Is the Counseling Compact Good for Therapists?
Curt and Katie chat about the brand-new Counseling Compact and what therapists may not know or understand about these interstate agreements. We explore the proposed benefits as well as the potential risks and complications like regulatory discrepancies and a lack of consumer protections. We also look at how big tech can benefit while individual clinicians may be left unable to compete in a larger market.
Transcript
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In this podcast episode we talk about the new Counseling Compact and Psypact
The counselors got their 10th state and officially have Counseling Compact to practice in other states. We thought it would be a good idea to talk about what that means (and what we might want to pay attention to).
What is the Counseling Compact?
- Opportunities for practicing privileges (not licensure) in other states
- The complexity of putting together these interstate compacts
- Implementation and regulation hurdles
- Scope of practice discrepancies and concerns
- Law and Ethics practices across states
Benefits of Interstate Compacts for Mental Health Providers
- Continuity of care
- Ease of meeting with clients who are moving around the country
- Bringing clinicians to areas where there is a workforce shortage
Potential Problems with the Counseling Compact
“This very much goes against, according to the FBI, any sort of patient protection – that any of these licensing boards are put into place in the first place: to protect consumers.” – Curt Widhalm
- Not bringing more clinicians, if only states with workforce shortages join
- Doesn’t solve the infrastructure problems (i.e., stable Wi-Fi) for rural areas that typically don’t have local therapists
- The people who most benefit: the big tech companies like Better Help
- The FBI is opposing this legislation due to lack of federal background checks
- Lack of consumer protection or consistency in what consumers can expect from their therapist
- Costs for the therapists to get practicing privileges
- Large gigantic group practices and tech solutions will contract with insurance and leave smaller practices unable to compete and required to be private pay
Solving the Problems with the Counseling Compact
“It may actually delay [a national license], because it’s a band aid where people can go practice in other states. So why would I get a national license, if I can practice in a couple other states and not worry about taking another test, getting another background check…?” – Katie Vernoy
- Overarching regulation and expectations at a national level
- Federal bodies to oversee background checks and consumer protections
- Expensive, time-intensive
- We don’t have universal healthcare, so insurance parity will need to be addressed (and not just by big tech)
Our Generous Sponsors for this episode of the Modern Therapist’s Survival Guide:
OOTify
OOTify. “OOT” or “uth” (उठ) means “lift up” in the Hindi language. OOTify is a digital health solution that acts as an evidence-based hub to unify relevant mental health resources. Community, Connection, and Collaboration are critical to OOTIFY. As they lift the mental healthcare system, they ensure providers are part of the process. OOTIFY is a platform for providers, built by providers, and owned by providers. OOTIFY is the process of lifting up mental healthcare, while lifting each other up.
We need to talk about our mental health. We need to make our mental health stronger so we can withstand the things that happen in our life. We’re going to go through trials and tribulations. But if we can work on our mental health, proactively, our wellness, we can handle all that as a community and come together. People are more open to talk about these stories and say, “Hey, listen, I’m going through this too.” Do be you want to be a part of the solution by joining a new web three community focused on mental health and wellness? Join the OOTify community as an investor or mental health provider by visiting ootify.com/contact. You can also give us a follow on social media to stay tuned on exciting updates.
Turning Point Financial Life Planning
Turning Point Financial Life Planning helps therapists stop worrying about money. Confidently navigate every aspect of your financial life – from practice financials and personal budgeting to investing, taxes and student loans.
Turning Point is a financial planning & coaching firm that helps therapists stop worrying about money.
Dave at Turning Point will help you navigate every aspect of your financial life – from practice financials and personal budgeting to investing, taxes and student loans.
He’ll help you move through that feeling of being stuck, frustrated and overwhelmed…
And arrive at a place where you feel relief, validation, motivation and hope.
