[Counselor_Educ] VA Opens its Choice Program to CMHCs

[Bowen, Nikol]

ADVOCACY UPDATE - Dec 2015: VA Opens Its Choice Program to CMHCs

1 Recommend

The Department of Veterans Affairs' large new Choice Program<https://www.hnfs.com/content/hnfs/home/va/home/provider/veterans-choice-program.html> allows veterans to obtain a wide range of health care-including mental health-from non-VA providers. Given the well-documented shortage of VA mental health services and providers, the program has significant potential to extend VA payments to many CMHCs around the country.

The Choice Program covers veterans for non-VA facility care when a beneficiary would otherwise wait more than 30 days for an appointment, or when their travel to a VA facility would be an excessive burden. Throughout early implementation of the program, AMHCA has heard complaints from our members about exclusion of CMHCs from participation, and we have worked with our coalition partners and the VA to correct the problem. VA officials often cited the original language of the August 2014 statute as the source of CMHC exclusion. AMHCA has now heard from the VA that newly signed changes in the law  (Public Law 114-41)<https://www.congress.gov/114/plaws/publ41/PLAW-114publ41.pdf> have corrected the exclusion, and it will be expanding to more community providers.

On Dec. 1, 2015, the VA published new regulations known as "Expanded Access to Non-VA Care Through the Veterans Choice Program."<https://c.ymcdn.com/sites/amhca.site-ym.com/resource/resmgr/Advocacy/VA_PC3_Rule_Dec_2015.pdf> The new rule implements the expanded provider base portion of the legislation, and it is expected to now open up the program to CMHC participation. New providers must hold the same or similar credentials/licensure as a provider providing the same type of care in the VA. CMHCs, currently known in the VA as LPMHCs (licensed professional mental health counselors), are eligible for hire within the agency. Also, for certain types of care provided in the community that the VA does not offer, it will generally default to local state licensure criteria for that specialty area of care.

The VA just announced plans to Congress to revamp the Choice Program, consolidating seven distinct community-care programs into one, with consistent eligibility standards and provider payment methods across the program. According to VA Secretary Robert McDonald, the VA increasingly recognizes that the path to caring for veterans must include a more robust system of outside health care. McDonald said the VA intends to build an integrated provider network, with payment rates initially based on Medicare and evolving gradually to value-based payments.

Eventually, outside providers would be evaluated on performance and quality metrics and potentially receive higher paymens or be dropped from the list of eligible providers. Ultimately, the VA hopes to focus its Choice Program provider network on the most competent clinicians, including adopting the growing movement to measure the quality of care. Eventually, veterans would be given a list of providers to choose from, with ratings by health plans. The final system redesign will require further congressional approval before being fully implemented, but incorporation of more community providers is expected to move ahead of longer-range reforms.



http://connections.amhca.org/blogs/james-finley/2015/12/01/advocacy-update-dec-2015


Nikol Bowen, PhD, PCC
Assistant Professor
Practicum & Internship Coordinator
Counseling and Higher Education
Patton College of Education
Ohio University
bowenn at ohio.edu<mailto:bowenn at ohio.edu>

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