Had state lawmakers failed to quickly enact legislation enabling licensed professional counselors in Michigan to continue working with clients with mental illness, the result at Pine Rest Christian Mental Health Services would have been “pretty horrible.”
That’s according to Scott Halstead, a clinical neuropsychologist and the corporate director of the Professional Practice Group at Pine Rest, who notes that Michigan already has a chronic shortage of mental health providers. Eliminating some 10,000 licensed professional counselors from the mental health care system — as would have happened under a proposed change in state rules — would only have worsened the problem, Halstead said.
“It clearly would have limited our access significantly, and we’re already facing an access crunch. It would have made that problem even worse,” Halstead said. “It’s a good sense of relief that we have.”
Both the state House and Senate this month unanimously approved a bill that codifies into law the legal authority for licensed professional counselors (LPCs) to diagnose and treat clients. The legislation preempts a proposed new rule the state Department of Licensing and Regulatory Affairs (LARA) was considering that effectively would have stripped that ability.
LARA proposed the administrative rule to bring state regulations in sync with a 1988 law that does not specifically allow LPCs to diagnose and treat clients. For more than three decades, the state’s Board of Counselors and practicing LPCs have interpreted the law to mean they could diagnose and treat patients, according to a legislative review on the bill.
Legislation to fix the situation proposed during prior sessions had failed to gain the needed support. After the LARA proposal to align state rules with the 1988 law, LPCs across the state and their professional trade groups marshalled opposition to it and backed a legislative solution.
State Rep. Aaron Miller, a Republican from Sturgis, reintroduced a bill in March to allow LPCs to continue to diagnose and provide psychotherapy.
“We already probably have a mental health crisis in this state and I don’t think we need to make it worse,” Miller said at an Oct. 16 Senate Health Policy and Human Service Committee hearing on the legislation. “We need to make it better, if anything.”
LPCs are on “the front line of mental health care in this state and they’ve been doing what they are currently doing since 1988,” Miller said.
The legislation follows a July report by Ann Arbor-based Altarum that detailed a serious shortage of psychiatrists and other mental health care providers in the state. The study, commissioned and funded by the Michigan Health Endowment Fund, estimates that 650,000 people in Michigan with a mental illness and more than 500,000 people with a substance use disorder fail to receive any treatment.
Among the recommendations, Altarum suggested expanding “the number or size of programs to train non-clinician mental health or addiction health professionals in Michigan such as licensed professional counselors or licensed certified social workers,” as well as backing an effort to “remove restrictions on scope of practice that limit the ability of non-physician providers to practice to the full extent of their training and professional certification.”
LPCs in Michigan presently work with more than 150,000 people with a mental illness or substance abuse disorder, according to a legislative analysis of the bill.
Grand Rapids-based Pine Rest employs 43 LPCs who account for 20 percent of the therapists on staff. If the LARA rule had been allowed to go into effect, wait times for people to see a therapist could have grown from a week or so to two, three or even four weeks, Halstead said.
“If you’re struggling with depression or anxiety and you’re feeling pretty bad and want to talk to somebody, the longer you have to wait, the harder that is,” he said. “If you take 20 percent of the therapists out of our team, you just compound that problem. That’s just totally the wrong direction to go.”
At Hope Network in Grand Rapids, LPCs work with youths and adults with mental health issues, as well as people with developmental disabilities, said COO Tim Becker. LPCs account for about 20 percent of the services Hope Network provides annually to about 20,000 clients, Becker said.
“It would just overwhelm the system if those folks were not allowed to do what they do,” he said. “(The legislation) was essential.”
The bill to align the law and existing regulations passed the state House on Oct. 8 on a 108-0 vote, then sailed through the Senate on Oct. 17 on a vote of 38-0. Gov. Gretchen Whitmer was expected to sign the legislation into law with immediate effect.
In earlier legislative committee hearings, the bill drew objections from groups that took issue with the original language. Groups such as the Michigan State Medical Society and the Michigan Psychiatric Society worried the bill as initially written would have allowed LPCs to diagnose medical conditions.
The language was altered and it “pretty clearly states that they are not to make medical diagnoses,” Halstead said.