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2013 Advocacy Report

Creating a bridge from graduation to independent licensure

CTAMFT recognizes the difficult and unclear road through graduation and the “Pre-Clinical Fellow” membership category where new graduates need to provide 1000 hours of service under supervision. Many agencies require a license for fee-for-service positions, and the majority of insurance panels will not consider practitioners who have not had three years of licensed practice. CTAMFT Board voted in 2009 to pursue legislation for an “Associate License” or “LMFTA” to provide Public Health recognition/regulation of MFTs professional status after they have passed the national exam and while they are still working under supervision. Difficult state budget conditions have repeatedly stalled this bill, which was requested in 2010, as DPH requires funding to support any change in their procedure. Because of this, social workers, who passed a similar bill in 2010 have also continued to wait to implement their bill. This January, the legislative committee, headed by Susan Boritz met with the co-chairs of the Public Health committee to formally request the LMFTA again. The co-chairs agreed to introduce a bill, but the language for it was again dropped before the public hearing. Susan Boritz and President-Elect Denise Parent testified, asking for the language about the LMFTA to be included in another bill raised about accreditation, #6646. While #6646 moved forward, the LMFTA language was referred to DPH for questions and revisions. We are proceeding to work through the “scope of practice” questions with the Department of Public Health regarding the associate or provisional license or LMFTA this summer. We hope to get the LMFTA legislation in next session.

Technical Fix around COAMFTE accreditation, Bill #6646

CTAMFT and all divisions were asked by AAMFT/COAMFTE to remove the requirement for the US Department of Education accreditation from our statute. The old language required MFT programs to be accredited through COAMFTE and the USDE, and dated back to the days when programs were not housed in USDE accredited universities or colleges. Currently, without a statute change, MFT programs go through accreditation with the USDE twice, once through their parent universities/colleges and also when COAMFTE is required to submit accreditation materials to USDE. Bill #6646 eliminates this duplication. The technical fix around COAMFTE accreditation is passing through the legislature in this year’s session.

Raising Family Systems thinking and intervention in the wake of Sandy Hook

CT became the epicenter of debate on mental health and gun control following the excruciatingly painful events of December 14, 2012. By January 2013, a rush of mental health bill proposals were flooding into the capital, covering a wide array of case management and peer support services for the severely mentally ill, services for young adults 18-26, requirements for mental health first-aid training for school professionals as well as reporting requirements for suicidal/homicidal ideation. Noticeably absent were holistic, family-centered prevention and intervention alternatives, plans for coordinated community based multi-disciplinary crisis approaches, and fully considered ways to prevent a mass shooter in the making. Mental health legislative initiatives already underway include the forming of a task force to consider how to serve the severely mentally ill and address a gap in services for 18-26 year olds. The results of the CT Sandy Hook task force meetings and criminal investigation will be completed and presented in/around June 2013.

One of our valued CTAMFT members, Nelba L. Márquez-Greene, suffered the loss of her daughter and became an impassioned advocate on behalf of Sandy Hook families asking for reasonable bipartisan action regarding gun control and mental health. She has also been actively involved in the development of an organization called The Sandy Hook Promise. CTAMFT Board discussed the need to keep a rational, steady and strong presence in the dialogue about mental health and are using their contacts to be a voice at the interdisciplinary tables discussing mental health initiatives. Susan Boritz, our board Legislative Liaison, and a resident of Sandy Hook, testified at the Newtown Public hearing about the need for organized community and family-based, trauma-informed services. Many CTAMFT members contributed testimony, crisis support and advocacy during this difficult time in our state, and the CTAMFT Board cannot be more proud and thankful for the deep commitment of our membership at this time.

MFT and the Schools

CTAMFT continues to support the implementation of the recently passed MFT In The Schools bill in spite of resistance from some individual school systems and the Department of Education’s concerns about the ability of MFTs to work with individual “students.” CTAMFT members and University Professors Kathie Laundy and Ralph Cohen, as well as Laura McBride continue to clarify this point with the help of Senator Andy Fleischman. President Dorothy Timmermann and President-Elect Denise Parent met with NASW-CT Executive Director Steve Karp to discuss concerns about MFTs “taking social work positions,” and to further develop the understanding of the MFT in the school role.

At this time, MFTs frequently work with students and their families outside of schools, often from private practices, school-based health centers or youth service bureaus. The MFT In The School role allows a Superintendent to define and hire their mental health team with a school based MFT on their payroll to address the larger family issues that accompany students to school. There has often been confusion even in our own membership about whether MFTs can be hired in positions defined as “school social worker,” “school counselor,” or “school psychologist.” Interchangeable job description is not the intent of the legislation. Our lobbying firm has discovered that School Psychologists have had similar confusion about this issue, and we hope to have the same conversation with their representatives as we did with Steve Karp.

Advocating for treatment niches for MFTs

CTAMFT Board has recently begun discussing the possibility of staking a greater claim to the provision of couple and family work as a treatment niche for MFTs. MFTs have spent long years breaking into the traditional mental health system and there is strong evidence based research supporting family systems approaches to mental health intervention and prevention. Recent rumours that MFTs were being “locked out” of state jobs were a reason behind CTAMFT’s meeting with NASW-CT in addition to MFT in the schools. We were told that social workers have worked over twenty years to have social workers hired in positions that are defined as “social work” positions. The majority, if not all, social work positions at the Department of Social Services and Department of Children and Families are not designed to provide therapy, but instead provide information, resources, referral, crisis investigation and case management, many of which are Bachelor level positions.

While there is some overlap in MFT and social work roles, many (or all?) of us chose MFT training to provide clinical treatment to individuals, couples and families from a systemic perspective. It occurs to us, as a Board, that we can choose to shift our advocacy and legislative effort in the future to carve out space and funding for the treatment modalities we are deeply committed to, and highlight the expertise of MFTs to fill those roles. This does not mean that CTAMFT will not continue to review and advocate on parity issues and continue to ensure that we have equal opportunity to jobs that MFTs are qualified for, particularly in terms of Medicaid and Medicare reimbursement, Clinical roles and School-Based Health Centers. What it does mean, is that as a Board, we hope to spend more time defining our valuable role as interdisciplinary teammates and the best qualified providers of couple and family treatment. This may or may not include legislative effort, but will absolutely require advocacy and the use of our entire membership as ambassadors and leaders in developing funding streams and relationships within and outside the existing mental health system.

Summer projects involve making connections on the many task forces related to mental health, identifying procedures and contacts to further research how contracts with the state are being decided, and our Board will be doing some strategic planning around advocacy in the fall.

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