Oregon Division

Legislative Updates


COPACT is the Government Relations and Advocacy arm of ORCA and OAMFT who have come together to form a united statewide professional lobby presence in the Oregon State Capitol and with the Oregon Executive Branch. COPACT contracts with a government relations consulting firm and meets as a legislative committee to set priorities and provide direction and oversight of the lobby effort in Salem. We are in our 3rd legislative session with a lobbyist.



LEGISLATIVE SESSION 2017

A Busy 2017 Legislative Season

Larry Conner MA LPC, COPACT Government Relations Chair

As I write this, the 2017 Oregon Legislative Session is winding down, having tackled a broad range of issues touching mental health care. COPACT kept a close eye on all of them, evaluating 74 bills that would impact our practices, our agencies, and our clients. There were bills relating to CCOs; hospitals and mental health emergencies; firearms and the mentally ill; housing for the mentally ill; telehealth; social work in schools; public employee health care; forensic evaluations; sex offender treatment and nearly everything in between. 

To ensure that the voices of LPCs and LMFTs were heard, COPACT board members…

  • Made personal contact through one-on-one meetings with legislators at the Capitol;
  • Worked closely with our lobbyist Elizabeth Remley and her assistant Rachael Emory —our ongoing professional team in the Capitol;
  • Met weekly to discuss issues, strategy and tactics.

Among the many issues we worked on, here are some highlights that most impact the work of professional counselors and marriage and family therapists:

Protecting the rights of LPCs and LMFTs to provide specific types of therapy:

This session, Art Therapists and Sex Offender Therapists sought to create practice Acts—defined standards and requirements to do their specific types of work. We think that’s a good thing. However, in their original forms, these bills failed to exempt licensed mental health providers (like us!), which could have prevented LMFTs and LPCs from providing those services. COPACT successfully got the bill amended (no small task), ensuring that LPCs and LMFTs can still choose to provide services to sex offenders, and can continue to use art as part of our work with clients. 

Safeguarding flexibility in CEUs, and fighting against unnecessary mandates:

Senate Bill 48 had good intentions—to increase provider training in suicide prevention. However, the bill originally would have required LPCs and LMFTs to take recurring CEUs in both suicide prevention and pain management.  We at COPACT believe that mental health professionals should have the freedom and flexibility to take CEUs that will best support our specific areas of client work. COPACT fought hard on this one, defending our professional autonomy. As a result, the requirement for pain management CEUs was tabled, and suicide prevention trainings will be recommended rather than required.   

Fighting for fairer reimbursement rates:

This is huge, and could be the beginning of the end of 20 years of steady reductions in mental health reimbursement rates in Oregon! A joint effort of COPACT, the Oregon Independent Mental Health Professionals, the National Association of Social Workers-Oregon Chapter, and the Oregon Psychological Association—Senate Bill 860 requires the Department of Consumer and Business Services to examine mental health reimbursement cuts as potential violations of Oregon Parity Law. The bill has passed the Senate unanimously and is awaiting a vote in the House. COPACT has been working for this kind of legislation for the past seven years, and we’re not stopping until we get it done!

Improving client access to mental health prescriptions:

COPACT supported a bill allowing Psychologists with advanced training and supervision to prescribe certain medications. House Bill 3355 has passed the House and is awaiting a vote in the Senate. If it passes, there will be more options for our clients to get access to prescribers, which is especially important in rural areas where prescribers can be few and far between.

Protecting small clinics and private practitioners:

Because this session had to deal with a state revenue shortfall of $1.4 billion, much discussion took place around how the state could raise more revenue.  COPACT kept a very close eye on these discussions.  There was a time when it looked like all health care providers—regardless of size or scale—would pay a special tax to help cover the cost of the Oregon Health Plan.  That was modified so that only hospitals, large clinics, and health insurers will pay the tax. 

Standing up against harmful insurance practices:

When Regence created a new policy that would have increased out-of-pocket costs for our clients insured there (by applying the cost of intake sessions to the deductible, rather than covering those sessions via co-pay), COPACT got involved. We immediately used the ORCA listserv as a rapid-response tool, encouraging all ORCA members to contact Regence and oppose the change. Several weeks later, Regence issued a retraction of that policy, which we believe should mean intake sessions are again covered by co-pay. However, if that turns out not to be the case, please let COPACT know immediately though the ORCA listserv!