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Be sure and visit turningpointHQ.com and download the free whitepaper “7 Money Mindset Shifts to Reduce Financial Anxiety”
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Relevant Episodes of MTSG Podcast:
Special Series: Fixing Mental Healthcare in America
Why You Shouldn’t Sell Out to Better Help
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Curt Widhalm 00:00
This episode is brought to you by OOTify.
Katie Vernoy 00:03
OOTify is an immersive digital mental health ecosystem. It’s designed to help minimize the fragmentation, trial and error and overwhelm felt by both patients and providers in the process of giving and receiving care. OOTify is the process of lifting up mental health care while lifting each other up.
Curt Widhalm 00:20
Listen at the end of the episode for more information.
Katie Vernoy 00:23
This episode is also brought to you by Turning Point.
Curt Widhalm 00:26
Turning Point Financial Life Planning helps therapists stop worrying about money. Confidently navigate every aspect of your financial life from practice financials and personal budgeting to investing taxes and student loans.
Katie Vernoy 00:39
Visit turningpointhq.com. To learn more and enter the promo code ‘moderntherapist’ for $200 off any service.
Announcer 00:47
You’re listening to The Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 01:03
Welcome back modern therapists. This is The Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast for therapists about things going on in the therapy worlds. And recently, the 10th state has joined the counseling compact, which initiates that it is all coming together for licensed professional counselors here in America. And what this does is creates a whole lot of space for people to make up what they think that it is. And we are here to correct that information. So, Katie, lots of things to talk about in this episode, what are your initial reactions.
Katie Vernoy 01:49
So my initial reactions typically with all of these pacts, so there’s Counseling Pact, there’s PSYPACT or Counseling Compact and PSYPACT, which is a psychologist, and then the social workers are working on something. As for MFTs so far, we don’t have something going on. But I have mixed feelings. Because I think for me, I have clients who travel around to different states. And so I can only see them when they’re in states I’m licensed in, I’ve got ideas around being able to support folks in areas that have fewer clinicians or clinicians who specialize in and what they need. And I also recognize I live in a state that has a very high cost of living. And so if there are therapists in states with much lower cost of living who are quote, unquote, taking my clients, I think it would be something where that that may make it harder for me to compete in my own market. So lots of mixed feelings. And I’m not quite sure at least until we started prepping for this episode, I wasn’t quite sure what these compacts meant. And so I think probably we should start with, What’s the Counseling Compact? If we, you know, it’s PSYPACT different? What’s the social workers working on? But broadly, what are these things? And why do people care about them?
Curt Widhalm 03:05
So these pacts are going to be slightly different between the counselors and the psychologists and psychologists is PSYPACT. The Counseling Compact is for counselors, we’re not really going to talk a whole lot about social workers and MFTs, because they have not gotten their act together and have anything moving in this direction yet. Social workers do. But in talking about the two that are already in place, or quickly moving into place, what it does is allows for somebody, this is language from the Counseling Compact, what it does is allows for somebody who is licensed in and resides in one of the member states to have practicing privileges through some regulation stuff in other states. So it’s not just like a license reciprocity where you are granted now a 10 state license, you have to go through some certain steps of just picking a couple of states out of this here. But if you are, say, practicing in Nebraska, and you have a person in West Virginia, who wants to utilize your services, you would need to go to the West Virginia Board and have a streamlined ability to get a privilege to practice with clients in West Virginia.
Katie Vernoy 04:30
Okay, but you have to live in Nebraska, it can’t be like I live in California, and I’m licensed in Nebraska. So now then I can practice with somebody in West Virginia, if I get that streamlined.
Curt Widhalm 04:42
Yes, and this is the language that you have to be licensed in and reside in one of those states. So many people have licensure in multiple states already. If you are not one of the 10 states as a resident this does not apply to you. So this is not like a, you know, huge like opening up the gates to everybody living all over the place. California being where Katie and I reside, we can’t just go and get licensed in Utah and now have the ability to practice in all of these other states. A residency requirement is part of this as well.
