-needed counseling services to individuals across the U.S. The public health emergency declaration, in combination with HHS’s expansion of several telehealth, telemedicine, and telebehavioral initiatives, has given valuable flexibility to mental health counselors across the nation and has provided greater access to care for millions of Americans.
The renewal will take effect October 23 and last for 90 days.
October 2, 2020
HHS Announces $20 Billion in New Phase 3 Provider Relief Funding for Behavioral Health Providers
The Department of Health and Human Services (HHS) announced Phase 3 of the General Distribution of the Provider Relief Fund, which will allocate another portion of provider relief funding.
This new phase applies to various groups, including mental health counselors. While some behavioral health providers have already received prior general distribution payments, others have not. Working with the Substance Abuse and Mental Health Services Administration (SAMHSA), HRSA has developed a list of the nation’s behavioral health providers now eligible for funding, which includes, addiction counseling centers and mental health counselors. Providers can begin applying for funds on Monday, October 5, 2020.
October 2, 2020
House Passes Important Mental Health Legislation
Due in part to your advocacy efforts, today the House has passed several mental health bills that are endorsed by ACA:
- H.R. 5469, the “Pursuing Equity in Mental Health Act,” introduced by Rep. Bonnie Watson Coleman (D-NJ), and eight other Members of Congress. The bill would authorize federal funding to address mental health inequities among underserved populations, including communities of color. The bill includes provisions that would: create a grant program targeted at high-poverty communities for culturally and linguistically appropriate mental health services; support research into disparities in mental health; reauthorize the Minority Fellowship Program to support more students of color entering the mental health workforce; and study the impact of smartphones and social media on adolescents.
- H.R. 1109, the “Mental Health Services for Students Act,” introduced by Reps. Grace Napolitano (D-CA) and John Katko (R-NY). The bill authorizes grants to fund school-based mental health services. The program would support screening for social, emotional, mental, and behavioral issues, including suicide or substance use disorders; treatment and referral for these issues; development of evidence-based programs for students experiencing these issues; and other strategies for schools to support students and the communities that surround them. The goal of the program is to create partnerships between schools and community-based mental health professionals across the country.
- H.R. 5572, the “Family Support Services for Addiction Act of 2020,” introduced by Reps. David Trone (D-MD) and Daniel Meuser (R-PA). The bill authorizes the Secretary of HHS to award grants to support family community organizations that develop, expand, and enhance evidence-informed family support services for families and family members living with substance use disorders or addiction. The grants may be used to build connections between family support networks, with behavioral health and primary care providers, and foster care services, among others. The grant may also be used to reduce stigma around addiction and addiction treatment, family support outreach activities, and connect families to peer support programs.
It remains to be seen whether the Senate, which will now be in session next week due to the pending Supreme Court nomination, will consider these measures before the November 3rd election. ACA will keep you updated on any developments.
If you would like to become involved in ACA’s advocacy efforts, please contact us at email@example.com.
September 30, 2020
Veteran Affairs Rural Health Advisory Committee to Host Public Meeting
The United States Department of Veteran Affairs – Rural Health Advisory Committee will host three meetings beginning on October 5th to advise the Secretary on rural health care issues affecting Veterans. The committee reviews policies on Veteran care and discusses ways to improve care. This is an opportunity for counselors that work with Veterans to submit your input and learn about the process the VA takes to treat Veterans.
If you would like to join the virtual meeting, please utilize the link and/or phone number below.
Meeting Link: https://zoom.us/j/93537309124
Meeting Phone: 1-646-558-8656
Participant Code: 93537309124
Meeting Dates: October 5th – October 7th
Time: 11:00am-2:00pm EST
If you would like to submit comments to the record from a counselor’s perspective, please contact Ms. Judy Bowie at VRHAC@va.gov by 2pm EST on October 7th, 2020. If you would like to speak, you may send a 1-2 page summary of your comments for inclusion in the official meeting record.
If you need additional information, please reach out to Ms. Bowie at the e-mail address above.
August 10, 2020
Congressional Task Force Exams the Benefits of Telebehavioral Health
The House Ways & Means Committee’s Rural and Underserved Communities Health Task Force held its first roundtable discussion titled “Examining the Role of Telehealth During COVID-19 and Beyond.”
