APA Practice: Working for You
by Communications Staff
Playing an active role in health care reform and seeking higher reimbursement for
psychological services. Challenging abusive managed care practices. Helping psychologists
comply with "Red Flags" requirements from the Federal Trade Commission.
If you've missed these highlights and other recent news from the American Psychological
Association (APA) Practice Organization and the APA Practice Directorate, here's a wrap-up
of how we have been advocating for professional psychology in the past six months.
Practice Directorate Activity Highlights
February 2009 to July 2009
This report contains selected highlights of Practice Directorate activities from February 2009
through July 2009. Further information is available by sending an email or calling the
directorate office as indicated below.
Positioning professional psychology to play an active role in health care reform, including
seeking appropriate Medicare reimbursement for psychological services
For additional information, please email the Government Relations Department at
pracgovt@apa.org or call (202) 336-5889.
Working to insure implementation of a full mental health parity law
For additional information, please email the Government Relations Department at
pracgovt@apa.org or call (202) 336-5889.
Gaining expanded access to psychological services for needy children
For additional information, please email the Government Relations Department at
pracgovt@apa.org or call (202) 336-5889.
Revising Model Act for State Licensure of Psychologists
For additional information, please email the Practice Research & Policy Department at
profdev@apa.org or call (202) 336-5911.
Challenging abusive managed care practices
For additional information, please email the Legal and Regulatory Affairs Department at
praclegal@apa.org or call (202) 336-5886.
Gauging psychologists' satisfaction with managed care and health insurance companies
For additional information, please email the Legal and Regulatory Affairs Department at
praclegal@apa.org or call (202) 336-5886.
Seeking to ensure the availability of adequate psychological services for veterans
For additional information, please email the Practice Directorate Executive Office at
practice@apa.org or call (202) 336-5878.
Supporting proposed California regulations to permit psychologists in institutional settings to
practice fully and independently within their scope of licensure
For additional information, please email the Legal and Regulatory Affairs Department at
praclegal@apa.org or call (202) 336-5886.
Meeting the needs of families involved in child custody disputes
For additional information on guidelines, please email Governance Operations at
practice@apa.org or call (202) 336-5881.
Helping psychologists comply with "Red Flags" requirements from the Federal Trade
Commission
For additional information, please email the Legal and Regulatory Affairs Department at
praclegal@apa.org or call (202) 336-5886.
Supporting the Presidential Summit on the Future of Psychology Practice
For additional information, please email Governance Operations at practice@apa.org or call
(202) 336-5858.
Aiding the profession's quest for prescriptive authority
For additional information, please email the Legal and Regulatory Affairs Department at
praclegal@apa.org or call (202) 336-5886.
Affirming the value of psychologically healthy workplaces
For additional information, please email the Corporate Relations and Business Strategy
Department at practicemanagement@apa.org or call (202) 336-5900.
Expanding public education about psychology and the value of psychological services.
For additional information about the APA Public Education Campaign, please email the Public
Relations Department at pracpr@apa.org or call (202) 336-5898.
Renewing a partnership with the American Red Cross to aid individual and communities in the
aftermath of disasters
For additional information, please email the Public Relations Department at pracpr@apa.org
or call (202) 336-5898.
Addressing the health needs of rural residents
For additional information, please email the State Advocacy Department at state@apa.org or
call (202) 336-5864.
Affirming support of the concept of recovery for those with serious mental illness
For additional information, please email the State Advocacy Department at state@apa.org or
call (202) 336-5864.
Practice Directorate Activity Highlights
February 2009 to July 2009
The Practice Directorate is involved in a broad range of activities on behalf of practicing
psychologists in diverse settings and consumers of psychological services. The directorate's
primary activities involve confronting challenges and cultivating opportunities for professional
psychology.
APA Executive Director for Professional Practice Katherine C. Nordal, PhD, provides staff
leadership for the work of the APA Practice Directorate as well as the APA Practice
Organization (APAPO), a companion organization to APA. The APAPO was created in 2001
as a 501(c)6 organization under IRS rules to enable additional advocacy for the professional
practice community beyond what APA, as a 501(c)3 organization, is able to do.
Following are brief highlights of selected Practice Directorate activities and significant
developments from February 2009 through July 2009. Additional information about the topics
here can be found at the URLs listed.
Positioning professional psychology to play an active role in health care reform, including
seeking appropriate Medicare reimbursement for psychological services
The Practice Organization is working to urge policymakers to pass health reform that
integrates psychological services in primary care, preventive services and benefit packages.