Katie Vernoy 05:20
Well, one thing, I think that it does start things moving, because I know with PSYPACT, there are 34 states in process. So it is the beginning of something, it’s just a matter of right now, this is the very beginning stages and other states may join. But in some of the conversations and research we’ve done, it sounds like there’s a lot that goes into it once a state joins. And even in putting together the overarching compact, there is this need to get kind of almost universal expectations, kind of an overarching, regulatory body, there’s also needs to, you know, look at scope of practice issues, which at least as we’re aware of MFT stuff, but there’s very different scope of practice for California MFTs than there is for Texas, or West Virginia MFTs, for example. And so there’s a lot of complexity that’s going to be sorted out as this starts to get implemented. But the idea is that these compacts these interstate compacts are meant to provide a launchpad for more states to join, right?
Curt Widhalm 06:29
And this is some of the stuff that’s got to be ironed out over the next couple of years. And frankly, I’d be surprised if all 10 of these states are able to address some of these discrepancies over the next few years. And for example, and I know not all of these states are currently part of the 10. But they do sometimes have some legislation to get them involved in the Counseling Compact here. But looking at the different requirements in different states, Georgia as an example, one of the 10 States does have a pretty high barrier to entry when it comes to becoming licensed within the state. And so I’m going to emphasize again, this is practicing privileges in other states, that is not a full reciprocity of license. So if somebody is practicing, gets practicing privileges in Georgia as a member of this Counseling Compact, one of the things that needs to be addressed is the discrepancy between what is allowed from one state to the next, for example, some states allow counselors to provide diagnostics of clients, other states do not and what has yet to be ironed out on this is how much does this change the scope of practice in these other states? What’s unclear at this point is how these things are going to be regulated. While there is a central body that will oversee this compact, because of the way that it’s set up each of these states are the ones who are still overseeing their own licensees, disciplinary actions and abilities to practice. So it’s not like you’re gonna be able to sit at home and do telehealth across all of these 10 states, and be able to practice just in the way that you are at home with your home state’s clients, you’re also going to run into well, I can diagnose this client but not this one. Or I need to be aware of, you know, my ability to do things ethically, one way in one state, but because of the ways that the laws are written in another state, I’m not allowed to do this. So these are some of the things that now have to be centrally addressed across all of these states here.
Katie Vernoy 08:48
And I think it’s something that can get very confusing, but I want to re emphasize that there is this element of expectation that this means I’m in licensed and these other states and and because it’s practicing privileges, is it telehealth only? If I go visit the state, could I still see those clients in person? Like what is the what is the practical difference between practicing privileges and licensure? In this regard.
Curt Widhalm 09:12
The differences is, it’s not a license in another state. It’s the allowance of you to be able to provide services to people in that state. But it is not the equivalent of having a license in both states.
Katie Vernoy 09:30
But what is the practical difference there? Like why do I care if I’m licensed or have practicing privileges?
Curt Widhalm 09:37
One of the major differences is that it’s a lot easier to revoke practicing privileges than it is to revoke somebody’s license. Having a license in both states means that you are obligated to both states licensing boards. What practicing privileges means is that you’re allowed to practice here but you’re still responsible to your own state’s governing body for disciplinary actions, and so on and so forth. So it could be very easy. If a therapist is working with a client who’s out of state and residing in Georgia, for example, Georgia could very easily be like, you’re not meeting the requirements of practice in our state where you’re doing out things, things outside the scope of practice in our state. And we don’t like that, and you’re no longer allowed to practice here. So it’s a lot easier than going through a lot of the big disciplinary actions that may require revoking somebody’s license in a state that they’re actually licensed in.
Katie Vernoy 10:40
So for the clinician, it means that they would really need to be able to identify all the different scope of practice, how to really stay up to date in all these different states, as well as what is that kind of fine line that I can walk, either to treat all my clients the same, but super restricted, or, you know, like having different rubrics for how I treat each client. So it can get pretty complicated is what you’re saying, for the clinician to pay attention to what’s required of them.
