Inside this issue • The Counselor Advocacy Network: You CAN Do It! • Medicare Legislation Still a Top Priority • NBCC Supports Counselor Diagnosis in New York • Success Seen on Occupational Series Issue • VA Directed to Create Hiring Plan for Mental Health Counselors • Advocate Spotlight: Louise Sutherland-Hoyt   The Counselor Advocacy Network: You CAN Do It!     Since its inception, NBCC has advocated for board certified counselors and the counseling profession. Now, NBCC is taking its grassroots advocacy efforts to the next level and is excited to announce the launch of its Counselor Advocacy Network (CAN).This network of counselors will be able to act quickly to support legislative initiatives that move the counseling profession forward. CAN will make it easier than ever for counselors' voices to be heard by legislators. Those who are interested can sign up to get our grassroots alerts and/or become an advocacy leader! Anyone can get involved, and how much time you volunteer is your decision. There are different ways counselors can participate in the network. Most importantly, counselors can simply sign up to get NBCC's legislative alerts and take action by emailing, calling, or meeting with their legislators.   Counselors who want to get more involved can volunteer as State Advocacy Leaders or District Advocacy Leaders. State Advocacy Leaders serve as liaisons between NBCC and counselors in the state, and they help to mobilize counselors within their respective states. District Advocacy Leaders support grassroots advocacy within their U.S. congressional districts. "Our Counselor Advocacy Network provides an opportunity for counselors to quickly mobilize and respond to important legislative alerts," says Dave Bergman, NBCC's Chief Government and Strategic Affairs Officer. "Most legislative pushes are time sensitive, and we need to be able to move fast. The Counselor Advocacy Network provides counselors with an opportunity to quickly connect with their legislators." "Emails are helpful, but calls and meetings with legislators are key," Bergman says. "The Counselor Advocacy Network will grow our congressional footprint and enhance our grassroots effectiveness. We need counselors to sign up and help us grow our profession."   Top   Medicare Legislation Still a Top Priority     Medicare reimbursement for mental health counselors remains at the top of NBCC's list of federal issues. Over the past year, NBCC has engaged in extensive lobbying and advocacy efforts around H.R. 3032/S.1879, the Mental Health Access Improvement Act. Thousands of board certified counselors have also urged lawmakers to include this legislation in everything from spending bills to opioid packages.   The opioid crisis has put mental health and addiction issues in the spotlight on Capitol Hill. Opioid addiction has touched every state and congressional district in the nation, and members of Congress have shown a willingness to pursue a solution. NBCC has pushed to have this legislation included in packages that have been put together by several congressional committees.   The House Energy and Commerce and Ways and Means committees marked up several bills which were eventually passed by the full House as H.R.6, the SUPPORT for Patients and Communities Act, in June. The Senate Health, Education, Labor, and Pensions and Finance committees also marked up opioid bills. Each chamber will merge their respective bills on the floor and bring a package to a bicameral conference for final negotiations. To date, our Medicare bill has not been included in any of these proceedings or packages, although it has been under consideration. There is still hope for addition on the Senate floor, but the odds are long.   A general reluctance to spend significant federal dollars has been the only major obstacle to getting counselor Medicare legislation passed. The bills included in these opioid packages are all low cost measures that address very specific policy areas. The push for inclusion in the opioids bill, funding bill, and other health care packages have produced results. The legislation has gained a record 85 cosponsors between the House and Senate bills. There have been over 40 counselor Medicare bills introduced since 2000, two of which have passed the House and another two passed the Senate.  Language encouraging action on the issue was included in the FY18 omnibus spending and it was recommended by an influential federal committee on serious mental illness this year.    Pursuit of Medicare recognition for counselors is a highly political, long-term project that has been in process for many years and will require sustained advocacy and lobbying. Each push for inclusion in pending health care bills moves the legislation closer to passage and increases the chance for success in future bills. NBCC urges counselor patience and persistence to achieve this critical policy priority.   Top   NBCC Supports Counselor Diagnosis in New York     NBCC is working with the New York Mental Health Counselors Association (NYMHCA) to strengthen the scope of practice for mental health counselors in New York. Since 2015, Licensed Mental Health Counselors (LMHCs) from New York have been ineligible for employment by the Veterans Administration because the word "diagnosis" is not specifically included in the scope of practice. New York LMHCs will be further impacted in 2022 when an exemption enabling counselors to diagnose in state agencies expires, closing the door on counselor employment.  During the 2017-18 session, New York State Sen. Pam Helming (R-54th District) introduced S. 6582, which adds diagnostic authority along with increased clinical training requirements. The language mirrors the requirements and authority granted to Licensed Clinical Social Workers. The NYMHCA is spearheading the effort to pass the legislation and NBCC is providing guidance, resources, and strategic support. The organizations are preparing for movement in 2019 and working with state counselors and counseling programs to advance the legislation. Board certified counselors in New York are strongly encouraged to join in the effort and respond when NBCC calls to action are sent during the session.   