- Who were the founders of COPACT and how/why did it start?
The creation of COPACT was a joint effort of the Oregon Counseling Association (ORCA), the Oregon Association for Marriage and Family Therapy (OAMFT), and the Oregon Mental Health Counselors Association (OMHCA). In 2013 OMHCA merged with ORCA. The original COPACT team was Larry Conner LPC from OMHCA, Tracie MacDowell LPC from ORCA, and Steve Rodgers LMFT from OAMFT. The purpose of COPACT was to have ongoing lobbying and legislative work on behalf of LMFTs and LPCs in Oregon. The first goal was to address any legislation that included Social Workers and Psychologists, but not LPCs/LMFTs. That included malpractice reform legislation and the ability for a teen client to self-refer for counseling services.
- How does lobbying/legislation work (how long are the sessions, etc)?
That is actually a huge question to answer. Legislation can happen a number of ways. The way COPACT is likely to create legislation is to come up with a proposal that is called a Legislative Concept (LC). Once that has been written, COPACT reaches out to legislators to find sponsors to help move it through the legislature. One of the crucial parts of the process is that our lobbyist, Elizabeth Remley, maintains relationships with legislators throughout the year, so when COPACT approaches them with an LC, they are way more likely to get on board. Once we have sponsors, the sponsors submit the LC to become a bill which then moves into the legislature for the next session. The sessions are of two lengths: the long session which runs on odd years from around the first week in February until June or even July. That is when most big pieces of legislation are passed. The following year there is the short session, which runs on even years, and lasts 4-6 weeks. It is largely designed to pass legislation that has to do with the budget. However, legislators have the right to propose a limited number of bills that are unrelated to the budget, and sometimes in a very short time, an important piece of legislation can emerge.
Lobbying is a complex and multi-faceted process. I mentioned above, a big part of it is maintaining long term relationships with legislators. Our lobbyist also is in Salem throughout the year and is able to attend meetings with legislators, agency administrators, and the governor’s office on our behalf. Following those meetings, COPACT gets to hear about any legislation or agency policies that might have an impact on LPCs and LMFTs. Sometimes there is legislation that is threatening to our professions, and when we get news of it, COPACT is able to respond quickly to avoid a serious problem. Because all the COPACT team members have busy careers, we don’t have time to be in Salem throughout the year to hear rumblings and back door developments. Having a lobbyist there on our behalf keeps us all that much safer. Once a piece of legislation, that we support or oppose, becomes a bill, our lobbyist works with legislators to either get it passed, amended, or defeated.
Without COPACT LPCs and LMFTs would have no effective input in the legislative process. So, threatening things could come up in the legislature or state government and LPCs and LMFTs would have little ability to stop them. Furthermore, if LPCs and LMFTs wanted something passed in the legislature, they would have very little effectiveness. Having a lobbying organization and a professional lobbyist is crucial to the health of our professions.
- What is the Practice Act and why did we need it?
Back in 1989, after many years of effort, a group of LPCs and LMFTs were able to pass our first licensure bill, that was what is called, a title act. Essentially what that meant was that only a Licensed Professional Counselor and a Licensed Marriage and Family Therapist could use those titles. It did not require that anyone get a license, so there were many professional counselors and marriage and family therapists who practiced without a license. The original licensure title act set up an oversight board (OBLPCT) that was created to define licensure standards and policies and to discipline misbehaving licensees. That was the first step toward LPCs and LMFTs being recognized as professions providing mental health services in Oregon. Over a period of 15 years, LPCs and LMFTs tried to amend the licensure statute to get insurance reimbursement for our services. Over time, legislators became interested in our creating a practice act to replace the original title act. A practice act is much more difficult to define and to pass because it includes definitions of what professional counseling and marriage and family therapy are, and it requires that anyone who engages in those practices as defined, must be licensed. The Psychologists had worked under a Practice Act for several decades. The Social Workers and LPCs/LMFTs both worked under Title Acts. The legislature wanted all mental health providers to work under practice acts. In 2009 we were able to pass a Practice Act for LPCs and LMFTs. In doing so, we ensured that we were also able to obtain the right to reimburse our services through health insurers. Prior to 2009, LPCs and LMFTs worked almost totally on a cash basis, with only a few insurance policies written out-of-state covering our work. The Practice Act also made LPCs and LMFTs core providers of mental health services in Oregon alongside Psychiatrists, Nurse Practitioners, Psychologists, and LCSWs. That means, since that time, the State of Oregon has looked to us for input about state mental health funding and policies. COPACT has served as the voice for LPCs and LMFTs in state government.