Curt Widhalm 11:11
Yeah, and I think to this is where the goal is over the next couple of years to change some of this information. So that way, we’re able to make it a lot simpler for people because the goal in this is with the intention of making practice easier, allowing for more people to have access to more mental health providers. However, these obstacles exist, and giving kind of the next couple of years of the ability for state legislatures to change the subsequent laws that now need to go into effect because this is in place, the goal probably is to simplify this stuff.
Katie Vernoy 11:50
Okay.
Curt Widhalm 11:51
And I haven’t heard or seen anything where any of these member states have, you know, any real opposition in this way, it’s just that things in the legislature can take other priorities. I mean, we saw this with the COVID 19 pandemic, where it’s like all the states for a couple of years where like, everything now has to focus on COVID. So some of these obstacles are still in place. And it’s just a acknowledgment that that’s the system that we currently live in.
Katie Vernoy 12:21
So you mentioned kind of getting more providers for places that have provider shortages. And I think that’s one of the biggest stated benefits, I think, clinician match and finding clinicians that have a specialty when you don’t have a lot of clinicians in your state can be very helpful. There’s also continuity of care. I’ve talked about my clients traveling around and especially as things open back up, there’s clinicians or clients that are traveling a lot more and so we have to time their sessions versus just being able to meet at a regular time via telehealth, I think there’s a lot of positives that are being seen here. We’ve started talking about some of the hesitations and and and we are aware that the for the MFT stuff CAMFT, AAMFT and AAMFTRB, you know, what least AMFT and CAMFT are talking and have reached out to AAMFTRB, whatever that is.
Curt Widhalm 13:12
Yeah, you got it right.
Katie Vernoy 13:13
So there’s, there’s conversations happening, I think, and obviously different stages for all the licenses, there’s, there’s a, there isn’t a knowledge that this is something it’s kind of the wave of the future, because we can interact so freely across state lines, like why not get this process in place, but there’s a lot of complications, you know, the overarching scope of practice, the complication of setting it up and running it and all those kinds of stuff. There’s a lot of stuff that’s very challenging there. How much do we want to talk about that, that element versus you, you’ve already previewed for me anyway, that you are a little bit of a skeptic here. When do we want to what do we When do we want to shift gears to that? Because I think that there’s so many folks are super excited about this. And I think there are things that are exciting about it. But there are some real concerns that I want to make sure we get to. So where should we go next? I guess is the question that I’m asking here.
Curt Widhalm 14:06
So this has all of the makings of a wonderful piece of legislation and cooperation that I don’t know actually addresses what it’s saying that it’s intended to address.
Katie Vernoy 14:21
Okay.
Curt Widhalm 14:21
It is no surprise to anybody who listens to our podcasts that we have a mental health crisis, and we have a very understaffed mental health workforce. This theoretically allows for more clients to address more providers, but many of these states are amongst the most impacted as far as having the fewest providers available. And so if you combine 10 states who don’t have enough workforce for each of their own individual states, by their 10 powers combined, theoretically can’t address that even more people are going to be able to access a limited number of providers. It’s not like we have, you know, a bunch of people who are all just residing in Utah, there’s, you know, 9 million LPCs in Utah, who now just have like all of this free time to go and see clients who need to see counselors that Utah just has this, you know, mass amounts of people who have been confined to by state lines. This is, you know, a bunch of people without enough food now sharing that they don’t have enough food with more people in more places.
Katie Vernoy 15:38
It doesn’t make it worse. It just doesn’t solve it is what is how I see it. But I think if folks who, if these states that have those needs don’t get it started, I think it’s hard because I think the big states don’t need those extra jobs. Right? I mean, it maybe they do. I mean, I think there’s a lot of clinicians in California, they’re like, yeah, let me practice somewhere else, because I need I need clients, there’s, you know, you could trip over a therapist, every few steps in California. So I mean, it’s possible that with this starting, I mean, PSYPACT is going on 34 states. So we’ve moved beyond the the threshold in PSYPACT, where it’s just states that are having provider shortages. I think I think I see what you’re saying this does not solve? Did you want to start it?
