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APA Practice Directorate
Highlights of Recent Activities
February to August 1996
The latest in an organized series of Practice Directorate activities designed to enhance communication with psychology practitioners takes place during the 1996 APA Annual Convention in Toronto during a breakfast forum entitled, "Psychology and Community: Creating Connections for Health." At that event, several hundred participants will have an opportunity to engage in dialogue with APA leaders about ways to enhance psychology practice.
The directorate is relying on such dialogue for aiding the development of numerous diverse activities that help enable practitioners to maximize their professional stature and build positions of influence. Following is a brief summary of several key activities from the first seven months of 1996 that span the directorate's four major ongoing initiatives: legislative strategies, legal advocacy, marketplace activities, and public educaiton about the value of psychologicl services.
Launching the National Public Education Campaign
Following months of research and other strategic preparation, APA officially launched its public education campaign about the value of pschological services in February with press events in New York City, Denver, and Hartford. By the end of the summer, hundreds of psychologists throughout the country had participated in training meetings that focused on practical, grass roots strategies for implementing campaign-related activities. In addition to leading a series of regional training sessions, directorate staff and campaign consultants have conducted training during numerous state psychological association and division meetings.
A number of resources and educational materials associated with the campaign are being widely utilized by consumers and practitioners. From February through mid-July, more than 4,700 consumers called the toll-free campaign information line, 1-800-964-2000; 3,500 of them requested the APA brochure on therapy, "Talk to Someone Who Can Help." Meanwhile, of the more than 2,800 psychologists who accessed the same toll-free number during the same time period, 50 percent of the callers ordered a free implementation kit--a comprehensive, "how-to" manual covering campaign-related community outreach, media relations and advertising activities.
At its February meeting, the APA Council of Representatives directed the association to secure funding for the public education campaign through 2002 at a minimum of $1 million annually. Directorate officials and other APA leaders are actively urging members to participate.
Pursuing Precedent-Setting Legal Test Cases
In a landmark action, the New Jersey Psychological Association and seven individual psychologists filed a lawsuit against MCC Behavioral Care in May. The lawsuit claims that MCC, one of the largest behavioral health care providers in the United States, frequently terminates psychologists from its provider networks by invoking the "no cause" termination clause in its contracts in a manner which is against public policy, breaches agreements with its providers, is fraudulent, and harms both patients and providers.
This landmark case, believed to be the first of its kind involving a managed behavioral health care company, is the culmination of years of research and investigation of numerous membership complaints by the directorate's office of managed care. (This office assisted approximately 300 APA member callers during the first five months of 1996 alone.) The suit was prepared and filed with financial grant support from the APA's Committee for the Advancement of Professional Practice.
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Supporting Parity of Mental and Physical Health Insurance Coverage
The APA, along with the entire mental health community, won a stunning
victory in Congress this
past April when the Senate passed by a substantial majority the “mental
health parity'
amendment to the Kassebaum-Kennedy health insurance reform bill.The
provision in the Senate
bill sought to prohibit private health plans from imposing arbitrary
treatment limits or financial
requirements on mental health services that are not applied by a health
plan to its coverage of
physical health services.
Since the April victory, Russ Newman, Ph.D., J.D., the directorate's
executive director, has taken
advantage of several high profile media opportunities to advance the
association's position in favor
of mental health insurance parity.Meanwhile, APA joined with numerous
other organizations
advocating for mental health parity to form a coalition that has actively
countered inflated cost
estimates for the parity provision put forward on Capitol Hill by the
business and insurance
lobbies.
The directorate also helped mobilize substantial grass roots advocacy
by psychologists throughout
the country. Having established a “legislative hotline” in late April,
the directorate succeeded in
generating more than 7,000 calls and nearly 14,000 faxes to key congressional
members' offices by
mid-June in support of the parity amendment. As of late July, the outcome
of congressional
deliberations surrounding the Kassebaum-Kennedy bill was unknown, but
directorate officials were
encouraged that the resulting debate had raised the call for nondiscriminatory
mental health
coverage.
Advocating Federal Legislative Qualitv Standards for Health Plans
During the directorate's 1996 State Leadership Conference in March,
more than 300 psychologists
met with their elected congressional officials and called on them to
enact federal quality standards
for managed care and other health plans.
When the U.S. House Commerce Committee's Subcommittee on Health and
Environment
scheduled a May 30 hearing on problems with cost containment and managed
care, the directorate
responded by providing several patient witnesses who testified to the
need for a point-of-service
option and other patient safeguards in health plans. To help gain such
patient protections,
psychology advocates are urging members of Congress to cosponsor the
Family Health Care
Fairness Act. This bill, which includes a provision mandating out-of-network
health services
coverage, also contains language that would enable holding health plans
accountable for negligent
care.
