TRICARE Keeps Supervised Psychologists

WASHINGTON (CN) - The Department of Defense is keeping supervised psychologists as part of its TRICARE military health insurance system.

In an effort to improve mental health care among service members, the department issued new uniform standards in 2011, so quality would not vary from state to state, according to the action.

Initially, the department had planned to allow mental health practitioners with certain credentials to serve TRICARE patients independently, and to phase out psychologists who had to have doctor supervision.

The department believed its new rules would expand patient access to mental health care providers, and improve quality of care. Unfortunately, few psychologists have the credentials.

In response, the department has lengthened the time for counselors supervised by physicians to become certified to work independently, to 2017. It also points out that those counselors who have not finished the requirements may stay on with their supervising doctor.

The goal of the 2011 interim rule was to allow certain mental health providers to see patients independent of physician referral and supervision, and be paid under TRICARE. Counselors without a certain certification were able to work under physician supervision until Dec. 31, 2014. The rule anticipated that these counselors would seek certification in the mean time, and be able to practice independently.

The department expected that the interim rule would expand patient access to mental health providers. But detractors have worried that the Dec. 31 deadline would mean a drastic cut in available counselors at a time when the need for counselors is especially high.

Few counselors in the TRICARE system meet the initial criterion - graduation from a college accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), however. So, the agency has relaxed the requirements during a transition period, and lengthened the time to comply.

The qualifications listed in the final rule include: A master's degree in counseling from a program accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP); a state license in mental health counseling at the 'clinical' or the higher or highest level available in states that have tiered licensing schemes; the passage of the National Clinical Mental Health Counseling Examination and a well-defined scope of practice for practitioners.

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