Curt Widhalm 16:28
But I do want to correct one thing that you’re saying is, we have a bias because we hang out with a lot of therapists in a very populated city.
Katie Vernoy 16:38
Sure.
Curt Widhalm 16:38
But California has a mental health workforce shortage as well. It’s just that, this goes to address that there’s rural parts of our states. And there’s rural parts of a lot of these other states that are part of this, that we we have our own shortages, and we’re not able to address this inviting more people to address, you know, people in rural areas. It’s well intended, but it doesn’t motivate or necessarily get people to the jobs that are needed in these positions.
Katie Vernoy 17:12
What you just said actually made me think about the series that we’re still somewhat in the process of Fixing Mental Healthcare in America. But I think there’s that that piece that the the RAND Corporation identified where there has been efforts and telehealth is a great effort to try to bring, you know, therapy to these rural areas, but the infrastructure and you know, good good WiFi, and all of the pieces to actually be able to address these things potentially are more impactful than just adding clinicians from another state that are probably going to want to access or your wealthy urban clients anyway.
Curt Widhalm 17:52
Which leads to my second criticism of this is that because of the scramble that’s going to happen, the people who are most likely able to address the shortcomings of this public policy position across these 10 states are venture capital led groups like BetterHelp, that will do all of the legwork to match you up with clients in all of these rural areas. And we’ve got other episodes that we will talk in, you know, in BetterHelp’s defence it’s not just BetterHelp who can take advantage of these. But I have my concerns that the people who have already been doing this against the law, as we’ve discussed in our previous episodes are motivating therapists to practice across state lines, when they’re not allowed to are the ones who are going to continue to contribute to the already capitalistic problems of our profession. And once again, not really with the best intentions of what clients have in store for them. But just by virtue of being able to match people more easily than any of the individual therapists in private practice. Where like, hey, my clients going on vacation, I can still see them for their regular session.
Katie Vernoy 19:21
We’ll link to a lot of those episodes in the show notes. But but what I’m hearing you say Curt, is that this is super charging the big tech problem.
Curt Widhalm 19:31
Yes, it is.
Katie Vernoy 19:32
Okay. Mic drop.
Curt Widhalm 19:39
Pick that mic right back up, because they’re, I don’t know, I’m the resident, you know, contrarian of the show, the one who’s maybe trying to poke at things and often I hear from listeners or from Katie or other people in my life is like, Why let perfection be the enemy of good? And so I am looking, you know, for who else opposes this? And I did come across somebody else on the opposition side of this. And it’s a little group called the FBI.
Katie Vernoy 20:20
Why? Why is the FBI opposing this?
Curt Widhalm 20:25
For those unfamiliar with the FBI, they are a law enforcement agency. And they are one of the generally two places that when you go to get licensed that your background checks go to.
Katie Vernoy 20:38
Ah, yes.
Curt Widhalm 20:39
And so the rationale in other interstate compacts, including Counseling Compact, including PSYPACT, including medical compacts, and nurses compacts, the FBI has had a pretty consistent position on this. And their reasoning is that these states entering into these agreements, does not give them the right to supersede federal background checks. Now, allowing for practicing privileges in another state allows for the bypass of doing a background check for that state.
Katie Vernoy 21:13
Oh, interesting.
Curt Widhalm 21:14
And the way that the Department of Justice allows for some of these states to get the results of background checks, does not allow for them to share the information from those background checks.
Katie Vernoy 21:27
Oh, that’s why if you get licensed in another state, even if you can say like, Hey, I’m licensed over here, they did my background check. The new state still needs a background check.
