The Iowa Mental Health Counselors Association follows and reports on new legislation and updates to current legislation affecting mental health counselors in Iowa. To learn more about the current issues facing the general assembly, visit the Iowa Legislature General Assembly. You can read legislative announcements from 2016 through 2023. Weekly legislative updates can be found among the general News Items. Annual reports, Day on the Hill, and legislative agenda can be found here. Thank you for engaging in the process! We appreciate your support. Your dues go to making this advocacy possible!
Legislative Agenda 2023 – 2024
IMHCA is excited to announce our 2024 Legislative Priorities! Thank you to everyone who completed our survey this fall to craft these priorities. This year we will be focusing our attention on workforce development issues, increasing funding to the mental health provider loan repayment program, and identity protection for Counselors. Additionally, we will be working to protect LGBTQ+ rights, respond to licensure board changes, monitor the roll out of the Counseling Compact, and advocate for increased rates from private insurers.You can help us in these efforts! IMHCA’s annual Day on the Hill was scheduled for Tuesday, February 20, 2024. This year we hosted a legislator breakfast at 7:30am in the Capitol and returned in the afternoon to lobby in the rotunda. The day was followed by a social hour and summary of the day’s events to follow. We hope you can join us for parts or all of the days events! Watch our advocacy videos to help you make an impact on mental health legislation!
Advocacy 101 2024
Talking to your Legislator

Our Annual Day on the Hill Update 2023
Thank you, Thank you, Thank you. We had an amazing day on the hill. We had over 50 people registered and somewhere just above 30 attend. We love that we made contact with 12 legislators, and it turned out to be the NASW’s Day on the Hill! After our initial meeting for the day, our three goals were set:- Making sure legislators knew that the Counseling compact made it through the first funnel and that it would be coming to the floor for a vote. We wanted to make sure that legislators had all questions about the compact answered. We had a few questions, but mostly just support for the cause.
- Pushing the Non-Compete legislation through the Senate.
- Thank those who have been instrumental in getting legislation passed this year and last year.
IMHCA/ACA Day on the Hill 2023 | |||
| Tuesday, February 21, 2023 | |||
| Total Contacts | 14 | ||
| Total Legislators | 12 | ||
| Contact | Role | Notes | Bills Reviewed |
| Pete McRoberts | Lobyist for ACLU of Iowa | ||
| Tony Raymer | Easter Seals of Iowa/NASW Past President | Discussed his support of the bill along with Easter Seals. The Easter Seals Lobbyist was there as well. Discussed that this bill was not altering licensing information/scope of practice from what Tony knew about it. | HF 273/SF 210 Counseling Compact |
| Cindy Golding | |||
| Sharon Steckman | Representative | HF 273/SF 210 Counseling Compact | |
| Elizabeth Wilson | |||
| Ako Abdul-Samad | Representative | Very supportive | HF 93/SSB 1106 Non-Compete; HF 273/SF 210 Counseling Compact |
| Megan Jones | Representative | Thanked her for another year of Compact legislation and updated her on progress. | HF 273/SF 210 Counseling Compact |
| J.D. Scholten | Representative | ||
| Nate Boulton | Senator | Very supportive | HF 93/SSB 1106 Non-Compete |
| Charley Thompson | Representative | HF 273/SF 210 Counseling Compact | |
| Brad Zaun | Senator | HF 93/SSB 1106 Non-Compete; HF 273/SF 210 Counseling Compact | |
| Janet Peterson | Senator | Message left. | |
| Jeff Edler | Representative | Message left. | |
| Joel Fry | Representative | Message left. | |
Save the Date: FEB. 21, 2023
For our annual Day on the Hill!
Date Change! Day on the Hill is Tuesday, February 21, 2023. This is an opportunity to speak directly with legislators about our legislative priorities and issues that impact the counseling profession. This year IMHCA is partnering with ACA of Iowa for a joint Day on the Hill. We hope to see you there!
Check out our 2023 IMHCA Advocacy Toolkit (1).
The IMHCA Advocacy Toolkit is updated annually for our day on the hill. We have a lot of great information here including our bill watch list for the day, advocacy tips and tricks for year-round work, details for the day, and how the Iowa Legislature passes laws. This tool is helpful to keep updated on how to best advocate for our profession and those we serve.Watch Our introduction to Advocacy with Emily Piper, Lobbyist with Piper Consulting, and IMHCA President, Kayla Bell-Consolver:
KICK OFF to the 2023 LEGISLATIVE SESSION!
Welcome 2023! We will continue with Emily Piper of Piper Consulting for our Lobbying efforts. Our committee continues to meet monthly to tackle the legislative priorities and planning for events. Your legislative committee this year includes:- Legislative Chair: Ellyn Nitchals-Kellner
- Jennifer Becker – IMHCA Member
- Vicki Ailey-Roberson – IMHCA Member
- Courtney Ackerson – Past President
- Valeo “Leo” L. Khan-Snyder (ACA representative)
____________________________________________________________________________
ADVOCACY WITH AMHCA: CHANGE IN MEDICARE RULES
DATE: DECEMBER 2022
Although we have asked you on several occasions this year to reach out to members of Congress on our Medicare bill, it is critically important that we maintain a steady flow of messages over the next few weeks when key congressional non-defense spending decisions will be made.
It is the view of several lobbyists that the best chance for passage of our Medicare bill is during this current lame-duck session of Congress.
If our bill does not pass in this congressional session, we would need to begin the process anew in 2023 with a divided Congress, where it could be difficult to pass significant mental health legislation.
MENTAL HEALTH ACCESS IMPROVEMENT ACT (S.828/H.R. 432)Please contact the following Congressional Leaders:- Senate Majority Leader Chuck Schumer
- Senate Minority Leader Mitch McConnell
- House Speaker Nancy Pelosi
- House Ways and Means Committee Chairman Richard Neal
- House Energy and Commerce Committee Chairman Frank Pallone
KICK OFF to the 2022 LEGISLATIVE SESSION!
