Annual Legislative Updates

  • 2017 Legislative Session:

This was a complicated session, given many competing political tensions. While we had some limited success, MPA was unable to achieve all of its legislative goals this year. Below is a summary of what did make it into law. Also below, a summary of areas we will continue to pursue next session and for which we hope to have your continuing support.

    • What made it into legislation
      • Psychology Practice Act
        • An exemption was added so that individuals pursuing teaching and research in academic settings are not required to be licensed unless they are providing direct clinical services. At the same time, individuals working in academic settings may still use hours worked in teaching and research towards licensure, with appropriate supervision.
        • Students and supervisees are no longer included in the definition of a client
        • Full time employment is defined as 35 clock hours
        • The description of what constitutes psychological practice was changed to reflect language in the APA model licensing act
        • Telesupervision is defined and can be used for all postdoctoral psychological employment supervision
        • Obsolete language regarding licensed psychological practitioners was removed
        • Clarification was made regarding Board of Psychology membership
        • A requirement that the Board of Psychology review the reliability, validity, representativeness of sample, for any new additional national exam that is added as a requirement for licensure
        • Postdoctoral psychological employment may now occur over 12-60 months. Should an applicant exceed 60 months, the board may grant a variance
        • Requirements for relicensure are specified in statute
        • Guest licensure is increased from 7 to 30 days
        • Defines supervision as a collaborative relationship with facilitative and evaluative components
        • “Psychology Fellow” is a term that individuals may utilize to describe their position when completing postdoctoral psychological employment
      • Brief Diagnostic Assessment
        • The requirements for a Brief Diagnostic Assessment were pared down to allow for flexibility in diverse settings without compromising information gathering.
        • Three sessions may still occur prior to a diagnostic assessment being required
        • The new requirements for a Brief Diagnostic Assessment include:
          • Must include a face to face interview
          • Includes a written report which includes information about the recipient’s:
            • Age
            • Reason for referral
            • Presenting symptoms
            • History of mental health treatment
            • Mental status exam
            • Cultural influences and impact on client
            • A provisional clinical hypothesis
            • Completion of the Brief Diagnostic Assessment authorizes 10 subsequent sessions
            • During the 10 sessions allowed by the Brief Diagnostic Assessment, additional information can be gathered to complete a standard or extended diagnostic assessment
      • CPT Codes
        • A proposal requiring all providers to list their commonly used CPT codes and associated retail price was not included in the law signed by the governor
    • What did not make it into law that we will be pursuing
      • A change to licensure by reciprocity such that individuals licensed in another jurisdiction and no active complaints can immediately apply for licensure by reciprocity, removing the five-year requirement.
      • A user-friendly policy for registering primary supervisors
      • Allowance for multiple primary supervisors
      • Specification that 100 hours of supervision are required for postdoctoral supervised employment
      • Specification that no more than two hours per week of supervision are required for postdoctoral psychological employment
      • Allowance for supervisory flexibility in the case of illness or unavailability of the supervisor or supervisee. Up to 6 sessions can be missed, if the session is made up in the subsequent week. Hours worked in these skipped weeks would count towards licensure.
      • Specification of supervisor duties including provision of informed consent and development of a supervisory contract
      • Allowance for attestation by the primary supervisor when 1800 postdoctoral supervised employment hours are completed
      • Specification of protections for supervisees
      • Specification of supervisee duties
      • Description of required supervision documentation
      • Verification that individuals engaged in supervised postdoctoral psychological employment may work in other settings providing mental health services as long as these hours do not count towards licensure and have the supervision required within that organization.
    • What was never under consideration:
      • During the session, misinformation was disseminated that the changes to the psychology practice act would in some way impact the work of life coaches, perhaps requiring that life coaches be licensed as psychologists. This was never the case. The language of concern to life coaches has actually been part of the practice act since 1973. Nowhere in statute or in our bill is there comment on coaching. We were able to work with Minnesota representatives of the International Coach Federation to explain that nothing in the psychology practice act impacts coaching unless a coach is engaged in the practice of psychology.
  • 2016 Legislative Session:

    Duty to Warn
    The primary focus of the 2016 legislative session was to address a vulnerability for students related to duty to warn requirements that surfaced as a result of an appellate court decision. Based on the decision, Minnesota’s Psychology Practice Act was found not to offer protections to students required to break confidentiality in order to complete duty to warn activities in situations where danger to others was seen as a concern requiring informing the intended victim or police. The Psychology Practice Act was changed such that for this one circumstance of duty to warn, students were to be considered under the same protections as licensees. In addition to working to change the Practice Act to protect students, the Minnesota Psychological Association also submitted an Amicus Curiae Brief to the Minnesota Supreme Court for a hearing regarding the appellate court’s decision. The Minnesota Supreme Court upheld the lower court’s position. Thus it was crucial that MPA acted to protect students by changing the statute.

    Medical Assistance Rate Increase
    In 2007, critical access mental health providers were given a 23.7% Medical Assistance rate increase for outpatient services. This included Community Mental Health Centers and hospital outpatient services. This increase was based upon the rationale that these settings provided needed care to a more ill and safety net population requiring coverage of complex needs. Individuals with serious and persistent mental illness are often see by psychologists in other settings, and since 2007, MPA has sought to extend this rate increase to psychologists in all outpatient settings. Because 2016 was not a budget year, we were unable to obtain a hearing for this bill. MPA continues to work in coalition with other groups to have this rate increase extended.

