Authentic Collaboration Leads to Systemic Change in PA Mental Health Care Access

Thanks to the work of the Government Relations Committee for the Pennsylvania Counseling Association, Pennsylvanians now have better access to mental health care—and Duquesne counseling students can start practicing with increased compensation opportunities sooner to help fill the gap. 
 
Pennsylvania’s Act 76, passed in 1987, required new graduates of counseling programs to complete 3,000 supervised hours before they could hold a state-issued professional license to work as professional counselors. A related Pennsylvania insurance law (Title 40) states that these providers could not bill insurance companies for their services. This meant that new graduates were unable to receive insurance-based payment for their work for a significant window of time—sometimes years—until their requirements were met. This also meant that many consumers of counseling services could not use their health insurance benefits to pay for critical mental health care.
 
While insurance companies made concessions regarding Title 40 during the COVID-19 pandemic to allow Pennsylvanians to obtain mental health care, in January 2024, insurers began to uphold the insurance law and deny reimbursement to counselors who were working toward their 3,000 supervised hours for full licensure as professional counselors. As a result, fewer counselors were able to accept insurance for their services, which significantly limited income for new counseling graduates. Additionally, clients experienced difficulty finding a counselor, and some existing clients had to discontinue care because they could no longer use their insurance benefits. 
 
Luckily, new Pennsylvania legislation (Act 4 of 2024) amends the current professional counseling law and allows new graduates to apply for a first-tier counseling license—the Associate Professional Counselor license (LAPC). This license allows qualified graduates to test and apply for licensure immediately after graduation. 
 
The LAPC enables new counselors to receive compensation from insurers for their work while also allowing clients to use their insurance benefits for mental health care. Those who hold the new LAPC are expected to work for their required 3,000 supervised hours toward full and independent licensure as a Licensed Professional Counselor (LPC) in Pennsylvania.  
 
The new LAPC is expected to increase access to care across Pennsylvania while providing recent, qualified counseling graduates with the opportunity to begin their career and receive compensation upon graduation instead of upon completion of supervised hours.
 
The Government Relations Committee for the Pennsylvania Counseling Association worked tirelessly to become a trusted partner of Pennsylvania’s counselors and legislators to address this systemic challenge.
 
Together, the team drafted language to create Act 4 and developed talking points for legislators and their staff. Between November 2023 and March 2024, the law was introduced, passed, signed by the governor and implemented. The professional counseling licensure board is now accepting applications and providing first-tier, LAPC licenses to new counselors.
 
Duquesne counseling students—and counseling students across Pennsylvania—recognize they have a brighter future, more open doors and better job prospects, as they know they’ll be able to receive compensation for their services sooner with the removal of previous restrictions.
 

After earning her master’s in clinical mental health counseling through Duquesne’s School of Education, Edisa Music continues her studies in the counselor education and supervision doctorate program. She is happy to serve clients in private practice and make a difference. 
 
“We were in our journey of becoming early-career professionals, gaining clinical experience required for our licensure, which takes approximately two years,” she said. “But then we were hit with insurances pulling out, and we were left with a decrease in continuity of care and a deficit to clients who no longer had access to mental health care.”  

Edisa’s classmate Elena Shahen also works in private practice, and she looks forward to helping more individuals through Act 4.

“When insurance companies started abiding by Title 40, some of the clients I had been seeing for more than a year were not able to make it work without insurance, and we don't want to add even more stress and burden on their mental health and wellness by changing the pay structure,” she said. “With an associate license, now I can offer even more to many clients, and they have less of a financial burden.”