TNAMFT Major Federal Mental Health Policy Concerns  September 2018

Behavioral Health Provider Shortages 

There are significant shortages of mental health and substance abuse providers. In Tennessee, according to the Tennessee Department of Health and the Health Resources and Services Administration (HRSA), most Tennessee residents live in a Mental Health Professional Shortage Area as defined by HRSA. 

o In fact, only five counties in Tennessee are not considered to be a part of a Mental Health Professional Shortage Area. 

Residents who do not receive needed mental health services or delays in receiving these services due to a lack of providers are more likely to access hospital services or seek treatment in emergency rooms than residents who are able to access the services of behavioral health providers. 

Rural America suffers disproportionately from a shortage of mental health professionals. Over 85% of designated Mental Health Professional Shortage Areas in the U.S. are located in rural counties. Master’s level mental health practitioners, such as Licensed Marriage and Family Therapists (LMFTs) and Licensed Mental Health Counselors (LMHCs), are more likely to be located in rural areas than professions requiring a doctorate. 

Medicare Provider Shortages 

With the greater awareness of mental health issues in the population, we need to examine the issues affecting our senior citizens and the resources available to meet their needs. 

40% of the mental health workforce in this country, namely Licensed Marriage and Family Therapists (LMFTs) and Licensed Mental Health Counselors (LMHCs), are barred from participating as independent Medicare providers. 

o LMFTs and LMHCs are licensed in Tennessee to provide covered mental health and substance abuse services. 

o Even though TennCare and all major private insurers in Tennessee recognize LMFTs and LMHCs as eligible providers, Medicare does not recognize LMFTs and LMHCs as eligible providers. 

In order to address this Medicare shortage, legislation must be passed to allow both LMFTs and LMHCs to become Medicare providers. 

Opioid Epidemic 

The opioid epidemic has impacted every community in Tennessee and across the country. In 2016, there were more than 42,000 deaths involving opioids. 

Congress is working on legislation to address the opioid crisis. However, additional federal financial and other assistance will be needed in order to sufficiently address this crisis. 

The Medicare population, which can include non-seniors who are disabled by addiction, is in need of substance abuse counseling, particularly those addicted to opioids. 

LMFTs and LMHCs are licensed and trained to provide these substance abuse services to the Medicare population. 

Healthcare for Veterans 

The VA has a severe shortage of mental health providers. The VA is seeking to hire a net increase of 1,000 mental health providers by 2019. 

Although LMFTs and LMHCs are eligible to work as providers in VA facilities, LMFTs and LMHCs are not being hired in sufficient numbers by the VA to deal with the demand for services. 

The VA must allow for greater numbers of MFTs and MHCs to participate in their internship program which is the major path to VA full time employment 



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