Elected officials, state regulators grapple with proposed LPC rule changes

Oct. 13--TRAVERSE CITY -- Thousands receiving behavioral health services will lose access to mental health and substance abuse counseling if the state finalizes pending rule changes for Licensed Professional Counselors, say Munson Healthcare officials.

"This has garnered the attention of the whole state's healthcare industry and rightfully so," said Gabe Schneider, Munson Healthcare's director of government relations.

"We're in a period of healthcare shortage in behavioral health, especially in rural areas, so to think about removing more providers from the workforce? Certainly we can understand the frustration."

The Michigan Psychological Association has been lobbying the state's department of Licensing and Regulatory Affairs, and the legislature, for a clarification of the types of treatment LPC's can legally provide.

"There's no distinction right now, so for example someone trained as a school counselor might be providing mental health treatment and a consumer would not know," said MPA President Lisa Patterson. "We are not against LPC's. Our position is, let's give you the scope of practice according to the law."

Psychologists, professional counselors, state officials and legislators are in the process of deciding whether LPCs -- providers who have Master's degrees in various counseling disciplines with supervised post-graduate experience -- should be able to provide clinical services.

A bill aimed at skirting LARA rule changes by making a law to maintain the current scope of practice for LPC's was unanimously passed by the state House of Representatives Tuesday.

It now heads to the senate, where Sen. Curt VanderWall, R-Pere Marquette Township, chair of the Health Policy Committee, said testimony will be heard Thursday.

"Taking counselors away from an area where some of the most vulnerable people are, could do great harm," he said. "My position is, I'm concerned about what the department (LARA) could do."

Rep. Jack O'Malley, R-Lake Ann, voted for the bill; Sen. Wayne Schmidt, R-Traverse City, also expressed support.

"I'm in favor of it," said Schmidt. "The needs of mental health counseling here in northern Michigan and the Upper Peninsula are very important. And so any negative changes to access, well I'm not in favor of that."

Patterson said the MPA does not support the bill.

The group submitted an amendment that would have required LPC's to have specific education and training in mental health in order to provide mental health services, but lawmakers declined to include it.

HB4325 does specify LPCs need to have "general" education and training. If it is not signed into law, new rules governing LPCs could go into effect as early as mid-November.

Schneider said Munson submitted a letter to the state's Department of Licensing and Regulatory Affairs in "strong opposition" and "greatly opposed" to the changes. The full letter can be read online.

On Friday, more than a thousand people like Allison Wilson, a licensed professional counselor with Child & Family Services of Michigan, attended a public hearing in Lansing on the proposed changes.

LARA spokesman Matthew Erickson said 173 people spoke at the hearing and while numbers are not yet available on who spoke for and against, a transcript of the hearing is currently being produced.

Erickson said in an email that counselors will still be able to practice their profession under the new rules. And that the pending rules would simply, "move the existing language from one section to the proper section under the training and education portion of the rules.

But Wilson had a different take.

"People could lose their jobs," she said. "There were at least a hundred people giving testimony and all the people I observed were not in favor of the changes. I don't think LARA was prepared for that kind of showing from LPCs."

Wilson is one of six LPCs at Child & Family Services, who together serve 150 clients, she said.

There are about 10,000 LPCs in the state, according to the Michigan Mental Health Counselors Association, whose jobs are in jeopardy if the rule changes are made.

Across its nine hospitals, Munson Healthcare employs 53 LPCs, Schneider said, who each serve dozens of clients.

"We would not be able to use LPCs any longer," said Terry LaCroix-Kelty, Munson Healthcare's director of behavioral health. "We must have people who are able to asses and provide treatment and bill insurance and I think it would be quite devastating to all behavioral health organizations."

Schneider said the proposed rule changes stem from a 1988 ruling by then-Attorney General Bill Schutte's office which stated that LPCs did not have the authority to diagnose patients or use psychotherapy techniques.

Schneider said LARA staff has been trying to implement the rule changes since that time with little success.

Earlier this year LARA submitted the proposed rule changes, using verbiage calling for eliminating their ability to use "counseling techniques" with clients or to "diagnose and identify the problem," making standard counseling decisions a violation of their professional code of ethics.

"I think it would be quite devastating," said Terry LaCroix-Kelty. "I'm stunned that this is even being presented."

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