Article archive / June 1, 2011
Originally published: . Volume 2, No. 10. Source pages: 3, 4, 5.
Psychologists and counselors alike breathed a sigh of relief after Senator Willie Mount withdrew her bill to dissolve their boards, following lengthy testimony at the May 18 Senate Health & Welfare Committee.
But that was only one step in the politics. The possibility that the SB 226 was a bait and switch had been suggested by a number of sources to the Times. However Senator Mount seemed to be genuinely interested in why the Behavioral Health Professionals Working Group had failed to come up with compromise language, when she asked Dr. John Fanning what he felt might work in a new format for that group, as he testified against the omnibus board bill.
At the close of all the testimony however, Senator Mount had her substitute bill in hand. “With that,” she said, “I’m going to offer up an amendment in the form of a substitute bill which will specifically provide for the Licensed Professional Board of Examiners to clarify the language.”
Senator McPherson from Alexandria, a supporter of LAMP and of psychology, slowed the speed when he pointed out that the substitute bill was the same one Mount had offered before, and had been opposed by the psychologists. After this discussion the bill was deferred until the following week.
By the next week another bill had been written, placing limitations on the expansion or clarification, but also creating a consultation and collaboration clause that pulled in medicine and cut out those licensed by the psychology board. This new bill seems to be being negotiated by LAMP, heads to the House today after smoking it’s way through the Senate.
The new language also placed an emphasis on medication, and if passed, will place into law a requirement that a person seen by an LPC with a serious mental illness must also be under the care of someone who prescribes medication.
The fingerprint of LAMP on this new bill appears to annoy some, but LAMP leaders had authority to negotiate because on May 19, the LPA Executive Council sent a letter formally asking LAMP to help them.
Several factors seem related to the course of events.
DHH
There was important testimony from Department of Health and Hospitals Deputy Secretary Kathy Kliebert who answered several questions of the committee members, about new arrangements of mental health services in the state. This testimony would have had little to do with the omnibus-board bill, but it was related to Senator Mount’s substitute which would clarify counselors’ diagnosing.
Senator Cheek asked Ms. Kliebert, “Can an LPC bill Medicaid?” Kliebert said, “…individual practitioners are not able to bill for those services.” She continued, “One of the things we’re doing in developing our new Louisiana Behavioral Health Care Partnership is developing a system that would allow the individual practitioners to bill in accordance with their scope of practice.”
Senator Cheek commented about the gap in services in the state and asked if an “all hands on deck” approach was what was needed? To this Kliebert said, “I totally agree. We have problems in terms of getting the provider capacity we need for mental health in Louisiana. We know that. Whatever we can do to get people the right level of services and the right credentialed counselor works for everybody.”
“That is one of the things we’re trying to do in our reform of our managed behavioral care that we’re moving to, is to be able to do that,” Kliebert said. “To be able to allow them–the practitioners–to bill in those individual locations, at schools, in home services, where they need those services, vs. us having to provide more expensive clinic-based services or more expensive institutional services.”
Senator Cheek asked, “Can LPCs diagnose across the full spectrum?” Kliebert said, “No, not according to their current scope of practice… That clarification of the scope of practice would certainly help in our future, because we’re quoting what is in scope of practice.”
Lobbying
LPCs waged a comprehensive effort and especially in Senator Mount’s home district of Lake Charles where it is reported that she may be running for tax assessor. The LPC’s political effort against the consolidated board was said to include considerable contact with legislators, rallies, and even newspaper ads. Some of the LPCs and counseling students at the Senate hearing wore t-shirts with “Kill Bill 226.” According to reports 150 or more LPCs attended the hearing.
Psychologists, on the other hand, following Legislative Chair Dr. Jessica Brown’s directions, exhibited a “measured” approach, and were warned to avoid annoying or creating tensions with the Senator or committee members. Some in the association considered this too passive.
One critic told the Times, “LPA is the only organization I know that attempts to meet its political goals by doing nothing.”
In opposing the consolidated board, LPCs and psychologists were in agreement. At the initial hearing, Senator Mount held up a stack of cards of those speaking against the bill, saying, “I want ya’ll to note that there are no green cards,” indicating uniform support to kill the proposal.
Also, LPCs testified convincingly at the hearing, with testimony from numerous individuals in different regions of the state, as well as from Senator Mount’s district. In contrast only one psychologist testified for LPA, only one from Grassroots, and only one for himself.
Working Group
An attempt was made last year to encourage the two groups to resolve several issues through the Behavioral Health Professionals Working Group, a study group composed of members from both boards and state organizations, and created by Mount’s Senate Concurrent Resolution 100.
The conflict between the two professions has been going on for some time, including disputes over psychological testing and scope of practice, including a lawsuit filed (Louisiana v. Atterberry, 1995) by the LSBEP. However, for this effort, sources told the Times that testing was “off the table,” even though the two issues are viewed as related by some.
Some psychologists in the community expressed doubt as to whether they should fight over the issue of diagnosis.
However, the results of those in the Working Group were disappointing. Senator Mount said in the hearing that her goal in establishing the Working Group “…was simply to provide the most optimal starting point possible which would maximize the chances of successful compromise and collaboration.”
The lack of success in the Working Group prompted the Senator to send a letter to both communities criticizing the lack of a clear resolution and warning them that she would submit the bill to consolidate the boards in order to force cooperation. She noted at the hearing that the strategy had worked with riverboat pilots.
LAMP
A savvy political force, few in the psychology association believed that the Louisiana Academy of Medical Psychology-PAC was sitting on the sidelines. Legislative Chair Dr. Jessica Brown, in a meeting last month with members of Grassroots, had indicated that LAMP could effectively fight this bill if those in LPA would drop their complaints regarding Act 251. One other source indicated that same offer coming from LAMP.
Senator Mount’s most recent bill could further separate psychologists from medical psychologists on ideological grounds, and medical psychologists from psychology.
This could confirm some of the consequences of Act 251 alluded to by several national groups who are watching events unfold in Louisiana.
The Behavioral Health Professionals Working Group began meeting last year. The group struggled to develop compromise language for new legislation.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.