Area 4 Builds Effective Strategy for Influencing Political Process

Area 4's annual legislative Institute, held in Chicago in March, turned out to be an extremely successful way to help psychiatrists become more comfortable with and knowledgable about the legislative process and how they can influence it.

The two of us, members of the APA Government Relations Committee, organized the institute, whose purpose is to educate Area 4 district branches (DBs), and particularly their legislative representatives, about the importance of advocacy efforts on behalf of patient care and the profession of psychiatry at both state and federal levels. There were about 20 participants this year.

High on the agenda were opportunities to learn different kinds of lobbying strategies and understand how the political process works. This grass-roots lobbying may include individual advocacy efforts on specific legislation, getting across the views of an organization, and educating legislators about why action is critical on particular issues.

Psychiatrists compete with other interest groups for the time and attention of state legislators; thus, speaking with them directly is a way to provide expert information, opinions, and analysis to assist them in their deliberations.

An important part of the recent Area 4 program was to share ideas about what characteristics DBs want our lobbyists to have. The Illinois Psychiatric Society (IPS), for example, recently had to hire a new lobbyist. DB leaders decided to develop a list of questions for each candidate, and answers were distributed to IPS leadership.

The guest speaker at the recent institute was John Potts, president and CEO of Illinois Strategies, the group the IPS hired as its new lobbyist. It is also the lobbyist for the Illinois State Medical Society (ISMS) and other medical organizations. Illinois Strategies' first work on behalf of IPS was to convince lawmakers to kill a scope-of-practice bill that would have granted prescribing privileges to psychologists. Mr. Potts' message to lawmakers was simple: prescribing medication appropriately and safely requires complex knowledge that comes with years of study. So if health care workers want to prescribe medications they should go to medical school. Illinois Strategies, in conjunction with the ISMS, prepared a document titled “The Education, Training, and Licensure of Health Care Professionals: A Guide for Legislators Toward Maintaining High Standards, Quality of Care, and Patient Safety.” This document was provided to each member of the Illinois General Assembly to educate them on the differences between physicians and nonphysicians.

At the institute Mr. Potts discussed the importance of getting to know legislators through meetings and being accessible to them. He also emphasized that political implications of the decisions by legislators often override other reasons to support or oppose actions, no matter how noble those actions may be.

Reports from the institute participants provided a great opportunity to learn about issues and advocacy efforts in each state in Area 4. For example, Minnesota has a new legislature that is mostly Democratic but has a Republican governor. The previous legislature was dominated by Republicans, and the changed has caused some political realignment in the state. In Indiana, optometrists want privileges to prescribe Schedule II medication, and physician assistants want to prescribe independently. A parity bill was introduced in Michigan despite the difficulties in trying to get such a bill enacted in the past. In Wisconsin, the governor's budget includes a request to increase Medicaid reimbursement for mental health services. Missouri's governor has approved $700,000 to three autism centers to improve access to care. A scope-of-practice bill for psychologist prescribing is being pushed in Missouri by a former legislator who is a physician, and in Ohio the new governor is a psychologist, and psychiatrists there expect that psychologists will introduce a prescribing bill during the current session. There is also pending legislation in Ohio to grant marriage and family therapists the right to extend their scope of practice by diagnosing and treating mental illness.

The institute concluded by outlining legislative goals for the DBs in Area 4 for the rest of 2007. These include having each DB invite a state legislator to a DB meeting, inviting a legislator to write a column in the DB newsletter, working proact ively on public-polic y matters affecting mental health care, increasing the involvement of members in state medical associations, and encouraging members to participate with APA's political action committee (APAPAC) and with their state PACs.

From the many comments we heard from participants during and after the institute, it appears clear that it was well received and viewed as a valuable way to help DB members increase their participation in a political process that has a profound impact on them and their patients. It provided a forum to exchange ideas on key legislative issues for each state in Area 4 and can serve as a model program that other APA Areas might considering adopting.▪