- Who was behind the Practice Act?
A group of LPCs and LMFTs throughout the state worked from 2004-2009 to achieve the passage of the practice act. The process started with an LMFT from Ashland, Mary Lou Brophy, who contacted her legislator, Peter Buckley, and impressed him there was a problem to resolve. Several hundred LPCs and LMFTs joined in the effort, giving financial support and personal effort for years. After a painful defeat in 2007, Mary Lou Brophy had to move out of state to address a family need, and Bryan Nilsen LMFT, Jeff Harman LPC, and Larry Conner LPC, with a number of other core members of the team, took over the leadership of the coalition. The team wrote a practice act; hired a lobbyist, Elizabeth Cushwa; and in 2009, were successful in passing the Practice Act. It is important to note that this was the final effort that followed 15 years of frustrating, failed attempts to get insurance reimbursement for LPCs and LMFTs which was led by the leadership of OAMFT, ORCA, and OMHCA. Over those 15 years, our failed efforts taught us how to be successful in the legislature.
- How does COPACT represent me as an LPC/LMFT in Oregon?
First off, we listen to the input of LPCs and LMFTs through ORCA and OAMFT. Information comes to us from the organizations and from their listservs. If we hear of a concern we meet as a group to decide how to respond. For example in 2017, we heard from a number of LPCs and LMFTs that Regence had started to cover intake sessions as applying to the client’s deductible and was no longer a copay, which is what the US Affordable Care Act required. Very quickly COPACT, along with the Oregon Psychological Association, contacted Regence and they reversed the policy. That saved our Regence clients a lot of money out of pocket. The reason we got on that so quickly, was that we knew from our history, that once Regence makes a change in how they operate, it is very common for all the other insurers to follow suit.
Through our lobbyist, Elizabeth Remley, COPACT hears about what bills are being proposed by legislators and what policy changes are being implemented by the Oregon Health Authority, DHS or other state agencies. With that information, COPACT directs Elizabeth how to respond to the proposed changes, either telling her to support, to remain neutral, or to oppose the changes. COPACT members may go to Salem for a meeting with an agency leadership team, or to testify in a legislative committee. Other times we write letters to committee members supporting or opposing particular bills.
COPACT works directly with our licensure board, OBLPCT, to address changes OBLPCT makes to the Rule we work under. Let me explain what Rule is: The Law LPCs and LMFTs work under is made up of two parts: the Statute (ORS) which is passed by the legislature, and the Administrative Rule (OAR) that is written by oversight boards to implement and flesh out what is in the statute. So, when OBLPCT announces a change to Rule, (OAR Chapter 833), COPACT goes over each change to see if it is consistent with our Practice Act, (ORS 675.705 - 675.835). If we think the proposed changes to Rule are in conflict with what is contained in the Practice Act, we write long letters and potentially have a meeting with OBLPCT to try to resolve the differences.
Furthermore, when OBLPCT or anyone else wants to change the Practice Act, COPACT has to approve the language changes they wish to make. In a way, COPACT owns the Practice Act. We wrote it, and we have to approve any changes to it. COPACT has the ability to derail any threatening attempt to change the Practice Act. That remains true as long as we have a lobbyist watching our backs in Salem. Without a lobbyist, our ability to protect the Practice Act goes down considerably. We might not even know about a threat to our Practice Act until it was already passing.
- How does COPACT make decisions about legislative issues?