All in all, this was a very active legislative session for COPACT. We extend our deep appreciation to our talented lobbying team Elizabeth and Rachael, who serve our profession exceptionally. COPACT’s hardworking members include: Chad Ernest LPC, Jeff Olsgaard LPC, Andrea J. Wright Johnston LMFT, Steve Rodgers LMFT & LPC, Wendy Curtis LPC, Libby Schwartz LPC Intern, and Larry Conner LPC.

Please join us in standing up for our profession by making a donation today at www.copactoregon.com/donate, by making sure your memberships in ORCA and/or OAMFT are up to date, and by encouraging your colleagues who are not yet members to join our professional associations.

And remember—you don’t need any special training to be part of this work. If you care about our profession and want to make your voice heard, COPACT welcomes you. Just contact us at president@copactoregon.com. We are all in this together!

 

2015 Session

Below are bills that COPACT focused on during the 2015 session.  For the 2015 and 2017 sessions we have been working with Elizabeth Remley as our lobbyist who is part of Thorn Run Partners. She has done fantastic work in and out of sessions..

  • SB 430 allows the Boards of Licensed Professional Counselors and Therapists, Psychologist Examiners and Licensed Social Workers to withhold licenses from an applicant who has been convicted of a sex crime. COPACT supported this bill, which passed both chambers unanimously. It takes effect January 1, 2016.
  • SBs 787 and 834 would have created a formal workgroup on mental health access. While these bills died, legislative leaders will assemble informational round tables throughout the state on community mental health, and have invited COPACT to participate.  These workgroups have already started to meet and COPACT will be an ongoing part of their work.
  • HB 2023 requires hospitals to adopt and enforce discharge policies for patients admitted to the emergency room for a mental health crisis. COPACT provided comments to help shape the policy in HB 2023, which originally placed significant liability on hospital staff for what happened to a patient after they were discharged. The bill now requires hospitals to assess the patient’s aftercare needs and  aid in the patient’s “seamless transition from an acute care setting to outpatient treatment…” This bill impacts those LMFT’s and LPC’s working in those acute care facilities. The Governor signed this bill on June 18, and it takes effect July 1, 2016.
  • HB 2307 prohibits mental health professionals from providing “conversion therapy” to minor clients. Conversion therapy presupposes same-­-sex orientation is a form of mental illness, something that has been discounted by professional mental health organizations. COPACT joined other mental health organizations and civil rights advocates to support this bill, which passed and was signed into law by the Governor on May 18.
  • HB 2796 establishes a music therapy license in the state Health Licensing Office.  COPACT supported this bill, which addresses one of the outstanding licensing issues for mental health providers who aren’t licensed by OBLPCT – the others are dance and art therapists.  The organizations of COPACT have long supported those types of therapy and have been helpful in getting the licensing they deserve. The bill passed and was signed into law; it is effective immediately.
  • HB 3347  clarifies a provision of the civil commitment statute that says a person may be committed who, “because of a mental disorder” is “unable to provide for basic personal needs and is not receiving such care as is necessary for health or safety.” Jurisdictions around Oregon have interpreted this differently over the years, and HB 3447 seeks to clarify and standardize the definition of “basic personal needs.” Under the standards of HB 3347A, the harm must be serious, must be very close in time and must be addressable by a mental health intervention. The bill potentially allows for more flexibility to commit someone with good safeguards to protect the person’s rights. The bill was supported by mental health and disability advocates. The Governor signed the bill into law on June 16.
  • HB 3378 requires hospitals to adopt written discharge policies. This bill was negotiated with the Oregon Association of Hospitals and Health Systems
    (OAHHS) and was amended to reflect practices already in place at most hospitals in Oregon.  The bill calls for stronger discharge planning and operational plans the state agencies overseeing hospitals can review. It had broad support in both chambers and is effective January 1, 2016.
  • HB 2468 creates “network adequacy” standards for insurers’ provider networks and directs the Oregon Insurance Division to establish specifics for provider non-­- discrimination in rule. COPACT supports this opportunity to examine insurance networks and expand the options for mental health providers. This bill passed through both chambers and was signed into law on May 12 by Governor Brown. There is currently a workgroup meeting to work on the specifics of what network adequacy means.  COPACT is part of this workgroup. The “rules” are to be in place by January 1, 2016.
  • HB 3427 would have created an 18-­-member Task Force on Mental Health Care Reimbursement. See above for more details. COPACT supported this bill, but it died in Ways and Means due to confusion over the funding mechanism. Many Representatives and Senators are aware of this issue and COPACT will be putting attention on ways to bring more parity to the reimbursement issues.
  • SB 832 allows for full reimbursement of mental health services provided in a primary care setting by a Coordinated Care Organization. At the moment, providers cannot get full reimbursement for their mental health work if it is provided in conjunction with a primary care visit. COPACT supported this bill, which was championed by St. Charles Hospital in Bend. It passed at the end of session, after it was amended to reflect an agreement between hospitals and CCOs. It takes effect on passage. This means that if a patient sees their primary care doctor and then sees a therapist within that office, both receive full reimbursement for their services.  The hope is that this will expand the use of mental health practitioners in those situations.
  • SB 901 changes how patients are reimbursed.  As of now, patients will often receive a check and think it is a refund, thus not paying the provider. This bill requires insurers to directly reimburse a provider who bills the insurer.  In cases where the patient pays the provider up front and then seeks reimbursement from their insurer, the insurer can still send a check to the patient. SB 901 passed and takes effect January 1, 2016.

