Senate committee addresses mental health care provider shortages

Jan. 16—CHEYENNE — In hopes of addressing health care provider shortages and increasing access to mental health services, health care advocates pushed for two compact bills to move forward.

They were among the majority of stakeholders to testify Monday in the Senate Labor, Health and Social Services Committee, which worked on the two pieces of legislation throughout the morning. Both bills passed the committee 3-2, with Laramie County Republican Sens. Lynn Hutchings and Anthony Bouchard voting no.

Senate File 10 was the first bill considered, and it is designed to increase the number of licensed professional counselors who can practice in-state. Wyoming would enter into an agreement with 16 other states, and counselors could "exercise multistate licensure privilege in other states" that are part of the compact. This would apply to both in-person and telehealth care.

"Our professional counselors would not bring this to you if they didn't feel confident that it was good for Wyoming, and good for our people," said Vicki Swenson, a member of the Wyoming National Alliance on Mental Illness Board.

Health care advocates said the compact would attract more counselors to the state, as well as give rural health care providers the opportunity to stay.

Wyoming Association of Mental Health and Substance Abuse Centers Executive Director Andi Summerville told lawmakers that rural health care providers are difficult to retain because they can't build a thriving private practice in a very small area, and the "burden of getting licenses in other states to be able to do telehealth sometimes is prohibitive."

"This would allow some of those therapists in those rural communities to be able to provide services out of state and build out that practice," she said. "That is a huge benefit for our community mental health centers to be able to actually have physical folks in those communities."

AARP Wyoming Director Tom Lacock also argued in support of the bill, and said the compact maintains the rights of the state's existing mental health licensure boards and the Legislature's power to determine who is able to practice, while also allowing for multiple delivery methods.

"For our members, access to care through telehealth means choices and independence, from issues such as weather, transportation or lack of providers in their own communities," he said. "We know the nation's older Americans have taken to telehealth visits, which previously only reimbursed when the visit originated from another physician's office."

While all of the testimony on the bill was positive and came from a variety of health care organizations, there were still concerns voiced by Hutchings and Bouchard.

"One of the things I find troubling is that this is not like a compact where we're bringing in mechanics to fix cars, doctors or dentists to work on teeth. This is psychology," Hutchings said. "This is dealing with our minds and the souls of the people in Wyoming. And as guardians of the people's liberties and their monies, and what we set forth as laws, it's important to me to do the right thing."

Hutchings said entering the compact with "God knows how many other states," who may be more liberal-minded or have unique issues, would give them the power to make rules and create a bylaw.

Wyoming Counseling Association representative Lindsay Simineo and Sen. Stephan Pappas, R-Cheyenne, testified that this would not be the case.

Counselors who practiced in Wyoming would have to follow the state's rules and statutes.

"We believe it increases public safety for two reasons," said Simineo. "It lets those within the compact be on notice of what our state statutes are, and what our rules are, as well as we get to participate in that interstate database. We get to know who's in the database, who's practicing where and if there are any bad actors."

Pappas assured Hutchings that passing the bill would only clarify how the compact would operate and its limits, not change any Wyoming state law. He said he "didn't see where this fear of them being able to change something in Wyoming law is coming from. I just don't see that, because it can't happen."

Similar concerns were introduced by Hutchings when it came to Senate File 26, the other compact bill passed by the Senate Labor Committee. Despite pushback from the two Cheyenne lawmakers, it passed, as well.

The Psychology Interjurisdictional Compact authorizes psychologists not licensed in Wyoming to provide temporary in-person and telemedicine services for residents, which advocates argued would increase access to needed services.

"This compact is not about standard of care. It's not about limiting access. It is about licensure, and increasing the opportunity for access to care, and as well as for providers to easily practice across state lines," said Tammy Perrault, a representative from the Department of Defense State Liaison Office. "And that's why we at the Department of Defense support this and all other compacts."

Both bills passed the full Senate on first reading Monday and must get two more votes of support to move on to the House.

Jasmine Hall is the Wyoming Tribune Eagle's state government reporter. She can be reached by email at jhall@wyomingnews.com or by phone at 307-633-3167. Follow her on Twitter @jasminerhphotos and on Instagram @jhrose25.

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