The following individuals participated as panelists:
- Tearsanee Carlisle Davis, DNP, FNP-BC, FAANP: Director of Clinical and Advanced Practice Operations, University of Mississippi Medical Center’s Center for Telehealth; Assistant Professor, UMMC School of Nursing.
- Ateev Mehrotra, MD, MPH: Associate Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School; Associate Professor of Medicine and Hospitalist, Beth Israel Deaconess Medical Center.
- Keris Myrick, MBA: Chief of Peer and Allied Health Professions, Los Angeles County Department of Mental Health.
- Jason Tibbels, MD: Chief Quality Officer, Teladoc Health; President, The Institute of Patient Safety and Quality of Virtual Care.
In her opening statement, Rural and Underserved Communities Health Task Force Co-Chair Terri Sewell (D-AL-7) stated that the task force’s policy areas of focus will be: (1) addressing social determinants of health; (2) enacting payment system reforms; (3) strengthening technology and infrastructure; and (4) reinforcing the U.S. health workforce.
Please find below a summary of the relevant discussions:
All panelists agreed that certain telehealth flexibilities which have been granted during the COVID-19 public health emergency should be made permanent in order to continue expanding telehealth services in the U.S. Panelist Tearsanee Davis stated the “loosened [telehealth] restrictions for sites of service and enhanced reimbursement structure” have significantly improved patient experience and should be made permanent even after the COVID-19 pandemic ends. Panelist Jason Tibbels added that patient geographic restrictions and originating site restrictions should be permanently removed in order to modernize telehealth in the Medicare program.
Telehealth Payment Methods
Several Republican members on the task force discussed how telehealth services should be paid for while minimizing telehealth overuse. Co-chair Brad Wenstrup (R-OH-2) discussed various types of value-based alternative payment models and how these models could be incorporated for telehealth services. Panelist Ateev Mehrotra noted that the overall costs for furnishing telehealth services would be lower in the long-term and therefore should have a lower Medicare reimbursement rate or should be subject to alternative payment methods. Dr. Tibbels also noted that the Department of Health and Human Services (HHS) already has “extensive program integrity policies and procedures in place to fight fraud, waste, and abuse.”
Mental Health Services
Several panelists and task force members emphasized how telehealth could improve access to mental health services. Panelist Keris Myrick noted that the COVID-19 pandemic has exacerbated the negative mental health outcomes for patients who already suffered from depression or isolation before mandatory quarantine efforts began. Rep. Mike Thompson (D-CA-5) discussed how one mental health provider in his district increased their average telehealth visits from 300 a month to 3,000 a month.
In her opening statement, Co-Chair Sewell noted that an investment in technology infrastructure would be necessary in order to continue expanding telehealth access. Dr. Tibbels stated that Congress should invest in creating a “broader penetration of smartphone use and data plans among underserved populations” in order to maximize the benefits of telehealth expansion.
The Task Force did not indicate when it would meet next. We will continue to monitor and update.
August 5, 2020
Trump Administration Proposes to Expand Telehealth Benefits Permanently for Medicare Beneficiaries Beyond the COVID-19 Public Health Emergency
The American Counseling Association (ACA) has been tirelessly advocating for the extension of the national health emergency declaration, which would allow licensed professional counselors to engage in telebehavioral health services for those outside of the counselor's practice jurisdiction (i.e. state lines). Our short term goal had been to extend the emergency declarations for another 90 days and we were successful in that endeavor. Our long term goal is to have the telebehavioral health flexibilities available under the declaration made permanent.
In response to the value telehealth has shown during the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has proposed to permanently extend Medicare coverage of telebehavioral health services, as well as implement other flexibilities so that Medicare beneficiaries living in all areas of the country can receive convenient, high-quality care from the comfort of their home. Comments on the proposed regulations are due October 5, 2020. If you would like to submit comments regarding the proposed regulation, we have provided you with some talking points to help craft your message. Although bullets points are provided, you are encouraged to share your personal story.
