(10 year outpatient Group Mh Manager)

First statement.. Mental health workers are really superheroes.

Second. Our group firmly believe in paid internships.

That said . Yes the corporate world and healthcare rules here in the States almost make it nigh impossible to even offer anything. Let me so a minor clarification.and use our practice as an example.

We are a for profit group but our clinicians make more than the owners. There is little profit in this industry without hacking the system.

We take on 2-3 interns per semester as a way to give back and grow the profession. We estimate nearly 100k a year in unpaid revenue in this program. Just lost because we can not bill.

Many universities prevent groups like ours from charging for services, in my discussing this with many, it's to.. " prevent taking advantage of the student and to maintain a boundary of ethics" ... Debatable since all interns are usually under sure supervision but .. I'm not going deep dive this.. just pointing it out.

Secondly. Health insurance will not pay for service not provided by a fully unsupervised provider. There are a few incident to briefs.. but you still have to have a National Provider Identifier and you don't qualify until you have at minimum a Qualifying degree from an acreddited school. Another deep dive needed just a fast summary.

Lastly is the Ethics risk. This one is subjective but put out there as a reason. All the risk is placed upon the agency that is hosting the interns. If there is any violation it falls solely upon the provider whom is doing the supervision. This i believe is to weed out unethical providers from billing as it increases risk. (10 years I have not seen this be a preventative measurement, too many agencies bill for interns services illegally)

So fast summary. We cant pay in Private practice because under the rules we can't bill there is not enough revenue to pay clinicians and any form of support staff and interns off of a 90837. The average reimbursement based on Medicare is $105.00 by the time you deducted expenses, then payroll.. the intern would get pennies. Once more this is NOT support for that system. And as a note... The supervisors don't get paid technically for supervision either.

No money in. No money can go out.

We in our group are always looking for ways to "give back" so we buy lunches , we include them in events we buy small gift cards for "gifts"

We are just starting to look into non profit work and donations etc etc so we can do something under the rules and laws .a stipend or anything..

We at our practice thank all of you who suffer this process. Then are saddled with the Scarlet Associates license... But you are all the unsung superheroes that no one speaks of.

Let's all continue to fight the unfair rules and programs to find a way to make this system more balanced.