Public Policy & Legislation

The Department of Defense (DoD) has finally issued regulations allowing licensed professional counselors to practice independently within the TRICARE program, which provides health care coverage to more than 9 million military servicemembers, retirees, and their dependents.  DoD's regulations were released in the Federal Register of December 27, 2011, and take effect immediately. 

ACA has worked for years to establish independent practice authority for counselors, and the new regulation is an important step for the profession.  The regulation also establishes a transition period during which more flexible requirements will be in place, something that ACA has consistently pushed for.  However, not all licensed professional counselors will be eligible for independent practice authority under the new TRICARE regulation, and significant questions and concerns remain about how they will be implemented.  ACA will continue working to address these concerns and to push for recognition of all highly qualified licensed professional counselors.

During a transition period lasting until January 1, 2015, professional counselors at the independent level of licensure in their state may practice independently under TRICARE if they:

1)    Possess a master's or higher-level degree from "a mental health counseling program of education and training" accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and have passed the National Counselor Examination (NCE); OR

2)    Possess a master's or higher-level degree from a mental health counseling program of education and training from either a CACREP or regionally-accredited institution, and have passed the National Clinical Mental Health Counselor Examination (NCMHCE); AND

3)    Have at least 2 years of post-master's supervised practice including a minimum of 3,000 hours of supervised clinical practice, and 100 hours of face-to-face supervision.  This supervision "must be provided by a mental health counselor who is licensed for independent practice in mental health counseling in the jurisdiction where practicing and must be conducted in a manner that is consistent with the guidelines for supervision of the American Mental Health Counselors Association."

Beginning January 1, 2015, counselors seeking to participate in TRICARE (referred to as "certified mental health counselors" under the rule) will be required to:

1)    Pass the National Clinical Mental Health Counselor Examination (NCMHCE);
2)    Possess a master's or doctoral degree from a mental health counseling program accredited by the Council for  
       Accreditation of Counseling and Related Educational Programs (CACREP); and
3)    Meet the supervision hours requirements listed above. 

Beginning January 1, 2015, counselors who do not meet these requirements (and who have not already qualified as "certified mental health counselors" with TRICARE under the transition period rules) will not be allowed to provide services to TRICARE beneficiaries, even under physician referral and supervision.

It is not clear how the rule's requirement that degrees be awarded in a "mental health counseling program of education and training" will be interpreted, nor is it clear how DoD will verify that supervision is conducted in a manner that meet's AMHCA standards.  ACA will seek clarification on these and other aspects of the rules, and will be submitting comments to DoD prior to the comment deadline of February 27, 2012. 

Counselors are encouraged to read the regulations and provide comments as individuals.  For follow up questions for ACA, contact me at 800-347-6647 x234, or at sbarstow@counseling.org. 

Scott Barstow
Director of Public Policy & Legislation
American Counseling Association
ph  703-823-9800 x234 | 800-347-6647 x234
www.counseling.org

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