A bill to allow alcohol and drug counselors to bill Medicaid will help more people who struggle with substance abuse get back on their feet, lawmakers, state officials and advocates said Tuesday.
The House Human Services Committee is poised Wednesday to report H.69 to the floor favorably with an amendment.
The bill is a “way of addressing and attacking the lack of sufficient services and treatment for alcohol and drugs and opiates,” said Rep. Ann Pugh, D-South Burlington, the committee’s chair.
She said it will help more people get counseling, which complements treatment with medication. The state’s hub and spoke opiate treatment program requires patients, whether they visit regional methadone clinics or doctors’ offices, to receive counseling in addition to medication.
The bill would allow private-practice licensed alcohol and drug counselors to bill Medicaid and insurance companies, Pugh said, and enable the state to collect more accurate data about the number of people who struggle with substance abuse. The legislation is sponsored by Reps. Lynn Dickinson, R-St. Albans, Tom Koch, R/D-Barre and John Moran, D-Wardsboro.
Before voting on the bill, the committee took testimony from state health officials, private insurance companies, advocates and others.
“Clearly we recognize that there’s a need,” said Aaron French, deputy commissioner of the Department of Vermont Health Access. “Counseling is essential to treatment.”
The Vermont Council of Developmental and Mental Health Services opposes the bill. Julie Tessler, the council’s executive director, says the counselors do not have enough education or supervision at private practices.
“We do acknowledge that there is a need for additional workforce to meet the current demands for substance abuse expertise. One avenue to achieve this is to look at easing the process for mental health professionals to achieve dual certification,” Tessler said in written testimony from Jan. 22.
The counselors must meet licensing requirements, outlined during testimony by the Division of Alcohol and Drug Abuse Programs.
Bill Keithcart, board president of the Vermont Addiction Professionals’ Association, said the bill is a much-needed change to the law.
“It would just open up more services to those who are looking for substance abuse disorders,” Keithcart said.
There are 383 certified counselors in Vermont, Keithcart said. Of those, 129 have dual licensure as a social worker or mental health counselor. In addition, 228 people are seeking substance abuse counseling certification in Vermont, he said, quoting state statistics. State officials Tuesday did not respond to requests to verify the numbers.
Because the certified counselors can’t bill Medicaid, those who are dual-licensed as a mental health or social worker will often instead bill Medicaid for a mental health diagnosis, such as anxiety or depression, he said.
That results is misclassification of patients, because their condition is listed first as a mental health condition with substance abuse as a secondary diagnosis.
That means the state’s Medicaid data shows an inflated number of mental health patients, when in fact many of those people only have substance abuse problems, he said.
French said this bill will likely mean an additional cost to Medicaid for new patients who will now be able to receive drug and alcohol counseling. He did not provide a specific figure.
“The potential cost is outweighed by the benefit of people being able to work, people dealing with their addiction, people not moving from low-level alcohol and drugs to opiates,” Pugh said.