 

 


 

LEGISLATIVE SESSION 2013

Goals of Therapist and Counselor Legislative Work in Oregon
Following the passage of the Practice Act in 2009, which gave LPCs and LMFTs health insurance reimbursement rights, COPACT has had two major goals: to seek a level playing field for LPCs and LMFTs in Oregon and to raise the visibility of the counseling and therapy professionals with legislators and establish COPACT as the “go to” organization to represent our interests.  In this effort, we have amended statutes in Oregon where certain legal rights, privileges and obligations have been granted to Licensed Psychologists and Licensed Clinical Social Workers, but not to LPCs and LMFTs.  The reason for this is simple.  With the advent of Health Care Reform, it will become more important than ever for LPCs and LMFTs to have the same legal status as other licensed mental health care professionals.

2011 Medical Malpractice Parity
In 2011, COPACT led the effort on HB 2217 which passed unanimously in both the House and Senate and was signed into law by the Governor.  COPACT added LMFTs and LPCs to the longstanding statute reducing liability in medical malpractice lawsuits for almost all licensed health care practitioners, including Psychologists and Social Workers by exempting punitive damages. The exemption applies if, “The health practitioner was engaged in conduct regulated by the license, registration or certificate issued by the appropriate governing body and was acting within the scope of practice for which the license, registration or certificate was issued and without malice.”

2013 Consent to Mental Health Treatment for Teens
2013 COPACT REQUESTED BILL: SB 491, which gives teens, age 14 and up, the ability to consent to mental health services provided by an LPC or LMFT.  Almost 30 years ago, sensing the need to give teens from troubled families the tools to seek mental and physical health care services, the legislature began creating a body of law granting teens limited ability to consent to their own care.  As of January 1, 2014, thanks to the passage of SB 491, the ability to consent to mental health and addiction treatment will now be extended to teens seeking help from LPCs and LMFTs as well.

While this may seem like a pretty straightforward area of law to amend, it ended up being fairly complicated. Bills like this tend to engender public and legislative discomfort in the notion that minors would be able to seek services outside the purview of their parents, no matter the reason. The bill did in fact ignite this debate in the Oregon House where we nearly lost. However, in the end through some fast lobbying, we were able to prevail without any amendments to the legislation. COPACT will be monitoring the situation in the interim period between legislative sessions because there was some discussion of creating a work group to look at revamping the statute, and probably not in a good way. We appear to have been successful in quashing this effort but will keep an eye on it. With the passage of SB 491, we are very close to statutory parity with LCSWs .

2013 Update Definitions in the Practice Act
2013 COPACT REQUESTED BILL: HB 2768, which was an amendment to the Practice Act seeking two changes:

    1. We made the length of time required for internships exactly the same for LMFTs as LPCs.  Currently, LPCs can get licensed as soon as they finish their required hours of clinical experience even if that is before having completed three years of internship, yet even if LMFTs finish their required hours early, they have to wait until the end of the three years to become licensed.  Because of the passage of HB 2768, as of January 1, 2014, LMFT interns will be able to get licensed at the same pace as LPCs.
    2. We amended some of the definition language in the practice statute to make it more enforceable by our licensing board and to better situate ourselves for healthcare reform.

COPACT was committed to having a government relations consultant onboard before attempting to amend the practice act. Anytime a statute is opened up for one purpose it can be amended in any number of ways. We have been extremely concerned that we could face an amendment and might be unable to control the final language of the bill. We needed to have our lobbyist paying very close attention to this bill to ensure that we could block any hostile amendments. In addition, we also used the bill as an opportunity to continue to establish and improve COPACT’s working relationship with our licensing board staff, which is critical to our overall efforts to improve and achieve our larger government relations goals as an organization.

Reimbursement Rate Equity
COPACT also testified in favor of HB 2353, which was brought forth by the Oregon Society of Clinical Social Workers.  The bill was drafted and sponsored by Rep. Kennemer (R) who is a psychologist.  HB 2353 required all insurers to be more transparent about the method they use to determine reimbursement rates for psychotherapy.  Thanks to COPACT’s lobbyist negotiating with OSCSW, and the ongoing working relationship we have been building with them, an amendment was drafted to add LPCs and LMFTs to the bill, so that all psychotherapy providers in Oregon would be covered.  Even though this bill had bipartisan support, the House Health Care Committee chose to not to move it forward at this time.  Instead, there was discussion of pulling a group of stakeholders and legislators together in the interim, before the 2014 legislative session, to see if another approach can be worked out. COPACT will be at the table if that effort moves forward.

Increased Internship Availability
COPACT also worked in support of HB 2737 this session.  This bill will require insurers to reimburse the psychotherapy provided by independent mental health clinics throughout the state.  The main reason we support the passage of this bill is that it will increase the availability of internships for LPCs and LMFTs, as well as other licensed providers.  Additionally, we support it because it increases the availability of mental health services in rural and underserved areas in Oregon.   HB 2737 has passed both the House and Senate and is on its way to the Governor’s desk where we anticipate it will be signed into law shortly.

Health Licensing Board Consolidation
HB 3496, and a Senate companion bill sought to merge independent health licensing boards into a larger consolidated state agency. COPACT took a neutral position on the bill and suggested we would be willing to explore a Mental Health Licensing Agency, which would streamline certain administrative and human resources functions but retain the individual licensing boards and autonomy of each of the mental health professions. It is unclear whether legislators will pursue an interim workgroup to address this or let it go for now.  If there are interim meetings on this, COPACT will be involved in that discussion as well.

COPACT Members Putting a Face on the Profession(s) in the Capitol
The COPACT members providing testimony at the legislature during the 2013 session were Wendy Curtis LPC, Steve Rogers MFT, and Larry Conner LPC.  A big thanks to those who took the time to come to Salem and testify! We know it takes a big chunk of time out of your day and a lot of work to write the testimony and we really appreciate it!!

COPACT Needs Your Support!
COPACT works on behalf of all LPCs and LMFTs in Oregon.  In order for us to continue to protect our profession, we need to raise the resources necessary to maintain government relations and lobby work with the legislature and the executive branch. Without representation, we will be vulnerable to all the changes coming with Health Care Reform starting Jan 1, 2014.  Every other player in the system has professional help to navigate government and politics as health care transformation moves forward—insurance companies, nurses, doctors, psychologists, and social workers. LPCs and LMFTs need to have the same kind of strategic support to ensure our interests are represented.

Membership matters! In order to support our ability to contract with a lobbyist we need to make sure that you and your colleagues are (new or) renewing members of the Oregon Association for Marriage and Family Therapy.  And, if you wish, you may donate directly to the “Lobby Fund” on the COPACT website: www.copactoregon.com/donate

WHAT CAN YOU DO?
We are assembling a group that would form the legislative committee for the OAMFT. This group will meet electronically so no travel would be necessary. If you are interested please contact me at: Stephen.rodgers57@gmail.com or at 503-336-4904.

   1. Keep tabs here or at COPACT to see what is happening with the bills, they directly impact your practice.
   2. Find out who your legislator is and find a way of building a relationship. Get to know their aides in the town where they have an office. In the long run this pays huge dividends. This does not need to be complicated. A phone call to their office asking to speak to the aide who works on mental health issues is all it takes. Just introduce yourself, say you are concerned about mental health, that you are a marriage and family therapist, and hope they will support bills (you will see them shortly). Or just say hi and that you will be in contact as bills come forth. Don’t answer questions you don’t know the answers to, tell them you will research that question and get back to them---then call us.
   3. Help us organize other LMFT’s and Registered Interns. Encourage them to check out this website. Numbers matter!! Every phone call or letter you make represents hundreds of constituents because so few call or write.  It takes 5 minutes. 
   4. Make a donation to OAMFT specifically to pay for the work of our lobbyist.
 


To find and contact your legislator:
By Phone:
(503) 986-1187 or (800) 332-2313

Online:
Click on the link below, enter in your address and click “Submit”. Your federal and state legislators’ contact will appear. www.leg.state.or.us/findlegsltr/


Visit the AAMFT website for more information about MFT legislative issues and policy.  You can also sign up for updates from AAMFT.  Click here for details.

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