Mental health parity bills pass House, Senate

This just in from the American Mental Health Counselors Association:

E-News from Washington
Vol. 08-36
September 24, 2008
House, Senate Approve Landmark Parity Bills
In historic votes held Tuesday, September 23, both the U.S. House of Representatives and Senate passed separate bills requiring private sector health plans to end discriminatory coverage of mental health and addictive disorder services. The votes bring AMHCA, ACA and other mental health advocacy organizations significantly closer to the long-standing goal of enacting strong federal parity protections.
Both votes occurred Tuesday afternoon. A free-standing parity bill, H.R. 6983, the “Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act,” was voted on in the House of Representatives. The bill included the parity protections agreed to earlier this year by House and Senate negotiators, as well as provisions to offset the legislation’s relatively small costs. The House vote was 376-47, a very strong show of support for the legislation.
In the Senate, identical parity protections were included as part of a broad package of wide-ranging tax-related provisions, including extensions of expiring and expired tax credit and incentive programs, a short-term adjustment to the alternative minimum tax, and provisions for helping victims of recent natural disasters. The Senate vote on the package was 93-2.
It is unclear what the next step for the parity legislation will be, although further votes are expected in the coming days. House and Senate members have not yet reached agreement on how to pay for the tax-related provisions approved by the Senate, which is why the House considered the parity legislation separately.
AMHCA and ACA thank their members who contacted Congress in support of parity. We encourage counselors to stay tuned for further developments, and to be prepared for more grassroots work as needed. We’re almost there!
For more information, contact either Beth Powell with AMHCA (at 800-326-2642, ext. 105, e-mail: bpowell@amhca.org) or Scott Barstow with ACA (at 800-347-6647 x234, e-mail: sbarstow@counseling.org).
Beth Powell
Director, Public Policy and Professional Issues
American Mental Health Counselors Association
The only organization working exclusively for mental health counselors
801 N. Fairfax Street, Suite 304
Alexandria, VA 22314

I am glad to see this but the devil will be in the details of how to pay for it when we are in such a financial crisis.

Bullycide in America: New resource available

Some have asked me why I initiated and supported the Golden Rule Pledge Initiative along with the Day of Silence. Watch this video and I hope you can feel a little of the anguish that is the daily life of a child who is the target of bullying.

The song is a way of introducing the new e-book Bullycide in America: Moms speak out about the bullying’suicide connection. Full disclosure: I have some articles in this book and have done some volunteering for this group. These stories and those of kids I know have touched me in profound ways and I hope will go a long way toward creating change. There are multiple factors which inform an understanding of bullying and I hope these cases and articles will help raise awareness.
Bullycide

ThinkProgress is wrong: Palin did not reduce funding to Special Olympics

ThinkProgress has produced another inaccurate and misleading claim about Sarah Palin’s actions as Governor of Alaska.
They claim that she cut funds to Special Olympics in an obvious bid to paint her as a hypocrite given that she has a Down Syndrome son and she asserts that she will be an advocate for families with special needs kids.
Here is the 2007 budget with the Special Olympics line item:
AK Spec Olympic 2007
The program was alloted received $250,000 in FY 2007.
Here is the 2008 budget with the Special Olympics line item:
AK Spec Olympics 2008
The program received $275,000 for a 10% increase.
This type of attack is getting old. Palin opponents are going through these budgets looking for reductions in legislative allocations and then calling Palin’s program management “a cut in funding.” In fact, under Palin, Special Olympics received a 10% increase in funding.
ThinkProgress says that the Special Olympics operating budget was cut in half. Given what the 2007 budget says, I believe that claim to be incorrect. It appears that the projects funded “facility upgrades” in 2007 and “travel and event related costs and property acquisition” which were designed to supplement the Special Olympics. I went back to 2005’s budget and the Special Olympics only received $125,000 in that year. A review of Special Olympics 990 form shows that they received just over 1.8 million in revenues in 2006 and so this allocation from the state of Alaska did not slash their operating budget.
UPDATE: 9/18/08 – ThinkProgress made a bit of a clarification but didn’t really correct their misleading post with this:

It’s a stretch to say she “pushed” for any policy improvements. Though Palin did sign a law increasing special education funding in Alaska, “she had no role whatsoever” in its development, according to the bill’s author, Rep. Mike Hawker (R). Moreover, as governor, Palin vetoed $275,000 in Special Olympics Alaska funds (Page 100, SB 221 with vetoes), slashing the organization’s operating budget in half.
Update: To clarify, the documents show that Gov. Palin proposed cutting the Special Olympics budget in half. The actual budget as passed slightly increased Special Olympics funding, though by only half of what the organization had requested.

No, Gov. Palin did not propose cutting the Special Olympics budget in half. She reduced a proposed 120% increase to a 10% increase.

"Our operating budget was not reduced" – Director of teen center

I just received this from Deirdre Cronin, Executive Director of Covenant House Alaska. This debunks the Washington Post’s story I addressed yesterday. I had asked her for a statement regarding the Post story and she provided this information.

Covenant House
FOR IMMEDIATE RELEASE
September 4, 2008
Contact: Deirdre A. Cronin
Executive Director
907-339-4203
“Covenant House Alaska is a multi-service agency serving homeless and runaway youth, including teen mothers. The majority of the agency’s annual operating budget is privately raised, with no more than 10 to 15 percent of funds coming from state grants in any given year. We are grateful for the support we have received from Governor Sarah Palin, the Alaska legislature and our Congressional delegation over the years.
Despite some press reports to the contrary, our operating budget was not reduced. Our $3.9 million appropriation is directed toward a multi-year capital project and it is our understanding that the state simply opted to phase in its support for this project over several years, rather than all at once in the current budget year.”
Covenant House Alaska is Alaska’s largest private non-profit adolescent care agency serving homeless, runaway and at–risk youth between the ages of 13 and 21. With particular expertise in helping some of the most hopeless teens grow into independent, successful and productive adults.
-END

More on this story here…

Lancet: Women should be offered post-abortion psychological care

The British medical journal, The Lancet, published an editorial in their August 23 issue regarding appropriate care for women after an abortion. Although the editorial could have taken a stronger stance on the APA report, I believe they have issued an important caution to those reviewing literature on mental health and abortion.

More than a third of American women will have an abortion by the age of 45 years, if current rates continue. A study published in The Lancet last year showed that 1·5 million abortions were done in the USA and Canada in 2003, compared with 42 million abortions worldwide.
Much attention has been given to the ethical considerations of terminating a pregnancy, but little effort has been directed at the long-term mental health effects of abortion on women. In 1989, the American Psychological Association (APA) undertook a systematic review of the literature and concluded that a single elective abortion did not result in long-term mental health problems. However, in 2006, a study published in the Journal of Youth & Adolescence concluded that abortion had a greater risk of adverse mental health outcomes compared with childbirth. This review was used in a South Dakota court to support a proposal to have abortion made illegal. The proposal failed, but doctors in the state must now inform women having a termination that they will be at risk of future mental health problems.
Recognising the need for a definitive decision on the issue, the APA commissioned the Mental Health and Abortion report, released on Aug 13. The authors systematically reviewed 50 studies, published in peer-reviewed journals since their last report in 1989, and concluded that, among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have an elective first-trimester abortion than if they deliver that pregnancy.
Although this report shows that there is no causal link between abortion and mental ill-health, the fact that some women do experience psychological problems after a termination should not be trivialised. The APA report concludes that such cases are often the result of confounding issues, such as a history of mental ill-health. Abortion is an important part of comprehensive reproductive health services. Women choosing to terminate must be offered an appropriate package of follow-up care, which includes psychological counselling when needed.

Tennesee church shooter needed help but didn't get it

The Tennesee church shooter, James Adkisson, sounds like many other mass killers in this article from the Knoxville News-Sentinel. In the USA Today, the note he left was described as “irrational.”
In reading the Sentinel article, you get the sad picture of a person who was in need of mental health treatment but did not get it. His ex-wife attended this church which may have been a motive in the shooting.

