The list below highlights bills passed by the Maryland General Assembly during the 2020 Legislative Session which was cut short due to the current health crisis. As of this posting date, all bills are currently awaiting the Governor’s signature before becoming law, with the exception of HB 1663/SB 1080, which Governor Hogan signed on March 19, 2020. Due to the current health crisis, the Governor has been unable to attend to bill signings.
As passed by the legislature, the budget includes a 4% Medicaid provider rate increase for behavioral health services, starting July 1, 2020.
The legislature passed three telehealth bills impacting behavioral health services:
Behavioral Health in Schools
By Susan Roistacher LCPC
1. In the Maryland General Assembly:
LCPCM’s lobbyists and Legislative Chair cull through all proposed legislation each year to identify bills that impact our practice and our clients. In 2018, we reviewed almost 80 bills and testified on 15, including bills affecting Medicaid and teletherapy regulations. Most significant this year was our participation in the 10-year Sunset Review of the Board of Professional Counselors and Therapists. The legislative Sunset Review of the Board resulted in 2 years of legislative oversight and 33 mandates for improvements.
2. With the Board of Professional Counselors and Therapists (BOPCT):
LCPCM makes a concerted effort to stay abreast of Board actions and decisions by attending monthly meetings and addressing the Board on specific topics. We provide information and assistance whenever possible. LCPCM shares your requests, complaints, and suggestions for change. This year, we discovered that it is more effective for LCPCM members to contact the Board directly by email, in addition to contacting LCPCM. We encourage you to share your concerns with the Executive Director, Kimberly Link, at: email@example.com. Please be sure to also copy me, Susan Roistacher, Legislative Chair at: firstname.lastname@example.org. I want to know your concerns, so we can offer support when needed and can advocate more effectively. The following is a list of some LCPCM 2017-2018 advocacy projects related to the BOPCT:
3. On state healthcare regulation and planning workgroups:
As representatives of LCPCM, our members and lobbyists monitor and participate on interagency state committees, public advocacy groups and behavioral health coalitions. These groups generate new ideas for legislation and regulations that effect mental health treatment services in Maryland. For example, member Angela Mazer, LCPC serves on the Children’s Behavioral Health Coalition (CBHC). The Children’s Behavioral Health Coalition (CBHC) brings together a range of advocacy groups with a focus on policy issues and concerns specific to children and youth with behavioral health needs and has produced a 2019 Legislative Agenda. Other groups include the MD Health Insurance Protection Commission (Robyn Elliot, lobbyist) and monitoring the MD Medicaid Advisory Committee (Rachel Faulkner, lobbyist).
4. With National organizations:
1. The LGPC Committee: LCPCM formed a LGPC committee co-chaired by members Robert Castle LCPC and Katy Schaffer PhD. It is creating a guidebook designed to help LGPCs navigate the often confusing and somewhat arduous road to licensure. The guide should be available this Fall. The committee members are LGPCs who provide valuable information to LCPCM, to better serve their needs.
2. Conferences: We offer two full-day conferences a year for CEU’s at a discounted for members. LCPCM works hard to contract with well-known professionals who can provide informative and stimulating trainings. Our networking luncheons are included as a special benefit to our members who continue to support all the work we do.
3. Supervisor Trainings: LCPCM is the main provider of supervisor training for LCPCs and others in Maryland. This 18- hour CEU training is offered 3-4 times a year and fulfills the training requirement for clinicians to be approved by the BOPCT. Marsha Riggio, LPC, PhD teaches the training and consistently gets rave reviews.
4. Committed Professionals: Once an all-volunteer association, today LCPCM has a professional lobbying group (Public Policy Partners) and a webmaster (Debbie Hastings-DesignMe Creative). We also have a business administrator, Sharon Nalley, who has been with us for a year. She is an experienced financial bookkeeper who can professionally handle our increasing volume of diverse activities including registrations and CEU certificates.
