What rules changes is LARA proposing?
The actual text of LARA's proposed rule changes may be found
here
. To be clear, some of the proposed rule changes are not contentious and make necessary and appropriate updates. Others related to R338.1751 and R338.1757 are a cause for serious concern.
First, LARA is recommending the repeal of virtually all the rules that define a licensed professional counselor's scope of practice under R338.1751. These are the
current rules
that have been recognized as part of a counselor's scope since they were first promulgated after the passage of the
Licensed Professional Counselor statute
in 1988. Instead the department insists these definitions should apply only to the educational preparation of counselors and not to counseling practice.
Second, LARA is also pursuing the repeal of the rules identifying the requirements for providing counseling supervision (R338.1757), one of which is specific training in supervision. This training is a national standard for professional counseling.
What would the impact of these changes be?
R338.1751:
Included in the repeal of the definitions in the rule is the practice of "counseling techniques" and the related ability to "diagnose and identify the problem". Without these and numerous other definitions, the counseling scope of practice will be severely restricted.
These changes in scope also put Michigan's LPCs in violation of the American Counseling Association's Code of Ethics (E.5.a. Proper Diagnosis), which requires the proper diagnosis of a client's mental disorder before treatment and could subject them to permanent expulsion from the profession.
Under
Michigan's public health code
, LPC's are legally required to comply with their professional code of ethics. They will be violation of this statute. Ultimately, these rule changes will prohibit Michigan's 10,000 licensed professional counselors from continuing to practice in the state and leave hundreds of thousands of residents without the treatment they need.
Additionally, insurance companies will no longer cover services of LPCs as a diagnosis is required for reimbursement.
R338.1757:
If this rule regarding counseling supervision requirements is rescinded, counselors who provide supervision without training would be practicing in violation of the ACA's Code of Ethics (F.2.a Supervisor Preparation).
Furthermore, LPCs who received their supervision in Michigan may not be eligible for licensure in other states because their supervisor would not be qualified in the state to which the counselor is moving.
Why is LARA proposing these changes?
The Attorney General's office raised concerns a few years ago as to whether the counseling rules were properly aligned with the counseling statute, questioning whether the rules exceed the statute. Since LARA only has the authority to promulgate rules, not change statute, they have proceeded with the only option available to resolve this concern: repeal the rules in question.
What is the status of the proposed rule changes?
Despite the unanimous objections by the Board of Counseling, on July 18, 2019, LARA filed a formal request for rule making and submitted its draft rules. The associated
Regulatory Impact Statement
for the proposed rule changes was filed on August 28, 2019.
This action triggered the setting of the required public hearing, which is scheduled for Friday, October 4 at 9:00 am at the G. Mennen Williams Building Auditorium located at 525 W. Ottawa Street in Lansing, Michigan.
After this public hearing, the rules can be certified, and a report submitted to the Joint Committee on Administrative Rules (JCAR). JCAR, a legislative body, has just 15 session days to review the rules. Their only course of action if they object is to introduce legislation within another 15 days to repeal them. After the JCAR review is completed, the LARA Director can adopt the rules.
When would the proposed rules take effect?
The rules changes were written with immediate effect. Given the above timeline these proposed rule changes could be in effect as early as November of this year immediately rendering Michigan's 10,000 licensed professional counselors unable to diagnose and, therefore, unable to legally practice in our state.
What can be done to oppose the proposed rule changes?
Any member of the public may comment in opposition of the proposed rules changes at the October 4th hearing. Written comments may also be submitted electronically any time before 5:00 pm on October 4th to
BPL-BoardSupport@Michigan.gov
What organizations are opposing the proposed rule changes?
The following are some of the organizations that have expressed opposition to LARA's proposed rule changes:
MMHCA (Michigan Mental Health Counselors Association)
CMHAM (Community Mental Health Association of Michigan)
MHA (Michigan Hospital Association)
MPCA (MI Primary Care Association)
MATCP (MI Association of Treatment Court Professionals)
MPFFA (MI Professional Fire Fighters Association)
ACA (American Counseling Association)
MCA (Michigan Counseling Association)
NBCC (National Board for Certified Counselors)
MASW (MI Association of Social Workers)
MSCA (Middle School Counselors Association)
Central Michigan University
Eastern Michigan University
Oakland University
Spring Arbor University
University of Detroit-Mercy
Wayne State University
Western Michigan University
Hope Network
Pine Rest
MI AFSCME
Oakland County
How do the proposed rule changes relate to HB 4325?
The proposed rules are the administrative response to the Attorney General's question as to whether the rules align with the statute.
HB 4325
is the legislative response.
What does HB 4325 do?
HB 4325, sponsored by Rep. Aaron Miller (R-Sturgis), would codify into statute the existing rules that have come into question instead of repealing them. This preferred solution allows counselors to maintain their ability to properly diagnose and treat individuals with mental and emotional disorders. The bill also makes a number of technical updates to the 30+ year old law.
Does HB 4325 change the scope of practice for licensed professional counselors?
No. It maintains the scope of practice that has been in placed since the Licensed Professional Counselor law was passed in 1988.
Does HB 4325 change who is eligible to be licensed as a professional counselor?
No. It maintains that only those with the education and training in the diagnosis and treatment of mental and emotional disorders and meet the standards of the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) are eligible for licensure.
What is the status of HB 4325?
HB 4325 (S-3) was passed unanimously out of the House Health Policy Committee on September 19, 2019. The bill has been referred to the House Ways and Means Committee. A hearing and vote is expected on October 2. The bill will then be sent to the full House of Representatives for a vote.
How would the passage of HB 4325 affect the proposed rules?
HB 4325 negates altogether the need for LARA's proposed rule by resolving the Attorney General's question. It would nullify the proposed rules if they were to go into effect.
Who is supporting HB 4325?
To date the following organizations have formally taking a position supporting HB 4325, and many more are expected to as future opportunities in the legislative process allow:
MMHCA (Michigan Mental Health Counselors Association)
MPCA (MI Primary Care Association)
MATCP (MI Association of Treatment Court Professionals)
NBCC (National Board for Certified Counselors)
MASW (MI Association of Social Workers)
MSCA (Middle School Counselors Association)
Central Michigan University
Eastern Michigan University
Oakland University
Spring Arbor University
University of Detroit-Mercy
Wayne State University
Western Michigan University
Hope Network
A few related other facts:
Our nation is facing a mental health crisis and there simply aren't enough counselors and other mental health professionals to meet the burgeoning demand for services, according to a recent analysis by the U.S. Health Resources & Services Administration (HRSA).
HRSA estimates nationally we need to add 10,000 providers in each of seven separate mental healthcare professions by 2025 to meet the expected growth in demand.
In Michigan there are nearly 1.4 million adults with mental illness and 67,000 youth suffering from a major depressive episode. The majority of these individuals are not receiving the care they need.
Costs are the reason nearly half of the adults are not receiving the treatment they need. Mental health counselors are uniquely qualified to meet the challenges of providing high quality care in a cost-effective manner.