(http://www.apapractice.org/apo/in_the_news/psychology_focuses.html#)
Dr. Nordal joined other invited health care practitioners, leaders and aides to President
Obama on at the July 2 White House Stakeholder Discussion Group. She emphasized that
health reform must include psychological services as part of primary care.
http://apahelpcenter.mediaroom.com/index.php?s=press_releases&item=74
In a May 11 letter to Senate Finance Committee Chair Max Baucus (D-MT) and ranking
member Charles E. Grassley (R-IA), Dr. Nordal focused on Medicare payment reform,
lowering barriers to psychologists' services and psychology training and workforce.
http://www.apapractice.org/apo/in_the_news/practice_leader_presses.html#
Doug Walter, JD, legislative counsel for the APAPO, was invited to participate in key
stakeholder discussions about health care reform convened by the Senate Health, Education,
Labor and Pensions (HELP) Committee. The only participant associated with a non-physician
provider group, Walter is helping to bring the perspective of the mental health and substance
use communities to these discussions.
http://apapractice.org/apo/in_the_news/congress_combines.html#
During the March 2009 State Leadership Conference, psychology leaders conducted 330
visits to House and Senate offices to advocate for the passage of health reform; extending
restoration of outpatient mental health reimbursement cut by the Centers for Medicare and
Medicaid Services (CMS); making psychologists eligible for Evaluation and Management
(E&M) code reimbursement; and adding psychologists to the Medicare "physician" definition.
http://www.apapractice.org/apo/in_the_news/hundreds_of_psychology.html#
As of the end of June, three key House committees have included professional psychology's
top Medicare priority - a two-year extension of the five percent psychology payment
restoration - in draft health care reform legislation.
If passed, the extension will result in an estimated $60 million in payments for psychotherapy
services in 2010 and 2011. This money otherwise will be cut as a result of CMS' Five-Year
Review rule. http://apapractice.org/apo/in_the_news/house_committees_include.html
As developments continue to unfold throughout the summer, APAPO will continue to educate
membership on the work the association is doing to represent the interests of professional
psychology with monthly articles and Q&As in the PracticeUpdate e-newsletter.
Meanwhile, the APA, along with the associations for Psychiatry, Social Work, Nursing, and
Child and Adolescent Psychiatry, is seeking to have the psychotherapy codes included in the
next Five-Year Review as a way to raise the codes' reimbursement values. APA and the other
societies are now reviewing data and research about the provision of psychotherapy services
and working to formulate compelling evidence arguments for re-valuing the codes. The multispecialty group met in February, April and June to discuss their progress. The group has a
collaboration website where documents for use in developing the compelling evidence
argument can be posted and reviewed.
Working to insure implementation of a full mental health parity law
By successfully combining grassroots advocacy, direct lobbying on Capitol Hill and political
giving, the Practice Organization, along with a broad coalition of organizations, was crucial in
achieving passage of a mental health parity law in October 2008.
http://apapractice.org/apo/in_the_news/forefront_of_advocacy.html#
Federal agencies are now tasked with writing the regulations that will implement the new law
and The Practice Organization is keeping the pressure on. In May, Executive Director for
Professional Practice Katherine C. Nordal, PhD, sent a letter to these agencies calling for
straightforward regulations that carry out the intent of the legislative sponsors to end
discriminatory financial and treatment limitations on mental health and addiction services.
http://www.apapractice.org/apo/legislative_advocacy/apa_practice_presses.html#
Gaining expanded access to psychological services for needy children
On February 4, President Obama signed into law The Children's Health Insurance Program
Reauthorization Act of 2009. An expansion of the State Children's Health Insurance Program,
the new law raises the total number of uninsured children covered by basic health insurance
from seven to 11 million and specifically clarifies that the Wellstone-Domenici Mental Health
Parity and Addiction Equity Act of 2008 applies to SCHIP, ensuring parity in coverage for
mental health services. Regulations will be written governing the delivery of mental health
services under the new law. The APAPO will be an active part of that process, advocating for
psychologists' interests during the rule making.
http://www.apapractice.org/apo/in_the_news/health_insurance_program.html#
Revising Model Act for State Licensure of Psychologists
The Task Force to Revise the APA Model Act for State Licensure of Psychologists again
solicited public comment on a draft revision of APA's Model Act from March 5 through June 5.
The draft revision was also reviewed by Boards and Committees at the Consolidated
Meetings in March. Since some of the proposed changes have been quite controversial, the
Task Force provided the rationale for some of the proposed changes and created a
"Frequently Asked Questions" document so that reviewers would better understand the
intention of the Task Force in proposing various recommendations.
Over 20,000 comments have been received, the vast majority of comments consisting of a
variant of a form letter created by the National Association of School Psychologists and
submitted by their members and advocates. Task Force members have already received
copies of these form letters and the remaining comments are being reviewed.
