Use Congressional Recess to Advance Medicare Recognition

The House and Senate have struggled for almost three years to advance mental health legislation that responds to the epidemic of mass gun violence and its political linkage to inadequate mental health services. The House finally passed its bill on July 6, in greatly watered down form before recessing until after Labor Day. Movement on the Senate version has been even slower, bogged down largely over disagreements on federal gun laws. The House bill that passed, “Helping Families in Mental Health Crisis Act,” (HR. 2646), was ultimately able to attract overwhelming support (422-2) on the House floor. The years-long negotiation process produced a final bill that is much more modest than the original bill, but many mental health advocates view it as a valuable step toward delivery system reform.  

The revised House bill, HR. 2646, creates a new position of Assistant Secretary for Mental Health and Substance Use Disorders and establishes the National Mental Health Policy Laboratory and the Interagency Serious Mental Illness Coordinating Committee. Over the concerns of many Democrats, the bill authorizes no additional federal spending, but does expand the number and type of mental health services that states may cover under Medicaid; prohibits Medicare and Medicaid from restricting access to drugs used to treat mental health disorders; and expands the Certified Community Behavioral Health Clinics demonstration program. Although the Senate and House bills are now more similar, Senate consideration remains mired by ongoing disputes on gun issues and Senate supporters were concerned it could fail to pass before Congress recesses in early October for the elections.

AMHCA Medicare Advocacy Strategy: AMHCA has long viewed the Senate and House mental health reform bills as good targets to add on our Medicare provider status legislation (S. 1830/HR. 2759). Our Medicare coalition has held many meetings with congressional offices to urge inclusion of our Medicare provider status language (S. 1830/HR. 2759) in the mental health reform package, but it was ultimately excluded from the House bill due to its budget impact. Since the target House bill required no new spending in order to pass the floor, AMHCA’s amendment, which carries a substantial new spending estimate from the Congressional Budget Office, was ultimately excluded from the House target vehicle. In the Senate, AMHCA is continuing to work with our coalition partners to add it to this version. Our coalition has also brought to the Senate sponsors some SAMHSA/HRSA/PHS amendments that would address CMHC recognition in federal workforce data collection programs. AMHCA anticipates that discussion of the mental health reform legislation will continue throughout the remainder of 2016, providing an avenue for consideration of our Medicare provision.

Action Requested: AMHCA hears regularly from congressional offices that constituents (i.e., mental health counselors) haven’t spoken up in support of our Medicare bill. Therefore, AMHCA continues to encourage more grassroots messages from our members to congressional offices. We strongly encourage our members to request their Senators and Representatives to cosponsor our Medicare provider status bill (S. 1830/HR. 2759).  See AMCHA Connections for assistance sending email messages to Representatives and Senators. 



BRANCHES: Catherine Roland elected ACA's 65th President

Dear Colleagues:

ACA Nominations and Elections Chair, Dr. Cirecie West-Olatunji and I wanted you to know that Dr. Catherine B. Roland has been elected to serve as ACA's 65th President. Dr. Roland will begin her term as ACA President-elect on July 1, 2015 and will assume the presidency on July 1, 2016.

Dr. Roland has served as a volunteer leader at both the division and national levels. She currently serves as a member of ACA's Governing Council.

In addition to Catherine, Dr. Perry Francis and Dr. Joshua Watson ran in the election. ACA leaders and members appreciate all who are willing to run for office. The commitment of these fine individuals to run demonstrates their desire to improve the profession. Fielding such strong candidates reminds us that ACA is able to attract superior individuals who wish to serve.

Catherine is currently Chair of the Counseling Program at the Washington, D.C. Campus of The Chicago School of Professional Psychology (TCSPP). She is a licensed professional counselor in New Jersey and Arkansas, and a National Certified Counselor. She has been in private practice for 30 years and has worked at the university level for the past 24 years. She received both her M.Ed. and Ed.D. from the University of Cincinnati. She earned her B.A. from Marshall University in Huntington, West Virginia.

If you would like to contact Catherine, her e-mail is: This email address is being protected from spambots. You need JavaScript enabled to view it.

Please join us in wishing her well as she begins this important journey in ACA leadership!


