The American Counseling Association’s Office of Public Policy and Legislation held the 2007 Legislative Institute in Washington, D.C., Feb. 25-27. Seventy-two ACA members from 21 states attended workshops and briefings on various aspects of legislative advocacy and public policy.
As part of the Legislative Institute, attendees learned the basics of the policymaking process and how to engage in state and federal advocacy. In addition, they took part in role-playing exercises that prepared them to lobby on Capitol Hill and back in their home states. Among the primary federal policy issues highlighted at this year’s institute were funding for the Elementary and Secondary School Counseling Program, Medicare coverage of licensed professional counselors and mental health parity legislation.
ESSCP is the only federal program that provides school districts with resources to provide comprehensive counseling services. Adequate access to school counseling services is shown to help improve both students’ academic achievement and school safety.
Because of ESSCP’s statutory funding trigger, middle and high schools are not eligible to participate in the program until total funding exceeds $40 million. In Fiscal Year 2007, Congress appropriated $34.65 million for ESSCP. This year, President George W. Bush’s budget again calls for the elimination of all funding for the program.
Rep. Jim Langevin (D-R.I.) is requesting that his colleagues join him in writing to House appropriators to ask them to provide $75 million for ESSCP in FY 2008. A funding level of $75 million would allow secondary schools to receive support similar to what was provided for elementary schools in fiscal years 2005 and 2006.
“The more representatives we can get signed on to Congressman Langevin’s letter, the more support that shows for the Appropriations Committee,” says ACA Public Policy Director Scott Barstow.
In addition, the 110th Congress is likely to take up Medicare legislation later this year. A renewed interest in mental health access issues should translate into increased support for establishing Medicare coverage of state-licensed professional counselors.
Medicare is the nation’s largest health insurance program, covering roughly 38 million elderly Americans (65 or older) and approximately 5 million Americans with disabilities. The program was established in 1965, and its mental health benefit has remained virtually unchanged since that time. Medicare covers inpatient care, some partial hospitalization programs and outpatient care. Clinical psychologists and clinical social workers were added to the benefit package as independent providers of outpatient mental health services in 1989.
There are several significant shortcomings in Medicare’s coverage of mental health services. State-licensed professional counselors are not covered, and Medicare requires beneficiaries to pay 50 percent of the cost of outpatient mental health treatment, as compared with the 20 percent co-payment for all other outpatient services. As a result of its meager benefit package, more than 80 percent of Medicare mental health spending goes to inpatient treatment.
In both 2003 and 2005, the Senate approved legislation that included Medicare coverage of counselors, but each time a lack of support in the House of Representatives kept the provision from being enacted. In the 110th Congress, however, this should not be a problem, Barstow says, because the new chair of a key House subcommittee in charge of writing Medicare legislation is Rep. Pete Stark (D-Calif.). “Chairman Stark has for years introduced legislation known as the Medicare Mental Health Modernization Act (H.R. 1946 in the 109th Congress), which would establish Medicare coverage of counselors and take other steps to improve Medicare’s mental health benefit,” Barstow says. He notes that Stark is again expected to introduce this legislation, including the counselor coverage provisions, later this year.
On Feb. 26, Legislative Institute attendees had an opportunity to hear from Rep. Brian Baird (D-Wash.) regarding mental health parity legislation. A Senate committee has already approved legislation to require most private health insurance plans to cover mental health and substance abuse treatment in the same manner as other health services. Similar legislation (H.R. 1424) is pending in the House of Representatives. Baird, formally a practicing psychologist and now in his fifth term in office, spoke to attendees about the importance of parity legislation and how to discuss it with policymakers.
The group returned to Capitol Hill again on Feb. 27 for the ACA Legislative Service Award breakfast. This year’s breakfast honored Reps. Michael Michaud (D-Maine) and Jerry Moran (D-Kan.), who received ACA’s 2006 Federal Legislative Service Award for their work in securing explicit recognition of licensed professional counselors within the Department of Veterans Affairs health care program.
Michaud expressed his gratitude for the award and reiterated his commitment to improving veterans’ well-being. “We must do more in the mental health area to enhance the services to our returning vets,” he said. This year Michaud is chairing the House Veterans Affairs subcommittee on Health.
