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Follow VPR's statehouse coverage, featuring Pete Hirschfeld and Bob Kinzel in our Statehouse Bureau in Montpelier.

New Law Expands Medicaid To Licensed Drug And Alcohol Abuse Counselors

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Starting in October, licensed addiction counselors in Vermont may accept Medicaid payments even if their clients do not have mental health disorders.

There’s a change on the horizon for people who need help with alcohol and drug addiction. Starting in October, licensed counselors may accept Medicaid payments even if their clients do not have mental health disorders. That new state law is likely to expand access to treatment.

Vermont’s Department of Health uses a list of preferred providers for addiction treatment who are eligible for Medicaid reimbursement. Independent counselors outside that network cannot receive Medicaid payments unless their client is diagnosed with a mental illness as well as substance abuse. That can be a barrier to care for some people without that dual diagnosis. 

Dean Corcoran is a licensed counselor in St. Johnsbury, said he's glad the new law will soon allow him to accept Medicaid payments for addiction treatment, even though his busy practice is not in the state’s preferred provider network.

“The way it will affect [me] is that when I do have openings now, of course I will be able to say yes to the nice people that call with Medicaid [even if] I really can’t find a mental health diagnosis to fit them,” Corcoran said.

It will also become easier for people to find help close to home from an individual counselor, rather than the larger groups in the state’s network. Cindy Thomas, who directs the Division of Alcohol and Drug Abuse programs at Vermont’s Department of health, welcomes the new law.

"When I do have openings now, of course I will be able to say yes to the nice people that call with Medicaid [even if] I really can't find a mental health diagnosis to fit them." - Dean Corcoran, Stl. Johnsbury licensed counselor

“What it will do is open up the access, adding a number of providers to our system who are able to provide a variety of services,” Thomas said.

But not everyone supported the bill. Some testified to lawmakers that it weakens quality control. Julie Tessler is executive director of Vermont Care Partners, a trade group representing preferred providers. She says they have to meet high standards to join the state network. Independent counselors, she says, do not get as much oversight.

“So it’s a trade-off to increase accessibility to increase options for consumers, but it changes the way the system works,” Tessler said.

One of those changes is to move the licensing of addiction counselors from the Department of Health to the Office of Professional Regulation. The aim is to set a standard baseline for entry into the drug and alcohol counseling profession.

But that doesn’t mean experienced help is available to everyone who needs it. Even in the preferred network, starting salaries for counselors can be low. And state officials admit that in some areas, there are still waiting lists for treatment. 

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