Richard Yep
Chief Executive Officer

What  wonderful news - Catherine had been very active in NJCA while she taught here - at Montclair I believe - great news for NJ -and for her.  We are most fortunate to have a number of national leaders active in the NJCA -
Nancy Benz- NJCA Executive Director

Health Bill Fine Print—and Counselor Medicare Coverage—Comes Down to Final Hours

Later this week, House leaders will finalize a package of changes to make to the Senate’s version of health care reform legislation.  We need Medicare coverage of licensed professional counselors to be included in this package!  Although ACA is working to get Medicare coverage of counselors included in the reconciliation package, this effort will not be successful unless members of Congress hear from counselors.

We need counselors from across the country to call their members of Congress and congressional leaders to ask for approval of health care legislation which includes Medicare coverage of medically-necessary outpatient mental health services provided by licensed professional counselors.  

To find out who your members of Congress are—and find phone numbers for their offices and those for House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid—go to ACA’s internet action center at  

Do you want to even the playing field between counselors and other master’s level mental health professionals?  If so, it is imperative that we gain recognition under Medicare, and to gain recognition under Medicare it is imperative that counselors make their voices heard in Congress.  NOW IS OUR CHANCE!

For more information or to share your comments, contact:

Scott Barstow
Director of Public Policy and Legislation
American Counseling Association
5999 Stevenson Avenue
Alexandria, VA  22304

703.823.9800 x234
703.405.9711 (cell)
703.823.0252 (fax)
800.347.6647 x234
703.823.6828 TDD

This email address is being protected from spambots. You need JavaScript enabled to view it.

NCC ALERT: Health Reform Passes without Counselor Medicare Language

March 22, 2010

On Sunday, March 21, the House of Representatives passed the Senate health care reform bill, sending it to President Obama for signature. While language adding counselors to the list of Medicare providers made it through a preliminary vote in the House Budget Committee, it didn’t survive compromise with the Senate in the Rules Committee, thus ending its chance for inclusion in the final package.

NBCC, along with ACA, AMHCA, AAMFT, and CAMFT worked aggressively to get and keep our language in the reform package throughout the process. While the original House-passed legislation included our provision, the Senate bill did not. Development of the final product became a highly political process that hinged heavily on budgetary issues. Our cost was modest compared to the overall reform price tag, but all new spending was closely scrutinized and many similar provisions did not make it through this screening--including the social work Medicare priority relating to skilled nursing facilities. Success of the reform package was uncertain until the very end, when the House marshaled the votes to pass the Senate bill 219-212, along with a “reconciliation” bill on a vote of 220-211 that incorporates the House-Senate compromises. The reconciliation bill must still pass the Senate, but only 50 votes are required so approval is almost certain. Both measures will be sent to the President for signature.

While we did not succeed in final passage, we have again moved the ball even closer to the goal. We will continue our push for inclusion of Medicare counselor coverage in all relevant health care vehicles, and potential opportunities this year are already being rumored. Your advocacy efforts helped bring us to the brink of success and we hope you will keep up the calls and letters in our next big push. We cannot succeed without your help and will not stop until we get the ball across the goal line. If you have any questions, please contact NBCC at This email address is being protected from spambots. You need JavaScript enabled to view it..
Thank you for your support and perseverance.
Dave Bergman
NBCC VP for Legal and External Affairs

ACA Update: Congress Passes Medicaid/School Aid, Supporting Many Counselors

ACA Update: Congress Passes Medicaid/School Aid, Supporting Many Counselors

 Today, Congress passed legislation, by a 247-161 vote, providing education and healthcare aid to help states ratchet back massive cuts in the face of budget shortfalls. The final legislation provides $10 billion to help prevent approximately 140,000 teachers, school counselors and other education-system personnel from losing their jobs this school year. These jobs are essential to keeping local schools, districts and state education departments functioning for our students. The legislation also extends, through June 30, 2011, Medicaid increases made under the American Reinvestment and Recovery Act of 2009. This funding enables states to continue providing a range of community-based mental health services and supports that are lifelines for many low-income Americans and individuals with disabilities. The president is expected to sign the bill into law soon.  

ACA thanks all the counselors who advocated for this important legislation! You made this victory a reality! Thank you!

  To unsubscribe from this email list, please contact Christie L. Lum, Public Policy and Legislation Coordinator, at This email address is being protected from spambots. You need JavaScript enabled to view it. mailto:This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy815 + '\'>'+addy_text815+'<\/a>'; //--> .

