Veterans Administration and Diagnosis Issue

See below a recent document from the Veterans Administration states that NY's LMHC's cannot be hired to do clinical work due to the lack of the word "diagnosis" in our scope of practice.  This formal statement allowed NYMHCA and its advocacy partners (NYAMFT and NAAP) to launch a campaign to draw attention to this issue.


  SUBJ: New York Licensure for Licensed Professional Mental Health Counselor 
  It has come to the attention of the Recruitment and Placement Policy Service (R&PPS) that the New York 
  license for a Licensed Professional Mental Health Counselor (LPMHC) does not allow the LPMHC to diagnose. 

  VA Handbook 5005, Part II, Appendix G46, Paragraph 2 c. states that “Persons hired or reassigned to LPMHC 
  positions in the GS-101 series in VHA must hold a full, current, and unrestricted license to independently 
  practice mental health counseling, which includes diagnosis and treatment.” Diagnosis is a primary role of the 
  occupation and therefore VHA cannot employ an LPMHC whose only licensure is from New York. The 
  LPMHC may hold another state license that allows them to diagnose. 

  In order to address and resolve these issues, VHA Human Resources Offices must follow the guidance listed 

   Identify any LPMHC who has a New York license and confirm whether or not they have another state 
  license that will allow them to diagnose.  

   HRO’s must remove LPMHCs (from the GS-101 Licensed Professional Mental Health Counselor 
  position) who only have a New York license from their positions. At the discretion of the facility, these 
  employees may be converted to and retained in other positions for which they qualify. 

   HROs may retain LPMHCs that have another state license that allows them to diagnose. 

11/3/15    Letter to Governor Cuomo from Advocacy Partners:

Honorable Andrew M. Cuomo
State of New York
Executive Chamber
State Capitol
Albany, New York 12224

November 3, 2015

RE: Article 163 Mental Health Practitioners Scope of Practice Issue 

US Department of Veteran Affairs Bulletin (10/27/2015) – Mental Health Counselors in VA facilities must be removed because NY Statute does not allow LPMHCs to diagnose.

Dear Governor Cuomo:

On behalf of our clients, the New York Association for Marriage and Family Therapy (NYAMFT), the National Association for the Advancement of Psychoanalysis, (NAAP), and the New York Mental Health Counselors Association (NYMHCA), we would like to bring to your attention the recent bulletin issued by the U.S. Department of Veteran Affairs dated October 27, 2015 and the devastating impact it will have on access to qualified mental health care in VA facilities. We respectfully request a meeting to discuss ways to resolve this issue and, under your leadership, maintain the integrity of New York’s veteran mental health delivery model.  

Chapter 676 of the Laws of 2002 created four individually licensed masters level mental health professions: mental health counselors (LMHC), marriage and family therapists (LMFT), psychoanalysts (LP) and creative arts therapists (LCATS). Each profession is authorized to practice psychotherapy as defined in paragraph two of section eight thousand and one of the education law. In addition, the scope of practice of mental health counselors includes the authority to “identify, evaluate, and treat dysfunctions and disorders”. Each profession is authorized to use “accepted classifications signs, symptoms, dysfunctions and disorders, as approved in accordance with regulations promulgated by the department, in the practice of such licensed profession”. Subsequently, section 79-9.6 of Commissioner’s regulations accepts the Diagnostic and Statistical Manual of Mental Disorders (DSM) as being an accepted classification system.  

The American Psychiatric Association states that the DSM-V is “[u]sed by clinicians and researchers to diagnose and classify mental disorders, the criteria are concise and explicit, intended to facilitate an objective assessment of symptom presentations in a variety of clinical settings—inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care.” (emphasis added).  

While there exists strong indication in both statute and regulations that the professions licensed under Article 163 of the Education law are authorized to diagnose the aforementioned bulletin highlights the gravity of the lack of the term actual term “diagnose”. The bulletin herein enclosed states that effective immediately “HRO’s must remove LPMHCs who only have a New York license from their positions”. Veteran’s Affairs (VA) asserts “diagnosis is a primary role of the occupation” and concludes that “the VHA cannot employ an LPMHC whose only licensure is from New York.” as New York’s license does not authorize LMHCs to diagnose.

While this bulletin only mentions mental health counselors by name, all Article 163 licensed mental health professionals currently working in the VA setting would be impacted. New York is already facing a shortage of veterans’ mental health providers. Therefore, this new information certainly creates a crisis for those New York State veterans seeking mental health services from the VA in New York. 

We welcome your leadership in responding to New York’s most vulnerable population, including its veterans and seek an opportunity to discuss this at your earliest convenience. 


Denise Murphy McGraw
Partner, Hill Gosdeck & McGraw LLC

Theresa Cosgrove
Director of NYS Legislation & Government Relations, Pitta, Bishop Del Giorno & Giblin LLC

Heather G. Evans
Hinman Straub Advisors, LLC
What you can do!

Use the template of the letter below and send it to your state legislators!
Click on the link below to see NYMHCA's Capital Region Chapter President Libby McGinn on Capital Tonight (11/11/15) discussing the need to resolve the diagnosis issue. 
Click on the link below to hear the radio interview (11/11/15) with  NYAMFT president Carol Podgorski discussing the diagnosis issue on the Capital Pressroom