legislative

Texas lawsuit challenges MFT diagnosis of mental illness

by

Updated 9/7/2011 – Updated link to legal document.

===

The Texas Board of MFT Examiners has been sued (summary | legal document) by the Texas Medical Association, alleging that MFTs should not have the authority to make diagnoses of mental illnesses. The case has the potential to set a dangerous precent for mental health care nationwide.

At issue is a proposed Texas rule that would simply make MFTs’ ability to diagnose explicit. In every state where MFT licensure exists, MFTs routinely assess, diagnose, and treat mental illness. The terminology in statute may differ from state to state, but these tasks are part of MFT practice in every state. When the TMA initially raised concerns about making this ability explicit in the Texas MFT scope, the licensing board dismissed their concern, noting

The inclusion of the term “diagnosis” in §801.44(r) does not expand the scope of practice of marriage and family therapy into the practice of medicine, but accurately reflects the scope of practice of marriage and family therapy.

So what gives?

Physicians are trying to expand their exclusive control of medicine. Under the guise of “protecting the public,” the Texas Medical Association and its sister organizations in other states are not just seeking to keep non-physician healthcare providers from expanding their scope of practice, but are actually seeking to actively roll back existing practices. In Texas, the medical association was successful in keeping podiatrists from expanding their scope to include the ankle.

What’s different in the MFT case is that family therapists were making no effort at all to expand their scope of practice.

What’s clear about the Texas case is that if the TMA wins, it would absolutely not be serving the best interest of patients. Texas already has a severe shortage of psychiatrists, as well as a shortage of mental health care workers generally. Marriage and family therapists receive specific training and supervised experience in the assessment, diagnosis, and treatment of mental illness. Restricting who can diagnose mental illness by removing MFTs from that task would only make it harder for patients to access clinically appropriate care.

An update on the lawsuit from the Fall 2008 Houston Association of MFTs’ newsletter can be found here. The Texas Association for Marriage and Family Therapy is working diligently to help the licensing board defend against the lawsuit. If you would like to help, the best way is to donate to the TAMFT Political Action Committee.

New year, new Medicare efforts for MFTs

by

Will this be the year MFTs finally are included in Medicare? There are promising signs.

First, there is already momentum for adding MFTs to the list of accepted providers. MFTs have been on three bills, one in each of the past three Congresses, that successfully passed out of one legislative house. (Twice we’ve made it out of the House of Representatives, once out of the Senate.) So far, no bill to include MFTs in Medicare has survived both houses and made it to the President’s desk. But with a new President, a new Congress, and a new public focus on health care reform, there looks to be a good window of opportunity.

There are two bills (HR1693 in the House, and its companion Senate bill, S671) already introduced in the current Congress that would bring MFTs into Medicare. Both are bipartisan efforts that have very low initial costs and are likely to lead to long-term savings as Medicare patients would be able to more easily receive early treatment for mental health disorders. Both have strong and growing support from key committee members in both houses.

In the larger conversation about health care reform, there is also good reason to be optimistic for the MFT profession. The body of knowledge supporting the clinical effectiveness and cost-effectiveness of our work continues to grow at a rapid pace, and with licensure now in 48 states and DC, the case for inclusion is stronger than ever.

I’ll keep you posted as the bills move forward. Stay tuned to aamft.org for updates and calls-to-action, when contacts with specific legislators can help turn their votes.

MFTs (finally) earn job classification with Veterans Affairs (VA)

by

My friends at AAMFT Government Affairs have great news: The Department of Veterans Affairs (VA) has finally approved a new job category for marriage and family therapists (MFTs)! This has been a long time in the making, as the VA had dragged its heels since the law mandating such a job category was enacted in December 2006.

Partial text from the AAMFT letter to members follows.

Despite the uncertain timeframe for necessary next steps within the VA, the AAMFT will continue to advocate on behalf of the MFT profession to see that there is swift and fair resolution to final VA implementation. The AAMFT will be working alongside the VA Human Resources’ office to formalize the establishment of new qualification standards for these emerging VA positions. They have indicated that they will seek counsel with our professional organization moving forward as an MFT subject matter expert for the actual development of these classification standards.

Ever since Public Law 109-461 (the Veterans Benefits, Health Care, and Information Technology Act) was signed back in December of 2006, the AAMFT has been vigilant in pushing for its resolution and enactment, allowing veterans’ around the country access to the services of MFTs. Over the last few months, AAMFT joined forces with the American Counseling Association (ACA) and the American Mental Health Counselor’s Association (AMHCA). In recent weeks, the California Association for Marriage and Family Therapy (CAMFT) also signed onto the united front of AAMFT, ACA and AMHCA. These latest initiatives have been aimed at getting Congress to vocally express its desire for “the will of law” to be adhered through swift VA implementation of MFT and Licensed Professional Counselors (LPCs).