5. Supervisor/Supervisee Connection: The LCPCM website has an on-line service to help LGPCs find the supervisor who best meets their needs. It has information about the prospective supervisor’s background, experience, and specialties. The BOPCT’s website lists approved supervisors, but only provides contact information. This service is the brainchild of Robert Castle, LCPC, PhD who designed and implemented the project.
6. BOPCT Nominations: LCPCM nominates members to serve on the BOPCT and submits them to the Governor’s office. We are pleased that over the years, many of our members have been selected and served.
7. Parity: Professional parity is an LCPCM priority. We work toward parity legislatively, but also in the community. If requested, LCPCM will assist members confronted with workplace discrimination based on the LCPC title. Members are encouraged to contact us if you need support or intervention on your behalf.
LCPCM and National Association of Social Workers-Maryland Chapter have joined together to introduce a bill this session of the Maryland General Assembly that would require Medicaid to reimburse Medicaid behavioral health providers for what will be called “telehealth” services. Senator Kathleen Klausmeier will sponsor the bill in the Senate and Delegate Sheree Sample-Hughes will sponsor the bill in the House of Delegates.
Use the link below to view the PowerPoint presentation from the LCPCM Legislative Seminar held on 5/9/17.
HB 245 (SB 310) Support
Child Abuse and Neglect - Failure to Report
Del. Kathleen Dumais et al.
HB 579 (SB 858) Support
Mental Health - Wraparound Services for Children and Youth
Del. Samuel Rosenberg et al.
HB 595 (SB 497) Support
Behavioral Health Community Providers - Keep the Door Open Act
Del. Antonio Hayes et al.
HB 682 (SB 551) Support
Department of Health and Mental Hygiene - Clinical Crisis Walk-In Services and Mobile Crisis Teams - Strategic Plan
HB 802 Support with Amendments
Health Insurance - Provider Panel Lists
Chair, Health and Government Operations Committee et al.
HB 944 Oppose
Criminal Law - Professional Counselors and Therapists - Misconduct (Lynette's Law)
Del. David Vogt et al.
HB 984 (SB 17) Support
Open Meetings Act - Retention of Minutes and Recordings - Revision
Del. Sid Saab et al.
HB 1103 Support with Amendments
Health Care Practitioners - Use of Teletherapy
Del. Kirill Reznik et al.
HB1217 (SB899) Support with Amendments
Maryland Medical Assistance Program-specialty mental health
HB 1318 (SB929) -Support
Network Access Standards and Provider Network Directories
HB 1437 – Support
Education- Individualized Counseling Services-Requirements
HB 334 – Support with Amendments
Access to accurate provider directories
Thus far, LCPCM is supporting the following two bills in the Maryland General Assembly and urge you to contact your Delegates and Senators to do the same. You can find the information you need to make these contacts by going to the Maryland General Assembly website (http://mgaleg.maryland.gov)
1. The Keep the Door Open Act (SB 497 / HB 595), will improve access to care by ensuring that our community behavioral health providers have the resources necessary to treat those in need. The Senate bill was introduced with 27 co-sponsors and is scheduled for a hearing later this month. The House bill will be heard in the Health and Government Operations Committee next week!
2. These bills that were introduced last week (SB 551 / HB 682) will require the Department of Health and Mental Hygiene to work with other stakeholders in developing a plan to ensure that walk-in and mobile behavioral health crisis services are available to Marylanders across the state. This walk-in capacity is critical. In places that have implemented highly efficient crisis response systems – both in Maryland and throughout the United States – a central hub, operating 24/7, where individuals in crisis and their families can go without an appointment, is a key to success.
Dear Maryland Mental Health Counselor Community:
I know that I have bombarded you with pleas and special requests this summer, but this one is my most impassioned plea to you for assistance.
Contrary to what any of us would believe was possible, we now have sister groups of mental health counselors sympathetic to the CACREP only perspective, in different parts of the country, lobbying members of Congress to deny mental health counselors who graduated from non-CACREP and counseling psychology programs (with five years experience) the automatic right to practice in TRICARE, as proposed in a revision to the National Defense Authorization Act (NDAA).
