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Tricare Mental Health Provider Change Delayed

A Tricare mental health counselor rule change that some worried could drastically reduce the pool of available providers has been delayed until 2017, while a rule allowing others to operate under supervision has been extended indefinitely.

The rule, which limited Tricare approved mental health providers to those with a masters degree or higher from a school with accreditation from the Council for Accreditation of Counseling & Related Educational Programs (CARCREP) among other qualifications, was set to take effect Jan. 1.

While some advocates worried that the new accreditation would limit by as much as 70 percent how many providers were available to military families, others thought different facets of the rule change would expand the number of providers who were newly able to operate independently of physician supervision.

"Going forward the provider pool is going to be much smaller which, in this current climate – our suicide rate sis till high, our families are still dealing with mental health on a daily basis -- kind of leaves you scratching your head, saying why is this happening when you need more counselors," said Dr. Ingrid Herrara-Yee, who co-founded Military Spouse Mental Health Professionals Network, a group to support military spouse counselors and mental health professionals.

She said that 80 percent of her members did not come from CARCREP accredited schools. In her home state of Massachusetts, she said, only one school is CARCREP accredited. Neither Boston or Harvard Universities use the CARCREP accreditation, for example, she said.

Officials with the Military Officers Association of America (MOAA) felt the rule changes were a good idea because they encouraged a uniform standard while expanding the number of providers who could practice independently. However, they said the delay was also a sign the Tricare officials are listening to feedback from the community.

"On first blush it appears Tricare gave careful consideration to the 400 plus public comments received after the interim rules was issued in December 2011," said Karen Golden, MOAA's deputy director of government relations. "I hope professional schools will use this opportunity to carefully evaluate accreditation for their respective institutions."

A Tricare official speaking on background said they decided to delay the rule change based on feedback from advocates and schools who did not meet the accreditation requirements. Doing so will give providers more time to obtain the certification to practice properly, he said.

Under the current rule other, non-CARCREP accreditations are accepted for  mental health counselors as long as they have finished a master's degree or higher from a mental health program. They must also pass the National Clinical Mental Health Counseling Examination (NCMHCE) or National Counselor Exam (NCE) and complete practice supervised hours.

A separate category allows for "supervised mental health counselors" with a masters in mental health counseling or a related field to practice under a physician's oversight without meeting the supervised hours or examination bench marks.

Before the decision to delay the rule change, Tricare officials planned to permanently bar supervised mental health counselors from practicing under Tricare, while requiring all non-supervised ones to come from a CARCREP accredited program.

Now under the delay decision supervised mental health counselors are permanently permitted, while those without the CARCREP accreditation have until 2017 instead of Jan. 1 to become compliant.

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