What single-payer health care would mean for California therapists

California flagThe Healthy California Act — California’s single-payer bill — continues to make progress through the state legislature. If signed into law, it would make California the first state to have a statewide single-payer health care system, even as the federal Affordable Care Act may be scaled back. How would single-payer health care impact therapists, counselors, and related mental health providers?

Here, I’ll do a quick review of what we know so far. It’s broken down into three questions providers rightly ask about the bill: How would it impact my client load? How would it impact my rates? And, How would it impact how I run my practice?

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New Mexico, Nevada, Connecticut ban conversion therapy for minors

Ryan McGuire - Licensed under Creative Commons ZeroEarlier this month, the governors of Nevada and Connecticut signed laws banning conversion therapy for minors in those states. These follow the signing of a similar law in New Mexico in April. According to the National Center for Lesbian Rights, nine states now ban the practice. The District of Columbia and cities including Seattle, Cincinnati, and several in Florida have enacted similar bans.

If you are not familiar with the practice, conversion therapy (also sometimes known as reparative therapy) involves efforts to change someone’s sexual orientation. The American Psychological Association and other professional mental health groups have strongly disavowed the practice. They note that there is no evidence that the treatment is generally effective, but there is evidence of harm that it can cause.

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How President Trump will impact US mental health care

Future President Trump // Photo credit: Gage Skidmore [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia CommonsDonald Trump was elected President of the United States yesterday in what has been labeled a stunning upset. While much of the broader social discussion today will focus on how Trump’s victory happened, as psychotherapists we now must consider how President Trump will impact our profession.

Mental health is not mentioned in Trump’s health care reform paper or on the health care page of his campaign web site. So for this post, we look to his other stated policy goals to see how mental health care would be impacted.

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Texas Supreme Court to hear appeal on MFT diagnosis

Texas CapitolEarlier this year, the Texas Supreme Court refused to hear a case about marriage and family therapists’ (MFTs’) ability to independently diagnose mental illness. While MFTs are trained in diagnosis, a lower court ruled that the state’s licensing board overstepped its authority in an attempt to add the word “diagnosis” to the MFT scope of practice. Going further, the court ruling determined that MFTs should not have been independently diagnosing in the first place. (Though the word “diagnose” was not previously in the scope language, MFTs diagnosing mental illness was common practice, as it is around the country.) The state Supreme Court’s refusal to hear the case meant that the lower ruling stood, and MFTs could not diagnose.

Court procedures in Texas allow for one final appeal of the court’s decision not to hear a case. The AAMFT filed an appeal on June 13. In a rare move, the court granted that appeal. Later this year, the Texas Supreme Court will hear arguments about whether MFTs should be allowed to independently diagnose mental illness.

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MFTs lose diagnosis fight at Texas Supreme Court

TexasUpdate, February 24, 2017 – The Texas Supreme Court agreed to rehear the case, and ruled that MFTs *are* allowed to independently diagnose. More on the ruling can be found here.

Original post, published June 6, 2016 – Ten days ago, the Texas Supreme Court refused a petition for rehearing from marriage and family therapists (MFTs) seeking to preserve their ability to independently diagnose mental illness. The refusal brings at least a temporary close to a years-long fight between MFTs and the Texas Medical Association, with TMA winning. It could impact other master’s-level professionals not just in Texas but around the country.

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