Mental Health Board
March 28, 2010
By Jerry Kopel
The longer SB 187 simmers in Senate and House
committees, the worse it smells from the amendments to the mental health
law and violation of DORA's Sunset Review.
While I was not in
attendance during the testimony before the Senate Health Committee, the
most striking development was the failure of DORA to announce either
opposition or support for the bill's original language or the additions
put on by licensed psychotherapists before sending the bill to Senate
Finance Committee.
The original fiscal note of March 22d showed
state expenses in fiscal 2011 -2012 of $268,546 and $1,586,517 in fiscal
year 2012 - 2013. That will be increased under Health Committee
amendments, one of which dealing with unlicensed psychotherapists should
greatly increase the number of violations subject to the grievance board
and subsequent cost to the board and the state funding.
There were
only two Health Committee members to voice opposition to the additional
amendments, Sen. Shawn Mitchell (R) and Kevin Lundberg (R), although both
voted to send the bill to Finance Committee.
My Feb. 4th column on
DORA's 76 page mental health occupation Sunset review zeroed in on a
possible fight between licensed and unlicensed psychotherapists. But now
it takes second place.
First place goes to a rather devious
additional change in the 92 page bill clearly OPPOSED in the October 76-
page review and clearly NOT recommended for the Sunset bill, SB 187. It
takes majority control from public members on the mental health boards and
transfers control in each board to the particular occupation regulated.
The bill summary on page 2 of the mental health bill reads "The bill
implements the recommendations of the sunset review and report on state
regulated mental health professionals as follows":
If that ground
rule had been followed, this column would not have been written. Despite a
definitely firm turn-down of the professional members suggested
shift-in-power argument, Dept. Of Regulatory Agencies staff laid out on
page 50 and 51 of the October report why "NO change" was needed in the
makeup of each mental health board.
But if you read page 4 of the
SB 187 summary, it appears as if DORA said "yes" to change.
In
1998 the grievance multi-discipline board used to discipline all mental
health professionals was repealed under an agreement by the various
occupational groups with senior DORA employee Bruce Douglas to substitute
seven member boards capable of disciplinary action for each occupation.
There were four public members and three occupational members. That was
done despite recognition that the multi-discipline grievance board was
working.
From the report:
(Question) "It was argued by some
professionals that the board should be composed of professional member
majorities instead of the current public member majority. They argue that
because the mental health professionals are unique in being able to
determine whether a violation of the statute or rules has occurred, a
professional member majority is necessary.
(Answer) "During DORA
staff's review of case files, it was clear that the current composite of
the boards was able to effectively discern whether a violation of the
statute or applicable rules occurred. Experience as a psychologist for
example, was not necessary to determine whether a violation occurred.
"In addition to reviewing files, DORA staff monitored board meetings
and recognized that board members possessed the appropriate level of
expertise or knowledge of the statute and rules to effectively diiscern
whether a mental health professional should be disciplined."
CRS
12-43-203 (3) (d) allows boards to convene advisory committees of
professionals who possess a level of knowledge "that a board lacks" to
determine whether a violation occurred. From fiscal years 2004-05 through
2008-09 NONE of the boards convened an advisory committee to address
complex issues, according to staff.
Research staff: "Consumer
protection is the driving force behind regulation of occupations ...
current composition of boards are working well to provide protection to
consumers."
Issues which end up in consideration of violations are
not exclusively dealing with psychotherapy. There are a variety such as:
Incomplete disclosure statements to clients, failing to complete a mental
health evaluation, practicing with a lapsed license, working as an
addiction counselor while under the influence of drugs.
Disciplinary actions according to DORA from July 2004 through June 30,
2009 on licensed and non-licensed psychotherapists, social workers,
marriage and family therapists, professional counselors and addiction
counselors totalled 319, an average of 64 per fiscal year.
If I
could decide what to do, it would be to continue the existence of the
mental health boards and add a board for addiction counselors. Let the
other issues wait to be considered in 2012 subject to DORA review of
Health Committee amendments and the DORA opposition to the claim of
support to the mental health professionals attempt to change majority
control of the mental health committees.
(Jerry Kopel served 22
years in the Colorado House.)
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