APA Practice: Working for you

Brief highlights of selected Practice Directorate activities and significant developments from February 2009 through July 2009

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 e-mail the Government Relations Department or call (202) 336-5889.

Working to insure implementation of a full mental health parity law
For additional information, please e-mail the Government Relations Department or call (202) 336-5889.

Gaining expanded access to psychological services for needy children
For additional information, please e-mail the Government Relations Department or call (202) 336-5889.

Revising Model Act for State Licensure of Psychologists
For additional information, please e-mail the Practice Research & Policy Department or call (202) 336-5911.

Challenging abusive managed care practices
For additional information, please e-mail the Legal and Regulatory Affairs Department or call (202) 336-5886.

Gauging psychologists' satisfaction with managed care and health insurance companies
For additional information, please e-mail the Legal and Regulatory Affairs Department or call (202) 336-5886.

Seeking to ensure the availability of adequate psychological services for veterans
For additional information, please e-mail the Practice Directorate Executive Office 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 e-mail the Legal and Regulatory Affairs Department or call (202) 336-5886.

Meeting the needs of families involved in child custody disputes
For additional information on guidelines, please e-mail Governance Operations or call (202) 336-5881.

Helping psychologists comply with "Red Flags" requirements from the Federal Trade Commission
For additional information, please e-mail the Legal and Regulatory Affairs Department or call (202) 336-5886.

Supporting the Presidential Summit on the Future of Psychology Practice
For additional information, please e-mail Governance Operations or call (202) 336-5858.

Aiding the profession's quest for prescriptive authority

For additional information, please e-mail the Legal and Regulatory Affairs Department or call (202) 336-5886.

Affirming the value of psychologically healthy workplaces

For additional information, please e-mail the Corporate Relations and Business Strategy Department 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 e-mail the Public Relations Department 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 e-mail the Public Relations Department or call (202) 336-5898.

Addressing the health needs of rural residents
For additional information, please e-mail the State Advocacy Department or call (202) 336-5864.

Affirming support of the concept of recovery for those with serious mental illness
For additional information, please e-mail the State Advocacy Department 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.
(Psychology Focuses on Health Care Reform)

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.

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.
(Practice leader Presses for Payment Reform in Health Care Debate)

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.
(Congress Combines Medicare and Health Care Reform: Professional Psychology Amplifies Its Message)

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.
(Hundreds of Psychology Leaders Call on Congress)

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.
(House Commettees Include Psychology's Top Medicare Priority in Reform Bill)

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 multi-specialty 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.
(In the Forefront of Advocacy)

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.
(APA Practice Calls for End to Discriminatory Limits to Mental Health Services)

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.
(Health Insurance Program Expansion Helps Children in Need)

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. ("Model Act for State Licensure of Psychologists": Public Comments Now Being Accepted)

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.

(California Is Latest State to Join Nationwide Class Action Litigation)
(APA Practice Organization Becomes Involved in Class Action Litigation

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.
(APAPO Survey on Health Insurers Headed to Members)

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.
(Veterans Affairs Psychology Leadership Conference Highlights VA Health Care)

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 (PDF, 64KB).

These guidelines 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.
(Revised Guidelines Address Child Custody Evaluations)

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.
(Guidance for Psychologists on "Red Flags Rule" Compliance)

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."

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.
(Oregon Eyes Prescriptive Authority Goal for 2010)

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.
(Psychologically Healthy Workplace Program, Psychologists Connect Via Social Media)

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 (APA Poll Find Economic Stress Taking a Toll on Men), the APA Help Center posted "Staying Resilient Through Tough Economic Times," its third piece related to fostering resilience in the difficult economy.
(Tips on Fostering Resilience in Tough Times).

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.
(APA-YMCA Partnership Helps Families Focus on Healthy Lifestyles)

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.
(Managing Anxiety About the Flu Outbreak)

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.
(APA and American Red Cross Reaffirm Historic Partnership)

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.
(National Health Service Corps Offers Loan Repayment Program)

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."