Welcome 2022! We already have quite the active year. Your legislative committee this year includes:- Legislative Chair: Lynn Giang
- Ellyn Nitchals-Kellner – At large IMHCA board member
- Jennifer Becker – IMHCA Member
- Vicki Ailey-Roberson – IMHCA Member
- Kayla Consolver – IMHCA President
- Courtney Ackerson – Past President

We are welcoming a NEW LOBBYIST this year as well.
Please give a warm welcome back to Emily Piper.
2021 Annual Legislative Report
1629522557866_IMHCA final report 6.21____________________________________________________________________________Advocate for Medicare Reimbursement on Tuesday, Sept. 14, 2021!
See the following note from our parent organization:Dear AMHCA Members,AMHCA is extremely excited to announce our virtual action day to support the Mental Health Access Improvement Act (HR 432 / S 828)! We need your help!On Tuesday, September 14th, please join us in tweeting, posting on Facebook, and calling your Representatives and Senators in support of making marriage and family therapists and mental health counselors Medicare-eligible providers in legislation Congress is now considering!Your voice, together with many voices across the country, will amplify our message to Congress! You will find information about what we are advocating for as a group together, who are our target Senators and Representatives from your state, sample Twitter and Facebook posts and graphics in the attached packet.More information can be found on our website at https://www.amhca.org/advocacy/medicare and more will be provided in the next few days and can be, and AMHCA will be announcing the virtual action day through social media today. Get the word out on #MedicareMentalHealth and #SeniorsMentalHealth!Any questions? Email us at info@amhca.org.Sincerely,AMHCA Team________________________________________________________________IMHCA’s 2021 Conference Legislative Review
Power Point Presentation
IMHCA 2021 Legislative Review_______________________________________
IMHCA’s 2021 Day off the Hill, March 11, 9 AM-1 PM (Save the Date)
2021 IMHCA Advocacy Toolkit(2)Register for our Day off the Hill, 2021 virtual advocacy day by March 7th, 2021 and receive a swag bag from IMHCA with items to participate in day on the hill. Join us on March 11th, 2021 to advocate for mental health and licensed counselors across the state. We really hope to have multiple areas of the state represented, so please join us from all corners as we engage in this advocacy process from the convenience of your own location! Our first ever virtual day off the hill is bound to be a great success.Register in advance for this meeting: https://us02web.zoom.us/meeting/register/tZMrfu6urzwpEtG1RC1fTMgOl44jqrv_Rs6QAfter registering, you will receive a confirmation email containing information about joining the meeting. Want to know more about how to read legislative updates and prepare fore day on the hill? Watch our lunch and learn advocacy training here: https://youtu.be/HCuSxvSmVuYIMHCA’s 2021 Legislative Training:
Watch our virtual training to prepare for Day on the Hill and help understand the bill watch list! IMHCA started a YouTube Channel. Legislative Training here.IMHCA’s 2021 Legislative Agenda
STATE AGENDA:Proactive- Public policy
- Ensuring the safety of our license and licensure board
- Telehealth
- Ensuring that the membership has an understanding the difference between what is legislated and what are other outside topics or issues such as private insurance rules
- Parity issues
- Billing locations
- Crisis services for mental health in the state
- Ensuring funding of the Children’s Mental Health Bill
- Licensure bills – protect the integrity of the board of behavioral sciences
- Cutting Medicaid or Medicare services
- Reimbursement concerns
- Banning conversion therapy in the state of Iowa
- Support coalition work such as work with:
- Iowa Schools Mental Health Alliance
- One Iowa
- NAMI of Iowa
- ACA of Iowa
- Iowa Psychological Association
- Represent our license well and ensure that legislature understands who we are and how we fit in the mental health picture
- Raise awareness that the VA is now able to hire LMHCs in the system.
- Maintain weekly updates in the legislative session
- Send regular surveys to our members to ensure that our lobbyist has data to back up the legislative agenda and discussions with legislatures
- Give feedback when we are hearing from our members
- Passage of Medicare provider recognitionfor mental health counselors and marriage and family therapists.
- Increase professional unification among the states: education, training/supervision standards/portability.
- Increase workforce opportunities through advocating for VA hiring of licensed professional mental health counselors.
- Expand federal (Public Health Services Act) definition of the mental health workforce.
- Department of Transportation Substance Abuse Treatment Recognition.
- Increase collaboration on unification with American Association of State Counseling Boards (AASCB), Association for Counseling Education and Supervision (ACES), the National Board for Certified Counselors (NBCC) and the American Counseling Association (ACA).
- Improve licensure portability across states.
Advocate for Mental Health and Your Profession!
Our Annual Day on the Hill
Wednesday, March 11, 2020 12:30 pm – 4:30 pm
At the Des Moines Capitol Building
Agenda:12:30 pm – 2:00 pm: Advocacy Training at the Iowa Association of Community College Trustees (IACCT) building. See map in additional materials at the link below.Move to the capitol.2pm – IMHCA President Welcome & remarks and Government Chair remarks/IMHCA Lobbyist remarks (room G-19 or alternate meeting space is lower level by the information desk)2:30pm – Legislator Guest Speakers3pm – Advocate!4pm – Closing Remarks & Conference Reminder Please familiarize yourself with the attached 2019|2020 Guide to the Iowa Legislature. It also includes pictures of all the legislators, which will be very helpful when looking for legislators to approach.2019-2020_Iowa_Legislature_Guide-Jan31Location of the IACCT building, where we meet from 12:30-2 PM IACCT Building Location Near CapitolParking Map: Capitol Complex Guest ParkingMap to find rooms throughout the day (rooms to be announced) Capitol_Rooms_MapPlease RSVP or send any questions to imhcapresident@gmail.com 1-2-2020: IMHCA Welcomes New State Lobbyist!IMHCA is excited to announce we have a new lobbyist representing us at the state level. At this time, IMHCA would also like to express our sincere appreciation for the excellent work of our previous lobbyist, Emily Piper, for the past ten years.Our new lobbyist is Renee Schulte at Schulte Consulting, LLC!
