The state House Ways and Means Committee voted today to advance a bill designed to keep Michigan’s licensed professional counselors on the job without disruption.
House Bill 4325 was unanimously approved to the applause of those in the room. The vote came a week after a hearing attended by dozens of counselors and their advocates who fear a proposed rule change by the Michigan Department of Licensing and Regulatory Affairs could put them out of work.
LARA maintains that state regulations implemented in 1989 do not allow LPCs to diagnose patients or use psychotherapy techniques to treat them, but unclear wording meant counselors have been practicing for years in violation of those rules.
For years, LARA has threatened a crackdown, unless the legislature changed the law to resolve the issue. That hasn’t happened so far, and LARA officials say they are done waiting. They have proposed a “clarification” of the rules that match their interpretation of the current law, which would forbid LPCs for diagnosing patients or use psychotherapy techniques to treat them.
LARA held a Oct. 4 hearing on the rule change, and could implement the new rules in mid-November unless HB 4325 is signed into law.
If the bill is not passed, then 10,000 licensed professionals counselors would lose their ability to see patients and provide mental health services in a clinical setting, said Sara Sue Schaeffer, a LPC in Sturgis told the Ways and Means Committee during the Oct. 2 hearing.
“A low estimate is that 150,000 Michigan citizens would be without mental health services, and there are not enough of the other providers to go around to take up that slack,” Schaeffer said.
“We have a mental health crisis in our state in terms of access to services in a timely manner,” she said. “It would be devastating.”
She said it’s flabbergasting that LARA is now trying to significantly change rules that LPCs have followed for years.
“It was never a concern for 30 years” that licensed professional counselors were diagnosing and treating patients, Schaeffer said. “But what LARA has explained to us is that there is new interpretation, and they believe all those attorneys generals and (Joint Committee on Administrative Rules) groups and directors were wrong before.”
Parts of the bill are opposed by the Michigan Psychological Association, which has questioned the training that LPCs receive.
At the Oct. 2 hearing, Dr. Judith Kovach, who was representing the MPA, said her group is “anxious” to get the bill passed.
“MPA has a long-standing mission to promote access to mental health services for all Michigan residents,” she said. “This includes care by a diverse group of mental health providers.”
“At the same time,” she said, her group also is committed to “high-quality care,” and they are concerned that HB 4325 is not specific enough about the training that licensed professional counselors must obtain.
As currently written, she said, “an individual with a degree specialization in, for example, college counseling or career counseling could treat someone with a disorder as serious as bipolar disorder or schizophrenia. The language in the bill does not match the specificity that governs the preparation and training of other mental health professions in our state.”
If those more explicit standards were included, she said, MPA would support a grandfather clause that would allow LPCs who lack sufficient training to stay on the job while they obtain the additional education needed to meet the new standards.
Kovach was questioned by lawmakers about whether there has been a particular issue with the diagnoses and treatment offered by licensed professional counselors. Kovach said she didn’t have statistics, but she thought a “reasonable number” of LPCs were doing diagnostic testing and/or treating “major psychosis” beyond the scope of their training.
Rep. Roger Hauck, R-Union Township, pushed back on that. “I guess I’m confused,” Hauck said. “You don’t have statistics, But you told me a reasonable number are practicing” beyond their training.
“Did I hear you wrong?” he said. “How can you get information that tells you some people aren’t (practicing within their scope) but don’t have the numbers of what really is happening?”
Kovach conceded she didn’t have numbers, but added, “It’s more than one person over the years. There have been dozens that have come to our attention.”
Others at the hearing pushed back against the idea that LPCs are undertrained.
Sally Reames, chief executive officer of the Community Healing Centers based in Kalamazoo, said LPCs are a vital part of the network of mental-health providers. “They are talented counselors,” she said.
Karen Smigelski, a Lapeer counselor, said she opened her own counseling agency in Lapeer in 2011 and she and her business partner recently invested in an expanded to a second location. If the rule changes go into effect, she said, it could be financially devastating.
“We would have to shut our doors,” she said. “And if all our master’s degrees are considered worthless in the state of Michigan, what will we all do? How do we support ourselves and our families? With my personal debt invested in a dream, my oldest son in college, a lack of income: Where would I go?”
Meanwhile, hundreds of licensed professional counselors and their advocates packed a public hearing Oct. 4 held by LARA about the proposed changes.
Most expressed outrage and bewilderment at the prospect of losing their livelihood and losing the clients who depend on them.
Laura Kellicut, a counselor in Kalamazoo, told the committee that her “entire livelihood depends on my LPC.”
“The changes LARA has proposed will take away my ability to provide for my family, as well as causing unnecessary anxiety and stress for my many clients, who already struggle with anxiety, depression, trauma and various other things,” she said. “This would be detrimental to the progress that these clients have made. Many would struggle if they had to start with someone new; this is terrifying to many of my clients.”
Kathryn Zuverink said she owns a counseling practice that serves 27 adults and adolescents, some of whom are suicidal.
She and her colleagues are “in the trenches with them every week, sometimes multiple times per week trying to keep them safe and healthy,” Zuverink said. “Please do not get in the way of their treatment.”
The bill passed with changes sponsor Rep. Aaron Miller, R-Sturgis, said “do not erode the original purpose of this bill.” One changed how a diagnosis was described and another added a provision saying licensees could not administer a test they hadn’t been trained to administer.
It heads next to the full House. It must pass the House and Senate and be signed by Gov. Whitmer to become law.
Miller said last week on an overtime segment of Off The Record on WKAR the bill was gaining a sense of urgency in the legislature and “I think this is on the fast track.” The new LARA rules could go into effect in November, Miller said.
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