Are we One in our acceptance of the impact of the Affordable Care Act (ACA) on the way clinical mental health counselors will be working a decade from now?
First let’s look at the ACA so that we can become one in our understanding and acceptance of the reality that it will bring to our profession. The ACA was signed into law to reform the health care industry by President Barack Obama on March 23, 2010 and upheld twice by the Supreme Court on June 28, 2012 and on June 25, 2015. It is "the law of the land,“ even though many people would like to see it repealed and are still not willing to accept it or refine it The ACA’s official name is the Patient Protection and Affordable Care Act (PPACA). It is also commonly referred to as Obama care, health care reform, or the Affordable Care Act (ACA). By April 19, 2014, 8,019,763 had enrolled in the ACA which represents 28% of those eligible for coverage under the ACA. By end of enrollment period in 2015, 11.7 million were enrolled in state and federal marketplaces. Also 10.8 million were covered through Medicaid and CHIP and 5.7 million were able to stay on their parents’ plan. It does appear that the ACA is here to stay. So how does it affect Clinical Mental Health Counselors both in private practice as well as in public, non-profit and private provider organizations?
I had the great pleasure at the 2015 AMCHA Conference in Philadelphia, of hearing Monica Oss, the CEO of Open Minds who consults with health and human service organizations around the country. I was so impressed that I contacted her to let her know that my hope was that we could get more information from her. Luck had it that the editor of the new AMHCA Advocate (in magazine format) had already arranged for her to post an article in it, which appeared in the August 2015 edition.
Monica Oss presented in that article a great list of tools which CMHC’s need for success in the next 10 years due to the changing market place post the Affordable Care Act. They included:
- Knowledge of and ability to use new treatment tools-genetic, diagnostic, disease statement management, neurotech, pharmaceutical etc.
- Ability to use new tools and techniques for consumer engagement and “whole person” health management.
- Ability to use electronic health record (EHR) data and clinical decision support tools (this is common in service provider organizations but not as common in private practice settings)
and for those CMHCs who are employed by service provider organizations
- Ability to work as part of a medically oriented clinical Team
In other words Oss is telling us that we CMHCs need to become One on Integrated Medical Teams. Are we CMHC’s ready to be One with Integrated Medical Teams?
My hope is that by your participating in the AMCHA Connections, Integrated Medicine Community and by utilizing the AMHCA webinars on Integrated Primary Care you all will be better able to feel One on integrated medical teams.
To meet some of the needs which Monica Oss identified we want you to be aware that there are exhaustive lists of materials aimed at helping CMCH become effective Behavioral Health Consultants in integrate primary care on my website.
1. Assessment Measures: On the “Clinical Assessment Tools” page at: http://www.coping.us/cliniciantreatmenttools/assessmenttools.html are measures which are free and downloadable. Most are very short and take less than 10 minutes to administer. They can be read to patients and then their answers can be written down if needed. The majority of the measures specific to healthcare are promoted by SMHSHA and its sponsored related organizations including the PROMIS and PHQ measures.
2. Tools for engaging the whole person’s health management: There are three places where such tools are available:
A. “Clinician Worksheets and Handouts” page at: http://www.coping.us/cliniciantreatmenttools/worksheetsforclinicians.html which contains copious lists of free downloadable clinical tools to help with psychoeducation of patients to focus on their optimal health.
B. “Integrated Primary Care Tools” page at: http://www.coping.us/behavioralmedicine/integratedprimarycaretools.html which contains links to three specific psychoeducational programs to use with patients. These programs: The SEA’s Program; Balanced Lifestyle Program and Strategies for Success in Health Management all contain powerpoints, handouts and other tools which CMHC’s can personalize as their own to use with patients in primary care or other community settings.
C. "“APPs that Work! For Clients and Practitioners” page at: http://www.coping.us/cliniciantreatmenttools/appsthatwork.html which contains information on free apps which clients can use to enhance their physical and metnal mental health.
3. Tools for being an effective member of a medically oriented clinical Team: The entire Behavioral Medicine Section at: http://www.coping.us/behavioralmedicine.html contains loads of free materials which include case studies, video lectures, references on research into behavioral medicine interventions and the language and approach that mental health professionals need to adopt so as to become One on the Integrated Medicine Team.
4. Using Evidence Based Treatments when in the integrated medicine setting: An additional issue which CMHCs will need to concentrate on is the notion of joining the "medical model" means just like the doctors of medicine CMHCs need to demonstrate that the tools, treatments and therapy they are offering patients have a proven research effectiveness. For this reason, although many counselors are very resistant to using Evidence Based Practices (EBPs), when working in the medical setting it becomes imperative. For this reason I developed an online book: "Evidence Based Practices for Mental Health Professionals" available free at: http://www.coping.us/evidencebasedpractices.html . It is imperative that CMHCs work at expanding their repertoire of EBPs and be able to demonstrate to their integrated medical team that they utilize only those interventions with patients which have solid research backing.
My hope is that you read Monica Oss’s article and give a close look at the materials available for you on the above links. We want to equip all of you to become ready for the seismic changes coming into the professional world of Integrated Medicine and we want our CMHC’s to be able to be equipped to enter this world in a comfortable sense of being One with it.
So we move on to become One in our pursuit of legitimacy for being members of Integrated Medicine teams.
Reference: Oss, M. (2015). The Advocate, 38(6), p.8-12.