Renee Schulte has over 20 years of leadership experience in the mental health field at the national, state, and provider levels. Her work in the public and private sectors has given her a unique understanding of the complexities in this area. Renee is nationally recognized for her expertise in behavioral heath policy, system design, policy and financial analysis, and strategic consulting.As a licensed mental health therapist, Renee has worked in many levels of care including psychiatric hospital, child welfare, and therapeutic foster care. Prior to her election to public office, Renee served on the National Violence Against Women task force in the Bush administration. As a legislator, she spearheaded the passage of mental health redesign in Iowa creating a regional system from an original 99 county system. She began Schulte Consulting, LLC in 2012.As a consultant Renee has worked with multiple states creating strategic plans, legislation and regulations. She has also used her expertise and unique background in government relations and consulting for both non-profit and for-profit providers of healthcare services. She has taught at multiple colleges and universities in the psychology department, encouraging the next generation to join in this important work. She and her husband, Brent currently reside in Urbandale, Iowa.Renee’s Personal Message for IMHCA members: “I am honored to represent IMHCA at the Statehouse this year, as a long time member of IMHCA I understand the challenges facing our community. I look forward to working with the public policy team to protect our license and advance our legislative agenda.” 10-25-2019: IMHCA is accepting proposals for State Legislative Lobbyist Services. Please download the RFP for complete information.IMHCA Lobbyist RFPThis additional document answers questions that have been posed to IMHCA related to this RFP:Response to RFP Inquiries IMHCA Second Funnel ReportApril 5, 2019Under the Golden DomeThe second funnel deadline, by which a bill must have passed one chamber and a committee in the other chamber, occurred this week. By all accounts, it seemed less hectic and frenetic than prior years. There were a large number of bills in both chambers that did not have companions in the other chamber. This can complicate the process of getting a bill through the process.Budget bills began to appear in both chambers. These bills are the starting point but it’s important to note that the House and Senate have not agreed on budget targets for each of the ten individual budget bills. May 3 is the last day that legislators receive their per diem and clerks and other support staff are also no longer paid after this date.Budget bills of interest to IMHCA membersHF 758: Education budget bill- Health care loan repayment program — $250,000 ($50K increase).Eligibility for this program is expanded through SF 167 to include mental health professionals.
- $1.4 million to the area education agencies to provide mental health awareness training for schools and to identify the best ways to meet mental health needs of students.
- $306,000 for a children’s 24-hour mental health crisis hotline
- $1.2 million to buy down the childrens’ mental health waiver waiting list
Join us for our Annual Day the Hill from 2-4 PM on Wednesday, March 13th, 2019!
More information can be found here: https://imhca.net/newsletters/day-on-the-hill-march-13-2019/ Action Request on HF 666 – Licensure Review Bill; March 15, 2019What does HF 666 do?This bill requires the state government efficiency commission (comprised of legislators) to review at least one third of all professional licenses, certifications and registrations every two years.The state government efficiency commission must make recommendations on each of these categories related to continuation of the requirement for licensure, education requirements for licensure and scope of practice. The commission must consider health and safety implications and may request input from the licensure board and other interested parties. The legislature, as a whole, would then vote upon these recommendations.This is a repeat of an attempt several years ago to eliminate certain licensure requirements. That bill was ultimately defeated but it proposed to elminate licensure of mental health counselors. The bill’s sponsor met with mental health counselors on our Day on the Hill and suggested that we have too many licensed occupations in the state and that some professions use this to exclude people from serving in those occupations.The bill is eligible for debate on the House floor.What can you do?Contact your representative and express your opposition and concerns with this bill. To find your representative and contact information, enter your home address in this link and you will be directed to your representative’s information: https://www.legis.iowa.gov/legislators/find.Here are some suggested points to use in your communication with your representative:- Explain the why it is important that mental health counselors are licensed
- Explain why the educational and training standards and board oversight are important.
- Ask your legislator to oppose passage of HF 666.
- Be polite.
- Be succinct but specific about your position.
- Make the ask.
- School-based telehealth for behavorial health services. The proposed legislation enacts a permissive regulatory framework to guide local development of school-based telehealth systems, including:
- Limited to Behavioral Services, Consistent with Standards of Care
- Mental Health Providers Proving Telehealth Services Must Have an Iowa License
- Changes to Chapter 229 – Involuntary commitment statute. Proposed language, modeled after the process used in Colorado, provides more authority to chief medical officer or designee to determine if hold or release is necessary without magistrate approval.
- Implementation of Recommendations of the Children’s System Board.These recommendations include:
- age-appropriate, universal behavioral health screenings that determine whether a child needs behavioral health services1 shall be provided at periodic intervals to Iowa’s children and their families.
