A Historical Overview of CAP'S Legislative Activities
CAP was incorporated as a non-profit professional association in 1992. At that time there was a need from the then “nonlicensed” or “unlicensed” community of psychotherapists to organize in order to protect their rights to practice in Colorado. Over the past twenty years CAP has grown in recognition as a significant player in the legislative community concerning the practice of psychotherapy.
In 1991, a proposed Colorado Mental Health Licensing Statute would have prohibited unlicensed psychotherapists who had been working in the state for some time from providing services to the public. Because of the diligent efforts of Steve Andreas and several others such as Rob Williams, the proposed legislation was not passed. It failed because solid national research and data that had been collected by the Colorado Department of Regulatory Affairs was shared and brought to public attention.
Instead of banning unlicensed psychotherapy, the result of making the research and reports public, was for DORA to allow the continued practice of psychotherapy and to place unlicensed psychotherapists on grievance boards.
In 1992, Steve Andreas became the first unlicensed psychotherapist to serve on a DORA grievance board for psychotherapists. Since then DORA has balanced the representation on its Boards with registered psychotherapists and members of the general public. DORA has improved access by the public to a wide variety of mental health services by developing databases of therapists and making sure that psychotherapists are working within their area of competence.
Since 1992 there have been three “Sunset Reviews” by the Department of Regulatory Agencies. Each one involved the DORA reviewing the existing law and making recommendations to the Colorado Legislature for statutory changes. And in each of these reviews a coalition of mental health provider groups, including CAP, has collaborated to advocate and lobby DORA and the legislators on common positions and recommendations for change in the Sunset Review and subsequent legislative process
In 2003 the mental health coalition collectively agreed to keep the non-licensed providers in the mental health statute with little opposition. Though many licensed providers and some of their membership organizations may have preferred the elimination of the provision for non-licensed psychotherapists, the presence of the non or “un” licensed providers had already begun to become institutionalized in the mind of the state legislature and the Department of Regulatory Agencies. To remove the provision for such practitioners would not have been politically feasible. This was a direct result of CAP’s professional presence.
During the period from 2003 through 2012 CAP has participated in heading off some potentially negative legislation that would have caused difficulty for all the various mental health practitioners. Our lobbyists and board legislative chairs have kept a careful watch and identified when lobbying was needed at the state capital. CAP representatives stayed involved to assure that the integrity of the Mental Health Practice Act prevailed.
Also, during the 2003 meetings of the Mental Health Coalition, CAP began helping the other providers become more aware of the prohibited activity in the statute known as the “dual relationship” clause and how this language was vague and conflictual and needed to be clarified. However, there was not enough movement or initiative among the provider groups or the Department of Regulatory Agencies at the time to promote effective change in the language of the law.
Meanwhile, in the period leading up to the 2011 Sunset Review there was a pattern of misinterpretation of the dual relationship clause in the mental health statute on the regulatory side. (This included some DORA licensing boards and staff and the Colorado Attorney General’s staff to the mental health licensing boards and the Mental Health Grievance Board (now the Board for Registered Psychotherapists). An unspoken policy had been adopted by some regulators that there should be a categorical prohibition against any dual relationship. There was clearly no language in the statute that gave such interpreted authority.
CAP worked with the Mental Health Grievance Board and the DORA to bring clarification concerning the interpretation of the clause. CAP representatives were able to help the involved parties to better understand the current facts. We were able to assist in the adoption of new regulations so that a categorical prohibition of dual relationships were no longer to be the unwritten rule. The statute should be viewed in light of the various codes of ethics in different national provider groups. CAP showed that such relationships could be beneficial. This is one more way that CAP is keeping mental health on the forefront of the radar in the state of Colorado.
By 2010 and 2011 members of the Mental Health Coalition were 100% behind an amendment to the law clarifying dual relationships and in effect barring any unwritten policy of categorical prohibition. The final outcome around the issue (very short version) is that an amendment was introduced to the 2012 Sunset Review bill supported by DORA and the coalition that called for the department to issue guidelines for providers around the clause. This, in effect , has brought the long sought after change in the law.
Additionally and notably, DORA recommended that the unlicensed providers term in statute should be changed to “registered psychotherapists”. This recommendation was then included in the bill which was introduced in January of 2011. Not surprisingly most of the other provider groups were vehement in their opposition to this change and fought and lobbied against that change throughout the whole legislative process in January through May of 2011.
Nevertheless, CAP, through the its leadership, its legislative chair, its lobbyist and its responsive membership helped to keep the thinking of the legislators straight so that the Sunset Review Bill as passed into law Spring of 2011 included the change to “registered psychotherapists.” We are especially grateful to Suzi Vannuci and Greg McHugh for their tireless efforts on our behalf to make this happen.
CAP should be proud that over the years it has acquired significant improvements in the law for its members and the public.