As you can imagine this is a very concerning development, as it gives the false impression that concerned mental health counselors are decrying the practice of unqualified mental counselors, who are identified by their graduation from "unaccredited" or non-CACREP schools. I confess that it is surreal and disconcerting to read these communications to Congress and to see counselors trying to undermine the careers and livelihoods of their fellow counselors. Nothing can be more distressing to witness than this.
Many of these commentators are trying to spin the false narrative that allowing non-CACREP counselors to practice in TRICARE will prevent all counselors from ever practicing in MEDICARE. There is no connection between TRICARE and MEDICARE in current bills before Congress and to suggest this connection is misinformation.
I need every non-CACREP counselor in Maryland to write a short email through the following link (that contacts the entire Maryland Congressional delegation) in order to explain your exceptional competence as a mental health counselor from a non-CACREP school and to ask our Maryland representatives to support the revision in the NDAA that gives all mental health counselors with 5 years experience the right to practice in TRICARE. If you write a sentence, a few sentences, or a paragraph, your email will make a difference, however short or long.
I wish I had the wisdom to explain to you why our sister associations are trying to harm us rather than reaching out in support. However, I believe our kindness and respectful advocacy will inevitably win out over the hurtful behavior that is being directed against us. I believe our greatest enemy is not those who attack us but the indifference of the overwhelming majority who know what is happening is wrong and choose to do nothing. If every counselor in Maryland stands up for what is right, we will prevail against this undeserved threat to our practice rights and mischaracterization of our competency.
Please take a moment to voice your opinion to the Maryland Delegation in Congress by sending your email to the link below:
The distribution list address is:
This is being sent to:
Jean Doyle - Legislative Director for The Honorable Barbara A. Mikulski
Tommy Bredar - Legislative Correspondent for The Honorable Benjamin L. Cardin
Priscilla Ross - Legislative Director for The Honorable Benjamin L. Cardin
Jodi Schwartz - Legislative Assistant for The Honorable Benjamin L. Cardin
John Dutton - Legislative Director for The Honorable Andrew P. Harris
Walter Gonzales - Legislative Director for The Honorable C.A. Ruppersberger
Raymond O'Mara - Legislative Director for The Honorable John P. Sarbanes
Christopher Schloesser - Legislative Director for The Honorable Donna Edwards
Jim Notter - Legislative Director for The Honorable Steny H. Hoyer
Suzanne Owen - Legislative Director for The Honorable Elijah E. Cummings
Sarah Schenning- Legislative Director for The Honorable Christopher Van Hollen
Xan Fishman - Legislative Director for The Honorable John Delaney
McKenzie Haynes - Military LA for The Honorable John Delaney
Thank you again for your assistance.
On Monday, the 22nd, a Congressional Conference Committee met to decide whether ALL Mental Health Counselors will be able to see TRICARE beneficiaries, irrespective of whether they went to a CACREP School. The American Counseling Association advocated for a special provision in the National Defense Authorization Act that would grandfather ALL Mental Health Counselors as independent providers who possess 5 years of clinical experience. This grandfathering period would last 10 years.
This is a VERY IMPORTANT precedent and I am asking every member to take a moment to send an email to a specially created listserve below that emails every legislative director involved in the conference committee. I need you to write a brief statement telling Congress why CACREP should not be used as the sole criterion to select providers for TRICARE. I fear if we do not stand strong now, the use of CACREP as a selection criterion for insurance reimbursement will seep into MEDICARE and other insurers.
It is a heavy burden to serve as President of our state association while knowing that many of us could face employment and insurance discrimination in the future if we do not act concertedly now to address this threat. I want to do everything possible on my watch to stand up for our profession in Maryland, but I need your help. Thank you for taking a moment to email these legislative staffers. You could make a difference in securing the profession we love into the future.