- Estalbish set of behavioral health core services and supports domains developed
- Additional $11 million in fiscal years 2020 and 2021 to medicaid to help cover new services provided by the mental health regions
- $4 million for new psychiatric residency programs at the University of Iowa for doctors who will practice in rural areas
- $150,000 to train nurse practitioners and physician assistants in mental health
- Legislation that creates a children’s mental health system that works in tandem with the adult mental health system
- $1.2 million to eliminate the waiting list for home- and community-based children’s mental health services
- $300,000 to train teachers to recognize signs of mental health issues
Final Legislative Summary May 11, 2018
YOUR ACTION IS NEEDED – PROTECT INSURANCE REIMBURSEMENT FOR TEMPORARY LICENSED MENTAL HEALTH COUNSELORS Please see details at the bottom of this entry
Iowa Mental Health Counselors Association Final Legislative Summary May 11, 2018
Reflections on the 2018 Session:Despite both chambers and the governor’s office being controlled by Republicans, the legislative session went into overtime. Differences over the depth of tax reform and how to shape the state’s budgert caused legislators to work through the month of April, finally adjourning on May 5.Mental health was a big focus in this legislative session and numerous bills were enacted into law to expand services to address mental health concerns. And, IMHCA secured a significant victory in the enactment of legislation that creates different business opportunities for mental health counselors and other mental health professionals. Despite the simple nature of this bill, passing a bill is always harder than killing one!HF 2300 – LLCs/PLCs: This bill allows licensed mental health counselors to form partnerships with each other or with licensed psychologists, marital and family therapists, or licensed independent social workers under the state’s limited liability statute as well as the professional corporation statute. The bill was signed into law on April 2 and becomes effective on July 1.HF 2305 – telehealth: This bill requires insurance companies regulated by the state to treat health care services delivered via telehealth in the same manner as those services when provided by direct provider contact. This is not a payment parity bill but it would prohibit those insurance companies from refusing to establish a reimbursement for telehealth services if it also covers those services when delivered in person. The bill was signed into law on March 29 and becomes effective July 1.HF 2456 – behavioral health: This bill is the behavioral health policy bill that incorporates the recommendations of the complex needs workgroup (legislatively appointed after the 2017 legislative session) as well as recommendations from the IHA-IMS workgroup on behavioral health. The bill was signed into law on March 29, 2018. The major provisions of the bill include:- Clarifies Licensure for Subacute Care Facilities
- Regions Shall Ensure the Availability of Core Services, Contingent Upon Federal Funding Availability, No Later Than October 1, 2018
- Regions May Partner to Make Core Services Available
- Medicaid Must Cover Medically Necessary Core Services Core Services Include:
- 22 Assertive Community Treatment (ACT) Teams
- 6 Subacute Regional Access Centers (Established by December 31, 2019)
- Intensive Residential Service Homes (IRSH) for up to 120 Patients Statewide
- Modify Regions’ Civil Commitment Process:
- Ensure Civil Commitment Prescreening Within Four Hours of Emergency Detention
- Ensure the Coordination of Appropriate Levels of Care, Including Securing Inpatient Psychiatric Beds or Community-Based Resources and Services, When Needed
- Ensure Ongoing Consultation with a Physician or other Mental Health Professional While Patients Remain in the ER
- Clarifies Disclosure of Mental Health Information to Law Enforcement
- Expedites Release of Patients in a Mental Health or Substance Abuse Involuntary Commitment if Recommended by the Examining Physician
- Clarifies Transport Responsibilities for Patients Under a Mental Health Involuntary Commitment
- DHS & IDPH Must Establish a Statewide Crisis Hotline
- DHS & IDPH Must Convene Stakeholders to Review the Mental Health and Substance Abuse Involuntary Commitment Process and Make Recommendations for Improvement
- DHS & IDPH Must Convene Stakeholders to Review the Role of Tertiary Care Psychiatric Hospitals in Delivering Mental Health Services and Issue Recommendations by November 30, 2018
- Standards for timely claims processing
- Standardized medicaid provider enrollment forms
- Review of the effectiveness of prior authorization standards
- Independent audit of small claims to determine the accuracy of MCO determinations and payments
- Directs DHS to convene a workgroup to review the health home program and issue recommendations for the future of that medicaid initiative
- Ask that she retain Division XXVIII – Coverage of Behavioral Health Services Provided by Certain Providers.
- Talk about the importance of this training and being reimbursed for the services you provide in delivering mental health services around the state.
- Share any personal experiences you have had as a temporary licensee or in supervising an individual with a temporary license.
Legislative Alert from AMHCA; May 11, 2018
House of Representatives Considering Opioid Emergency Response Act, Including Provisions Adding Licensed Mental Health Counselors to MedicareThe U.S. House of Representatives Committee on Ways and Means is in the midst of considering legislation to include in their opioid package. A senior member of the Ways and Means Health Subcommittee, Congressman Vern Buchanan (R-FL) introduced the Opioid Emergency Response Act (HR 5531) last month, which includes provisions that would add licensed mental health counselors as eligible Medicare providers.The Committee on Ways and Means plans to markup opioid legislation the week of May 14th, and AMHCA needs your help! See below, and call your Member of Congress today to URGE WAYS AND MEANS TO INCLUDE HR 5531 OR HR 3032 IN THEIR MARKUP LIST, BECAUSE #SeniorsNeedMHCounselors!| Alabama | Terri Sewell (D) | (202) 225-2665 |
| Arizona | David Schweikert (R) | (202) 225-2190 |
| Florida | Carlos Curbelo (R) | (202) 225-2778 |
| Florida | Vern Buchanan (R)*Note: AS the sponsor of this legislation, thank him for his efforts supporting Mental Health Counselors in HR 5531! | (202) 225-5015 |
| Georgia | John Lewis (D) | (202) 225-3801 |
| Illinois | Peter Roskam (R) | (202) 225-4561 |
| Illinois | Darin LaHood (R) | (202) 225-6201 |
| Illinois | Danny Davis (D) | (202) 225-5006 |
| Indiana | Jackie Walorski (R) | (202) 225-3915 |
| Kansas | Lynn Jenkins (R) | (202) 225-6601 |
| Massachusetts | Richard Neal (D) | (202) 225-5601 |
| Michigan | Sander Levin (D) | (202) 225-4961 |
| Michigan | Mike Bishop (R) | (202) 225-4872 |
| Minnesota | Erik Paulsen (R) | (202) 225-2871 |
| Missouri | Jason Smith (R) | (202) 225-4404 |
| Nebraska | Adrian Smith (R) | (202) 225-6435 |
| New York | Joseph Crowley (D) | (202) 225-3965 |
| New York | Brian Higgins (D) | (202) 225-3306 |
| New York | Tom Reed (R) | (202) 225-3161 |
| North Carolina | George Holding (R) | (202) 225-3032 |
| Ohio | Jim Renacci (R) | (202) 225-3876 |
| Ohio | Pat Tiberi (R) | (202) 225-5355 |
| Oregon | Earl Blumenauer (D) | (202) 225-4811 |
| Pennsylvania | Mike Kelly (R) | (202) 225-5406 |
| Pennsylvania | Pat Meehan (R) | (202) 225-2011 |
| South Carolina | Tom Rice (R) | (202) 225-9895 |
| South Dakota | Kristi Noem (R) | (202) 225-280 |
| Tennessee | Diane Black (R) | (202) 225-4231 |
| Texas | Kenny Marchant (R) | (202) 225-6605 |
| Texas | Kevin Brady (R) | (202) 225-4901 |
| Texas | Lloyd Doggett (D) | (202) 225-4865 |
| Texas | Sam Johnson (R) | (202) 225-4201 |
NEW LAW in Iowa Allowing Counselors to form LLC or Professional Corporations
April, 2, 2018: The governor signed into law HF 2300, effective July 1, 2018. This bill allows psychologists, mental health counselors, marriage and family therapists and licensed independent social workers to form limited liability corporations or professional corporations.HOUSE PASSES OMNIBUS SPENDING BILL FOR FY 2017-18
Joel E. Miller (AMHCA)The House of Representatives passed the “omni” or “omnibus” in federal budget language, which contains many appropriation bills – a huge legislative measure of 2300 pages which contains a $1.3 trillion spending bill to fund the federal government until September 30th (the remainder of the 2017-18 fiscal year).The Omnibus bill now goes to the Senate where it faces an uncertain fate. If the Senate does not take action by Friday, March 23rd, the federal government will shut down. If the bill passes, it will give us six months without Continuing Resolutions (CRs) that have kept the government running the first six months of the fiscal year.Our Medicare provider recognition bill language in the House budget legislation – H.R. 3032 – was not included in the final House bill and unlikely to appear in any Senate bill for fiscal year 2017-18. However, we will have multiple opportunities in the Proposed Federal Budget deliberations for FY 2018-19 that the House and Senate will take up soon after they pass the 2017-18 spending package. There will be various mental health and opioid-related bills under consideration over the next few months where we hope to attach our Medicare CMHC recognition bills. We are already advocating behind the scenes to hopefully make this happen.In the House budget bill we did achieve a success where language was included in the HHS/Labor Bill section of the Omnibus stating:“Mental Health Providers.-The (budget) agreement is aware that Medicare beneficiarieshave limited access to substance use disorder and mental health services,particularly in rural and underserved areas. The (budget) agreement notes concern about theshortage of eligible mental health providers for the Medicare population andsupports efforts to explore the expansion of the mental and behavioral health workforce.”(Division H, pg. 50 of the Labor/HHS Conference Committee report)We hope this guidance in the HHS bill section will set the stage for serious consideration and passage of our Medicare bills in any final budget legislation in fiscal year 2018-19.We will provide additional information when, and if, the Senate approves a final bill that aligns with the House Omnibus bill, and then must be signed by President Trump before the spending bill becomes law.Best,JoelJoel E. MillerExecutive Director and CEOAmerican Mental Health Counselors Association (AMHCA)675 N. Washington St., Suite 470Alexandria, VA 22314T – 703-548-6002F – 703-548-4775www.amhca.orgIowa Legislature ADVOCACY TOOLKIT
This excellent resource was prepared for our 2018 Day on the Hill, but it will help you with your advocacy efforts all through the year! 2018 IMHCA Advocacy Toolkit.Mental Health Day on the Hill: SAVE THE DATE!
The Iowa Mental Health Counselors Association (IMHCA) invites you to join us on Monday, March 5th, 2018 at 2:00PM (legislative dining room, ground level) for our annual “Mental Health Day on the Hill” advocacy event, held at the State Capitol Building in downtown Des Moines, Iowa.Mental Health is extremely important and should be made a priority. Whether you are merely interested in how policy impacts Iowa’s mental health delivery system, a student pursuing a degree in the mental health field or you are a provider looking to share your story and advocate for your profession, this is your chance! Simply RSVP to government@imhca.net by March 2. Please include your name and email to receive more information closer to this event.If you would like more information about IMHCA, please subscribe to our e-mail distribution list at https://imhca.net/ or simply follow us on Facebook and/or LinkedIn.The Iowa Mental Health Counselors Association would like to thank you in advance for your participation in this event and for your continued support.We look forward to seeing you on March 5th at 2:00PM on the Hill!February 16 Legislative Update – First Funnel Deadline
- Clarifies Licensure for Subacute Care Facilities
- Regions Shall Ensure the Availability of Core Services, Contingent Upon Federal Funding Availability, No Later Than October 1, 2018
- Regions May Partner to Make Core Services Available
- Medicaid Must Cover Medically Necessary Core Services
- Core Services Include:
- 22 Assertive Community Treatment (ACT) Teams
- 6 Subacute Regional Access Centers (Established by December 31, 2019)
- Intensive Residential Service Homes (IRSH) for up to 120 Patients Statewide
- Modify Regions’ Civil Commitment Process:
- Ensure Civil Commitment Prescreening Within Four Hours of Emergency Detention
- Ensure the Coordination of Appropriate Levels of Care, Including Securing Inpatient Psychiatric Beds or Community-Based Resources and Services, When Needed
- Ensure Ongoing Consultation with a Physician or other Mental Health Professional While Patients Remain in the ER
- Clarifies Disclosure of Mental Health Information to Law Enforcement
- Expedites Release of Patients in a Mental Health or Substance Abuse Involuntary Commitment if Recommended by the Examining Physician
- Clarifies Transport Responsibilities for Patients Under a Mental Health Involuntary Commitment
- DHS & IDPH Must Establish a Statewide Crisis Hotline
- DHS & IDPH Must Convene Stakeholders to Review the Mental Health and Substance Abuse Involuntary Commitment Process and Make Recommendations for Improvement
- DHS & IDPH Must Convene Stakeholders to Review the Role of Tertiary Care Psychiatric Hospitals in Delivering Mental Health Services and Issue Recommendations by November 30, 2018
- Clarifies Licensure for Subacute Care Facilities
- Modifies Regions’ Reserve Fund Standards to Establish 30% of Annual Expenditure Limitation
- Regions Shall Ensure the Availability of Core Services, Contingent Upon Federal Funding Availability, No Later Than July 1, 2021
- Regions May Partner to Make Core Services Available
- Regions’ Annual Reports Must Outline Plan to Make Core Services Available
- Regions Must Provide Quarterly Reports on Their Progress Toward Making Core Services Available
- Medicaid Must Cover Medically Necessary Core Services
- Core Services Include:
- 22 Assertive Community Treatment (ACT) Teams
- 6 Subacute Regional Access Centers
- Intensive Residential Service Homes (IRSH) for up to 120 Patients Statewide
- A Single Statewide Crisis Hotline
- Warmline Regional Services
- Allows DHS to Implement Changes with Emergency Rules
New Iowa Legislative Session Schedule
Monday, January 8 marked the start of the 87th General Assembly and the 2018 legislative session in Iowa. With Medicaid privatization and the current state of our mental health system listed among the top priorities for legislators, it looks to be a busy session for the Association’s Government Relations committee!Make sure your voice is heard! Email government@imhca.net today and tell us what you would like legislators to know heading into the session, and don’t forget to sign up for email alerts and regular updates throughout the year by visiting https://imhca.net or by following us on Facebook and LinkedIn!Here is a schedule of the legislative session, 2018 legislative sessionThank you for your continued support, and we look forward to serving your legislative interests on the hill in 2018!Respectfully,The IMHCA Government Relations CommitteeMedicare Reimbursement Advocacy November 15, 2017
Medicare Reimbursement for LMHC’s and MFT’s
We are closer than ever to getting this law passed!
We Need Your Help!
On Wednesday, November 15, 2017, the entire mental health counselor community is uniting through social media outreach, combined with calls, to U.S. Senate and House offices, to build support for and pass S. 1879 / H.R. 3032 into law. We need your help to pressure your Representatives to support the Seniors Mental Health Access Improvement Act!ABOUT THE SENIORS MENTAL HEALTH ACCESS IMPROVEMENT ACTIf passed by the U.S. Congress, the Seniors Mental Health Access Improvement Act (S. 1879/HR 3032) would include licensed mental health counselors and marriage and family therapists as eligible recipients of Medicare funding.More information here.Legislative Update – April 25, 2017
Reflections on the 2017 SessionThe 2017 legislative session concluded early Saturday morning after a marathon all night session. At the end of the day, the issues of medical cannabis oil and water quality threatened to hold up the conclusion of the legislative session. Legislators successfully reached agreement on the first but could not find common ground on the two water quality proposals. This session marked the first time in twenty years that all three branches of government were controlled by Republicans. Republicans pushed through major policy initiatives over the strong objections of Democrats, creating a somewhat acrimonious environment. In addition, Republicans faced a worsening budget situation and were forced to make reductions in the current year’s budget. The budget picture for FY 18 was no better and many programs saw reductions to stay within the statutory spending requirements.Perhaps the biggest success for IMHCA and the other targeted professions is the defeat of legislation to eliminate licensure. These proposals emanated from the governor’s office. The defeat of this legislation is a shining example of the power of grassroots. As we transition to a new governor, it will be incumbent upon us to determine if she carries the same opinion that Governor Branstad held. One thing is clear – legislators do not share his desire to eliminate licensure for marriage and family therapists, mental health counselors and social workers.FY 18 Health and Human Services BudgetThis budget, like all others, was not immune to reductions to adapt to the lowered revenue estimate. Some key provisions impact mental health services:- Eliminate the program to train psychiatric physicians’ assistants at the Cherokee mental health institute ($8,000)
- Eliminate the University of Iowa hospital primary care model for mental health treatment ($78,309)
- Suspend the medical residency program targeted at psychiatry ($2 million)
- Reduce funding to the autism/ABA program ($1.05 million)
Legislative Update – March 31, 2017
Under the Golden DomeThe Legislature concluded its second funnel week, a time when all policy bills must have passed one chamber and a committee in the opposite chamber to remain alive. This does not apply to budget and tax bills. And, as is always possible in the legislative world, procedures exist for bills or bill language to be resurrected. Nothing is truly dead until the legislature adjourns for the year.The next serious work for the legislature will be developing a budget to accommodate the reduced revenue available for the current fiscal year (FY 17) and the upcoming fiscal year (FY 18). The legislature will transfer funds from the cash reserve fund to balance the budget for FY 17. However, the statute requires this fund to be “replenished” in the next fiscal year. Governor Branstad has proposed doing this over a two-year period to reduce the pressure on an already dismal budget situation. As required by law, he submitted his revised budget proposal for FY 18 to reflect the lower revenue estimates announced two weeks ago. Legislative leaders are faced with a difficult task of finding reductions and have yet to release their own revised budget targets.Bills that Survived – 2nd FunnelHF 215: This bill requires state-regulated insurance plans to provide coverage for ABA treatment for autism consistent with the requirements already imposed on the state employee’s plan. IMHCA is registered in support of this bill. Governor Branstad signed the bill into law on March 30.HF 593: This bill gives mental health providers the authority to perform examinations and to involuntarily commit someone with a substance abuse problem. The authority is limited to the scope of licensure and authorization of each individual practice area. IMHCA is registered in support of the bill which has been sent to the governor for his signature.Bills that FailedSF 453: duty to warn law enforcementSF 477: Medicaid claim paymentSSB 1071: health care worker attraction and retention workgroupLegislative Update – March 3, 2017
Under the Golden Dome
The Legislature concluded its first funnel week, a time when all policy bills must have passed a committee in one chamber to remain alive. One of the most controversial bills, HSB 138 died a quick death after marriage and family therapists, mental health counselors and social workers, among others, raised serious objections to the elimination of their licensure.
