Article archive / August 1, 2013
Originally published: . Volume 4, No. 12. Source pages: 3.
The 26-page revision of regulations governing counselors was published in the July issue of the Louisiana Register. Licensed Professional Counselor Board (LPC Board) Executive Director Mary Alice Olsan previously told the Times, “It was a huge body of changes.”
The LPC Board reworked major sections of the rules because of Act 320 of the 2011 legislative session and Act 636 of 2012, which amended Act 320. The LPC Board had also passed emergency rules in order to deal with some of the problems in the consultation and collaboration requirements in the 2011 law that expanded the scope of practice for counselors.
But, Act 320 prohibited the counselor from working with a person with serious mental illness, “… unless that individual is under the active care of a practitioner who is licensed by the Louisiana State Board of Medical Examiners and is authorized to prescribe medications in the management of psychiatric illness, and only in the context of an ongoing consultation and collaboration with that practitioner.”
The wording created problems with client rights, confidentiality and healthcare costs.
In 2012, Act 636 amended the earlier law by deleting the requirement that the counselor’s client had to be under the active care of a practitioner who is licensed by the state medical board. The words, “when medication may be indicated” and “in accordance with industry best practices, consults and collaborates with…” were substituted. Also, an advanced practice registered nurse was included as a choice for consultation.
The new rules clarify the consultation/collaboration situation which says that the counselor may not work with a person suffering from a serious mental illness “when medication may be indicated,” and so must consult with a professional who is licensed under the state medical board to prescribe, such as physicians, psychiatric nurse practitioners, or medical psychologists.
The rule provides the following background:
“1. Mental Health Counseling/Psychotherapy Services––rendering or offering prevention, assessment, diagnosis, and treatment, which include psychotherapy, of mental, emotional, behavioral, and addiction disorders to individuals, groups, organizations, or the general public by a licensed professional counselor, which is consistent with his professional training as prescribed by R.S. 37:1107(A)(8), and code of ethics/behavior involving the application of principles, methods, or procedures of the mental health counseling profession.
“2. However, a counselor may not assess, diagnose, or provide treatment to any individual suffering from a serious mental illness when medication may be indicated, unless the counselor consults and collaborates with a practitioner who is licensed or holds a permit with the Louisiana state Board of Medical Examiners or an advanced practice registered nurse licensed by the Louisiana state Board of Nursing who is certified as a psychiatric nurse practitioner.”
“The definition of Serious Mental Illness applies to individuals suffering from schizophrenia or schizoaffective disorder, bipolar disorder, panic disorder, obsessive- compulsive disorder, major depressive disorder, moderate to severe, anorexia/bulimia, intermittent explosive disorder, autism, psychosis NOS (not otherwise specified) when diagnosed in a child under 17 years of age, Rett’s disorder, Tourette’s disorder, and dementia.”
The new rule clarifies certain aspects of wording of Medication is Indicated:
“Medication is Indicated— when the client has been diagnosed with a serious mental illness and: i. when the client or legal guardian discloses the prescribed use of psychiatric medication; ii. when the counselor, client, or legal guardian believes that the use of prescribed psychiatric medication may facilitate treatment goals and improve client functioning.”
The rule also clarifies that consultation and collaboration, “––may be specific or general in nature.” This distinction allows the counselor to choose a variety of different actions depending on whether the client gives permission for, or agrees to a particular track for consultation and collaboration with someone licensed under the medical board.
The new rule notes, “General Consultation and Collaboration. When medication is indicated for clients who have been diagnosed with a serious mental illness and when the client does not assent to a specific consultation, the counselor must attempt to consult with a practitioner within a reasonable time for a general consultation without releasing any identifying information about the client.”
The 26 pages of revisions and additions were also needed to implement Act 276 of 2012, which allows for licensure of individuals in military. And, the changes updated the LPC Code of Conduct with the latest edition of the American Counseling Association Code of Ethics.
The full text is available in the July issue of the Louisiana Register.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.