There
are several points that you can use in written or verbal correspondence
with your legislators in support of the Coalition's legislative
efforts:
1. LPC's and LMFT's fully qualified.
The
required training for LPCs and LMFTs to acquire and maintain
licensure meets or exceeds that of other professionals in
the state’s mandated provider pool. (See Comparison
of Mental Health Providers).
In addition, the lawful Scopes
of Practice for LPCs and LMFTs include “identification”
and “diagnostic appraisal and assessment” of mental
health conditions and problems.
Finally,
competent practice by LPC's and LMFT's is ensured by the Oregon
Board of Licensed Professional Counselors and Therapists.
2.
Increased consumer access
Every
citizen in the state of Oregon has the right to access confidential
mental health care. Recently, mental health parity
became the law in Oregon, suggesting that consumers should
have as much access to mental health care providers as they
do to physical health care providers. However, current practices
by insurers operating under Oregon statutes significantly
limit access to mental health care providers.
3. Improved consumer protection
HB
2506 contains provisions to:
- Strengthen
the Board's
powers
to discipline LPCs and LMFTs who have engaged in sexual
activity with their clients.
- Increase
the number of licensees working under board oversight to
ensure ethical practice.
- Clean
up statutory language to require that all licensees have
clinical training and experience.
- Clearly
define the practices of professional counseling and marriage
and family therapy so that consumers of mental health services
will know what to expect from licensed providers.
4. Too many restrictions on LPC's and LMFT's.
Despite
their approval by a state licensing board, LPC's and LMFT's
are wrongfully excluded from the state’s mandated provider
pool. This limits the ability of these small businesses to
meet the mental health care needs of Oregonians. Oregon statutes
should be changed to mandate that LPC's and LMFT's be reimbursed
by insurance companies and managed care organizations for
their services.
Current
Oregon law already requires insurers to pay for mental health
services provided by physicians, psychologists, clinical social
workers, and nurse practitioners.
5.
Inadequate service in rural areas.
The
impact of restricting the size of mental health care provider
networks is most noticeable in the rural areas of Oregon where
providers are few and far between. This limits the abilities
of these rural consumers to access mental health care providers.
6.
Supply and demand works.
Increased
access to a larger provider pool will translate to decreased
health care costs. Research suggests that improved access
to mental health care providers results in an additional savings,
a medical cost-offset. (See background material in
Resources.) For example, people
may reduce their use of health care services after individual
psychotherapy, thereby lowering overall health care costs.
A
1985 study by Regence Blue Cross-Blue Shield of the Oregon
law that mandated reimbursement of LCSW's revealed an increase
in service at reduced cost. Why shouldn’t this service-cost
relationship also apply to LPC's and LMFT's?
There's
research evidence to support this. A 2002 economic
impact analysis from the Journal of Health Politics, Policy
and Law. Anne Carroll (Rider University) and Jan M. Ambrose
(La Salle University) examined all states that had "Any
Willing Provider" (AWP) laws on the books. These laws
mandate that all providers of a service (e.g., mental health
care) are eligible for reimbursement from insurers as long
as they adhere to company standards. Their analysis concluded
that
the
impact of both types of AWP laws is such that the profit
margins, or "bottom lines" of HMOs are unaffected
by their presence....[O]ur results robustly indicate that
fears that such laws will adversely affect the profitability
of HMOs are unfounded, at least insofar as these laws are
currently used.
Increasingly,
states are implementing AWP laws (read the Vermont
experience). Here in Oregon, insurance companies such as Regence
Blue Cross/Blue Shield still maintain that expanding provider
pools with LPCs and LMFTs will drive health care costs up.
We think this is "voo-doo" economics.
