Health care groups backing bill to overhaul psychology law

Mental health care providers in Wisconsin are backing new legislation that would overhaul state law surrounding psychology and the board overseeing the practice. 

Dr. Heather Smith, an associate professor at the Medical College of Wisconsin, says the bill would “greatly enhance” the ability of health care systems in the state to train and retain licensed psychologists. 

“AB 487 allows for updating of the Wisconsin psychologists law to bring it into accord with the psychology licensure laws of the majority of other states,” she said yesterday during a public hearing held by the Assembly Committee on Health. 

The proposed legislation has broad industry support including MCW, Marshfield Clinic, Rogers Memorial Hospital, the Milwaukee County Behavioral Health Division and the Wisconsin School of Professional Psychology. 

“As far as we can see, this has been a pretty popular bill,” said Dr. Greg Jurenec, a faculty member for the WSPP. He explained that several changes to state law over the years have lowered the standards for the state’s psychology license. 

“Starting in 2016 when the code was revised, we lost the ability to require a predoctoral internship, which was one of these core standards to practice in clinical psychology across the country,” he said. “The second thing that changed was the whole landscape of health care reimbursement.” 

He said insurers will no longer pay for services unless providers of counseling and other mental health services are officially licensed. According to Jurenec, an individual with a PhD in psychology who’s done an internship has significant experience and training. But since they don’t have a license, third-party payers often won’t pay for them. 

“That makes it hard to get a job, to get supervised and to reach the one-year post-doctoral experience,” he said. 

Some psychologists-in-training get that experience through formalized post-doc programs, but Jurenec says these are limited in number and size. Some go to work for the government such as the Department of Corrections, while others can get jobs as licensed professional counselors. 

“This isn’t really a good set up anymore, and it has become really difficult and challenging for people to meet the post-doctoral supervision requirement,” he said. 

Due to the changes in health care reimbursement and Wisconsin groups’ inability to offer pre-doctoral internships, new graduates are “challenged in meeting this essential post-doctoral requirement.” 

“Wisconsin is now below the standards of our neighboring states, as well as general national standards,” Jurenec said. 

Smith told members of the Assembly Health Committee that requiring a post-doctoral internship is “not part of or even allowed under the state statute,” despite the experience being a “minimum professional training standard” recognized by professional psychologist organizations as well as other states. 

“AB 487 addresses that deficiency,” she said yesterday. “In doing so, it gives legitimacy to the Wisconsin psychologist law that currently does not exist.” 

She said the bill would also eliminate the “additional step and expense” of obtaining a secondary credential for insurance reimbursement purposes to make up for the state license’s shortcomings. 

“Through this systematic change, MCW will be more likely to retain our high-caliber post-doctoral fellows long-term and therefore enhance the overall supply of providers for mental health care in Wisconsin,” Smith said. 

Dr. Jennifer Michaels with Marshfield Clinic agreed the bill would help address the state’s shortage of mental health services. 

“We’re a big system, and every day our medical and behavioral health professionals within the system experience the challenges of shortages of mental health care workforce in our state and the limited access,” she said. 

Jurenec said the bill would bring the state’s standards “up to par with those of our neighbor states,” namely by writing the pre-doctoral internship requirement back into the law “so that the code can be correctly supported by statute.” 

Aside from some of the changes to licensing regulations, the legislation would also grant the governor more control over members of the Psychology Examining Board. Under current law, the board is composed of six members, including four licensed psychologists and two public members, and each psychologist much represent a different specialty area. 

The bill would eliminate that requirement for specialty area representation, instead requiring that the governor nominate psychologists to the board that represent various specialties “to the extent possible.” 

The legislation was introduced by Rep. Paul Tittl, R-Manitowoc, and Sen Alberta Darling, R-River Hills. 

See the bill text: