A Mid Michigan counselor is speaking out today about how changes to laws and regulations could affect mental health care access for thousands of people across the state. It’s a bureaucratic jumble that may all come to a head Friday.
Recent surveys show that one in five Michigan adults struggle with a mental health issue. That same research reveals that almost half of those diagnosed are not getting treatment they need, showing that the Great Lakes State is in the midst of what some are calling a mental health care crisis. Serving on the front lines of the battle are Licensed Professional Counselors, or LPC’s. Tracey Galgoci is an LPC in Mount Pleasant.
“We work in community mental health agencies, private practice, school settings, substance abuse settings, in-patient psychiatric facilities, University Counseling Centers,” she says. “LPCs are everywhere.”
But recently, rumblings from the state capital have brought some concerning news for LPC’s like Galgoci. The problem involves a complicated ‘laws versus rules‘ situation. It all starts with how Licensed Professional Counselors are regulated by the state of Michigan.
“So each health profession that has a license also has a law that defines and describes their practice and what they can do and what they can’t do,” Galgoci explains. “And then there’s a set of rules that go along with that law, and the rules go into a little bit more detail about things and define things a little more thoroughly.”
Galgoci says today’s problems began years ago, when The Board of Counseling knew the rules needed to be updated. In the midst of the process of updating everything, Michigan’s Licensing and Regulatory Affairs—or LARA—also weighed in on updating the rules.
“LARA’s interpretation now is that the rules cannot define, describe, or expand anything that isn’t already written in the law,” Galgoci says.
But here’s where it gets even more complicated: the rules change is happening at LARA, and, at the same time, state lawmakers are proposing a new law in the House: House Bill 4325. That bill clearly defines a Licensed Professional Counselor’s ‘scope of practice,’ which is essentially what a counselor is allowed to do.
“So in this case, the big word that…is causing the most issue is the ability to be able to diagnose and identify a problem,” Galgoci explains. “So right now, that is not written into our scope of practice that we can do that. It’s written into the rules, but it’s not in our law.”
Galgoci explains that it all comes down to this: in order to treat patients and bill insurance, LPC’s have to make a diagnosis. And if LPC’s can’t make a diagnosis, there is the possibility that the 10,000 LPC’s in the state of Michigan won’t be able to treat clients, with or without insurance. Galgoci says this factor could affect hundreds of thousand of patients.
“We just need an updated counseling law that clearly codifies our scope of practice,” Galgoci adds.
The good news, according to Galgoci, is that House Bill 4325 is that law. The bill just needs to get passed in the House and in the Senate.
“What we’re asking right now is just that everyone reach out to their state representatives and senators and express their support for House Bill 4325.”
But there is some urgency, and that goes back to that ‘laws vs. rules’ situation mentioned earlier, with Michigan’s Licensing and Regulatory Affairs--or LARA--looking to change the rules. Galgoci explains.
“We never had these rules changes hanging over the head of the profession. So that’s what’s creating some urgency right now--is that the proposed changes to the rules have already been submitted.”
Galgoci says that LARA is holding a public comment meeting in Lansing on Friday October 4th. The meeting is open so that the general public can have their voices heard on these proposed rules changes.
But she also wants to make it clear that LARA is just doing its job: “Their job is to read laws and read rules and make sure all of those things meet their standards. So I don’t want to make them out to be the bad guy in this story.”
Galgoci says the big picture issue is this: if LARA passes the rules change and House Bill 4325 doesn’t pass, it could spell disaster for LPC’s--and for patients needing mental health care.
“I want everyone to know that this is an issue that will impact you; it will impact your family; it will impact your neighbors,” she says. “Depression, anxiety, grief and loss, addiction: those are things that affect everyone--regardless of age, regardless of gender, regardless of socioeconomic status. Everyone at some point is touched by that.”
The Michigan Psychological Association has also weighed in on this situation, saying they would support House Bill 4325 if amendments are made that clarify LPC training requirements, along with mental health assessment tools. The MPA also says that, like LPC’s, they want to work toward making mental health care accessible to everyone in Michigan.