    Repeal of Sunset of the Provider Tax
    The Provider Tax is set to sunset in 2019. Legislation was introduced during the 2016 session that would repeal this sunset such that the Provider Tax would continue to be collected. MPA testified in opposition to this bill, explaining that while psychologists support the value of Minnesota investing in health care coverage for its working poor, we believe that the burden to support this value should be shared by all Minnesotans, not just health care providers. The bill did not advance and the 2019 Sunset of the Provider Tax remains in place.

    Psychology Practice Act
    In 2016, MPA heard from psychologists that issues were arising related to licensure of academic psychologists and concerns about the requirements for postdoctoral supervised psychological employment. The legislative committee worked with a variety of stakeholders in preparation for the 2017 legislative session to bring clarifying changes to Minnesota’s Psychology Practice Act.

    Workforce Issues

    MPA continued to work with other stakeholders regarding efforts to address policy issues that would support the development of a strong and diverse psychology workforce through loan forgiveness programs and measures to support availability of supervision for students and individuals completing postdoctoral supervised psychological employment.

  • 2015: MPA came together in an unprecedented way with other mental health professionals to try to gain equality in how Medical Assistance services are reimbursed. Beginning in 2007, critical access providers were given a 23.7% raise that did not include mental health professionals working in private clinics or private practice. A bill to extend the 23.7% to all mental health professionals was heard and adopted for inclusion in the omnibus bill. Unfortunately, the measure was not ultimately included in the Health and Human Services Budget Bill. MPA will continue to pursue the raise in Medical Assistance payments. For some, the 2015 legislative session had a focus on attempting to exempt providers from the EHR mandate. MPA members expressed multiple positions on whether or not to remove the EHR mandate, and the organization worked to hear all viewpoints and pursue legislative action that would protect the role of psychology in the health system while also protecting privacy and avoiding financial and operational burdens for practitioners.  Ultimately, a compromise measure that would allow solo providers and those working in cash-only practices to be exempt from the requirement to use an interoperable Electronic Health Record was passed by the legislature. In 2015, MPA also reviewed new rules regarding teachers to be licensed as specialists in autism spectrum disorders to ensure that teachers would not expand their scope of practice and that the new rules would not allow teachers to diagnose mental health disorders.
  • 2014: Much of the legislative work MPA provides is to influence the discussion at the legislature such that harmful legislation does not become law. In 2014, MPA participated in supporting many important discussions. For example, MPA provided testimony related to gun violence supporting the fact that individuals with mental illness are not, as a group, more violent than the general population and to block efforts to unnecessarily restrict the rights of those who have been diagnosed with a serious mental illness. MPA also weighed in on discussions regarding school-based mental health services and the role of the Board of Psychology.
  • 2013: MPA passed a bill that allows psychologists to bill Medical Assistance for consultation to primary care providers including pediatricians. Consultation can be through in-person, phone, email, or fax contact that is initiated by the primary care provider. This provision allows psychologists to move toward providing more integrated care for the people they serve.  Senator Julie Rosen championed MPA’s bill and was recognized as State Legislator of the Year at the APA State Leadership Conference.
  • 2012: MPA worked with partners to prevent Physician Assistants from being named as mental health professionals in Minnesota for purposes of payment through Medical Assistance. Concerns were raised about training for PA’s in mental health. They are able to provide whatever care their supervising physician allows based on the physician’s assessment of the PAs competency. No requirements, then, are in place for mental health training. Due to concerns about safety issues, payment by Medical Assistance was restricted to hospital inpatient settings but with no change in professional definition. MPA also carefully watched the unfolding of the work of the Sunset Commission as it reviewed the health licensing boards. Testimony was provided about the need for psychologists to be evaluated by peers, and the need for separate, distinct boards for the various mental health professions.
  • 2011: MPA worked to ensure funding for mental health services in a time of significant cuts. Testimony was provided regarding the Health and Human Services budget, concerns about reductions in funds for the development of multicultural providers. Efforts were successful in keeping intact the level of reimbursement for psychologists for services provided to dual eligible individuals with Medicare and Medical Assistance.
  • 2010: MPA was able to pass legislation that made significant changes to the licensing laws. Changes were made in guest licensure, volunteer licensure, portability of licensure, and changes in the composition of the Board of Psychology. Equally important, MPA was able to block legislation that would have expanded the ability of other professions to diagnose ADD/ADHD in recommendations to schools for special services. MPA was added to legislation as a group to serve on a transformation task force for Chemical and Mental Health Service in the Department of Human Services. MPA also testified with regard to concerns about cuts to mental health funding and plans to abolish the GAMC program for the poorest Minnesotans.
  • 2009: Through legislation, MPA was able to get appointments to the Legislative Task Force on Autism Spectrum Disorders and to the Health Care Reform Review Council. Changes were also made to the licensing laws with regard to psychologists’ ability to discuss medications with their clients.
  • 2008: Legislation to allow psychologists to make the diagnosis of ADD/ADHD to initiate the process of evaluation for school services is passed. Prior to the legislation, only physicians could make the diagnosis.