Legislative News

E-News from Washington

Vol. 06-28
June 21, 2006

Mental Health Counselors included in New Rural Health Care Legislation

The American Mental Health Counselors Association (AMHCA) and the American Counseling Association’s (ACA) effort to gain Medicare reimbursement for state-licensed mental health counselors took one step further on June 13, 2006, with the introduction of S. 3500, the Rural Hospital and Provider Equity (R-HoPE) Act of 2006.

S. 3500 was introduced by a bipartisan group of Senate Rural Health Caucus members, of which Thomas and Sen. Kent Conrad (D-SD) serve as co-chairs. The legislation was referred to the Senate Finance Committee. The R-HoPE Act brings to five the total number of proposals under which mental health counselors could bill Medicare.

In addition to S. 3500, bipartisan legislation is pending in the Senate (S. 784), also introduced by Sen. Thomas and his Finance Committee colleague, Sen. Blanche Lincoln (D-AR), to reimburse mental health counselors under Medicare. In addition, in May 2006, Rep. Barbara Cubin introduced a House companion bill (H.R. 5324) to S. 784. The Medicare Mental Health Modernization Act (H.R. 1946)/(S. 927) that would, among other things, allow mental health counselors to provide mental health services to Medicare beneficiaries is also pending.

In addition to allowing LMHCs to bill Medicare, S. 3500 would adjust Medicare payments to rural hospitals and make a series of changes to boost funding for rural clinics, doctors and ambulances. Many of the provisions extend or alter rural health care provisions that were included in the Medicare Modernization Act passed three years ago.

Although the legislation’s primary focus is on rural health care, S. 3500 would allow mental health counselors and marriage and family therapists to be reimbursed in all areas of the country.

ACTION NEEDED

Call your Senators and ask them to cosponsor and support both S. 3500, the Rural Hospital and Provider Equity Act, sponsored by Sens. Craig Thomas (R-WY) and Kent Conrad (D-SD) and the Seniors Mental Health Access Improvement Act (S. 784).

TARGETS

Members of the U.S. Senate, especially members of the Finance Committee. To find out of your Senator is a member of the Finance committee, visit the committee website at http://finance.senate.gov/. If you don’t know the name of your Senators, visit the website for the U.S. Senate at www.senate.gov. The U.S. Capitol switchboard can be reached at 202-224-3121.

SAMPLE MESSAGE

“As a constituent, I am calling to ask the Senator to cosponsor and support two bills that would allow state-licensed mental health counselors to provide mental health services to Medicare beneficiaries. S. 3500, the Rural Hospital and Provider Equity Act, and S. 784, the Seniors Mental Health Care Access Improvement Act would provide better access to mental health care for our nation’s growing number of senior citizens. Access to providers is especially difficult in rural and underserved areas, and mental health counselors are often the only mental health provider available”.

AMHCA and ACA will continue to meet with members of the Senate to increase support for this legislation. If you have any questions or need additional information, please feel free to contact Beth Powell at AMHCA at 800-326-2642, ext. 105 or by e-mail at bpowell@amhca.org. Brian Altman at ACA can be reached at 800-347-6647, ext. 242, or by e-mail at baltman@counseling.org


E-News from Washington

Vol. 06-27
June 09, 2006

Children of Depressed Parents Have More Health Problems

The adult offspring of depressed parents are far more likely than those of non-depressed parents to have psychiatric and medical problems, such as cardiovascular disease, according to a study reported in the June American Journal of Psychiatry.

The study found that the rates of anxiety disorders, major depression, and substance use disorders were about three times that of offspring from non-depressed parents 20 years after a baseline survey. In addition, adult children of depressed parents had about five times the rate of cardiovascular illness as children of non-depressed parents. The study’s lead author and investigator Myrna Weissman, Ph.D., is a professor of epidemiology in psychiatry at the College of Physicians and Surgeons and the School of Public Health at Columbia University. She first began following her sample of 151 children from depressed and non-depressed parents in 1982 in their homes in New Haven, Conn.

Some of her samples were drawn from the offspring of depressed adults receiving outpatient depression treatment at Yale University's depression research unit in the early 1980s. According to the study, the adults who volunteered their children to be studied were moderately to severely depressed. She also recruited children of non-depressed parents who participated in the Epidemiologic Catchment Area study.

Dr. Weissman assessed 220 offspring aged 6 to 23 in both groups at baseline and then at two years, 10 years, and 20 years later. By the 20-year follow-up evaluation, there were 101 offspring with one or more parents with depression and 50 offspring with parents with no depression.

To screen the offspring, researchers used the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, the Global Assessment Scale, and the Social Adjustment Scale-Self Report. Researchers also used a standard medical checklist to gather information on non-psychiatric medical conditions.

Twenty years after she first studied them, Weissman found that the offspring of depressed parents had higher rates of major depression over the two decades (65 percent) compared with offspring of non-depressed parents (27 percent) in her sample. Compared with their peers, children of depressed parents had about three times the risk of developing depression by the time they were adults. In addition, while just 15 percent of offspring of non-depressed parents had a phobia, 43 percent of offspring of depressed parents did, which meant they had three times the risk for developing a phobia by the time they were adults.

The study noted that "peak of first onset [of psychiatric disorders] was before the age of 20, with anxiety disorders before puberty and with major depression and substance dependence after puberty." Twice as many of the offspring of depressed parents (19 percent) developed an addiction to drugs or alcohol, as did those of non-depressed parents (8 percent), putting them at more than twice the risk of developing a substance use disorder. Offspring of depressed parents also had more medical problems than their counterparts.

The study found that by the 20-year evaluation, 11 percent of offspring of depressed parents had developed cardiovascular disease, compared with only 2 percent of children of non-depressed parents, making the former about five times as likely to develop heart problems as adults. Offspring of depressed parents were also more than twice as likely to develop a neuromuscular disorder.

Dr. Weissman cited a number of studies that found an association between depression and cardiovascular illness and said that an association between the two conditions could stem from altered immune, platelet, and hypothalamic-pituitary-adrenal axis functioning in depressed patients.

She said that neither parents nor children with depression should be considered in isolation of one another. "If clinicians see a child with a psychiatric illness, they should examine the parents and see if one or both are depressed," Weissman said, and do the same for depressed adult patients who have children. "Parents and children should be considered a package."