The Task Force continues to work closely with liaisons to try and reach a resolution on the
controversial proposed changes. Once the Task Force is satisfied that enough resolution has
been reached among key constituencies, it will finalize the document. The Task Force hopes
to do this during the summer of 2009 with the intention that a final version will be reviewed by
BEA, BPA, CAPP, and CECP in the fall and will return to Council in February 2010.
http://www.apapractice.org/apo/in_the_news/0.html
Challenging abusive managed care practices
On June 23, The California Psychological Association (CPA) and psychologist James Peck,
PsyD, filed a class action complaint against the nation's largest health insurer, WellPoint Blue
Cross Blue Shield, in federal court in Sacramento. The APA Practice Organization (APAPO) is
working closely with outside counsel and CPA to provide extensive legal, policy,
communications and other support for this legal action. The suit alleges that the company
used a flawed database to suppress the "usual, customary and reasonable" (UCR) rates
utilized to pay for out-of-network services.
In addition, on July 1 The New Jersey Psychological Association (NJPA) became a named
plaintiff in the parallel nationwide class action litigation against Aetna in federal court in New
Jersey.
http://apapractice.org/apo/in_the_news/california_is_latest.html#
http://apapractice.org/apo/in_the_news/apa_practice_organization0.html#
Gauging psychologists' satisfaction with managed care and health insurance companies
In the fall of 2008, the APA Practice Organization conducted a pilot survey of practicing
psychologists in New York and Georgia to gauge member satisfaction with managed care and
insurance companies. The pilot survey results demonstrated some significant differences in
the largest companies' treatment of patients. The pilot survey results and feedback have been
used to design a refined survey to be launched by the APA Practice Organization nationwide
this summer.
The national survey is designed to demonstrate to employers, consumers, state regulators,
psychologists and the companies themselves which ones do better or worse in providing
access to psychologists, authorizing necessary care and respecting patient privacy, as well
how they treat psychologists. By sharing the results widely, professional psychology will help
hold companies accountable for the care being provided to patients and for their treatment of
psychologists.
http://apapractice.org/apo/in_the_news/apapo_survey_on_health.html#
Seeking to ensure the availability of adequate psychological services for veterans
The 12th annual Department of Veterans Affairs (VA) Psychology Leadership Conference held
in May 2009 drew approximately 160 VA psychologists. This year's conference shone a
spotlight on the Veteran Affairs Central Office (VACO) rollout of the Uniform Mental Health
Services Plan, designed to ensure comprehensive mental health services throughout the
entire Veteran Affairs mental health service delivery system consistent with the VA's mental
health strategic plan. The annual conference is co-sponsored by the APA Practice Directorate,
Div. 18 (Psychologists in Public Service) and the Association of VA Psychologist Leaders.
http://www.apapractice.org/apo/in_the_news/veterans_affairs_psychology.html#
Supporting proposed California regulations to permit psychologists in institutional settings to
practice fully and independently within their scope of licensure
On June 22, Dr. Nordal sent a letter to the California Department of Public Health's Office of
Regulations and Hearings commenting on the office's May 29 changes to proposed regulation
regarding scope of practice for psychologists in licensed health facilities. The letter applauded
some of the changes but cautioned that others would "lead to continuation of the existing
discrimination against psychologists and the corresponding deprivation of psychological
treatments to patients."
Meeting the needs of families involved in child custody disputes
At its February 2009 meeting, the American Psychological Association (APA) Council of
Representatives approved newly revised guidelines for child custody evaluations entitled,
Guidelines for the Evaluation of Child Custody in Family Law Proceedings.
These guidelines (http://www.apa.org/practice/guidelines-evaluation-child-custody-familylaw.pdf) make a clear distinction between forensic evaluations and the advice and support
that psychologists provide to families, children and adults in the normal course of
psychotherapy and counseling. Evaluations occurring in other contexts such as child
protection matters are not covered by these guidelines.
http://www.apapractice.org/apo/in_the_news/revised_guidelines.html#
Helping psychologists comply with "Red Flags" requirements from the Federal Trade
Commission
Two articles in the Practice Update explained the "Red Flags Rule" from the FTC-which are
intended to reduce identity theft-who must comply and how to do so by the August 1, 2009
deadline.
http://www.apapractice.org/apo/in_the_news/red_flags_rule_guidance.html#
Supporting the Presidential Summit on the Future of Psychology Practice
Practice Directorate staff provided principal staff support for the first Summit on the Future of
Psychology Practice. Psychologists and thought leaders from other fields met in San Antonio
for the Summit, a Presidential Initiative of James Bray, PhD, to begin shaping a vision for
psychology's future in light of health care reform, demographic and economic shifts, and other
changes affecting psychology practice. Executive Director for Professional Practice Katherine
C. Nordal, PhD addressed summit attendees on "Implementing the Practice Agenda."
http://www.apa.org/practice/summit.html
Aiding the profession's quest for prescriptive authority
This year, prescriptive authority legislation has been introduced in a record 10 states -Arizona,
Hawaii, Illinois, Mississippi, Missouri, Montana, North Dakota, Oregon, Tennessee and
Wisconsin. Oregon Psychological Association's (OPA) prescriptive authority legislation, HB
2702, was signed into law on June 25. Although the legislation fell short of OPA's ultimate
goal, this is the farthest a prescriptive authority bill has progressed since the first one was
introduced in Oregon six years ago.
