Capitol Hill Briefing Highlights Adding MFTs and Counselors to Medicare
On Thursday, the National Council for Behavioral Health, on behalf of the Medicare Access Coalition, hosted two congressional staff briefings on improving Medicare to better serve seniors with mental illness. The briefing featured community mental health professionals from Peak Wellness Center, who shared the challenges they face in finding Medicare-eligible providers to treat their older adult clients. The event highlighted pending bipartisan legislation that would expand the mental health workforce by adding marriage and family therapists (MFTs) and licensed professional counselors (LPCs) to the Medicare program.
Panelists for this briefing included: Dr. Jovier Evans, National Institutes of Mental Health (NIMH); Linda Goodman, Peak Wellness Center, Wyoming and Karl Cline, Peak Wellness Center, Wyoming. Briefing sponsors included the Medicare Access Coalition and National Association of Rural Mental Health (NARMH).
MENTAL HEALTH NEEDS OF OLDER ADULTS
Dr. Jovier Evans, a researcher specializing in geriatric mental health at NIMH, opened the day’s briefing with some harrowing statistics about older adult suicide. According to Dr. Evans, older adults have the highest rate of suicide of any age group and suicide attempts tend to be more lethal for this population.
One key to preventing older adult suicide is detecting and treating depression and anxiety disorders. Unfortunately, fewer than half of seniors with depression are ever formally diagnosed and of those who are identified, fewer than half receive treatment.
Dr. Evans noted that when seniors are referred to mental health services, “the good news is that treatment works.” A combination of medication and psychotherapy shows the most effective health outcomes. The latest research shows that collaborative care models are highly promising for treating older adults. Collaborative care models integrate primary care and behavioral health care, which is particularly important for older adults, who tend to have multiple chronic health conditions.
MEDICARE AND WORKFORCE CHALLENGES
Linda Goodman, Chief Clinical Officer at Peak Wellness Center in Cheyenne, WY, offered first-hand insights into the challenges community mental health providers encounter when serving Medicare clients. Linda said she faces tough decisions every day when trying to match an older adult, covered by Medicare, with the right treatment professional. For example, it can be most clinically appropriate to refer a senior client to one of their licensed professional counselors or marriage and family therapists on staff, but that care must go uncompensated. This is due to the fact that Medicare does not cover these types of mental health professionals, despite their equivalent education and licensure standards to providers already included within Medicare.
Medicare’s exclusion of MFTs and LPCs is even more harmful considering the huge shortages in the mental health workforce, Karl Cline, CEO of Peak Wellness Center, explained. The problem is even more extreme for providers like Peak Wellness Center that serve a largely frontier area. In fact, 15 of Wyoming’s 23 counties report shortages of psychiatrists, psychologists and social workers. According to Karl, adding MFTs and LPCs to Medicare would provide the workforce that is desperately needed to serve the growing Medicare population. “Allowing marriage and family therapists and mental health counselors to bill Medicare for their services is a simple solution to address the serious problem of untreated mental illness in older Americans.”
MENTAL HEALTH ACCESS IMPROVEMENT ACT
The National Council planned and hosted the briefing to urge the passage of the Mental Health Access Improvement Act (S. 1879/ H.R. 3032), which would allow licensed professional counselors and marriage and family therapists to bill Medicare for their services. Senator Barrasso (R) of Wyoming, one of the bill’s primary sponsors, explained that untreated mental illness and suicide are widespread issues in need of greater attention: “It’s people of all ages impacted … These are our families, these are our friends.” The National Council for Behavioral Health’s Chuck Ingoglia explained that by removing Medicare’s harmful exclusions of qualified mental health providers, Congress can address workforce shortages and improve the quality of care for older adults.