Curt Widhalm 21:37
And giving practicing privileges as I understand this legislation to be written today does not require background checks. It allows for the disciplinary boards to share information about discipline. But let’s say that a therapist from one of these 10 states, goes on a weekend Bender in Vegas and ends up in the Clark County Jail. That information does not necessarily get shared with either licensing states because why, but then also doesn’t get shared with any of the other practicing privileged states. It’s not something that would mess like up. Overall therapists don’t get arrested.
Katie Vernoy 22:22
Yeah, just don’t
Curt Widhalm 22:23
Yes. But especially don’t get arrested in your practicing states, because you’re practicing states have with their own State Department of Justice’s, like, California BBS. Like if somebody gets arrested, and they’re licensed California, they get a little like, ping the next morning of like, hey, one of your licensees was arrested. But if you’re, if you’re gonna get arrested, don’t get arrested, you know, being outside of your jurisdiction, at least, there’s some opportunities to fall through the cracks there. And the…
Katie Vernoy 22:55
Are you telling people to how to avoid getting in trouble?
Curt Widhalm 22:58
This is not legal advice. And legal advice, once again, is don’t get arrested. But what the FBI’s database does, is allows for this information to be pinged in each time that somebody goes through a background check. The FBI is saying that this does not actually empower any of the states to know information if somebody was to have a an offense against them that wasn’t caught or happened after their own background check to get a license in their own state.
Katie Vernoy 23:31
Well, I’m just even thinking for myself, I have not been arrested. I don’t have anything that I have to worry about. But yeah, I haven’t had a background check for 15 years? So I could be doing all kinds of stuff and get practicing privileges elsewhere – is what you’re telling me?
Curt Widhalm 23:48
Yes. And so this very much goes against, according to the FBI, any sort of patient protection that any of these licensing boards are put into place in the first place to protect consumers.
Katie Vernoy 24:03
Well, I haven’t think taking this further the whole consumer protection angle, and I think I’m gonna give you credit, you mentioned this before we started recording. But as a consumer, I have no place to check if you actually do have practicing privileges in my state, or if there’s any problems. I mean, I guess I could look at your licensing state if I knew how to do that, knew where to do it, and can see if there’s any any dings on your license, but, but it really takes some of the stuff out of the consumers hand being able to identify, you know, anything about the person that they’re working with.
Curt Widhalm 24:41
And I imagine that these are things that are going to need to be addressed over the next few years as having some way of centrally notifying each other’s state licensures or any of that kind of stuff. And I’m sure that there’s somebody out there saying, But Curt this hasn’t been a problem with PSYPACT yet. And the answer that I have back in response to you is “that we know of, and it will likely happen.”
Katie Vernoy 25:13
Well, I think it’s something where there’s, and this was something that I hadn’t thought about. But in a conversation that we had, I think it’s something where, with psychologists, the, as far as I know, the licensing exams, their expectations are pretty constant across the United States. And so if somebody messes up in the state that they’re licensed in, that’s going to have a big impact, because it is the same pretty far across and I, this doesn’t address the federal background checks. But I think it does address this kind of idea of all the complexity and and consumers having an issue because what they’re expecting from their clinician is not what they get, because their clinician practices way differently than anybody in their state, for example, but MFTs don’t have that. I mean, there’s that there’s a national association, but all 50 states basically have different expectations. Counselors, I think, are a little bit more streamlined and so that’s probably why they’re moving forward. Social workers are very streamlined, and I’m sure they’re going to probably get, you know, glide through this. But I think it’s something where that feels solvable, you know, getting a getting some way that there’s this the background checks and that kind of stuff, if you’re if you’re part of this compact, if you choose to get practicing privileges, there’s a federal body that you then have to get a background check. And then that, you know, somebody at the federal level is running it versus each state having to do it. You know, I think there’s some legislation that could probably really help this. But that seems really expensive. And I’m wondering, you know, there’s part of me, that’s like do therapists care? Do to consumers care? I mean, like, we’re worried about this regulation and there’s part of me, and there’s a whole podcast devoted to this Very Bad Therapy. But there’s, there’s bad clinicians that are not going to have oversight. But then there’s also all of these clients, who don’t have access to therapists who accept them as who they are. And so having some of these things come into place, like to me, it seems like it could be good. So I’m getting all over the place. So bring us back to something that’s that’s helpful. But I think there’s, there’s this element of it feels solvable. I just don’t know the timeline, or how much money, but…
Curt Widhalm 27:36
That those two points are the problems that I foresee with this, that it’s none of these things that I’m bringing up are unsolvable. Maybe the BetterHelp thing. But…
Katie Vernoy 27:52
That’s a different problem. It’s separate from this problem to solve.