 For more information, please contact:

 Dominic W. Holt

Legislative Representative

American Counseling Association
703-823-9800 x242

800-347-6647 x242

This email address is being protected from spambots. You need JavaScript enabled to view it. mailto:This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy74373 + '\'>'+addy_text74373+'<\/a>'; //-->



Register Today!
ACA 2011 Conference & Exposition
March 23-27 | New Orleans, LA
Cosponsored by the Louisiana Counseling Association

VHA Jobs Slow to Open to Counselors

In late September, the Department of Veterans Affairs released a new occupational standard for positions as “licensed professional mental health counselors” (LPMHCs) with the Veterans Health Administration (VHA).  The standards were released pursuant to legislation enacted by Congress and President Bush in December of 2006.

The ink is barely dry on the new standards and there are additional issues related to implementation which need to be addressed, but thankfully VA headquarters staff have indicated that VHA facilities can begin using the new standards—and hiring counselors—immediately.  We’re encouraging the VA to adopt changes to the standards to expand the number of highly qualified counselors eligible for these positions, but we’re also working with them to gain the hiring of counselors under the standards as adopted.  (The standards are posted at

Unfortunately, we are hearing from counselors that positions are going to continue to be open only to social workers (or psychologists), that other VA or federal Office of Personnel Management rules or policies need to be changed before they can hire counselors, and that they don’t need counselors (although positions for social workers are being posted).

We want to know more about how VA medical centers and clinics are, or aren’t, implementing the counselor recognition law.  We’re working with VA headquarters staff on implementation, and we’d like to be able to document how this is going.  (You can check for mental health counselor positions at VA facilities online at either or; a directory of VA facilities is at 

If you have contacted your local VA office about applying for a position doing mental health counseling work, please share your story with us by faxing or emailing me at the number/address below.  If possible, please include the job description for the position you inquired about, the name and location of the VA facility, and share what you were told regarding eligibility of licensed professional counselors for the position.  Please know that we will not share any information, with any VA staff, that could be used to identify you without first obtaining your explicit prior permission. 

Please share any information you can with us.  With your help we can more quickly identify roadblocks to counselor recognition, and work to remove them. Thanks!

Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
ph  703-823-9800 x234 | 800-347-6647 x234

fax  800-473-2329

email  This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy15978 + '\' target="_blank">'+addy_text15978+'<\/a>'; //--> 

Register Today!
ACA 2011 Conference & Exposition
March 23-27 | New Orleans, LA
Cosponsored by the Louisiana Counseling Association

Update: Congress Passes TRICARE Law, DoD to Write Regulations

Congress Passes NDAA Recommending Independent TRICARE Practice for Counselors

On December 22nd, Congress passed legislation that directs the Secretary of Defense to implement regulations authorizing counselors to practice independently under TRICARE by June 20, 2011.  TRICARE is the health services program operated by the Department of Defense (DoD) for military personnel, retirees, and their dependents.  For many years, counselors have been the only master’s level mental health professionals required by TRICARE to operate under physician referral and supervision.  The TRICARE reimbursement policy issue is under the jurisdiction of DoD, and is separate and distinct from the issue of recognition of licensed professional counselors within health care programs operated by the Department of Veterans Affairs (VA).

The language enacted on TRICARE is a significant accomplishment for the counseling profession and the culmination of many years of hard work by ACA, the American Mental Health Counselors Association (AMHCA), and the National Board for Certified Counselors (NBCC), and is a significant improvement over earlier versions of the legislation.  The language was included in the National Defense Authorization Act (NDAA), H.R. 6523, which authorizes spending for defense programs for fiscal year 2011.  The president is expected to sign the legislation into law shortly.

Section 724 of H.R. 6523 (entitled “Licensed Mental Health Counselors and the TRICARE Program”) states in full:

Not later than June 20, 2011, the Secretary of Defense shall prescribe the regulations required by section 717 of the National Defense Authorization Act for Fiscal Year 2008 (Public Law 110-181; 10 U.S.C. 1073 note).

Section 717 of the 2008 NDAA gave DoD the authority to prescribe counselor independent practice regulations, but no movement had occurred due to an intervening study by the Institute of Medicine, and the possibility of Congress weighing in on the issue.  With adoption of the June 20th deadline, Congress has indicated DoD needs to go forward under existing authority.