Counselorlicense.com – Caveat emptor.

The public has a right to be confused about credentials in mental health. With several different mental health professions (psychiatry, psychology, professional counseling, social work, marriage and family therapy, and addictions counseling), it is hard to keep up with the various titles and credentials used by the professions as well as the differences from state to state. In some states (e.g., my former residence, Ohio), one must be credentialed in order to practice, but in others (my current residence, Pennsylvania) one does not need to be licensed to practice professional counseling, marriage and family therapy or social work.
The public can be easily fooled in this environment and even those with some mental health training might think certain credentials will help them gain competitive advantage. Hence, legitimate credentialing bodies have taken steps to alert the public about what appear to be business ventures. For instance, the National Board of Certified Counselors (NBCC) provides this information regarding the American Psychotherapy Association. Sounds official, right? However, these credentials have no legal standing or recognition with any regulatory body.
What prompts this post is the emergence of another such credential with the catchy slogan – Become a licensed counselor! at Counselorlicense.com. At first glance, I thought it might be a parody. Check out this testimonial:

From a job standpoint, I was like a fish out of water. I tried every profession known to man, from office work, to real estate, to nearly every infomercial in existence. I wanted to work for myself, but as a single parent, needed significant income, but could not do extensive travel, as required in sales positions. As a “people person” I loved helping struggling couples and Church members with everything from finances to relationships, and our Pastor suggested I check out PSU. I started in a spare bedroom, and made over $1,400 the first week, and felt happier helping people than I ever have in my life. I now have my own office, secretary and mini daycare room, and can’t wait to get up in the morning to start my day! Thank you hardly says it…

The phrase “started in a spare bedroom” pointed toward parody to me but I have learned that the American Counseling Association is not amused. David Kaplan, Chief Professional Officer, at the ACA said this in an email about the Phoenix State University “credential.”

You can be assured that ACA, through its Council of Presidents and Region Chairs (COPARC), is working on this issue and taking this credential seriously.

A Whois domain search of the counselorlicense.com reveals the following:

Registrant:
Halstead, Tom
ETI
7760 e SR 69
suite c5-390
Prescott Valley, AZ 86314
US
Domain Name: COUNSELORLICENSE.COM
Administrative Contact, Technical Contact:
Halstead, Tom
ETI
7760 e SR 69
suite c5-390
Prescott Valley, AZ 86314, US
928-830-8467 fax: 866-857-2594
Record expires on 04-Apr-2009.
Record created on 04-Apr-2008.

Not surprisingly, Mr. Halstead is the owner of the various proofs of legitimacy he advances to support the pastoral counseling certificate. For instance, the websites of the Pastoral Church of America, the Phoenix State University, and even the accrediting body he says accredits the PSU, the Association of American Trade and Vocational Schools are all owned by Mr. Halstead. Of course, they all point to each other as evidence for their prestige. The AATVS website says it is “the oldest and largest accrediting organization for trade and vocational universities, colleges and schools, and has been accrediting university schools and labs since 1897.” Google it in quotes, however, and only two listings pop up, the website and Phoenix State University.
A call to the number given yields a recording asking the caller to contact PSU via email. So I did and received an automated reply. No answers as yet to my questions about how many students PSU enrolls or how I can contact one of those counselors who started in the spare bedroom. If you go to tomhalstead.com, you will find a web design business. From the looks of all the domains and websites he has, no wonder no one is answering the phone; he probably is very busy.
UPDATE: 6/3/08 – I spoke with James Rough, Executive Director of the Ohio Counselor, Social Worker & Marriage and Family Therapist Board who informed me that he has asked the Ohio Attorney General’s office to investigate potential consumer fraud by counselorlicense.com. If this office doesn’t have jurisdiction or ability to intervene, then he will write the Arizona and Colorado consumer fraud offices to ask for an investigation. I suspect other state boards will follow suit.

House passes mental health parity legislation

I posted about HR 1424 recently, noting that the mental health parity bill was going to be voted on soon. On Wednesday, the House of Representatives passed HR 1424. See this New York Times report for details.

