APA Creates Blueprint for Future

The start of a new year is an exciting time. It gives us an opportunity to re-evaluate our successes and failures, make adjustments, and move forward. APA’s advocacy activities for parity, privacy, and patient protection are on course. In addition, following the 9/11 attacks we have launched the National Partnership for Workplace Mental Health to combat the mental health impact of terrorism, disaster, and economic uncertainty in the workplace (see page 1). The 14-member national partnership (including APA, Centers for Disease Control and Prevention, Center for Mental Health Services, Delta Air Lines, Dow Chemical, Dupont, Glaxo-SmithKline, National Association of Manufacturers, Goldman Sachs Group Inc., and other major employers) will provide employers nationwide with a first-response capability, editorial materials, training, and other tools to meet the mental health needs of their employees in the wake of terrorism and disaster.

Working together, APA will help develop a broad array of services including science-based mental health educational materials, a training curriculum that employers can adapt to the needs of their own workforce, and studies on workplace mental health issues and on the comparative effectiveness of new workplace mental health prevention and intervention strategies. You can be assured and be proud that your APA’s commitment to the well-being and appropriate psychiatric treatment of the nation’s workforce will continue long after September 2001.

While there have been successes, we have also had many tough issues to deal with. In previous columns, I have mentioned that APA must live within its means. We cannot continue to do everything we are now doing. During the last several years, APA’s revenues have not kept up with expenses. There has been a slow but steady reduction in dues-income collection. No increase in national dues, with inflation factored in, equals a loss in revenue rather than holding steady. In addition, a series of information systems costs, including Y2K and our national membership and billing systems, have been expensive and somewhat frustrating. A low attendance at the Institute on Psychiatric Services in Orlando this past October resulted in a loss of more than $200,000, which can be attributed to the institute’s occurring four weeks after September 11. The decision to go forward with that meeting was the appropriate professional decision and, in my opinion, outweighed the fiscal issue.

During the December Board of Trustees meeting in Washington, D.C., the Board carefully walked through our financial and budget situation over the last few years (see page 2). While we are still a financially sound organization with reserves of more than $15 million, the financial trends are in the wrong direction. The Board of Trustees made it clear that decisions will be made to reverse these trends and place us on an increasingly solid fiscal base. Doing so will allow us to concentrate our energies on the priority items that members, the Assembly, and Board of Trustees direct.

In December the Board authorized a financial oversight group that is tasked to meet with the medical director monthly to review financial expenditures and projections and make budgetary mid-course corrections to minimize cost overruns and create effective responses to revenue shortfalls. Monthly reports from this group will be distributed to the Board of Trustees and the Assembly Executive Committee. In addition, the Board has obtained a consultant to look at how our 501(c)6 not-for-profit organization functions and clarify and improve the Board’s oversight responsibilities. There is no need to continue to do things as we always have. We can do better. This report will be ready for consideration and implementation at the March Board of Trustees meeting.

For the last several years, while transitioning from a 501(c)3 to a 501(c)6 not-for-profit organization and expanding services, we have overspent our resources and have dipped into our reserves more than planned. The Board feels that there should be no further use of reserves other than those uses planned and prepared for in the past. The reserves should have new withdrawals only in exceptional circumstances. In addition in the 2002 budget, there is a $500,000 item to begin replenishing the reserves for future requirements that may arise. In October 2001, the Board, seeing the budgetary shortfall coming, asked me to appoint the Long-Range Budget and Planning Task Force to look beyond 2002 and begin planning for fiscal and structural changes to the organization that will make it more cost-effective and efficient. This committee, chaired by Dr. Paul Appelbaum, president-elect, is meeting regularly and will report back to the Board in March with what will become a series of recommendations to streamline and make more efficient our entire Association. We will also find new revenue. We will live within our means. We have much to do for our patients and profession. ▪