Section 724 is similar to past House language, but significantly different than earlier Senate defense bill language on this issue, which had included an array of specific criteria counselors would have to meet in order to practice independently under TRICARE.  Rather, the language directs DoD to establish the criteria for independent practice.  ACA, NBCC, and AMHCA successfully convinced Congress to leave specific criteria out of the law in order to avoid tying DoD’s hands, and to allow greater flexibility in counselor participation in the future.

Once signed by the President, the new law will set a deadline of June 20, 2011 for new regulations authorizing counselors to practice independently.  ACA, AMHCA, and NBCC will be trying to work with DoD to ensure the regulations are inclusive of all qualified professional counselors.

For more information, contact either myself or This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy12392 + '\' target="_blank">'+addy_text12392+'<\/a>'; //--> , with AMHCA, or This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy15481 + '\' target="_blank">'+addy_text15481+'<\/a>'; //--> , with NBCC.

Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
ph 703-823-9800 x234 | 800-347-6647 x234

From ACA Counseling Today Feb 2011 issue:

DoD required to issue counselor recognition regulations

On Dec. 22, both the House of Representatives and the Senate passed legislation authorizing defense spending for the fiscal year. President Obama was expected to sign the legislation into law in the near future. Section 724 of the bill requires the DoD to issue regulations allowing independent practice of licensed professional counselors by June 20. This language is a significant accomplishment for the counseling profession and the culmination of many years of hard work by the American Counseling Association and our sister organizations the American Mental Health Counselors Association and the National Board for Certified Counselors.

Earlier in 2010, the Senate Armed Services Committee drafted a version of the defense authorization bill that included very detailed and restrictive language delineating which counselors could practice independently under TRICARE, which is the military’s health care system for service members, retirees and their dependents. For almost two decades, licensed professional mental health counselors have been the only widely recognized master’s-level mental health professionals required to operate under physician referral and supervision. This past fall, ACA, NBCC and AMHCA worked jointly with staff from both the House and Senate Armed Services Committees to urge adoption of language that was more inclusive than that found in the original Senate bill. These meetings led to a consensus that the best way forward was to establish counselor requirements for independent practice in regulations issued by the DoD, instead of in a statute written by Congress. ACA, AMHCA and NBCC will encourage the DoD to adopt regulations that recognize all highly qualified counselors as capable of practicing independently within TRICARE.

If you have questions about passage of the defense authorization bill and its language referencing counselors, contact Scott Barstow at This email address is being protected from spambots. You need JavaScript enabled to view it..

Stopgap spending measure keeps lights on until March

Congress has passed, and the president has signed, a temporary extension to keep most government programs funded at Fiscal Year 2010 levels until March 4, 2011. The bill freezes federal civilian employees’ pay for two calendar years beginning in 2011 and maintains the Pell Grant maximum award at its FY 2010 level.

Although FY 2011 started this past October, the 111th Congress was unable to find enough common ground to pass any of the 12 annual spending bills. Thus, the 112th Congress that began in January will set spending levels for government programs for the rest of FY 2011. With many incoming congressional conservatives having vowed to cut government spending sharply and the new Republican majority in the House controlling the development of spending legislation in that chamber, negotiations between the House, the Senate and President Obama on appropriations bills will be highly contentious. Unfortunately, education and health-related programs frequently are first on the chopping block. ACA is continuing to educate Congress and the administration on the importance of investing in school counseling services. For more information on current developments and how you can help, contact ACA’s Dominic Holt at 800.347.6647 ext. 242 or This email address is being protected from spambots. You need JavaScript enabled to view it..

TRICARE Rules Authorize Independent Practice for "CMHCs"


American Mental Health Counselors Association
801 N. Fairfax Street, Ste. 304
Alexandria, VA 22314

Major Advance for the Profession!
TRICARE Rules Released Authorizing Independent Practice for "CMHCs"


Washington, DC – December 27, 2011 – Long-awaited TRICARE rules authorizing independent practice for "Certified Mental Health Counselors" (CMHCs) were released in today's Federal Register, December 27, 2011, 32 CFR Part 199. The new rules advance mental health counselor provider participation requirements from working under the supervision and referral of a physician to autonomous practice and third-party reimbursement.

The rule, released in interim final form, establishes a transition period to phase out the requirement for physician referral and supervision for mental health counselors and creates a new category of allied health professional known as "certified mental health counselors" (CMHCs). Once phased in, CMHCs will be the only authorized mental health counselors to participate under TRICARE. The provider standards will be fully in force on January 1, 2015, meaning that all CMHCs that want to serve TRICARE beneficiaries must qualify under the new rules by December 31, 2014. The new rules include a critical grandfather provision for current practitioners, and also rapidly accelerate national movement toward CACREP accreditation for clinical mental health counseling programs.

