LB 344 – Change credentialing and regulation of mental health substance abuse centers

Good morning, Chairman Riepe and members of the HHS Committee.  My name is Nicole Fox and I am the Director of Government Relations for the Platte Institute.  Thank you, Senator Albrecht, for introducing LB 344.  I am here today to testify in support of this bill.

Mental illness is prevalent amongst all age groups and socioeconomic statuses.  The National Alliance on Mental Illness reports that it affects 1 in 5 Americans, and about half of all Americans will experience a mental health problem at some point in their life.  Half of mental health conditions begin by age 14, and 75% of mental health conditions develop by age 24.  According to the American Academy of Pediatrics, mental and behavioral health is the largest unmet health need for children and teens in foster care. 

UNMC’s Behavioral Health Education Center of Nebraska cites that there are some parts of the state in which there is no access to mental health practitioners for literally hundreds of miles. When it comes to mental health, rural patients typically are much sicker. They don’t have access to the type of mental health care that someone would receive in Omaha.  Rural Nebraska is also battling a major methamphetamine problem – methamphetamine addiction brings with it many serious mental health consequences.  88 of Nebraska’s 93 counties are recognized as mental health professional shortage areas by the U.S. Health Resources and Services Administration

Regardless of the age of diagnosis, early engagement and support are crucial to improving outcomes and increasing the promise of recovery.  Behavioral health care is changing.  As a nation, we have moved away from providing care in institutions and psychiatric hospitals toward an approach that supports people with behavioral health needs in their community, close to the support of family and friends.    

Currently, Nebraska law requires persons desiring to become a Licensed Independent Mental Health Practitioner to have completed at least a Master’s degree that is primarily therapeutic mental health in content and have completed at least 3,000 hours of post master’s supervised experience in mental health practice.  These 3000 hours must be supervised by a licensed physician, a licensed psychologist, or a LIMHP and must be accumulated not less than 2 years nor more than 5 years after completion of the master's.  This creates undue hardship for those who can earn hours in less time or for those who make take more than 5 years to earn the hours.  For persons wanting to become a Licensed Alcohol and Drug Abuse Counselor in Nebraska, 6000 hours of supervised drug and alcohol counseling work experience is needed – if the individual has completed a Master’s degree with an emphasis in counseling, addictions, social work, sociology or psychology, the degree substitutes 4000 of the hours required. 

Occupational licensing laws were initially created as a means of protecting the public from negligent and unqualified practitioners, but more and more, an unintended consequence is that occupational licensing is making it difficult for new workers to enter the workforce.  We are seeing this in Nebraska.  Requirements for mental health practitioners and substance abuse counselors are unjustifiably more onerous in Nebraska than in other states.   During the 2016 legislative session, a hearing took place to discuss the shortage of mental health professionals in our state, and testifiers noted that due to the very steep and strict requirements to obtain provisional licenses, graduates were leaving the state in search of work in states where licenses were granted with fewer restrictions.

LB 344 provides alternative methods to obtain a Mental Health Practice License or an Alcohol and Drug Counseling License in Nebraska through reciprocity by recognizing licensure and other requirements from other states.  It includes additional degrees or substantially equivalent degrees to be considered acceptable for licensure as a mental health practitioner.  Currently an applicant for a provisional license must identify his/her supervisor at the time of application.  This bill will allow an applicant to obtain the provisional license and then seek employment.  Once employment is arranged, the provisional licensee will have 30 days to register the supervisor.  Doing so removes the specific timeframe that supervised experience hours are required to be earned. 

This will make Nebraska’s job licensing requirements more consistent and competitive with our neighboring states, so that we keep individuals from leaving our state in search of work elsewhere.

The Platte Institute strongly supports occupational licensing reform as a means of lessening burdens to those trying to enter the state’s workforce.  I ask that you advance LB 344 out of committee.  Thank you for the opportunity to testify today.  I am happy to answer any questions the committee may have.