HSB 174 was quickly introduced to place a one-year moratorium on new licensure categories and establishing a licensure review work group. This bill also failed to move through the process. However, legislators amended HF 229, originally a bill about electrician licensure, by striking the underlying language and inserting most of the language from HSB 174. However, HF 229 did not pass the House State Government Committee and the issue is dead for now. Keep in mind that reduction of licensure and oversight boards appears to be a priority for this governor. Until the legislature adjourns, nothing is officially dead.IMHCA Day on the Hill-March 13Are you attending the legislative day for mental health counselors on March 13? If not, please consider attending. This is a perfect opportunity for you to talk with legislators about your profession, the importance of a strong oversight and licensure program and how you serve mental health needs of Iowans. The day begins at 2:00 p.m. in the Legislative Dining Room at the Capitol with a briefing on the mechanics of talking to your legislator and the issues of the day. More information is available at https://imhca.net/upcoming-events/.Bills that SurvivedSF 75: This bill gives mental health providers the authority to notify law enforcement to protect the health and safety of a patient or a clearly identified victim. It also provides immunity protection for mental health professionals who do not provide this notice. IMHCA worked with the subcommittee to draft an amendment to clarify the situations in which such notification could occur and to provide immunity. IMHCA is registered as neutral on the bill. The Senate Human Resources Committee approved the bill.SF 342: This bill allows a 1 ½ % penalty to apply to all clean claims submitted to Medicaid for reimbursement that are past 90 days. Clean claims is defined as “all information required for processing the claim is included”. The bill was also amended to include language from SF 343 that allows up to one year to file Medicaid claims. IMHCA is registered in support of the bill. The Senate Human Resources Committee approved the bill.SF 400/HF 215: These bills require state-regulated insurance plans to provide coverage for ABA treatment for autism consistent with the requirements already imposed on the state employee’s plan. IMHCA is registered in support of both bills. The Human Resources Committees in each chamber approved these bills.SSB 1071: This bill directs the Department of Public Health to convene a workgroup and make recommendations on health care worker attraction and retention. IMHCA is registered in support of the bill. The Senate Human Resources Committee approved the bill.Bills that FailedSF 85: art therapist licensureSF 192: ABA licensureSF 254: provider ask about gun ownershipSF 255: provider ask about anything other than health and insuranceSF 286: restore reimbursement cut to community mental health centers and othersSSB 1160: telehealth insurance coverageSSB 1168: telehealth insurance coverageHF 319: mental health providers can do substance abuse commitmentsHF 342: mental health levy rate increaseHF 343: mental health levy rate increaseHF 348: telehealth insurance coverageHF 352: school suicide, trauma informed care trainingHSB 138: certificate of need/hospitals, licensure billHSB 174: certificate of need/licensure studyUPDATE ON HSB 138-Dead! – Feb. 28, 2017
HSB 138 is officially dead! Thanks to all of you who emailed, called and attended the subcommittee. Today, HSB 174 was introduced and includes a ban on any new licensure programs and establishes a licensure board programmatic review committee. It does not impact licensure for marriage and family therapists, mental health counselors or social workers. It does establish a committee to review and make recommendations for all professions that are required to have licensure. This is an opportunity for mental health providers to be involved in that process, and IMHCA will ensure its members are represented at that table! Know that your voices will continue to be heard!UPDATE ON HSB 138; Feb. 24, 2017
ACTION ALERT! Feb. 23, 2017
Attention Providers!
Your license to practice is currently under attack!
The Iowa Mental Health Counselors Association (IMHCA) has issued a call to action in opposition of HSB 138, a House Study Bill proposed by Governor Branstad that would take away a protection for Iowans as well as put Iowa last in the nation by removing licensure for the profession and eliminating the Board of Behavioral Sciences and the Board of Social Work.Below are several talking points for you to refer back on as you join IMHCA in reaching out to lawmakers and expressing your concerns for HSB 138.- Mental Health Counselors are licensed, not registered, in all 50 states as well as the District of Columbia. This provides us with the right to practice. One of the many challenges that professionals would face under this bill is the ability to move from this state to another without a license, and still be allowed to practice. Removing licensure would undoubtedly prevent the providers impacted by this bill from getting licensed in other states.
- Insurance companies and employers have requirements that mental health professionals are licensed. Tricare and the VA require Mental Health Counselors to be licensed at the highest level in their state. Getting rid of licensure will reduce the number of practitioners eligible to serve our veterans and other Iowans.
- Iowa already suffers from a shortage of mental health professionals. It is imperative that we continue to ensure access to qualified mental health professionals, including Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, and Licensed Master’s and Independent Social Workers.
- Regulatory boards, such as the Board of Behavioral Science and Board of Social Work, have the primary goal of ensuring protection of the public through setting and enforcing rules related to education, ongoing training, and upholding ethical standards. Numerous complaints are made annually regarding concerns from vulnerable Iowans about potential ethical violations ranging from professionals breaking trust by betraying confidentiality, taking advantage of someone financially, lying about claims, to having sexual relationships with clients. Licensure boards provide accountability for the profession as well as protection by ensuring those who commit violations are not able to practice or get additional training to demonstrate improvement.
1007 East Grand Ave. Des Moines, Iowa 50319
Phone: 515-281-5211
For more information on how you can get involved in IMHCA’s legislative efforts, click on ‘Events’, or send an email to government@imhca.net and let us know you would like to help!Respectfully,Kacey M. Peterson, MS, LMHCFeb. 18, 2017; Day on the Hill Advocacy Event
Join us at the capital on Monday, March 13th, 2017, starting at 2 PM! See additional details on our event page: https://imhca.net/events/day-on-the-hill/Legislative Update – February 3, 2017
Under the Golden DomeWe are four weeks into the legislative session that has largely been defined by divisive issues, lack of civility and general inability to come together for the good of Iowa. It is only destined to get worse as legislators settle school funding, make changes to collective bargaining and debate educational vouchers.The pace of work on other, less controversial, legislation, has been slow. Committees are routinely cancelled and the pace of bill introduction lags behind prior years. Legislators did resolve the necessary reductions in the current year’s budget to accommodate for a reduction in projected revenue growth. And, the Republican leadership in the two chambers reached agreement on school funding. This allows legislative leaders to move forward to put the FY 18 budget together. Revenues are also projected to be tight for FY 18 with approximately $178 in new revenue available after accounting for the built-in increases in the budget.Bills Of Interest Complete text of bills can be accessed at the following link: https://www.legis.iowa.govSF 75: This bill requires a physician to notify law enforcement of a potential dangerous situation with a patient with a mental health condition. IMHCA is registered as neutral on the bill and has raised concerns about what this is intended to accomplish and the potential to violate patient privacy. The bill was referred to the Senate Human Resources Committee.SF 85: This bill establishes a licensure procedure for clinical arts therapists and places them under the purview of the board of behavioral science. IMHCA is registered as neutral on the bill. The bill was referred to the Senate Human Resources Committee.SSB 1043/HSB 41: These bills expand the state employee insurance coverage for applied behavioral analysis for autism treatment. IMHCA is registered in support of both bills. The House Commerce Committee approved HSB 41. SSB 1043 was referred to the Senate Commerce Committee.IMHCA Government Relations Committee Update; March 2016