During a transition period from today's release date until December 31, 2014, mental health counselors who do not meet the requirements for independent practice as established in the rule may continue to provide services to TRICARE beneficiaries under the requirements of physician referral and ongoing supervision. When the transition period ends on December 31, 2014, all CMHCs who seek to continue providing services under the TRICARE program must have met the independent practice requirements outlined in the rule. After that date, professionals who do not meet the requirements for CMHC participation will no longer be recognized by TRICARE and payment for their services will not be allowed even if they work under the supervision of a physician.

New Provider Participation Standard
Grandfather Provision: To practice independently, CMHCs must meet one of the following two quality standards on or before December 31, 2014:

  1. Possess a master's or higher-level degree from a mental health counseling program of education and training accredited by CACREP and must have passed the National Counselor Examination (NCE); or
  2. Possess a master's or higher-level degree from a mental health counseling program of education and training from either a CACREP or regionally accredited institution and have passed the NCMHCE.

Required CACREP accreditation and NCMHCE passage after December 31, 2014: A CMHC entering the program on or after January 1, 2015:

  1. Must pass the National Clinical Mental Health Counselor Examination (NCMHCE) or its successor as determined by TRICARE; and
  2. Must possess a master's or higher level degree from a mental health counseling program of education and training accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP)

A CMHC must also be licensed for independent practice in mental health counseling by the jurisdiction where practicing. In jurisdictions with two or more licenses allowing for differing scopes of independent practice, the licensed mental health counselor may only practice within the scope of the license he or she possesses. The rules also permit TRICARE to amend or modify their requirements, qualifications or criteria in the future to accommodate professional quality and licensing standards as they may change over time.

AMHCA Supervision Standards Incorporated
CMHCs must have a minimum of two (2) years of post-master's degree supervised mental health counseling practice, which includes a minimum of 3,000 hours of supervised clinical practice and 100 hours of face-to-face supervision. Required supervision must be provided by a mental health counselor who is licensed for independent practice in mental health counseling in the jurisdiction where practicing and must be conducted in a manner that is consistent with the guidelines for supervision of the "American Mental Health Counselors Association."

In 2010, the Institute of Medicine (IOM) recommended that independent practice of mental health counselors under TRICARE should occur under certain circumstances. Their recommended provider participation criteria included, "A master's or higher level degree in counseling from a program in mental health counseling or clinical mental health counseling that is accredited by CACREP; a state license in mental health counseling at the clinical or the higher or highest level available in states that have tiered licensing schemes; passage of the NCMHCE; and a well-defined scope of practice for practitioners." The TRICARE rule will implement these standards over time while preserving the requirement for 3,000 hours of supervised clinical practice and 100 hours of face-to-face supervision. The rule also expressed TRICARE's commitment to ensuring that the quality standards recommended by the IOM are adopted by program, but the agency understands that the availability of CACREP accredited mental health counseling training programs and the use of the NCMHCE as a quality standard are not yet widespread in the field.

AMHCA plans to release further analysis and guidance to its members on this important new rule.

Useful Links
CACREP Accreditation
AMHCA Standards for the Practice of Clinical Mental Health Counseling
Contact James K. Finley, AMHCA Director of Public Policy, at 800-326-2642, X-105, or This email address is being protected from spambots. You need JavaScript enabled to view it." ' + path + '\'' + prefix + ':' + addy14713 + '\'>'+addy_text14713+'<\/a>'; //--> .


Join AMHCA in Orlando

Join the conversation!AMHCAThank you for your membership and support of the American Mental Health Counselors Association, the ONLY organization working exclusively for the mental health counseling profession.


ACA UPDATE: U.S. Dept of Education Accepting School Counseling Grant Applications!

The U.S. Department of Education is requesting applications for new fiscal year (FY) 2012 grants under the Elementary and Secondary School Counseling Program (ESSCP). The purpose of ESSCP is to support efforts by local educational agencies (LEAs) to establish or expand elementary school and secondary school counseling programs.  The deadline for submitting applications is 4:30 pm eastern time on May 25, 2012.    

