The Louisiana Department of Health (LDH) is taking a key step to increase the availability of mental health providers in the state with a plan to expand Medicaid reimbursement eligibility to provisionally licensed mental health professionals (PLMHPs) while they are seeking full licensure.

Currently in Louisiana, PLMHPs can practice and provide mental health therapeutic services under the supervision of a fully licensed mental health professional (LMHP); however, these providers cannot receive Medicaid reimbursement. This policy change will allow PLMHPs who provide these critical services to obtain reimbursement from the Medicaid program as they are working toward full licensure. Under the state’s current framework, only LMHPs — which include licensed clinical social workers (LCSWs), licensed marriage and family therapists (LMFTs) and licensed professional counselors (LPCs) — are eligible for reimbursement for these services.

Louisiana, like the rest of the U.S., is facing critical behavioral health workforce challenges, while the need for services is as great as ever. Nationally, one in three people live in areas lacking mental health providers. In Louisiana, the Health Resources and Services Administration estimates only 26% of mental health needs are being met. At the same time, the number of adults reporting symptoms of anxiety and/or depressive disorder has steadily increased over the last five years, with 32.5% of Louisiana adults reporting symptoms in 2021.

One in five Louisiana adults live with mental illness, and Louisiana ranks 35th among all states for its suicide rate. Expanding access to services by increasing the number of providers eligible for Medicaid reimbursement is a critical part of LDH’s priority to address these complex behavioral health challenges. The Department estimates that over 4,000 providers in Louisiana would be newly eligible for reimbursement under this policy change as early as August 1. This includes as many as 1,796 provisionally licensed professional counselors, 137 provisionally licensed marriage and family therapists, and 2,564 licensed master social workers.

“This change is an exciting development for the thousands of Louisianans who have struggled to find providers to care for them,” said LDH Secretary Dr. Ralph Abraham. “A workforce shortage is one of the biggest challenges we face here in Louisiana as we work to improve mental health outcomes. This change — led by our Medicaid and Office of Behavioral Health teams — is an important step in expanding the availability of providers and critical mental health services for Louisiana residents.”

LDH is developing the change in partnership with behavioral health leaders from across the state, including the CEOs of Volunteers of America, Voris Vigee, David Kneipp and Carolyn Hammond.

“As CEOs of Volunteers of America affiliates across Louisiana, including Volunteers of America Southeast Louisiana, Volunteers of America South Central Louisiana, and Volunteers of America North Louisiana, we commend LDH for its commitment to innovation in addressing the state’s behavioral health challenges,” the CEOs said in a joint statement. “This new policy change will result in increased access to essential care throughout Louisiana, where a shortage of licensed mental health professionals persists. We are grateful for LDH’s proactive efforts and look forward to continued collaboration in meeting the behavioral health needs of our communities.”

Colette Melancon, LCSW-BACS, the CEO of Covington-based Therapeutic Partners, said, “Real-life experience with supervision is the most powerful learning environment for clinicians to grow.”

“To develop a strong, clinically competent workforce, we need to allow LMSWs, PLPCs and PLMFTs to function fully in the traditional outpatient setting,” Melancon said. “Allowing these clinicians to bill CPT codes will increase access to care and strengthen our clinical workforce. Access to care and attracting and retaining competent clinicians is vital to better outcomes for our clients and this change is one step closer to achieving those goals.”

Before this policy is fully effective, rule changes and a state plan amendment (SPA) are required. The Notice of Intent of the proposed rule has been posted and can be accessed here. LDH expects publication of the final rule on July 20. If approved by the U.S. Centers for Medicare and Medicaid Services, implementation is expected to begin on August 1.