Curt Widhalm 27:55
Right. But it’s probably going to be a lot more costs that are passed on to the providers than anybody sees. The buzz that I’m initially hearing from people on this is very much like you that most people are taking this as, oh, I can just kind of see my clients wherever they travel, as long as they’re in one of these 10 states.
Katie Vernoy 28:19
Yeah.
Curt Widhalm 28:19
And that is not true. And each one of these states is going to be additional costs. And you know, the background checks thing is, all right, you still go down to your local fingerprinting place, you do your live scan, you’re just having it reported to a different state board and the FBI each time. And those things add up, you know, 50 bucks at a time adds up. Yeah, times that by 10 states, times it by the application fees, because part of the legislation that was written for all of these states is basically written by the same people. And it’s, you know, quote, unquote, not actually a direct quote here, but not going to have anything more than administrative costs passed on to clinicians. There’s a lot of administration costs in this that any of the licensing boards are more or less operating at a break even point that adding on a bunch of new staff to process out of state therapists and to verify things. Those are going to be cost that add up. Are they going to be cheaper than getting a license and meeting all the requirements in these other states? Absolutely. But these are costs that are going to add up for people. This is not going to be a free for all that all of these state licensing boards are going to allow here.
Katie Vernoy 29:40
Yeah, I think that’s the thing that’s that’s hard because there’s a lot of elements to this, that says that like this is this, this makes everything smooth and easy. This really provides additional access and the more we’ve talked together about it when we’ve talked to other folks about it, it just I’m hearing that there is so much complexity to how this operates, that it may not happen for all states, because you know, states that have enough clinician, states that have a higher cost of living, they may not feel the need to, to add to their costs, or their clinician base. And so they’re not going to take it on. But but when I look at, you know, really what we’re talking about, it’s, it’s trying to put a bandaid on this problem. And hopefully, it’s it’s something that there’s actually real federal legislation that can help to increase the infrastructure in places that need more clinicians, help to, to create systems that actually address some of these concerns that you’re bringing up. But that would require tax dollars, versus clinicians paying application fees, and all those things. I mean, I heard, I think that’s the thing I heard was like, millions of dollars to get this setup, you know, I mean, like, that’s, I guess, if you’ve got a lot of clinicians, that’s a cross of a lot of clinicians, you know, if they are savvy clinicians, those fees are then incorporated into the fees they charge, which then for private pay clinicians anyway means that they’re charging more. Insurance panels aren’t going to pay you more just because you’ve got some extra that’s under your belt. And so it’s something where the cost thing hasn’t been figured out, nor has the infrastructure both on the client side, but also on this regulatory side, it feels like there’s just so much to figure out here.
Curt Widhalm 31:35
And that’s something that I haven’t even seen how insurance is going to work across state lines that I willingly admit that I don’t know the inner workings of a lot of the insurance process, but knowing that, all right, yeah, it’s great that you can see a client to timezones away. But does their insurance allow it? And this is another factor that’s going to be in it. And, you know, we can talk all day long, and I’m already pre addressing some of the criticisms of this episode from people. We don’t yet have universal health care. Don’t even bring that up, like…
Katie Vernoy 32:14
Sure.
