Hello, State Leaders:

Last week I had the foresight to see that the Senate bill, as introduced was going to pose some controversy among our members. I was quick to pull together a call for my AMHCA public policy committee as well as send out an email to our regional directors, which I asked them to forward on to state leaders. A day ago, there were numerous “chain” emails going out from a New York woman by the name of Christine Richardson. Senator Lieberman’s office saw these emails coming in great number and asked about pulling the bill. We certainly don’t want that to happen. Myself and Senate staff have followed up with Ms. Richardson to let her know that her efforts are undermining attempts to get a bill at all- much less our great attempt to broaden the TRICARE bill so it allows more counselors to practice independently.

At this moment, I have received over 300 emails from members who find this law “repugnant” and many who want “nothing” versus this. I have personally written each one of these people back. Please see the attached Question and Answers sheet that I prepared; it describes our strategy moving this bill forward. Do know my colleagues and I wrestled with whether to go with this bill or not. The conclusion we came to is that in the past we’ve never advanced with a Senate TRICARE bill; it was the IOM report that even gave this profession credence with the Senate Armed Services Committee to get a Senate bill introduced. We presently have a more “general” House bill; the language in the House bill would allow anyone licensed to practice independently. Obviously, this language is more desirable. However, to progress and get a bill out of the House and into the Senate with Senate support, we need to have this issue before Senators, and the best way to ensure something gets into an omninus defense authorization bill, which is the military funding bill leaders in both the House and Senate are currently marking up at present, is to have a bill going in both congressional bodies. Our best hope to make the bill more inclusive is to go with having a bill introduced in both the Senate and the House and then use conference as a time to iron out language tweaks between House and Senate Armed Services Committee staffers and members. Several people have written me very condescending emails, telling me that my efforts are the antithesis of helping them, that I don’t care, that I am not working for them, and that we’re better off with no bill. I beg to disagree. I am working for counselors. Working the legislature is about nurturing relationships. We have worked for weeks to build support for counselor independent practice. Most legislators are not in the weeds of the IOM report and its bullet points; our main goal is to let them know soldiers need to be seen, and our folks are competent, caring, licensed professionals there to care for them. We don’t come across as caring when we slam the Senators who introduced the legislation or ask that we get rid of the legislation after it has been introduced. And, we don’t sound competent, when we start arguing about the IOM’s bullet points. I am the first to recognize these bullet points need tweaking. I received a call today from Senate staff asking how we could tweak the CACREP one. What this tells me is 1) enough emails on that topic have been received to alert staff to the need to make the bill more inclusive as to enhance access for soldiers and their dependents, and 2) we can build support for counselors by thanking Senators for their efforts to take up this issue.

For those who say this issue should just be dropped, I say: 1) Coming on the heels of the IOM report, the IOM’s overarching recommendation that counselors be able to practice independently was favorable news- and it’s the only way the Senate Armed Services Committee (SASC) was going to allow Senators to introduce a stand-alone bill that has any chance of going into the National Defense Authorization Act and becoming law. We could just have a stand alone bill with our language introduced, and know it cannot be incorporated into any legislation and it just dies. That would just be a show; that would not result in a law or more credence for the profession. For years, the SASC has been run by the same staffers; never before did they give us a bill. Finally, they have allowed us one on the Senate side. This is a step. Why? Because it means we can give the Senators a chance to vote on this and advance this to the House where if we have good cosponsorship among legislators, there is good likelihood this can become enacted into law. Our choices are this: 1) Nothing- Have nothing on the Senate side; something on the House side. But because we have no Senate bill, House bill has no ability to get into NDAA alone-absent Senate support from SASC staff. 2) Have bills introduced in each body and at absolute worst get some counselors into TRICARE independently, acquire support of Senators who introduced bill for general counselor issues including Medicare (ie we have GOP Senator introducing this with us- at a minimum if this law were to get her behind our Medicare legislation, we’d have a needed GOP Senator to get Medicare to pass. Not having a GOP Senator support our Medicare bill was the greatest reason for its inability to get into the final health reform bill), and then go back with some counselors already under TRICARE and be able to tweak language, as these counselors have proven themselves competent to practice independently, or 3) WHAT I AM AIMING FOR NOW- Have bills introduced in House and Senate. AMHCA members support Senators who introduced bill. AMHCA members solicit Senators to sign on as cosponsors to Senate bill. Julie works behind scenes with SASC on ways to tweak language. Bill passes House and Senate with desired support; bill goes to conference. We then have leverage to argue for enhanced language of House bill. More counselors get included. Lieberman, Collins, and McCaskill like counselors. They decide to later sign onto Medicare too. Everyone lives happily ever after………

Please think before firing off these emails and encourage your members to do so too. Legislation is a muddy process. It’s not easy. It’s not fun and games. I had the foresight to prepare you for this over a week ago before it was introduced. My colleagues and I are committed to lobbying for you. We’re trying to protect you from doing things which will be detrimental to you in the long run. The best way your members can support the process is to get their legislators to sign on to S 3371. Write general letters/emails expressing the need for more counselors to serve soldiers independently. Don’t get into the weeds of TRICARE IOM report bullet points. I have this to say, “Here’s to you, kid. We’re working for you! I’m your advocate.” I am not trying to make things worse. Nor are my colleagues at NBCC and ACA. ACA’s legislative affairs director is out of the country this week. We’ve tried to alert his assistant to all the emails, calls on this issue. If you know ACA members, please reach out to them and encourage them to read my Q and A and to be informed about the process before impulsively firing off a negative email, or even a well-intentioned email, with great potential to be misconstrued.

Thank you, wise leaders. I appreciate your help!