Larry Epp, President
Dear Fellow Maryland Counselors:
The Virginia Board of Counseling wants to restrict the practice of counseling in the Commonwealth within a ten year time frame to only counselors who graduated from a CACREP accredited graduate program. While in fairness to their proposal, they offer grandfathering to licensed counselors in other jurisdictions. We, however, are concerned about three possible ramifications of this regulatory change:
It creates the impression that graduates of non-CACREP and Counseling Psychology programs are in some way inferior; and we are concerned about how insurance companies may capitalize upon this distinction, as has already occurred with TRICARE reimbursement and Veteran's Administration employment.
Master Degree Recipients in Counseling Psychology, Clinical Psychology, School Psychology or various Expressive Therapies will not likely be licensable in Virginia as counselors, even if they are licensable in Maryland. They would first need to be licensed in Maryland, even if they graduated from a Virginia university unaffiliated with CACREP.
The proposal engenders hard feelings between the states as Virginia is instituting a standard that the graduates of many Maryland non-CACREP schools will never be able to achieve (Most Maryland schools are currently non-CACREP), thus they will be denied employment opportunities in Virginia. Whereas Virginia CACREP graduates will be able to freely seek employment in Maryland and Virginia (Most Virginia schools are CACREP). In a regional economy, where the ability to compete for better employment is important, Virginia CACREP programs are giving themselves an unfair advantage in the counselor employment market.
If the Virginia Board of Counseling adopts a CACREP only standard, it is preempting a needed national dialogue on how to creatively include all quality training programs in a national accreditation standard, whether CACREP's or the emerging MCAC's (a newer counseling accrediting body). CACREP has not established that its graduates yield superior clinical outcomes. In fact, the Institute of Medicine Study on Mental Health Counseling in TRICARE could not discern a difference in clinical outcomes between mental health professionals trained at the masters and doctoral levels. What CACREP offered was a consistency of standards across states for TRICARE credentialing, which we agree is necessary, but CACREP need not be the only organization that can insure this consistency in the future.
The Licensed Clinical Professional Counselors of Maryland (LCPCM) is disappointed that Virginia CACREP Counselor Educators cannot supportall counselors and all quality counselor preparation programs. The heart of the counseling profession is empathy, tolerance, and the creative development of solutions. There is a place in our profession for all counselors, CACREP and non-CACREP, Counseling and Counseling Psychology; and the mission of the Virginia licensure board should be to find that inclusive place.
Please tell the Virginia Board of Counseling and Virginia's governor that a CACREP standard for licensure is not an appropriate standard at this time.
Larry Epp, EdD, LCPC
President, Licensed Clinical Professional Counselors of Maryland
Susan Roistacher, LCPC - Legislative Chair
Several bills were proposed this year in the Maryland General Assembly of interest and importance to LCPCs. They affected the powers and requirements of the Board of Professional Counselors and Therapists and LCPC practice. Although many other bills of interest to LCPCs were proposed concerning such issues as mental health, health insurance, child abuse, sexual assault and domestic violence, this summary is limited to an overview of bills specific to the LCPC profession. Particular attention was paid to bills that included or excluded LCPCs.
HOUSE BILL 33 – PROFESSIONAL COUNSELORS –CONDUCT
(ALSO KNOWN AS LYNETTE’S LAW) - DEFEATED
House Bill 33 required strong action by LCPCM and its members. We are very pleased to inform you that we were successful stopping this bill in the Senate.
House Bill 33 discriminated against LCPCs and the other professions licensed by our Board of Professional Counselors and Therapists. Its objective was to stop “therapist sexual abuse” by making it a crime, but focused only on Professional Counselors. The genesis of this bill began last year, when a client of an LCPC was dissatisfied by the Board’s disciplinary action against her therapist. The Board allowed the therapist to voluntarily surrender his license after admitting in writing to engaging in a sexual relationship with the client. The client wanted more severe punishment for her therapist and approached Delegate Smiegle to submit a bill last year and again this year to make this behavior a crime, rather that a civil disciplinary matter.
Last year, and again this year, we offered to support the bill in the House, if it applied to all licensed mental health practitioners and not just Professional Counselors. Last year our amendments to include psychiatrists, psychologists, social workers, and psychiatric nurses were included and passed in the House only to be killed in the Senate Judicial Proceedings Committee. This year, our amendments failed, and the bill still passed in the House of Delegates. We strongly opposed the bill without our amendments and it fortunately died for a second time in the Senate Judicial Proceedings Committee.