Top   Success Seen on Occupational Series Issue     The committee report for the Senate FY19 Military Construction, Veterans Affairs, and Related Agencies appropriations bill contains language directing the Department of Veterans Affairs (VA) to work with the Office of Personnel Management (OPM) to create a federal occupational series for mental health counselors. The lack of an occupational series currently limits hiring, pay, and promotion opportunities in the federal government. This language is a major step toward lifting these unnecessary restrictions.   For more than a decade, NBCC has been fighting for the creation of a federal occupational series for mental health counselors.  In 2011, the VA submitted a letter to OPM requesting the creation of an occupational series at the urging of NBCC.  Senators Jerry Moran (R-KS), the original sponsor of the legislation making counselors VA providers, and Jon Tester (D-MT) have taken leadership roles and have put pressure on both the VA and OPM through legislation and congressional letters. In 2015 and 2017, spending bills passed by Congress included language recommending the creation of an occupational series. In 2015, OPM also released a report to Congress on the creation of the series.   NBCC will continue to work with the VA to ensure that the creation of an occupational series is included in its list of priorities to OPM. Our Congressional partners are also committed to seeing this burden lifted.   Top   VA Directed to Create Hiring Plan for Mental Health Counselors     The same FY19 Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA) appropriations bill addressed staffing shortages at the VA and directed the agency to create a hiring plan for mental health counselors.   The VA continues to underutilize counselors and NBCC has been pushing for increased employment. Counselors were first authorized to work in the VA in 2006. However, hiring did not begin until 2010 when the VA released its qualification standards for the profession. In 2013, language was included in FY14 MilCon-VA bill adding counselors to the VA trainee program. The FY18 MilCon-VA bill also included language encouraging, but not directing, the VA to create a staffing plan for mental health counselors.   NBCC will continue pushing the VA to create the staffing plan in accordance with the directive from Congress, and will offer any guidance that it can. We will also be reaching out to Congressional partners to have them author letters to the VA on the issue.   Top   Advocate Spotlight: Louise Sutherland-Hoyt     NBCC has been working to increase grassroots engagement among board certified counselors, and thousands have sent messages and called their legislators using NBCC's Action Center. In addition, many have signed up to serve as NBCC advocacy leaders. Louise Sutherland-Hoyt, NCC, CCMHC, MAC, LMHC, is an example of an advocate who has gone the extra mile. Over the past decade, Sutherland-Hoyt, a U.S. Army veteran who served in Vietnam, has engaged in a number of advocacy efforts that have grown the counseling profession. Her advocacy began 13 years ago when she moved to Nevada and realized the state did not have licensure for counselors. Despite no legislative advocacy experience, she threw herself into advocating for the development of a counselor practice act that would allow counselors to become licensed in Nevada. She reached out to NBCC and other professional counseling associations, and together they pushed forward in pursuing counselor licensure; in 2007, Nevada became the 49th state to establish licensure of professional counselors. "One thing I have learned is if it feels scary, do it anyway," Sutherland-Hoyt says. "As a counselor, we regularly meet with clients who are intimidating, and we often find ourselves in uncertain situations, but we get in there and do it anyway. Counselors are good at figuring things out." Since moving to Florida, she has been busy advocating at both the state and federal level. In 2018, Sutherland-Hoyt traveled to Washington D.C. to ask legislators to have counselors included in opioid legislation (H.R. 5531) that would allow counselors to be reimbursed by Medicare for providing services. When U.S. Rep. Vern Buchanan's office reached out to NBCC to find a counselor who could speak at the press conference announcing H.R. 5531, Sutherland-Hoyt was at the top of the list and a willing volunteer. "Counselors need to make their voices heard to ensure the profession can join the ranks of Medicare-approved mental health providers," she says. She has also called and met with her legislators and asked them to co-sponsor H.R. 3032 and S. 1879, which would have included counselors as Medicare providers. At present, she is working with Florida legislators to include the term "clinical counselor" in their title practice act, and she is advocating for legislation that would increase portability opportunities for counselors living in Florida. Sutherland-Hoyt says it is exciting to see results from advocacy efforts. "It all coalesced, we barnstormed the legislature and we saw results ... counselors are naturally great advocates," she says. She is direct when asked what advice she would give to counselors who want to advocate. "You can't wring your hands and roll your sleeves up at the same time," Sutherland-Hoyt says. "Actions speak louder than words. You have to decide who you want to be as a counselor." NBCC would like to thank Sutherland-Hoyt for her advocacy efforts. Those who are interested can sign up to get our grassroots alerts and/or become an advocacy leader!   Top Key Legislation Medicare H.R. 3032: Mental Health Access Improvement Act of 2017 S. 1879: Seniors Mental Health Access Improvement Act of 2017 HR 5531: Opioid Emergency Response Act Veterans' Affairs H.R. 3158: Better Workforce for Veterans Act of 2017 S. 1557: Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018 S. 1325: Better Workforce for Veterans Act of 2017 Federal Occupational Classification HR 5895: Energy and Water, Legislative Branch, and Military Construction and Veterans Affairs Appropriations Act, 2019 Federal Grants and Scholarship Funding HR 6597: Mental Health Professionals Workforce Shortage Loan Repayment Act of 2018 H.R. 5102: Substance Use Disorder Workforce Loan Repayment Act of 2018 HR 6470: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019 S 3158: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019 Military S. 1519: National Defense Authorization Act for Fiscal Year 2018 H.R. 2810: National Defense Authorization Act for Fiscal Year 2018