Top 15 APAPO Action Items 2016 & CAPP meeting update
It’s been a whirlwind week of meetings for me. I was privileged to speak at the Idaho Psychological Association on obesity, binge eating disorder, cultural competence, and future of practice on April 22-23, and the Ohio Psychological Association April 28th on panels for Early Career Psychologists and the OPA Leadership Development Academy. Both events reminded me of the energy and dedication of psychologists to our field.
With this mindset, I was off to Washington DC to attend my first in-person CAPP meeting (the above picture is deceiving; there was no time for sightseeing!). It was helpful to meet the other CAPP members and connect faces with the names, as well as to meet numerous liaisons who provided important input from divisions and other constituencies. Unfortunately, I missed the retreat the night before due to my OPA commitments. They discussed hot topics in practice for CAPP to keep on their radars. Here are just a few for the curious: reimbursement, integrated care, scope of practice, practice guidelines, managed care audits, coding, electronic medical records, specialist training, RxP, self-care, the intern imbalance, ECP debt, omnibus licensing boards, telehealth, suicide rates on college campuses, rural health, and culturally competent care. Clearly there are many member needs in the Practice Organization!
The meeting began with a thorough discussion of conflict of interest—all CAPP members signed and acknowledged any actual COI, appearance of conflict, financial, etc. A good example would be my current status as a member of the OPA board; I would need recuse myself from any decisions involving grants to OPA for example. We also discussed the status of the CEO search (committee has meeting/search firm is hired; http://www.apa.org/news/press/releases/2016/03/search-committee.aspx); and Ethics Commission (includes 9 psychologists and 8 non-psychologists from law, medicine, bioethics, etc.: http://www.apa.org/news/press/releases/2016/02/commission-ethics-processes.aspx )
Finances were discussed at length. If you’ve been following, you’ll know that APA Practice Organization membership is down about 35% resulting in serious financial difficulties for the organization. Regarding staffing, they are not filling vacancies and running very lean. There is a push to win back members, particularly those who renewed their APA membership but not their APA PO membership. Due to the significant financial loss, services are being cut. You may remember that legislative grants for 2016 were already cut, but more cuts are likely on the way.
One of the flagship activities for the APA Practice Organization for over 25 years has been the State Leadership Conference. Around 500 psychologists attended SLC in 2016 to a well- received program on “Expanding the Practice Spectrum” and represented psychology on Capitol Hill to advocate for practice issues. SLC is an event that energizes psychologists to engage in advocacy not just during the conference when they go to the hill but when they return home to their states. Unfortunately, due to the fiscal environment at APAPO, there is a broad look at substantial cost reductions including for State Leadership Conference 2017. Any changes to SLC funding will be finalized at the June board meeting and shared as soon as possible with SPTAs to help with budgeting.
Membership recruitment and retention was discussed at length. This is both critical to the survival of the Practice Organization, but more critically it’s about establishing the value of what the Practice Organization does for psychologists every day. Alternative business models for the Practice Organization were discussed, as one of the difficulties with the Practice Organization is that psychologists must be an APA member first (some psychologists would prefer to have the Practice Organization as their primary membership). This is a complicated issue for a number of reasons. Tax status and APA’s financial model are one factor—i.e., if APA (c-3) were to become a guild organization (c-6) they would forfeit most of their assets. This is further complicated by the fact that most Practice Organization staff are only funded a percentage of their time by APAPO; the other (often larger) portion is funded by APA. The Practice Organization on its own may not have the funding to maintain the talent that their relationship with APA allows them. Some of the ideas about membership recruitment and retention included: 1) partnering better with state associations—many of the APAPO activities such as organizational grants and SLC most benefit SPTAs; 2) engaging with divisions—many divisions are primarily for practicing psychologists and APAPO work is critical to their members; and 3) engaging early career psychologists--one action item included forming an ECP-led Engagement Work Group.
If APAPO is going to engage their current membership, win back past members, and bring in new members, their technology will need to better meet the demands of an increasingly tech-savvy group. The APAPO website needs help, including making becoming a member easier, providing easy access to tools & information for current members, and making it more clear all the amazing work the Practice Organization does for psychologists. A trial of an APAPO listserv was not successful, but the Practice Organization is committed to finding a way to hear more their members. They are working on more timely social media, an opt-in topical listserv, etc.
