True or False
1. LCPCs are not reimbursable?
2. LCPCs cannot supervise LCSWs
3. LCPCs are not MaineCare reimbursable?
4. LCPCs can NEVER see Medicare clients?
5. Only LCSWs can work in Integrative Health Care offices.
6. Only LCSWs can be school social worker.

All of the answers are FALSE.

I am hoping that you Aced this quiz but guess what? In the past year, these are the reasons LCPCs, LCSWs, Psychologists, agencies and medical facilities have told me why LCPCs are not being hired. Some hospitals and agencies actually have prohibitions against hiring LCPCs, citing these reasons. I should be grateful that we’ve moved past the qualification issue and really, this is what is so disturbing. The issue is not qualification, it is misinformation around reimbursement and supervision.

So please allow me to clarify the above issues.

1. LCPCs are, in fact, reimbursable with almost every insurance.
The reimbursement issues are specific to Medicare and TriCare. Both of these are federally regulated and currently there are bills in legislation to include mental health counselor in Medicare which will solve the problem. TriCare has already included mental health counselors but having trouble with reimbursement.

The reason LCPCs are NOT Medicare reimbursable is national politics…. In some cases, waivers are available so that LCPCs can see Medicare clients but agencies must be willing to do a little extra work to make this happen.

When I ask agency HR, financial leaders and CEOs how much of their actual income is from Medicare and TriCare, the average answer is under 2%. So really, LCPCs are not being hired because this issue is confusing and it is easier to say NO than do the extra work.

2. It is true the LCPCs cannot supervise conditional social workers for hours of experience toward licensure per licensure regulations. After a social worker is independently licensed, there are no provisions around who can provide general consultation and supervision. LCPCs can provide quality supervision for LCSWs. They can also provide supervision for LMSWs but not for hours toward licensure.

3. LCPCs ARE MAINECARE providers. And LCPCs are taking the financial hits right along with all other mental health clinicians.

4. LCPCs in some situation can see Medicare clients.
There is a waiver that can be used when a) there is not social workers to provider services or b) there is a specialty that only the LCPC can treat. I have had several agency folks tell me that the waiver was discontinued so I called myself and learned that this is NOT TRUE. The reasons LCPCs have been denied are 1. The paperwork is wrong or 2. the clinician or agency filed the waiver not the client. MISINFORMATION

5. LCPCs can work in integrative health. I am unsure where it was decided that LCPCs can’t do integrative health work. When I inquire about why “LCSW only job requests”, the answer I get it is “The Behavioral Health Specialist position that we have available requires the LCSW licensure only”. WHY I ask WHY? Who made this rule? Based on WHAT criteria? Medicare again?

Because less than 2% of clients/patience are Medicare LCPCs are prohibited?

6. When schools are looking for “school social worker” LCPC are equally as qualified to serve. Often, educators do not know the difference between LCSW and LCPC so when they see the words “school social worker” it is taken literally. It is important to be educating HR and school personal and decision makers about the different mental health options.

So I have had the opportunity to talk with MANY, MANY, MANY social workers about this issue. They are not happy either because on the flip side, they feel discriminated because the LCPCs are getting the good jobs and LCSWs have to see the Medicare and TriCare only.

We need to work together. Until the Medicare issue is resolved federally, we, ALL, clinicians in Maine need to rally so LCPCs and LCSWs can develop the best working conditions for ALL mental health consumers. WE NEED TO STEP UP AND STOP BEING THE PROBLEM. When we are not proactive, we are reactive, thus creating the problem.

What next?
1. Serve on a strategizing committee. We originally established a collaboration committee between Maine Counseling Association and Maine Mental Health Counselors Association to explore these issues. Only a few people have remained focused so we are again trying to develop a strategizing committee including social workers.
2. SPEAK UP. When someone tells you that an LCSW or LCPC can’t apply or can’t do the work, be CURIOUS. Don’t rely on misinformation. We all need to get educated and be asking why or why not. “Just because” or “they are not reimbursable” are not acceptable responses.
3. Respond to the LCSW only ads. Again, be curious and ask why LCPCs are not eligible. I have had the good fortune to be able to educate and bring awareness to many hiring groups and they have even reposted the positions. Thank you if you are one of those people.
4. Begin to advocate for the profession at large and eliminate the professional silos. We have way more power when we stand together. As we all have been hit by the MaineCare changes, one large voice is way better than a bunch of small ones.
5. PLEASE SHARE THIS LETTER WITH PEERS AND COLLEAGUES.

We are not in a war so let’s stop the battle and work together. We need each other and I suspect the mental health climate is going to become more complex. It is important to let go of the excuse “Medicare” and start educating for collaboration.

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