Protecting Professional Roles for Doctoral Psychologists
The directorate is working closely with state psychological associations
to confront mounting
threats to psychology licensure laws.In some situations, proposed bills
would extend the
independent practice of psychology to nondoctoral providers.In other
circumstances, licensed
doctoral psychologists are being prohibited from practicing in certain
settings such as schools
unless they obtain a new, nondoctoral credential.
In mid-July, directorate officials participated in a regional coalition
meeting involving leaders of 12
state psychological associations from mostly southeastern states. The
overall purpose of this
meeting was to begin discussing strategies for forestalling increasing
legislative challenges to
doctoral-level psychology practice.
In a related important development, at its February 1996 meeting, APA's
Council of
Representatives approved a statement of recognition of “health service
provider” that offers an
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appropriate means of identifying licensed psychologists who are qualified
to deliver health services.
The APA Board of Professional Affairs coordinated the policy statement's
formulation.
The directorate is also actively engaged in advocacy for psychology's
role in the massive
reorganization of the VA's health care delivery system.These efforts
have recently intensified in
response to organizational plans introduced at some VA medical centers
across the country that
threaten the continued provision of psychological services.
Aiding State-Level Initiatives Aimed at Securing Prescriptive Authority
In June, the APA Board of Directors approved two documents developed
to support psychology's
efforts to gain prescriptive privileges:model legislation for prescriptive
authority, and
recommended postdoctoral training in psychopharmacology. The Board
also allocated funds to the
directorate to help support its various efforts to promote state-level
prescriptive authority for
practitioners. According to a recent directorate survey, seven states
anticipate pursuing related
legislative initiatives in 1997, thereby joining the three states (California,
Missouri and Hawaii)
that already have introduced such legislation.
Developing Products to Assist Psychologists With Business of Practice Issues
During the spring of 1996, the directorate unveiled seven new educational
manuals for
practitioners as part of the APA Practitioner' s Toolbox Series. The
entire series of eight manuals
is designed to offer practitioners comprehensive guidance and a variety
of practical strategies for
the evolving health care market.
The eight titles, available through APA Books by calling 800-374-2721,
include the following:
Building a Group Practice:Creating a Shared Vision for Success;
Contracting on a Capitated Basis: Managing Risk for Your Practice; Developing
an Integrated Delivery System: Organizing a Seamless System of Care; Contracting
With Organized Delivery Systems: Selecting, Evaluating and Negotiating
Contracts; Managing Your Practice Finances:Strategies for Budgeting, Funding
and
Business Planning; Marketing Your Practice:Creating Opportunities
for Success; Models for
Multidisciplinary Arrangements:A State-by-State Review of Options;
and Organizing Your Practice Through Automation: Managing Information and
Data.
Showcasing the Cost-Effectiveness and Value of Psvchological Services
The Practice Directorate is collaborating with Blue Cross/Blue Shield
of Massachusetts on a two-year
project to demonstrate the cost-effectiveness of integrating psychological
interventions into the
treatment of breast cancer patients. This unique initiative aims to
generate improved treatment
outcomes and increased patient satisfaction along with a decrease in
the overall costs of care.
The pilot phase involving 120 Boston-area women with breast cancer is
slated to begin this month.
As a key component of their treatment, participants will receive 16
weeks of supportive-expressive
group psychotherapy integrated with a patient-focused psychoeducational
workbook.
In addition, the directorate continues to work with the U.S. Department
of Defense (DOD) National
Capital Area Mental Health Alliance to develop an integrated behavioral
health delivery system
serving active military personnel and their dependents in the Washington,
D.C. area. APA is
advising the DoD on approaches on infrastructure requirements that
will allow for outcomes data
collection that the military can use to meet its unique goals.
At the same time, the APA Committee for the Advancement of Professional
Practice has
constituted an expert work group to analyze the results of the DoD
pilot project. The work group
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will develop recommendations about how the military outcome measurement
system might be
applied successfully outside the DoD health care delivery system.
Surveving Practitioners About Their Professional Settings, Activities and Concerns
Another of the recent activities in the directorate's ongoing communications
initiative with
practitioners involves a Committee for the Advancement of Professional
Practice (CAPP) survey
sent to all 47,000 licensed APA members. Nearly 16,000 psychologists
took the time to complete
and return this important survey, which was intended primarily to identify
practice settings,
primary work activities and top professional concerns.
A special June 1996 issue of the directorate newsletter, Practitioner
Update, was devoted to
summarizing key highlights of the survey results.CAPP and the Practice
Directorate intend to
use the survey data to guide new and enhanced efforts to address practitioners'
main professional
concerns and apparent obstacles to the diversified practice of psychology.
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