Helping District Branches And State Associations

One of my first acts as I entered the presidency was to appoint the Commission on Public Policy, Litigation, and Advocacy (COPPLA). The commission’s 13 members include four appointed members, a member of the Board of Trustees, chairs of the Committee on District Branch Relations and the Commission on Judicial Action, vice chairs of the Joint Commissions on Government Relations and Public Affairs, two members from minority/underrepresented groups, and a DB/state association president and executive director. Requests for assistance can be submitted to the commission, which has the capability to evaluate the most appropriate response—legal, legislative, and/or public relations.

At the time of this writing, COPPLA has recommended and the Board has approved $274,000 in funding in response to DB/state association requests for assistance with scope-of-practice issues, largely psychologist prescribing. The recipients were the Georgia, Texas, New Mexico, Hawaii, Oklahoma, New York, and California psychiatric associations. Additional recommended funding of $130,000 went to the Division of Government Relations for research on psychologist prescribing and a Medicare coverage study, for a grand total of $404,000.

What are some of the other things APA has done to assist our members? The Commission on Judicial Action recommended and APA provided $10,000 in support of amicus briefs leading to successful lawsuits in California and New York to protect the privacy of patient communications and the confidentiality of psychiatric records. The Board of Trustees authorized $30,000 funding to defray the expenses of DB federal legislative representatives attending the 2001 Federal Legislative Institute and their visits to Congress. Our corporate reorganization has enabled APA to provide more financial assistance directly to district branches through revenue sharing. This year DBs and the New York and California state associations will receive $700,000. Another $150,000 is available to DBs that have adjusted and lowered their dues for early career psychiatrists so the DBs won’t lose any revenue in this effort to make it easier for our young members to belong. I am hopeful that the direct financial assistance to DBs will result in their being able to lower or at least freeze their dues rates as APA has done for the past four years.

Individual members can also receive assistance with many problems through their DBs. When needed, DBs can turn to APA for additional help. For example, APA received a request from the North Carolina DB for assistance in protecting the privacy of psychiatric records from an insurer’s unreasonable demands (see story on page 12). Through DB and APA intervention directly with the carrier over the past year, demands for previous records were dropped, the amount of information required to document that appropriate treatment was delivered is minimal, and current patient permission is required for the release of records to the insurance company. Furthermore, the company has agreed to comply with the Health Insurance Portability and Accountability Act’s required privacy protections, including special protections of psychotherapy records, years before they go into effect, and is working with APA and the DB to establish a peer-review appeals mechanism when claims for payment are challenged. In this case, two members’ resistance to releasing records without a contemporary patient consent has improved the privacy protections for all patients covered under the insurance plan.

Another member who received assistance through the Managed Care Help Line wrote, “Your letters to the appropriate agencies. . .have brought about apparent corrected measures,” and “It has been a real comfort for me to know that there is someone. . .at APA advocating for both psychiatrists and patients alike.”

Moreover, the APA Division of Government Relations is in continuous touch with the DB/state organizations and is available for help whenever the need arises. What is amazing is that most members don’t seem to be aware of any of these efforts or activities. I am hopeful that this column will give you a better appreciation of some of the things APA is doing for you and our patients. ▪