So what is the Practice Organization doing for psychologists? Because that is the bottom line about what probably matters to each of you versus APAPO budgets and politics.
Here are my Top 15 APAPO Action Items on behalf of practicing psychologists in 2016:
Government Relations: working on the Medicare Mental Health Access Act to include psychologists in the Medicare physician definition (H.R. 4277/S. 2597) Rep Noem & Rep Shakowsky are sponsors; 20 cosponsors; Senate Bill sponsors: Sherrod Brown & Susan Collins: 2 cosponsors currently including Sen. Schumer. Looking at vehicles to get into law such as Medicare payment bills in house and technical in Senate, omnibus bill in December. This is critical to psychologists being eligible for incentives and reimbursement codes only open to "physicians" currently--i.e., bottom line reimbursement.
Government Relations: working on legislation to reform federal mental health funding, specifically the Helping Families in Mental Health Crisis Act (H.R. 2646) and the Mental Health Reform Act (S. 1945). Tim Murphy is the House sponsor; needs more bipartisan report. Senate sponsor is Lamar Alexander. The bill may stalled in election year politics and possible amendments related to gun control. The HIPPA provision is concerning to psychologists, in particular provision to modify privacy law to allow providers to communicate with family members of patients with SMI. APA shared concern but supported overall bill.
Medicare Incentive Based Payment System is being watched by APAPO advocacy staff. This is a new proposed rule from CMS; comments will be taken for 60 days “merit based incentive payment system.” PQRS, meaningful use programs end this year; these reporting aspects will be included in MIBPS. For psychologists, MIBPS will start in 2019. A quality component will be 50% of the score; advancing care 25% (how clinicians use technology), clinical practice improvement activities (patient safety, coordinated care—8 options include behavioral/mental health care) 15%, and cost and resource use 10%. Psychologists have the option to try the system in 2017.
Government relations: working on an initiative to engage psychology students in advocacy, the TEAM Project. This would involve FACs mentoring APAGS students as advocacy leaders “Training and Engaging with Advocacy Mentors APAPO TEAM program.
Legal/Regulatory team worked to resolve issues on use of 90837 vs. 90834 codes with three different insurers
Legal/Regulatory: Worked on parity enforcement, including filing complaints against Humana which appear to have stemmed the tide
Legal/Regulatory: APAPO is sponsoring multi-state summits on alternative practice models in Washington DC May 20th and Chicago June 24th Topics will include. Registration significantly discounted for APAPO members/great member value. http://www.apapracticecentral.org/update/2016/03-24/alternative-practice-models.aspx
Legal/Regulatory is working on Medicaid advocacy: intern reimbursement (DC, TX, NC, CA), including psychologists in medical home, and in DC have partnered with Children’s Hospital to work research on cost-effectiveness of psychological interventions.
APAPO provides CE Opportunities at a discount for APAPO members on topics such as HIPAA compliance:http://www.apapracticecentral.org/ce/courses/1370022.aspx
APAPO provides resource s and information on business of practice, HIPAA compliance, alternative practice models and more: http://www.apapracticecentral.org/business/alternative/index.aspx
APAPO provides timely newsletters and updates such as Good Practice Newsletter and Practice Update to keep you informed on hot topics in practice: see latest edition with topics such as provider contracts and successful use of PQRS: http://www.apapracticecentral.org/good-practice/index.aspx and http://www.apapracticecentral.org/update/index.aspx
State Leadership Conference 2016—brought 500 psychologists to Capitol Hill to advocate on your behalf
APAPO Organizational grants—provided $250,000 to 26 small state organizations to help pay for lobbying for state issues and to keep small SPTA doors open
Educating the public about the value of psychological services/marketing: APA Practice Directorate partnership with PhoneRover reaches approximately 87,000 primary care patients each month with messages about mental and behavioral health.
Public education campaign's "Stress in America" survey was released revealing the impact of discrimination on stress; many practicing psychologists engaged with media to discuss outcomes.
I think that’s a pretty good list and pretty good value for APAPO membership dues. But what do you think? I would love to hear feedback from current, former, and never APAPO members. Because in the end, any organization is only as good as its membership and the value it brings to members.
