NBCC is committed to supporting service members, veterans and their families and ensuring access to qualified mental health counselors. NBCC pursues numerous legislative and government affairs priorities for this purpose, as well as its own programs.

For years, professional counselors were excluded from the DOD, reducing the availability of needed mental health care providers. NBCC has had great success in its government affairs efforts to open the military health systems to counselors, but there is still work to do before counselors are employed on equal terms with other professions.

Previously, counselors were required to obtain physician referral and supervision when serving TRICARE beneficiaries, a burdensome requirement not placed on other mental health professions.

NBCC, in coalition with other counseling organizations, passed legislation to remove those restrictions and allow for independent practice. After further encouragement, the DOD released an interim final rule establishing qualifications for independent practice in December 2011 and a final rule in July 2014.

Not only did the lack of independent practice recognition subject counselors to unnecessary and wasteful physician supervision requirements, it also created problems for counselors seeking employment throughout the DOD, as other programs base their hiring on TRICARE regulations.

The effort encompassed several bills, two laws (public law 110-181 and public law 111-383) and two federally mandated studies, including the Institute of Medicine’s Provision of Mental Health Counseling Services Under TRICARE and a report by the RAND Corporation. After further endorsement by NBCC, the National Defense Authorization Act (NDAA) for Fiscal Year 2011 directed the DOD to establish requirements for counselor independent practice under TRICARE. While Congress mandated that the DOD establish such requirements by June of that year, it left the specifics to the DOD. In December 2011, the DOD finally released an interim final rule establishing these requirements.

Credentialing for the newly created provider category—TRICARE certified mental health counselor (TCMHC)—began mid-2012 and is administered by four separate TRICARE regional contractors: North, South, West, and Overseas.

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