By Lucy A. Homans, Ed.D.
Director of Professional Affairs
This will be my last article for the Washington Psychologist. I still find it a little hard to believe that after about 25 years, I will no longer be answering your questions, driving to Olympia or monitoring to Skippy as she gets all riled up over the latest effort by insurance companies to make your lives a living hell.
The terrific news is that WSPA has hired Dr. Samantha Slaughter as your new DPA! I have worked with Samantha in her role as the WSPA Federal Advocacy Coordinator and on several policy issues, some of which are listed below. I will hand off several issues to her that I think will be of importance to WSPA members going forward. In no order of importance here is what I have continued to work on.
Problems with mental health services covered by Labor & Industries (LNI): LNI does not have an associate medical director for Behavioral Health. It is time to meet with the current Medical Director and address that gap, as well as discuss LNI’s use of a flawed tool that the agency requires to assess level of functioning. Given the amount of trauma and chronic pain diagnosed in worker’s compensation, LNI is way behind in addressing currently appropriate and effective behavioral health services.
Applied Behavior Analyst (ABA) advisory board rule making: The ABA Advisory Committee to the state Secretary of Health has been attempting to write WACs that run counter to state statutes regulating the ABA practice. WSPA has been working with attorneys at the APA Practice Organization to address this problem. Additionally, our own Examining Board of Psychology (EBOP) is concerned with this matter. The statute is clear that currently licensed providers for whom the practice of ABA is within their scope of practice do not have to attain a second license to do this work. The ABA advisory board would like new rules prohibiting psychologists from supervising ABA trainees. This rule would prevent many well-trained psychologists from fully practicing within the scope of our license.
Allowing psychology interns to be reimbursed for mental health treatment to Medicaid enrollees. WSPA has a lot of support for this effort and over 25 other states have already passed similar laws. We have received assurances from the Governor’s health policy staff and from senior staff at the Health Care Authority (HCA) but have not yet received details on how this will become active.
The Governor’s behavioral health budget for 2019 – 2020: Governor Inslee has announced his requests to the Legislature for state spending for behavioral health. His proposals are transformational. The total for this segment of his budget is a request of $675 million. Please keep in mind that this is just the behavioral health part of his budget. The Governor would like to eliminate all civil commitment (not criminal) beds from Western & Eastern State hospitals. This would mean building community based beds and different access to services. Additionally, he proposes adding coverage for a variety of levels of intensity of care such as day treatment and intensive outpatient treatment in publicly funded integrated care systems. A new community based training and treatment program would be funded for the University of Washington through the Department of Psychiatry & Behavioral Sciences. WSPA will need to work with his staff on access to services such as psychological treatment for chronic pain and addressing the opioid disaster.
The examination by the Office of the Insurance Commissioner (OIC) of the extent to which commercial insurers in Washington State are complying with or violating federal and state mental health parity laws. WSPA leadership has a seat on the advisory committee for this two-year effort by the OIC. Bravo! These laws are more complex than the name “parity” implies. We need to be able to ensure that insurers are obeying the laws.
RxP: Fair warning – what you are about to read is just my personal opinion. I’ve read the statistics for Washington State and access to appropriate and effective assessment for and monitoring of psychotropic medication is a serious and chronic problem. Legislators, primary care physicians and patients are asking me when we might introduce legislation to allow psychologists to prescribe. Psychologists in Washington State should do this.
All of you should reach out to Samantha at her new DPA email address, DPA@WSPApsych.org and welcome her! She will do a wonderful job. As for me, as I have said so often, it has been my honor to represent Washington State psychologists. You are committed to providing excellent mental health care to our patients. Stay engaged with WSPA! Again, the new email address for Samantha is DPA@WSPApsych.org. This will be the ONLY time that I have ever said if you have questions, do not email me at my email address! Errant emails to me will immediately be forwarded to Samantha. Thank you so much for giving me (and occasionally Skippy) the opportunity to have such an interesting career. I will miss you.