Your voice is important. Those who have doubts about the power to advocate and work for the profession need only contact Michigan advisors. This fall, approximately 10,000 licensed professional counselors (LPCs) participated in a grassroots campaign that thwarted attempts to impair their ability to practice.
On Friday, September 13 – some would consider an appropriate date to be disastrous – Michigan's Department of Licensing and Regulatory Affairs (LARA) released a public hearing to comment on proposed changes to state rules that determine the scope of the practice LPCs. The announcement confirmed that despite the objections of the government advisory body and the protests by local supporters for months, LARA continued its plan to change practically all previous rules for the scope, but also to repeal them. Most critically, the proposed changes would remove the practice of LPCs for "counseling techniques" and the ability to "diagnose and identify the problem". In other words, LARA intended to strip Michigan LPCs' rights to diagnose clients and exercise psychotherapy.
Without this ability to diagnose, neither counselors nor clients could apply for reimbursement of the insurance sum – a devastating blow to practitioners. But the damage wouldn't stop there. The repeals proposed by LARA threatened the existence of the consulting profession in Michigan by removing LARA's right to offer psychotherapy. How do consultants who cannot advise practice? The answer: you don't.
"The ramifications [if LARA was successful] were that 10,000 counselors would not be able to practice legally," said Michael Joy, president of the Michigan Counseling Association (MCA). "They would have essentially lost their jobs."
Joy, a member of the American Counseling Association and LPC in private practice, adds that the cancellation of LARA would have failed up to 150,000 customers. Because their counselors were unable to practice, clients should have had treatment from other therapists. Since most psychiatric doctors in Michigan already have severe cases, the search could have taken months. During this time, these clients had received no help, Joy continues. This breach in the continuity of psychiatric care would have been a serious therapeutic setback and could have jeopardized client well-being, he claims. Those with more acute symptoms may even need hospitalization.
LARA's interest in changing the scope of practice rules for LPCs in Michigan is not new. Many experienced consultants had been preparing for an official proposal for years and were working on several fronts to prevent a crisis. Although advocates attempted to work with LARA, the Michigan Mental Health Counselors Association (MMHCA), a former division of the MCA, instituted a security line by engaging a lobbyist and appealing to state lawmakers.
In March 2019, House Bill 4325 was introduced in the Michigan legislature. The goal was to create a law that updates the level of practice and licensing requirements for LPCs to ensure that counselors are still able to diagnose and treat clients. HB 4325 would replace the changes proposed by LARA. The law had strong bipartisan support and made its way through the Michigan legislature, but there were questions as to whether time would pass.
The clock ticked – loudly.
"Really, no one knew that the trigger would be withdrawn until this public announcement was made [from LARA] and that's how the madness actually started," explains Stephanie T. Burns, an LPC in Michigan and Ohio and an active member of ACA, MCA and MMHCA. "LARA had made its proposals and the Michigan advice center had unanimously vetoed all changes at that point, and in response, LARA's powers decided to bring them up anyway …"
If LARA had not been affected by the comments and statements from the public hearing in October, the removal of the advisors' scope could have been effective in November. Michigan LPCs had to fight hard and quickly for their work. And they did.
When the news of LARA's plan spread, a fundamental wave of support was triggered. MCA sent a distress signal to the American Counseling Association (ACA), whose government team was on the move. Brian Banks, ACA's director of public order and intergovernmental affairs, began developing a strategy with MCA to formulate a plan. ACA has sent a VoterVoice email notification to its members in Michigan that guides subscribers through the process of contacting federal and state lawmakers. The ACA government team has expanded the call to action and posted advocacy notifications for all consultants in Michigan on Twitter and Facebook. ACA also contacted the branch of the National Association of Social Workers in Michigan, the Michigan Primary Care Association and the national offices of the National Alliance for Mental Illness and the American Federation of State, County, and Municipal employees. MCA began to circulate a petition and posted members who were ready to attend the LARA hearing in front of the myriad of customers they had helped and the lives they believed had a hand in the rescue. MMHCA also asked members to testify personally at the hearing if possible or, if not, to email their written statement to LARA before October 4.
Meanwhile, Burns, an associate professor of advisory training at Western Michigan University, began to inform alumni and colleagues of the threat to all LPCs and the urgent need to contact LARA and state lawmakers. Burns not only engages in her own advocacy work, but also teaches her students how to effectively stand up for them. For this reason, she had already formulated steps and languages for actions to be taken by email and letter, which were published as templates on the MMHCA website.
Thousands of advisors responded to the call for action prior to the hearing, accused LARA of protests, and urged their representatives to move forward and approve HB 4325. Advisers bombed the hearing on October 4. In fact, the turnout exceeded the venue's fire regulations, so Joy said that not everyone who showed up could get in.
Banks attended the hearing to provide ACA's testimony, which was written by Richard Yep, the chief executive officer.
"ACA wants to support our members and the profession at the highest level," says Banks. "Being in Michigan to support the profession was a crucial step in showing LARA and the law how important these issues are."
The ACA statement highlighted the crucial role LPCs play in providing Michigan residents with mental health and drug abuse. Preventing clients from being treated by counselors would greatly exacerbate the lack of mental health providers, particularly in rural areas of the state. In addition, LARA's actions would have violated ACA's Code of Ethics, requiring consultants to make a proper diagnosis prior to treatment.
Burns also focused on the ACA Code of Ethics in her written communication and at a meeting with the Michigan Senate Health Policy Committee. It specifically referred to the part of the Code of Ethics that professional advisors cannot leave or neglect their clients. "I said [to the committee]," LARA will be responsible at this moment for causing harm to our customers – serious harm. "
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In the end, the combined efforts of MCA, MMHCA, ACA and, above all, thousands of consultants from across the state paid off. In October, both Michigan legislatures voted unanimously to adopt HB 4325. On October 29, Governor Gretchen Whitmer signed the law.
Burns and Joy both praised ACA for their support, particularly their decision to send Banks to testify personally at the hearing, rather than handing in the statement from a distance. Joy adds that the knowledge he has gained at the ACA Leadership Training Institute has helped him develop an effective approach to MCA.
"Michigan is a perfect example of how grassroots advocacy works when it is effectively organized," Banks says, adding that the campaign was one of the strongest he has seen in his 20 years in the field Has.
Sometimes a Michigan-sized crisis is needed to drive large-scale grassroots efforts. But Burns and Banks urge the advisors not to wait. The profession faces numerous critical questions, such as the struggle for Medicare reimbursement. Legislators and regulators will decide on the profession with or without advice from the advisors, Banks emphasizes.
"We have to have a place at the table."
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Laurie Meyers is a senior writer for Counseling Today. Contact her at [email protected]
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The opinions and comments expressed in articles from CT Online do not reflect the opinions of the editors or guidelines of the American Counseling Association.