Curt Widhalm 32:15
Don’t make arguments about systems that we don’t have. These are problems that need to be addressed in the meantime. And yeah, I know that some people are going to say that this is the first step towards national licensure and this kind of stuff. OK or maybe…
Katie Vernoy 32:32
It may, it may actually delay it, it may delay it, because it’s a band aid where people can go practice in other states. So why would I get a national license, if I can practice in a couple other states and not worry about taking another task, getting another background check, blah, blah, blah. I before we before we finish up, because I think there’s probably going to be responses that then lead to additional episodes on this topic. But I think that just to kind of maybe poke the beast here a little bit. But with the with the insurance stuff, I think we’re already seeing what insurance companies are going to do. And that is contract with these large tech companies that have clinicians across all the states pay them more so clinicians can get more, but it means that individual practitioners almost de facto have to be private pay, because they’re going to get worse insurance rates, and they’re not going to be able to really compete, certainly not in advertising dollars, or whatever. And we have a whole episode on this, but they’re not able to compete with a gigantic quote unquote, tech solutions and or group practices. And so I think, I think it’s something where there is a lot to consider here. I think there’s going to be a lot of conversations that we want to have related to the disruptors, the tech disruptors in the space, who are the good ones, who are the ones that are challenging, and potentially hurting our profession? How do we, you know, step into this and, and take ownership of this space because, you know, there is so much and and potentially these these compacts allow for us to compete at this level. Or it may make it harder and I guess that’s to be seen, I really think.
Curt Widhalm 34:14
Giving over the power, giving over the insurance contracts to publicly traded corporations means decisions get made quarter by quarter based on profits. And that is not what the healthcare system should be. We’re kind of in a space where some people are able to compete against that but so many more episodes to be done on this. We will include some links to some stuff in our show notes. You can find those over at mtsgpodcast.com. You can bring up your concerns or tell us why you think that I am wrong on our social media.
Katie Vernoy 34:54
Or I’m wrong. I we’ve got a lot that we said here. So definitely join us over at the Facebook Group, tell us what we’re what we missed, because we certainly missed a lot, I’m sure.
Curt Widhalm 35:04
And until next time, I’m Curt Widhalm with Katie Vernoy.
Katie Vernoy 35:08
Thanks again to our sponsor, OOTify.
Curt Widhalm 35:10
“OOT” or “uth” (उठ) means “lift up” in the Hindi language. OOTify is a digital health solution that acts as an evidence based hub to unify relevant mental health resources. Community connection and collaboration are critical to OOTify. As they lift the mental health care system, they ensure providers are part of the process. OOTify is a platform for providers built by providers and owned by providers. OOTify is in the process of lifting up mental health care while lifting each other up.
OOTify 35:43
We need to talk about our mental health. We need to make our mental health stronger so we can withstand the things that happen in our life. We’re gonna go through trials and tribulations. But if we can work on our mental health proactively our wellness, we can handle all that as a community and come together, people are more open to talk about these stories and say, Hey, listen, I’m going through this too. Do you want to be a part of the solution by joining a new web three community focused on mental health and wellness? Join the unified community as an investor or mental health provider by visiting ootify.com/contact. You can also give us a follow on social media to stay tuned on exciting updates.
Curt Widhalm 36:25
This episode is also brought to you by Turning Point.
Katie Vernoy 36:29
We wanted to tell you a little bit more about our sponsor Turning Point. Turning Point is a financial planning and coaching firm that helps therapists stop worrying about money. Dave, our good buddy over atTurning Point will help you navigate every aspect of your financial life from practice financials and personal budgeting to investing, taxes and student loans. He’ll help you move through that feeling of being stuck, frustrated and overwhelmed, and arrive at a place where you feel relief, validation, motivation and hope.
Curt Widhalm 37:00
And for listeners of MTSG you’ll receive $200 off the price of any service. Just enter the promo code ‘moderntherapist’, be sure and visit turningpointhq.com and download the free white papers Seven Money Mindset Shifts to Reduce Financial Anxiety. That’s turningpointhq.com
Announcer 37:18
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