We meet together as a group weekly when the legislature is in session and once a month the rest of the year. We go over legislation and legislative concepts and we address mental health policy issues that show up. On our team we have LPCs and LMFTs who are interested in politics and mental health. Some have legislative experience. All have the passion to care about how political decisions affect the lives of Oregonians with mental health and addiction issues. Together we develop a strategy to address whatever issue comes up. We rely on our lobbyist, Elizabeth Remley to guide us through the thicket of political activity in Salem. Whenever COPACT wants to take a position on a bill or ballot measure, or to pass a bill of our own, we always pass it by the leadership of ORCA and OAMFT first.
- Does COPACT address malpractice issues?
In 2011, COPACT wrote and passed a bill that added LPCs and LMFTs to malpractice legislation that already applied to social workers and psychologists. They had been exempted from punitive damages in malpractice lawsuits. LPCs and LMFTs were not exempted. Punitive damages are the big monetary fines that are assigned to punish professionals who lose malpractice cases in court. Thanks to HB 2217 in 2011, LPCs and LMFTs did not have to worry about facing huge punitive damage fines.
- What bills have you helped pass that impact me as an LPC/LMFT?
Let’s do this by year:
-2010: we passed HB 3668 which amended the practice act to allow 100 LPCs working as school counselors to hold onto their licenses.
-2011: we passed HB 2217 which extends the exemption from punitive damages in malpractice suits to include LPCs and LMFTs.
-2013: we passed HB 2768 which amended the Practice Act to make practice definitions clearer and better situated for health care reform. It also amended the LMFT internship process to allow the same amount of internship for LMFTs as LPCs. The same year we also passed SB 491 which allows teens to self-refer to access care from LPCs and LMFTs, and we worked on HB 2737, which allows independent mental health clinics to bill insurance in a way that has the effect of increasing the availability of internships.
-2015: we supported HB 2307, which prohibits the use of Conversion Therapy on minors, supported HB 2796, which created a licensure process for Music Therapists, helped clarify and supported HB 2023, which sets policies for hospitals when discharging mental health clients, supported HB 430, which prohibits licensure boards from issuing a license to a person with a conviction for sex crimes, supported HB 2468, which directs the Oregon Insurance Division to establish specifics for making provider networks more accessible for clients and providers, and supported HB 832, which allows for full reimbursement of mental health services provided in primary care settings. That same year we kept a close eye on two bills: SB 901, which requires insurers to directly reimburse an out-of-network provider who bills the insurer and HB 3347, which makes it easier for courts to commit a mental health patient under the basic personal needs criteria.
-2016: we kept an eye on SB 1558, which protects students’ mental health records.
-2017: we supported Art Therapists in their successful effort to obtain state licensure while protecting the right of LPCs and LMFTs to use are in their practices. We also worked to defend the right of LPCs to provide services to sex offenders. We successfully fought against legislative efforts to define required topics for continuing education training, and we helped develop and worked to pass SB 860 which creates a structure to evaluate mental health reimbursement reductions as potential violations of parity law. COPACT had been working on the reimbursement reduction issue in the legislature since 2010. We also kept an eye on a failed revenue raising strategy that would have increased taxes on all mental health related services.
-2018: we rested through a quiet short session where very little mental health legislation emerged.
-2019: we expect there to be much legislation on the Oregon Health Plan, mental health services and Health Care Reform.
- How do you decide who is on the board?
COPACT members are always on the lookout for LPCs, LMFTs, Registered Interns, and graduate students who show an interest in politics. We then ask them to consider joining COPACT. Right now we have six COPACT members. We could always use more. I would like to see that number double.
- Is COPACT independent of ORCA and OAMFT?
Absolutely not. COPACT is the political arm of both organizations. We do not engage in anything independent of the judgment of the boards of ORCA and OAMFT. COPACT’s bylaws are written clearly that it cannot go on its own and do whatever it wants to do. COPACT directors work at the pleasure of the Presidents of their respective home organizations. We refer to ORCA and OAMFT as the “Mother Ship.” .
The vast majority of our funding comes from the membership dues in ORCA and OAMFT. Most of our expenses are to cover the work of our lobbyist, Elizabeth Remley. Effective lobbying is not cheap. COPACT also receives some direct donations through Paypal on our website: copactoregon.com. Every bit helps.