Spring 2016: Volume 72, Number 1
by Samantha Slaughter, Psy.D.
As your Federal Advocacy Coordinator, I am privileged to be a part of the team representing you at the American Psychological Association Practice Organization’s (APAPO) annual State Leadership Conference (SLC). For those of you unfamiliar with the APAPO, it was established in 2001 to work alongside the American Psychological Association (APA) with the distinct focus of advocacy for the practice community. APA cannot participate in advocacy work due to rules set by the Internal Revenue Service for 501(C)(3) organizations. This makes the APAPO, a 501(c)(6) organization, a valuable ally to psychologists who are practicing clinicians. The APA focuses on the subject of psychology while the APAPO focuses on the practice of psychologists. In order to do this, the APAPO stays informed about national issues affecting the practice of psychologists and helps states in state-specific advocacy issues.
The distinction between the APA and the APAPO was the topic of much conversation at SLC this year due to the significant drop in members, and therefore dues, of the APAPO. If you haven’t paid the practice assessment, which is what the dues for the APAPO are called, hear me when I say you must reconsider. The APAPO not only provides a wealth of practice-specific information, such as how to abide by HIPAA rules, but it also provides valuable funding for state organizations. WSPA has applied for, and received, grant money from the APAPO over the years, allowing it to continue to provide valuable services. Finally, the APAPO covers some or all of the cost of Federal Advocacy Coordinators such as myself and the other attendees. However, due to the lost revenue, 2016 marked the first year that some positions did not receive the funding that is typical, which led to fewer psychologists lobbying at SLC and less direct federal advocacy. There are rumors that next year’s SLC will include even less funding. Reducing our lobbying numbers now is terrible as we must make sure our representatives in Congress hear our voices regarding the nationally significant mental health reform bills (read more below) and other relevant mental health issues such as Medicare. You can learn more about the APAPO at www.apapracticecentral.org. Ready to pay the practice assessment dues? Click here.
For this year’s State Leadership Conference, the theme was “Expanding the Practice Spectrum.” Topics included, but were not limited to, the current political climate, alternative practice models, thriving in independent practice, challenges of assessment practice, how to grow state organizations, and Medicaid. One of the more interesting sessions I attended included presenters from Optum (United Behavioral Health), Aetna, and Anthem (BlueCross/BlueShield). The take away was something that was not news to me, but I heard it with more emphasis and from the leaders of the largest national health insurers – the importance of outcome measures. At this point, there is no preference for outcome measures, but the Senior Vice President of Behavioral Quality Management at Optum, Bruce Bobbitt, PhD, (who is a psychologist!), noted that the PHQ-9 will likely be required in the future. The need for psychologists to use outcome measures makes sense as the Affordable Care Act does not work without numbers measuring the three aspects of the Triple Aim – population health, cost, and patient/client experience. Lawrence Grab, MBA, Staff Vice President of Behavioral Health Utilization Management for Anthem, noted that behavioral health is one of the top three drivers of costs for their members. He also stated that this year Anthem offers “online psychotherapy” to its members. The final participant, Mark Friedlander, MD, MBA, Chief Medical Officer for Aetna, discussed the fact that most of the resistance he sees to integration comes from physical medicine because if they screen for depression, for example, then they might actually find depression, which means needing to treat it, which drives up costs; however, ignoring co-morbidities drives up costs because of lack of treatment regardless of whether or not screening occurs.
In addition to presentations and workshops, the State Leadership Conference culminates in visits with our Senators and Representatives in Congress. This year’s focus, now that Medicare’s Sustainable Growth Rate is gone (Yay!), was comprehensive mental health reform legislation and including psychologists in the “physician” definition used by Medicare. We were able to visit most offices and spoke with legislative assistants (LAs) and one Congressman (Dave Reichert, R-8th district) about these topics. Say what you will about folks in either political party, but it seems that meeting with them one-on-one allows them to tell you about themselves and how mental health issues impact them personally. Representative Reichert was candid and shared many stories to illustrate why comprehensive mental health reform is important to him. He was not all talk as he had already added his name to list the cosigners, along with Representatives Herrera Beutler, McDermott, and Heck, to House resolution H.R. 2646 – Helping Families in Mental Health Crisis Act of 2015. In the Senate, the companion bill is S. 1945 – Mental Health Reform Act of 2015.
Regarding adding psychologists to the group of practitioners included in the definition of “physician” by Medicare, there are also bills in both the House and Senate, H.R. 4277 – Medicare Mental Health Access Act and S. 2597 – Medicare Mental Health Access Act. Derek Kilmer, D-6th District, is a cosigner on H.R. 4277. We have lobbied about this issue every year I have participated in SLC. It is important for our psychologist colleagues in hospitals and other medical institutions because not being a part of the definition means they have to be supervised by a physician, resulting in notes needing to be signed off on and being unable to work independently even though our license allows us to do so. In addition, not being included in the definition means that our jobs at such facilities are unprotected and are therefore some of the first on the chopping block when cuts have to be made. Many of our colleagues in our state hospitals have lost their jobs because of this. No psychologists equals no one providing behavioral health treatment to patients with dementia who make up the largest number of residents in our state hospitals.
You can read more and see the progress on all these bills by searching for them at . Want to let your Congressperson know your thoughts or that you want her or him to support these bills? Find your Congressperson’s contact information here: https://www.govtrack.us/congress/members.
Overall, and as usual, SLC left me exhausted and energized at the same time. It has been a pleasure serving as your Federal Advocacy Coordinator for the last five years. As always, please feel free to email me any questions you may have about the conference or our advocacy efforts at the national level.
Samantha Slaughter, PsyD
WSPA Federal Advocacy Coordinator