While we are optimistic about the proposed rule, we would like to emphasize that this is a proposal and that nothing has become permanent. As ACA continues to push for full inclusion of professional counselors as Medicare providers, this would be an additional benefit and the first step towards what we hope will be even greater opportunities for our members and other professional counselors.
Here is the information from CMS who is now advocating for our goal to have the emergency declarations made permanent! ACA will continue to monitor the proposal and we will keep you updated on its progress.
If you would like to become involved in ACA’s advocacy efforts, please contact us at firstname.lastname@example.org
Senate Republicans Unveil HEALS Act
On Monday evening, Senate Republicans released a series of bills, collectively titled the HEALS (Health, Economic Assistance, Liability Protection, and Schools) Act. The package of bills represent Senate Republicans’ first negotiation position with House and Senate Democrats for the next COVID-19 relief package. The suite of bills includes the following:
- From the Senate Appropriations Committee, the Coronavirus Response Additional Supplemental Appropriations Act, 2020.
- From the Senate Finance Committee, the American Workers, Families, and Employers Assistance Act.
- From the Senate HELP Committee, the Safely Back to School and Back to Work Act.
- From the Senate Judiciary Committee, the Restoring Critical Supply Chains and Intellectual Property Act and the SAFE TO WORK Act
- From the Senate Small Business Committee, the Continuing Small Business Recovery and Paycheck Protection Program Act.
Provisions of note:
The Coronavirus Response Additional Supplemental Appropriations Act, 2020.
National Institute of Mental Health: The bill appropriates $200 million, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally.
National Institute on Minority Health and Health Disparities: The bill appropriates $64.3 million, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally.
Substance Abuse and Mental Health Services Administration: The bill appropriates $4.5 billion for Health Surveillance and Program Support, to remain available until September 30, 2021, to prevent, prepare for, and respond to coronavirus, domestically or internationally. This sum includes $1.5 billion for substance abuse prevention and treatment block grants, and $2 billion for grants for community mental health services block grants. This sum includes $600 million for Certified Community Behavior Health Clinic Expansion grants. This sum includes $50 million for suicide prevention programs. This sum includes $100 million for activities and services under Project AWARE.
The American Workers, Families, and Employers Assistance Act.
Sec. 303. Authority to Extend Medicare Telehealth Waivers: The bill extends the Secretary of HHS’ authority to waive or modify requirements with respect to telehealth services through December 31, 2021, even if the public health emergency has ended before that time. The Secretary of HHS must post information describing the requirements applicable to telehealth services and other virtual services under Medicare Parts A and B and the Medicare Advantage program within three months of enactment of the bill, and prior to waiving or modifying such requirements. The Secretary of HHS must also conduct a study on the impact of telehealth and other virtual services furnished under the Medicare program and issue such report within 15 months of the date of enactment of the bill. The bill also requires the Medicare Payment Advisory Commission (MedPAC) to conduct an evaluation by June 15, 2021 of telehealth services under Medicare Part B related to the COVID-19 public health emergency and the appropriate treatment of such expansions after the expiration of the public health emergency. Section 303 extends the telehealth coverage waivers provided by the CARES Act.
Sec. 304. Extending Medicare Telehealth Flexibilities for Federally Qualified Health Centers and Rural Health Clinics: The bill extends Medicare telehealth flexibilities for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for five years beyond the end of the COVID-19 public health emergency. Section 3704 of the CARES Act authorized RHCs and FQHCs to furnish distant site telehealth services to Medicare beneficiaries only during the COVID-19 public health emergency.
The Safely Back to School and Back to Work Act.
Sec. 108. Telehealth Plans: The bill allows employers to offer telehealth as an accepted benefit to employees who are not full-time or do not qualify for their employer’s coverage during the declared COVID-19 public health emergency until the later of January 1, 2022 or the date on which the COVID-19 public health emergency ends.
The HEALS Act is still undergoing the negotiation process and some of the legislative language may change. The ACA Government Affairs and Public Policy team will monitor the bills’ process and will keep you updated as things progress.
Senate Democrats Introduce the Economic Justice Act
Senate Democrats have recently unveiled a proposal known as the Economic Justice Act that would infuse $350 billion in immediate and long-term investments into communities of color to help offset racial inequality. Lead by Senator Chuck Schumer (D-NY), the proposal also seeks to deliver ten financial investments over a period of five years to communities of color to support various initiatives such as child care, mental health, and job development.