See the picture from our “Day on the Hill” and read this update in a nice format by clicking the link to the PDF at the bottom of this article!Summary of Public Policy and Mental Health Awareness EffortsMarch was a busy month for the Government Relations Team! On Monday, March 7th 2016, the Iowa Mental Health Counselors Association held its 8th annual “Day on the Hill” advocacy event at the Capitol in Des Moines. With increasing interest and concern about the current state of Iowa’s mental health delivery system, the event has steadily grown in popularity since its inception during the 2008 Regular Session. This year we welcomed the highest number of attendees to date, consisting of mental health counselors, marriage and family therapists, and over a dozen students from Drake University’s Mental Health Counseling and Rehabilitation Programs. Numbering over twenty, participants gathered for a short briefing by IMHCA and IAMFT state lobbyist, Emily Piper, to review the afternoon agenda and hear the latest legislative update before heading upstairs to meet individually with Senators and Representatives from both sides of the aisle.Focusing on members of the Senate and House Human Resources Committees, Majority and Minority Leaders, and a small number of legislators from various participant districts, our emphasis this year was placed on educating session leaders from both chambers by summarizing key legislative efforts, communicating individual and collective experiences related to the privatization of Medicaid services in Iowa, and showing appreciation for supported efforts and/or movement on IMHCA monitored legislation.As is sometimes the case (these things are often difficult to predict), many of our meeting requests were met with disappointment as attempts to successfully navigate around caucuses in both chambers proved difficult. In spite of the unforeseen barriers and unusually quiet Senate and House floors, attendees were able to speak at length with House Representatives David Heaton (R), Beth Wessel-Kroeschell (D), Zach Nunn (R), and John Forbes (D) along with Senate Republican Leader Bill Dix. Each was receptive and willing to listen openly to the group’s concerns, and although there were a few spirited disagreements about the handling of Iowa’s Medicaid privatization efforts, there seemed to be bi-partisan agreement that a certain level of DHS and IME oversight would be necessary as the state forges ahead with a looming April 1st implementation date.It was refreshing to see folks come together once again to rally for quality mental health services, higher industry-wide standards, and accountability by our leaders as we face an ever-changing mental health delivery system in Iowa. A special thank you to Emily Piper for her continued efforts on our behalf, fellow IMHCA board members who took time out of their day to join in our efforts, our colleagues at the Iowa Association of Marriage and Family Therapists, the instructors at Drake University for relaying to graduate students the importance of becoming active in local public policy and advocacy efforts, and the providers who were willing to come to the capitol and share their stories in an effort to help make our 2016 Day on the Hill a success! Finally, to the IMHCA members and conference goers whose contributions make our lobbying efforts possible, we could not do this year after year without you.The Government Relations Committee looks forward to getting your feedback at the IMHCA conference in April! We also encourage you to check out the mental health observance reminders coming up for the month of April!Respectfully, Kacey M. Peterson, MS, LMHC Government Relations Committee Chair government@imhca.net Mental Health Awareness Calendar Reminders March Re-cap: American National Nutrition Month; Employee Spirit Month; Developmental Disabilities Awareness Month; National Sleep Awareness Week® (Mar. 6-13); Brain Awareness Week (Mar 14-20) April Observances National Autism Awareness Month; Alcohol Awareness Month; National Stress Awareness Month; Premenstrual Dysphoric Disorder (PMDD) Month; National Minority Mental Health Month; National Counseling Awareness Month; World Health Day (Apr. 7) Sign up now for the 2016 IMHCA Conference! (April 11th and 12th)IMHCA Committee March UpdateLegislative news – 02/03/2016
Managed Care Organizations
Quick Update From Our Legislative Lobbyist
Wednesday, Feb. 3, we made some progress in working with IME on issues related to timely reimbursement and to credentialing. We are told that as of today, everyone should be up to date on reimbursements and that the “bugs” in the credentialing process are fixed.
Also, we have been told that for issues with the IME management of behavioral health to directly contact the individuals listed below:
For reimbursement issues: Sean Bagniewski: sbagnie@dhs.state.ia.us
For credentialing issues: Paige Thorson: pthorso@dhs.state.ia.us
Legislative news – 01/26/2016
Under the Golden Dome
The second session of the two-year legislative cycle is largely focused on quickly resolving school funding for the next fiscal year. The resolution of this issue is critical to determining the other parts of the state’s budget. Committees are beginning their work to move legislation forward in anticipation of the first legislative funnel deadline, February 19. By this time, a bill must have passed a committee in one chamber to remain alive. This deadline does not apply to budget or tax bills.
The Governor’s budget for FY 2017 recommends $1.3 billion budget for Medicaid, a $23.4 million increase over FY 2016’s estimated costs. This includes a supplemental of approximately $40 million for FY 2016 to fully cover all costs. The delay in the implementation of Medicaid managed care is reducing the amount of “savings” that were projected for the current fiscal year. The legislature based the FY 2016 budget on a $51 million savings from the move to managed care. However, that number is continually being reduced as implementation is delayed.
Medicaid Managed Care Update
At this point, the program is scheduled to be implemented beginning March 1. Wellcare has had its contract cancelled by the state, leaving three remaining companies. While the delay has not negatively impacted reimbursements for physical health claims, it is causing sizable problems for behavioral health claims. Legislators appear to be more focused on the “bigger picture” and lost in that is the impact that the lack of reimbursements have on those who serve patients.
We need to shift the focus on this so that legislators help us “push” DHS and IME to resolve this problem quickly. Please consider sending an email to your House and Senate members. Make these key points in your email:
1. Identify yourself as a constituent and mental health provider in the subject line of the email.
2. Outline the problems and delays you have experienced in receiving reimbursement from IME.
3. Outline what impact this could have on your ability to continue serving clients on Medicaid and on your business as a whole.
4. Ask that your legislator raise this issue with IME and push for a quicker response time with respect to reimbursement.
To find your legislators by using your address, use this link: https://www.legis.iowa.gov/legislators/find
Bills of Interest
HSB 502: This bill would require coverage for telehealth services (distinct from coverage of telemedicine) for employees on the state’s health insurance. Telehealth may include situations in which there is a cost incurred for the service but does not involve direct care of a patient by a medical provider. IMHCA is registered in support of this bill which is in the House Human Resources Committee.
SF 2032: This bill creates a process to allow mental health providers to more easily share mental health records with other providers. The goal is to more easily allow access by physical health providers of these records when treating patients. HIPPA protections are maintained. IMHCA is registered in support of this bill which is in the Senate Human Resources Committee.