The Federal Register announcement regarding ESSCP grant applications is at  The electronic grant application should be posted soon on the website.  (According to the Federal Register notice, the ESSCP announcement can be found by clicking on “Grant Search” in the right-hand column, and entering “84.125” in the “Search by CFDA Number” box; this doesn’t appear to be working yet, however.)

Grant awards will be between $250,000-$400,000 per year, usually for three years, and the Department expects to award a total of over $21 million in grants.  Grants must supplement—not supplant—other federal, state, or local funds used for providing school-based counseling and mental health services to students.  Absolute priorities for the grants are to:
1)   Establish or expand counseling programs in elementary schools, secondary schools, or both; and
2)   Enable more data-based decision-making, especially in improving instructional practices, policies, and student outcomes in elementary and secondary schools.

The Federal Register notice states that when considering making awards in FY 2012 and subsequent years from the list of unfunded applicants, the Department of Education will award competitive preference priority points for…
--projects serving students residing on Indian lands;
--projects serving students enrolled in persistently lowest-achieving schools; and
--projects designed to address the needs of military-connected students.
Projects can only seek competitive preference priority points for one priority area.

Anyone considering applying for an ESSCP grant should read the Federal Register notice; additional information on the program is at the Department of Education’s webpage at  Grant applications can also be obtained a copy from the Education Publicans Center (EDPubs) by calling toll free 1–877–433–7827.  (If you use a telecommunications device for the deaf (TDD) or a text telephone (TTY), call 1–877–576–7734.  (If contacting ED Pubs, be sure to identify the program by CFDA number 84.215E.)

For more information, contact:

Scott Barstow  |  Director, Public Policy and Legislation

ph  703-823-9800 x234  |  800-347-6647 x234
fx  703-823-0252  |  web

VA Begins to Trumpet Newly Eligible Mental Health Professionals


     American Mental Health Counselors Association

VA Begins to Trumpet Newly Eligible Mental Health Professionals

Washington, DC – April 20, 2012 – Yesterday, the Department of Veterans Affairs (VA) responded to a backlog of mental health cases and widespread public criticism of its performance by announcing it will add approximately 1,600 more mental health clinicians to its staff in facilities around the country. The additional positions will include nurses, psychiatrists, psychologists, MFTs, mental health counselors, and social workers, as well as nearly 300 support staff joining its existing workforce of 20,590 mental health staff as part of an ongoing review of mental health operations within the VA. The press release by Veterans Affairs secretary Eric Shinseki failed to mention that mental health counselors and marriage and family therapists are included among the clinical professions eligible for hire. View the VA statement

The VA has assured AMHCA and its coalition partners that VA staff is promoting in press interviews the inclusion of mental health counselors in the group of eligible clinicians. Last evening, the PBS Newshour delved into criticisms of the agency's slow hiring of mental health staff and interviewed a VA spokesperson about their new hiring goals. Dr. Sonja Batten, deputy chief consultant for specialty mental health at the Department of Veterans Affairs, expressed "excitement" about being able to hire licensed professional counselors and marriage and family therapists in the interview on the Newshour program. View the program or read the text

Dan Holdinghaus, chair of AMHCA's Public Policy and Legislation Committee, reacted, "Statements by the VA to national news organizations trumpeting inclusion of our profession demonstrate that AMHCA and its coalition partners' advocacy before the VA has begun to raise awareness within the bureaucracy of the value of hiring our profession." Holdinghaus expects a slow process penetrating the VA hiring culture stating, "AMHCA has found the hiring process extremely cumbersome and led by staff that is inexperienced with mental health counselors." Nevertheless, Holdinghaus believes AMHCA is making progress in raising awareness within the agency.

Next week, the U.S. Senate Committee on Veterans' Affairs will hold a hearing on the adequacy of mental health services in the VA. The hearing is expected to feature a new report by the VA inspector general evaluating the adequacy of mental health services within the Department. The inspector general has a record of being sharply critical of VA performance in this area, and next week's hearing is expected to again subject the agency to withering criticism from Senators on the Committee. AMHCA's coalition has urged the inspector general to delve into VA hiring practices of mental health counselors and marriage and family therapists, but to date the reports have not done so.

Contact James K. Finley, AMHCA director of public policy, at 800-326-2642, X-105, or This email address is being protected from spambots. You need JavaScript enabled to view it..