The American Counseling Association will continue to monitor the progress of this legislation.
House Energy & Commerce Committee Markup Information
The House Energy & Commerce Committee held a markup of 30 health-related bills. Of note, the Committee favorably reported the following bills out of the Committee and to the full House of Representatives.
- Strengthening Behavioral Parity Act (H.R. 7539), with technical amendments. The legislation would increase parity in mental health and substance use disorder by limiting aggregate lifetime limits on mental health and substance use disorder benefits to better ensure coverage. The legislation would require that the financial requirements for mental health or substance use disorder benefits be no more restrictive than the financial requirements for medical or surgical benefits, requiring availability of certain plan information, and more.
- Suicide Prevention Lifeline Improvement Act of 2019 (H.R. 4564). The legislation would ensure the provision of high-quality service through the Suicide Prevention Lifeline by clearly defining and measuring performance indicators and objectives to improve the responsiveness and performance of the hotline and quantifying time frames to track the progress of the hotline in meeting such performance indicators and objectives, as well as setting other standards that crisis centers and backup centers must meet. This legislation also appropriates $5,000,000 to establish a pilot program to research, analyze, and employ technologies and platforms of communication for suicide prevention. Lastly, this legislation requires an HHS study and report on the implementation of this bill and a GAO study and report on the Suicide Prevention Lifeline.
- Campaign to Prevent Suicide Act (H.R. 4585), as amended. The legislation would require the Director of the Centers for Disease Control and Prevention (CDC) to conduct a national prevention media campaign to prevent suicide in the U.S., educating families, friends, and communities on how to address suicide and suicidal thoughts, and increasing suicide prevention resources of the CDC and the Substance Abuse and Mental Health Services Administration (SAMSA).
- Suicide Prevention Act (H.R. 5619), as amended. The legislation would authorize a pilot program to expand and intensify surveillance of self-harm in partnership with state and local public health departments and would provide suicide prevention services in hospital emergency departments. This legislation would appropriate $30,000,000 to establish a grant program to provide self-harm and suicide prevention services.
- National Suicide Hotline Designation Act of 2019, (H.R. 4194), as amended. This legislation would direct the Federal Communications Commission to designate ‘9-8-8’ as the universal telephone number for the national suicide prevention and mental health crisis hotline system operating through the National Suicide Prevention Lifeline and through the Veterans Crisis Line.
The Committee stated there will not be another markup until September. We will continue to monitor and provide updates.
ACA Urges HHS to Extend Public Health Emergency
The American Counseling Association (ACA) recently sent a letter to the Department of Health and Human Services (HHS) secretary Alex Azar requesting that HHS extend the public health emergency beyond its current July 25, 2020 expiration date so that licensed professional counselors can continue to offer the highest quality care and provide greater access to behavioral health services for millions of Americans through the COVID-19 pandemic.
July 15, 2020
The Trump Administration Rescinded ICE Rule for International Students
The Trump administration has rolled back its rule for international students!
On July 10, 2020, the American Counseling Association (ACA) and the Association for Counselor Education and Supervision’s (ACES) issued a statement opposing the U.S. Immigration and Customs Enforcement (ICE) regulation that stated international students must take at least some education in person for their F-1 and M-1 visas to remain valid.
This regulation would have caused 360,000 international students (as of 2019) enrolled at American institutions (which include students in counselor education) to leave the US or find an institution with in-person instruction.
The Trump administration has rescinded the ICE regulation that would have required international students to transfer or leave the country if their schools held classes entirely online as a result of the national health emergency. Federal immigration authorities agreed to pull the July 6 directive and “return to the status quo.”
The announcement brings relief to thousands of foreign students who had been at risk of being deported, along with colleges and universities that would have needed to act quickly and reassess their plans for the fall in light of the policy.
ACA is grateful to its membership for activating its grassroots networks so quickly. We are also grateful to ACES for their partnership on this matter. If you have questions or would like to become involved in ACA’s advocacy efforts, ACA’s Government Affairs and Public Policy team is happy to help. You can contact them at email@example.com.
