APA Board Takes Stance on Health Reform Proposals

APA's Board of Trustees voted unanimously at its September meeting in Washington, D.C., to add APA to the list of medical and advocacy organizations that have decided to give their support to HR 3200, a health reform bill that has been approved by three influential House of Representatives committees. The bill includes several mental-health-related proposals that would benefit psychiatric patients and improve access to mental health care, including strong mental health parity protections that extend beyond the provisions of the 2008 parity law.

Although “no bill is perfect,” APA President Alan Schatzberg, M.D., noted in his column in the October 2 Psychiatric News, HR 3200“ preserves the gains we have made in regard to parity and provides major benefits for our patients, including prior-illness protection and the elimination of proposed reductions in Medicare [physician] reimbursement.”

Also on the health care reform front, the Board endorsed the concept of a public option as long as physician participation in that type of insurance plan is voluntary.

In other actions, the Board approved a change in the composition of the Council on Minority Mental Health and Health Disparities. Once change takes effect, the council will have a voting member representing each of the seven minority/underrepresented groups that APA recognizes. They are Asian-American psychiatrists; American-Indian, Alaska-Native, and Native-Hawaiian psychiatrists; black psychiatrists; Hispanic psychiatrists; gay, lesbian, and bisexual psychiatrists; women psychiatrists; and international medical graduates.

Trustees also voted to terminate the APA Certification for Psychiatric Administration program largely because of the steadily increasing cost of administering the accompanying exam. Instead an “intensive course” on this topic will be included in the APA annual meeting program.

In addition, the Board agreed to retire many official APA position statements and replace them with updated versions that reflect new knowledge on the subjects. Among the revised position statements the Board adopted are ones covering the use of marijuana as medicine, substance abuse by adolescents, tobacco dependence, rights and regulations of psychiatrists practicing in managed care plans, use of hypnosis, employment-related psychiatric examinations, use of animals in research, and several related to HIV/AIDS treatment and testing. More information about these and other position statements can be accessed through the APA Web address at the end of this article.

Board members also had a preliminary discussion on a report from an ad hoc work group that was examining issues surrounding the integration of psychiatry into primary care, which has become a front-burner topic among psychiatrists and mental health professionals in the ongoing debate about reforming the U.S. health care system. The extent to which mental health care is provided by psychiatrists and mental health professionals in primary care settings could have a major impact on how those clinicians are paid under a health care system that looks very different from the current one, if the system is overhauled.

It is also viewed as a particularly critical topic in that between 60 percent and 80 percent of patients who seek treatment for a mental health condition do so in a primary care setting, but up to two-thirds of Americans who need mental health care receive no treatment at all.

One item in the recommendation section—“psychiatry must be included as an essential component in all federal- and state-funded medical-home demonstration projects”—was forwarded to the Council on Advocacy and Government Relations for further review. All of the recommendations in the work group's report will be discussed further and voted on in a Board of Trustees conference call, with the final report sent to the Assembly for review at its November meeting.

A summary of actions taken by the Board at its September meeting will be posted under Members Corner on APA's Web site at<www.psych.org>.▪