Article archive / July 1, 2011
Originally published: . Volume 2, No. 11. Source pages: 1, 5, 6.
Senator Willie Mount’s bill to help Licensed Professional Counselors (LPCs) clarify and expand their scope of practice, SB 268, passed both houses and was signed by the Governor on June 29th. The bill will require that LPCs work in consultation with a physician or medical psychologist licensed to prescribe under the state medical board if treating individuals with “serious mental illness.” And it will facilitate LPCs being added to the providers into new arrangements in state mental health services. The bill does not include psychologists as providers of this consultation to LPCs.
While some psychologists in the community did not oppose the intent of the change in wording for the LPC law, the psychology board and the state association had repeatedly opposed this move. Conflicts between the psychology and the LPC board had led Senator Mount to put together the Behavioral Health Professionals Working Group last year with the goal of developing language for the bill. The Working Group did not succeed. As a result, Mount threatened legislation to dissolve both boards and propose an omnibus board bill.
Robust opposition by LPCs and the low-key objections from psychology appeared to pressure Mount to withdraw the omnibus bill. She quickly introduced a substitute measure, a move that some viewed as a “bait and switch.”
The second bill turned into a third bill in the Senate Committee. This time behind the scenes negotiations developed a compromise measure that included a consultation and collaboration requirement. The compromise for psychology was develop- ed by LPA and LAMP. LAMP had been asked by the LPA Council to assist the efforts and the legislative chair, Dr. Jessica Brown.
Pressure to expand scope of practice for LPCs came from the LPC’s lobby, but also from the state. 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. “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.”
At the House Health & Welfare Committee, Brenda Roberts, President of the Louisiana Counselors Association, Michael Gootee, and other LPCs, testified in support of the bill. Dr. Jessica Brown testified for LPA.
Marolon Mangham, MBA, the Executive Director of the Louisiana Association of Substance Abuse Counselors and Trainers, testified against the bill, stating that it allows LPCs to work in areas of addiction without demonstrating competency.
Don Hidalgo, CEO of an employee assistance firm, criticized the requirement that a third party has to be involved with the LPC’s client, adding a layer of unnecessary expense for businesses who pay for these services. “Business is sensitive to the needless and unnecessary medical expense that they must pay for…” he said. He also criticized the bill for supporting “excessive use of psychotropic medications.”
During the progress of the bill, Dr. Alicia Pellegrin posted asking the committee members to “…actively support changing SB 228 to include LSBEP licensed psychologists, who are qualified to consult and collaborate with LPCs. This change also would expand the breadth of provider choices available for patients.”
Legislative chair Jessica Brown responded to Pellegrin that there was an “extremely low to no chance of being an acceptable option to the counselors or Senator Mount.” And that since counselors are already comfortable in a Medicaid setting and working with physicians, such an amendment would be a ‘deal-breaker for them.’”
Some in the association questioned Brown’s efforts, because sources have indicated she has ties with LAMP.
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