Today an email from the American Mental Health Counselors Association HQ provided more background.

E-News from Washington

Vol. 08-12

March 6, 2008

 

House Passes Historic Parity Legislation!

 

On March 5th the House of Representatives passed comprehensive legislation requiring private health insurance plans to use the same treatment limitations and financial requirements for mental health and addictive disorder coverage as is used for substantially all other covered services. H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” introduced by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), was passed with strong bipartisan support by a vote of 268-148. (House members’ votes are listed online at http://clerk.house.gov/evs/2008/roll101.xml.) The legislation is named for the late Senator Paul Wellstone of Minnesota, a tireless advocate for Americans with mental illness.

 

House passage of H.R. 1424 is an historic step forward for mental health and addiction treatment advocates, and comes after years of hard work by the mental health and addictive disorder advocacy community. Although similar in many respects to legislation passed last year by the Senate, H.R. 1424 provides more consumer protections by requiring plans covering mental and addictive disorder treatments to cover the full range of disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the same range of disorders as is covered for members of Congress and all other federal employees under long-standing requirements for Federal Employee Health Benefits Program (FEHBP) policies. Unlike the Senate’s bill, H.R. 1424 also stipulates that health plan covering out-of-network services for medical and surgical benefits must also offer out-of-network coverage for mental health and addictive disorder benefits. This requirement applies for both outpatient and inpatient care.

 

AMHCA and ACA applaud Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) for their long, hard, heroic work in gaining House passage of H.R. 1424. During floor debate, both Kennedy and Ramstad spoke about their own personal battles with mental and addictive disorders, their treatment, and how their treatment has enabled them to lead productive lives. AMHCA and ACA also thank those counselors who took the time to contact their representative on this issue.

 

Attention now shifts to House-Senate negotiations to reconcile their chambers’ versions of the parity legislation. Like the business community, the Bush administration argued in favor of the weaker Senate version, issuing a statement of policy expressing opposition to H.R. 1424. Despite this, AMHCA, ACA and other mental health and addictive disorder advocates are now working to build upon the strong bipartisan support for H.R. 1424 and the unanimous passage last year of the Senate’s bill, to encourage the development and enactment of parity legislation that provides consumer protections that are as strong as possible.

Beth Powell

Director, Public Policy and Professional Issues

American Mental Health Counselors Association

I recognize some social conservatives and business advocates do not favor parity. However, I see this as a very family friendly legislation. Severe mental disorders sap the resources of working families and are leading causes of disability. If this bill is law, managed care companies/insurers will still be able to deny inappropriate care for the questionable diagnoses in the DSM (e.g., caffiene intoxication) but will not be able to deny appropriate care for those who need it.

Mental health parity bill (HR 1424) debated this week

A bill that would force employers to provide mental health and addictions treatment coverage on par with medical conditions will be debated again this week. I say again because parity as a concept has been debated for a decade. It appears that this bill or something akin to it (HR 1424; SB 558) might pass this time around.

WashingtonWatch.com has this description:

Paul Wellstone Mental Health and Addiction Equity Act of 2007 – Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to prohibit treatment limits or the imposition of financial requirements on mental health and substance-related disorder benefits in group health plans which are not similarly imposed on substantially all medical and surgical benefits in any category of items or services under such plans.

Directs the Comptroller General to study the effect of the implementation of this Act on various aspects of the health care system, including the cost of and access to health insurance coverage, the quality of health care, Medicare, Medicaid, and state and local mental health and substance abuse treatment spending, and spending on public services.

I favor this bill. Families are often frustrated in their efforts to care for a family members with a mental or emotional disorder due to inconsistent and inadequate insurance coverage. With inadequate coverage, very few people can afford to pay for treatment of chronic disorders. Psychiatric disorders are major causes of diability but with adequate care, some diabilities can be addressed in an effective manner. Even with a significant mental disorder, people can continue to work productively if they have proper care.

For those inclined, the American Counseling Association has a position paper with suggestions for calling legislators to register viewpoints about the issue.