July 9, 2020
Expiration of COVID-19 National Emergency Declaration
On July 25th, 2020, the provisions supporting Licensed Professional Counselors (LPCs) within the National Emergency Declaration are set to expire. These provisions allow LPCs to provide mental health services while waiving certain telebehavioral health restrictions due to the coronavirus pandemic.
The American Counseling Association is aware of our members’ concerns, and in collaboration with our colleagues within the mental health profession, we have supported actions to request an extension to the national emergency. We expect a renewal of the public health emergency which would allow LPCs to continuing practice during the pandemic.
Public health emergencies must be renewed by Health and Human Services every 90 days, and the coronavirus declaration is set to expire July 25. The emergency was first issued in January, and was renewed previously in late April. The expected extension would last until late October.
Secretary Alex Azar of Health and Human Services (HHS) recently informed the public that he expects a renewal of the National Emergency. “I don’t know of any circumstance — I can’t imagine why that wouldn’t be renewed. I’d be quite surprised if that were not renewed,” said Secretary Azar.
States and lobbying groups representing a wide swath of health care interests have been imploring the White House administration for an extension, though last week HHS spokesperson Michael Caputo sought to sway away those concerns.
The American Counseling Association’s Government Affairs team is keeping a close eye on the progress of this extension. For questions or to take action on this issue, please email the ACA team at firstname.lastname@example.org.
June 30, 2020
ACA Sends H.R. 945 Support Letter to House Energy & Commerce
The American Counseling Association recently sent a support letter to the House Energy & Commerce subcommittee on Health in advance of the subcommittee’s hearing on "High Anxiety and Stress: Legislation to Improve Mental Health During Crisis.” The letter details the need for the inclusion of licensed professional counselors (LPCs) as Medicare providers.
H.R. 945, the Mental Health Access Improvement Act, will be one of a handful of bills discussed during the hearing. The Energy & Commerce subcommittee’s jurisdiction includes, among other things, public health and quarantine, mental health, public health insurance (Medicare, Medicaid), and private health insurance.
May 11, 2020
Medicare Bill Sponsor Sends Letter of Support to Congressional Leaders
The American Counseling Association recently requested stories from our members about the way COVID-19 has affected you and your clients. We took those stories, along with additional data, to the sponsor of the Mental Health Access Improvement Act (H.R. 945), Representative Mike Thompson (D-CA).
Rep. Thompson has been in talks with congressional leadership about the possible inclusion of our Medicare bill (H.R. 945) in one of the upcoming COVID-19 stimulus packages. Thompson’s office was able to submit a letter to congressional leaders on ACA’s behalf, detailing the need for the inclusion of licensed professional counselors (LPCs) as Medicare providers.
As Members of Congress continue to negotiate legislation responding to the COVID-19 pandemic, it is very important that you urge lawmakers to expand access to critical behavioral health services for Medicare beneficiaries. This is particularly vital during this time of uncertainty.
ACA is grateful to Rep. Thompson and his staff for all of their hard work and for supporting ACA’s advocacy efforts for professional counselors.
May, 4, 2020
Rural LPC’s Provide Telebehavioral Health Services under Medicare during Pandemic
On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed into law. Section 3704 of the CARES Act authorizes Rural Health Clinics (RHCs) and Federally Qualified Health Clinics (FQHCs) to provide telebehavioral health services to Medicare beneficiaries during the COVID-19 health emergency.
Medicare telehealth services generally require an interactive audio and video telecommunications system that permits real-time communication between the practitioner and the patient. RHCs and FQHCs with this capability can immediately provide and receive payment for telehealth services to patients covered by Medicare for the duration of the COVID-19 health emergency.
Remote telebehavioral health services can now be provided by any health care practitioner working for the RHC or the FQHC within their scope of practice. This includes licensed professional counselors (LPCs), working under the supervision of an RHC practitioner, and within their state’s scope of practice. The RHC or FQHC are eligible to bill for these services, NOT LPCs individually. Please take a look at the telehealth language, from the Center for Medicaid and Medicare services (CMS).
If you have questions or need additional information, please contact the ACA Government Affairs and Public Policy team at email@example.com.