The other mental health professions lobbied that their ethics and civil disciplinary measures are sufficient to deter this behavior. They strongly opposed making sexual acts with a client/patient a criminal offense. We argued that it was unconstitutional and discrimination to make a sexual act with a client a crime for just one group of professionals and not for all professionals who diagnose and treat mental and emotional disorders.
SB 607 Child Abuse and Neglect-Failure to Report and training – Defeated
LCPCM submitted written testimony opposing this bill which would have required all new and renewing health care licensure applicants to take a child abuse training every two years. In addition, it made it mandatory for the licensing boards to remove a healthcare provider’s license for failure to report child abuse. LCPCs are healthcare providers and therefore were affected by this bill. Although we supported the intent, we objected to the solutions.
We told the Senators that HB 607 requires the investigative agency to file a complaint to the Boards for “failure to report suspected abuse or neglect”. “Suspected abuse or neglect” is not defined. The child abuse reporting laws allow the clinician to violate the patient’s confidentiality when the clinician suspects that child abuse or neglect is occurring. The ‘suspicion” is in the mind of the clinician. The decision to breach the confidence of a patient based on a suspicion belongs to the clinician. Not every clinician will come to the same decision given the same circumstances.
HB1193 Task Force to Study Implementation of Strategies for Preventing Sexual Exploitation of Clients by Health Professionals (Smigiel) - Defeated
LCPCM supported this bill for two reasons. One was that we were specifically included on the Task Force. The other was because we know the discriminatory issues of HB33 (Lynette’s Law) will come up again next year.
HB841 State Board of Professional Counselors and Therapists and State Board of Social Work Examiners – defeated
LCPCM was neutral on this bill which specified language changes in our law regarding the denial of licenses to applicants who were sex offenders, guilty of crimes of moral turpitude, or guilty of a felony. We believe our law already states this in broader language and that the bill was unnecessary.
HB150-Maryland Behavior Analyst Act - Passed
Behavior Analysts are master’s level professionals who develop behavioral plans mostly for children and adults suffering with autism and dementia. They are not clinicians and do not treat individuals with mental and emotional disorders. This group and their clients sought licensure in order to be insurance reimbursable. BOPCT supported it and worked on the amendments. The Behavior Analyst will now have a license and will be regulated by a Committee under the administration of the Board of Professional Counselors and Therapists. They will not have a seat on our Board.
HB112 and SB448 - State Board of Professional Counselors and Therapists-Cease and Desist Orders and Penalties for Misrepresentation and Practicing without a license - Passed
LCPCM wrote testimony in support of this bill which puts some real clout in the Board’s ability to take action against people who misrepresent themselves as professional counselors and/or practice without a license. They have complained for years that they had little recourse in these situations. The Board will now be able to impose a fine up to $50,000.
SB 784 – Education-Loan Assistance – Professional Counselors and Alcohol and drug Counselors - passed
LCPCs, LCMFTs, and LCADC are now among the listing of professionals who are eligible to receive assistance from the Janet L. Hoffman Loan Repayment Program for graduate program tuition if their practice is in a high need geographic area of the State.
SB 803/ hb641 Courts and Judicial Proceedings – Communications Between Patient or Client and Health Care Professional-Exceptions to PRIVILEGE - passed
LCPCM wrote of letter of support for this bill which included LCPCs along with other mental health practitioners. This bill waives the client privilege if the clinical information is needed to support the provider in pursuing legal actions if the client presents a danger to the provider.
SB 882 Assertive Community Treatment (ACT) – Targeted Outreach, Engagement and Services (PUGH) –passed with significant amendments
LCPCM submitted written testimony in support of this bill with amendments to include LCPCs on the ACT team. The bill that passed established a committee to make recommendations to the General Assembly next year. The effort and focus is to provide crisis intervention and on-going services to the chronically mentally ill and potentially dangerous populations.
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