To Whom It May Concern,

I am writing in regards to DMAS’ proposed changes to provider qualifications as outlined in Chapter II, pages 15-16. I am deeply worried about the impact these changes will have on access to mental health counseling in the state of Virginia. These changes will lead to thousands of DMAS recipients not being able to access the mental health care that they need and those currently receiving services will have a disruption in service while finding another provider.

While the lack of health insurance is a significant barrier to care, another critical problem affects Virginia communities and Virginians — the significant and growing shortage of mental health care providers. Nearly half of Virginia communities, inner city areas and rural localities have too few providers to care for all of those in need.  In these underserved areas of Virginia, those who need behavioral health services must either travel a great distance to receive care or go without treatment. This is especially problematic for children and young adults. When we do not act early to support our children and young adults, we face consequences like significant increases in suicide, incarceration, homelessness, and school drop-out. These children and young adults end up needing even more extensive services well into adulthood. When we add up these losses of life and human potential, we see the incredibly high cost of not acting early. The statistics outlined above do not even include other bad outcomes, like losses in productivity, damage to relationships, and losses in life satisfaction as a whole. It is clear the increase in need for services for Virginians is a result of lack of qualified treatment providers for childrens’ mental health concerns. As such, increasing early intervention and the number of mental health providers is crucial to ensuring all who need services are provided them.

One form of early intervention is play therapy. The need for play therapy clinicians is in high demand across the state. Voices for Virginias’ Children found in September 2017 that 100 of the 133 localities in Virginia do not have enough mental health professionals to meet the need for childrens’ mental health services. The University of Virginia found in a study from February 2017 that more than 66,000 uninsured and Medicaid-insured Virginians with a mental illness are not receiving the services they need. Residents in Counseling and Supervisees in Social Work being able to see those with Medicaid for outpatient counseling is an important part of increasing the number of providers available. At my agency alone, we have over 50 children and 30 adults waiting for services. If Medicaid takes away resident in counseling and supervisee in social works’ abilities to see those with Medicaid insurance for outpatient counseling, these children and adults could wait years. With what we know about the need for early intervention, the timing of interventions’ impact on treatment outcomes, and the number of people waiting for services in Virginia, this is highly problematic.

It is clear that we have a crisis going on in the state of Virginia with regards to mental health. This is even with residents in counseling and supervisees in social work being able to see clients with Medicaid for outpatient counseling. I cannot imagine what said crisis will become should this ability be ended. I urge you to reconsider these changes and the impact they will have on mental health. DO NOT approve the proposed changes to provider qualifications for psychiatric services as outlined in Chapter II, pages 15-16 to stop the ability of residents in counseling and supervisees in social work to see clients in outpatient counseling settings. The consequences are too dire.

Sincerely,

Sarah Harig, MS, Resident in Counseling

Counselor

Family Service of Roanoke Valley

360 Campbell Ave SW

Roanoke, VA 24016

Phone: 540-563-5316, ext. 3064