ACA UPDATE: Dept. of Ed. Shadows D.C. School Counselor, + ESSCP Reminder

On Wednesday of this week, U.S. Department of Education (ED) staff spent time shadowing school staff at Washington, D.C. schools, in recognition of Teacher Appreciation Week. At the request of the Department, ACA and the American School Counselor Association (ASCA) connected ED staff with a local school counselor—Cristina Espinel-Roberts, at Brightwood Elementary School—for senior staff to follow as part of the day’s events, entitled “ED Goes Back to School.” Ms. Espinel-Roberts spent part of her workday with Greg Darnieder, Special Assistant to the Secretary for College Access. Following the school day, Espinel-Roberts and other school staff participated in a debriefing session with Secretary of Education Arne Duncan. Cristina spoke out about the importance of addressing children’s social and emotional needs to enable them to fulfill their potential, telling Secretary Duncan that although school counselors are often invisible, “it’s important to take account of us because we’re a very important part of the education process.” Espinel-Roberts is a member of both ACA and ASCA.

ACA and ASCA thank Ms. Espinel-Roberts for her work and for her advocacy in speaking up for the profession, and we’re pleased to have had the chance to highlight school counselors’ important role in elementary and secondary education in such a high profile way. We are continuing to work with ED staff to promote the school counseling profession. For more information, contact either Scott Barstow with ACA at This email address is being protected from spambots. You need JavaScript enabled to view it. or Amanda Fitzgerald with ASCA at This email address is being protected from spambots. You need JavaScript enabled to view it.


The deadline for submitting a grant application for the Elementary and Secondary School Counseling Program (ESSCP) is May 25th. The Department of Education has posted updated information on applying for grants on its website at Although competition for ESSCP grants is always heavy, ACA encourages interested LEA's to apply.

Scott Barstow | Director, Public Policy and Legislation

ph 703-823-9800 x234 | 800-347-6647 x234
fx 703-823-0252 | web

ACA UPDATE: Supreme Court Upholds Affordable Care Act!

From: Scott Barstow This email address is being protected from spambots. You need JavaScript enabled to view it.
June 28, 2012 3:32:13 PM EDT
This email address is being protected from spambots. You need JavaScript enabled to view it.
ACA UPDATE:  Supreme Court Upholds Affordable Care Act!
ACA Public Policy Listserv This email address is being protected from spambots. You need JavaScript enabled to view it.

This morning the Supreme Court ruled that the Affordable Care Act, our nation's first attempt to establish a health care system to provide insurance coverage to substantially all citizens, is constitutional.  The U.S. is the only developed country in the world with large numbers of uninsured people.

The ruling, authored by Chief Justice John Roberts, upheld the individual insurance mandate contained in the Act, but struck down an enforcement mechanism in the law to push States to implement an expansion of Medicaid coverage. Although the Roberts opinion rejected the argument that the individual mandate was defensible under Congress's authority to regulate commerce, it held that the individual mandate to buy insurance could be viewed as a tax, and thus was within Congress's authority to levy taxes.

On Medicaid, the opinion invalidated one of the law's provisions. As enacted, the Affordable Care Act allowed the federal government to withhold both new and existing Medicaid funding from States that do not participate in the Act's Medicaid expansions.  The Supreme Court held that this was too severe a penalty, however, and under the court's ruling only new Medicaid funding can be withheld from States that do not comply with the new expansion requirements.  The Affordable Care Act expands Medicaid eligibility to all individuals under the age of 65 with incomes below 133% of the federal poverty line, and requires Medicaid programs to cover an essential health benefits package including mental health services.  Since the federal government will pay 100% of the cost of the Medicaid expansion through 2016, and at least 90% thereafter, States are still likely to choose to meet the new Medicaid requirements.

Today's Supreme Court ruling allows implementation of the Affordable Care Act to move forward, ending months of uncertainty over the law's fate.  ACA has long supported the universal expansion of health insurance coverage in the U.S., and applauds the Court's ruling. The ruling is also being hailed by a wide array of health and mental health consumer and provider organizations as a key victory in the fight to reduce the number of Americans without health insurance, and increase Americans' access to mental health services.

Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
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4 Million Uninsured People With Mental Illness Will Be Denied Health Insurance

Nearly 75 Percent of These 4 Million Uninsured People With Mental Health Conditions Reside in 11 Southern States That Opted Out of the New Program

4 Million Uninsured People With Mental Illness Will Be Denied Health Insurance Because Their Home States Refuse to Participate in the ACA Medicaid Expansion Program

Alexandria, Va. – February 26, 2014 – AMHCA's new, groundbreaking study shows that nearly 4 million people with mental illnesses who are uninsured reside in the 25 states that have refused to participate in the Medicaid Expansion program under the Affordable Care Act (ACA). Many of these individuals have severe mental health conditions and currently have no health insurance coverage through any public or private plan, but will be denied the opportunity to obtain coverage for treatment since those states have refused to participate. States declining Medicaid Expansion represent 55 percent of all uninsured people with major mental health disorders who are eligible for coverage in the new health insurance access initiative.

Download the comprehensive study, "Dashed Hopes, Broken Promises, More Despair: How the Lack of State Participation in the Medicaid Expansion Will Punish Americans With Mental Illness"

Other key findings from the AMHCA report include:

  • 6.7 million uninsured people with a mental illness are currently eligible for coverage under the Medicaid Expansion that went into effect on Jan. 1, 2014. But the majority of these individuals with mental health conditions will be left out in the coverage cold due to their state’s antagonism toward the Medicaid Expansion health insurance initiative.
  • Nearly 75% (2.7 million adults) of all uninsured persons with a mental health condition or substance use disorder who are eligible for coverage in the non-expansion states (3.7 million), reside in these 11 Southern states that have rejected the Medicaid Expansion: Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia.
  • More than 1.1 million uninsured people who have serious mental health and substance abuse conditions live in just two states – Texas (625,000) and Florida (535,000). These more than 1.1 million individuals are eligible for coverage under the new Medicaid Expansion program, but won't receive it. Since officials in Texas and Florida (and other 23 states) have said they will not participate in the initiative, they are leaving their most vulnerable citizens without health insurance, even though the federal government will pay for it (at 100% for the first three years of the program and slowly tapering off to 90% in 2020 and thereafter). The funds for this are already included in the federal budget.

"If the 25 states do not participate in the new Medicaid Expansion program, uninsured citizens with mental illness who experience the misfortune of residing in those states will see their hopes of a healthier and better life dashed when they learn during the enrollment process that they will not be able obtain health insurance," said Judith Bertenthal-Smith, AMHCA president.

The U.S. Supreme Court ruled in 2012 that the new Medicaid Expansion program is an optional program; states can opt into or out of it at any time without incurring penalties. But states that perpetually opt out of Medicaid Expansion will hurt people with mental illness.

"The burden of mental illness in the U.S. is incredibly high due to increasing numbers of uninsured people with mental health conditions. The lack of health insurance coverage keeps people with mental illness from obtaining needed services and treatments—and follow-up care—that lead to achieving long-term recovery and improving their quality of life," said Joel E. Miller, executive director and CEO of AMHCA and author of the "Dashed Hopes" report. "Health insurance is the passkey to good, timely health care services, and state policymakers in 25 states are locking people out of the system."

Read the complete report

Affordable Care Act

ACA’s public policy department has prepared a handout for counselors containing answers to important questions surrounding implementation of the Affordable Care Act. It is important that you familiarize yourself with the facts surrounding the law, as much misinformation has been spread to date. Review the document here: If you have any other questions regarding the Affordable Care Act, you can access information through the CMS website ( or visit for the latest news and updates.


Beginning October 1st, all employers, regardless of size, are required to provide written notices to all employees – regardless of benefit enrollment status or full / part-time status – about health coverage options.

This includes notifications about federal and state health insurance marketplaces. These government-run marketplaces will be open this fall.

Employers can send the notices by mail or electronically. Effective January 1st, 2014, employers will have 14 days from the employees start date to provide a notice.

The Department of Labor has provided two sample notices (both are attached) for employers who currently offer coverage and for employers who do not offer health insurance.

Employers can also create their own notices, which must include:

  • Explanation of the marketplaces
  • Reference to
  • Information about premium subsidies that may be available if employees purchase a qualified health plan through the marketplace
  • Notification that employees may lose their employer contribution to the health plan if it is obtained through the marketplace



icon Sample Notice Already Offers Health Insurance

icon Sample Notice Does Not Offer Health Insurance

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New Jersey Counseling Association
P.O. Box 74
Cranford, New Jersey 07016
Telephone: (609) 273-9917
Fax: (908) 272-2144

The New Jersey Counseling Association is an NBCC-Approved Continuing Education Provider (ACEP) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.