Moran was unable to be at the breakfast because he was attending a funeral in his district for a servicemember killed in Iraq. Jeremy Stohs, his legislative assistant on veterans’ issues, accepted the award on Moran’s behalf.
Although the counselors have returned home from the Legislative Institute, their work is far from over. They are continuing their advocacy efforts on behalf of the counseling profession with calls, letters and e-mails to their state leaders.
“The visits to meet with the Senate and House aides were interesting and very important for each of us to be able to fully relate to the process,” says Steve Samat, past president of the Texas College Counseling Association and an associate professor at San Antonio College. “(Rep.) Ciro Rodriguez’s aide was a former teacher who asked some poignant questions, took good notes, asked about each of our handouts and seemed genuinely interested by making some excellent suggestions about actions we might want to look into.”
Samat says the Legislative Institute has given him both the tools and confidence to lobby on behalf of local issues in Texas, such as school bonds and teachers’ salaries. “We need to look at funding education instead of funding superintendents, especially when every cent a teacher makes is scrutinized,” he says.
Attending the institute also gave Samat a better perspective on what it means to negotiate red tape. “The building of coalitions and dealing with lobbyists was extremely helpful,” he says, “and this is the key to success at any level. The (institute) training on the whole process was excellent. It gave all of us a chance to walk through what actually goes on in the legislative process, which clarified the need for patience and compromise, but also why under the present partisan political climate little of worth is accomplished.”
Abigail Montoya, a counselor and public policy chair for the Colorado Counseling Association says, “I feel very strongly that no matter which profession you’re in, you have to know what types of legislation empower that profession. Especially with counseling, we face a lot of roadblocks in regard to equality in the field of mental health, and if we don’t speak up for ourselves, who will?”
Like Samat, Montoya says the experience she gained has inspired her to do more locally. “The Legislative Institute presenters have a good system going,” she says. “I want to thank CCA and ACA for the chance to serve my profession in such a capacity and for this special learning opportunity that will enable me to grow and better serve my clients and my community.” As a CCA chairperson, she says her goal is to reach as many incoming students to the counseling profession as she can and to touch base with established counselors to instill in them the necessity of going to government officials with one voice.
Of the 72 Legislative Institute attendees, 30 were counseling students from Wake Forest University in North Carolina. Counselor educators Laura Veach and Sam Gladding encouraged their students to participate in the hands-on political education seminar. The university’s counseling department secured a grant to pay for the students’ registration. “Other than that, all of the students paid their own way — hotel, gas and food,” Gladding says. “So they made a real commitment to get involved in the profession early in their careers.”
Many of the Wake Forest students hailed from states besides North Carolina, including Florida, Georgia, Maryland, California, Illinois, South Carolina, Alabama, Virginia and Pennsylvania, and even from two foreign countries (Japan and Romania). But most accompanied the Wake Forest faculty in visiting with congressional aides from North Carolina because they wanted to learn as a group about working with Congress. Counseling student Anna Levy led a group of fellow students and faculty members in a meeting with an aide from the office of Rep. Virginia Foxx (R-N.C.). Levy presented the facts on ESSCP and asked that the congresswoman sign Langevin’s letter in support of additional funding.
A few Wake Forest students did branch out on their own for appointments, including Katie Tison, a first-year student, and Melissa Kline, who expects to graduate in May. Tison, a Georgia native, and Kline, whose parents reside in Georgia, chose to meet with aides from the office of Sen. Saxby Chambliss (R-Ga.). Both were a bit hesitant at first but quickly overcame their anxiety after Tison recognized the aide as one of her former classmates at the University of Georgia. The coincidence put the two students more at ease about lobbying for their issues.
ACA staff members are currently coordinating follow-up contacts to the congressional offices visited by Legislative Institute attendees. Additionally, the Public Policy and Legislation staff urges ACA members to call their representatives about both the ESSCP and Medicare issues.
Announcements regarding next year’s ACA Legislative Institute will come out this summer and fall. Counselors interested in attending or learning more about legislative advocacy can contact ACA’s Christie Lum at clum@counseling.org or 800.347.6647 ext. 354.
The U.S. Capitol Switchboard can be reached at 202.225.3121. To find the names of your members of Congress or to generate an e-mail to your lawmakers on these issues, go to http://capwiz.com/counseling/home/.