http://www.apapractice.org/apo/in_the_news/oregon_eyes_prescriptive.html#
Affirming the value of psychologically healthy workplaces
The inaugural Psychologically Healthy Workplace Conference (Feb 28-March 2) in
Washington, DC, spotlighted employee well-being and productivity. Conference participants
also attended APA's 2009 Psychologically Healthy Workplace Awards ceremony, at which five
organizations were recognized for their comprehensive efforts to promote employee health
and well-being, while enhancing organizational performance and ten received Best Practices
Honors.
http://www.apapractice.org/apo/in_the_news/apa_announces_2009.html#
Expanding public education about psychology and the value of psychological services
In the midst of tough economic times and a flu scare, The APA Mind/Body Health Campaign
continues to educate the public about the connection between the psychological and physical.
With an April survey finding that economic stress is taking a toll on men
(http://www.apapractice.org/apo/in_the_news/apa_poll_finds_economic.html#), the APA Help
Center posted "Staying Resilient Through Tough Economic Times," its third piece related to
fostering resilience in the difficult economy
http://www.apapractice.org/apo/in_the_news/tips_on_fostering.html#
In April (California) and June (Maryland), the American Psychological Association, APA
Division 42 (Psychologists in Independent Practice) and the National Council of the YMCAs of
the USA (YMCA) held their first two pilot programs launching a partnership to help people
make healthy lifestyle choices for their mind and body.
http://www.apapractice.org/apo/in_the_news/apa_apa-ymca_partnership.html#
When Swine Flu fear swept the country and the Practice Directorate posted "Managing Your
Anxiety to About H1Ni Flu (Swine Flu)" to help psychologists assist their clients and others
assuage anxiety and separate fact from
fiction.http://www.apapractice.org/apo/in_the_news/managing_anxiety_about.html#
Renewing a partnership with the American Red Cross to aid individual and communities in the
aftermath of disasters
On February 26, 2009, the American Psychological Association (APA) and American Red
Cross (ARC) renewed a Memorandum of Understanding, originally signed in 1991. Through
the Disaster Response Network, APA offers the knowledge and expertise of its members and
ARC in turn provides an infrastructure and organization to incorporate their volunteer
contributions.
http://www.apapractice.org/apo/in_the_news/apa_and_american_red.html#
Addressing the health needs of rural residents
The Committee on Rural Health met March 20-22 in Washington, DC and moved forward with
its Primary Care Association Initiative begun Fall 2008 by agreeing to work with the Maine
Psychological Association to increase the number of psychologists and psychology trainees in
community health centers by working with the Maine Primary Care Association.
In June the National Health Service Corps announced its Loan Repayment Program for the
remainder of 2009 and fiscal year 2010. The program will provide almost $200 million for loan
repayment for clinicians willing to work in high need areas, such as rural community health
centers and rural health clinics. Staff prepared a Primer for Licensed Psychologists to explain
to how to apply for the funds and will reach out to the Rural Health Coordinators, Early Career
Psychologists, and practice and education communities to promote this opportunity to
psychologists. http://www.apapractice.org/apo/in_the_news/national_health_service.html
Affirming support of the concept of recovery for those with serious mental illness
The Task Force on Serious Mental Illness and Severe Emotional Disturbance sent a Draft
Resolution on APA Endorsement of the Concept of Recovery for Serious Mental Illness to APA
boards, committees, divisions, and affiliated SPTAs this spring. The resolution affirms APA's
support of the concept of recovery. Recovery is not a movement that recommends a specific
etiology for SMI, but rather it is a more comprehensive, person-based approach to treatment
that is sensitive to consumer-defined goals and recognizes the need to attend to a range of
psychological factors (e.g., identity, self-esteem) as part of an expanded definition of what a
positive outcome represents. The Resolution was passed by the Board of Directors at their
June meeting and will be forwarded to Council in August.
At the 2009 APA Convention, CAPP (Committee for the Advancement of Professional
Practice) and the Task Force will host a symposium entitled, "Roles, Opportunities and
Obstacles for Psychologists: Developing and Implementing Evidence Based Practices for
People with Serious Mental Illness or Serious Emotional Disturbance."