Cutler Retires After Decades Of Shaping MH Legislation

As a quarter-century of service as APA’s government relations director and chief lobbyist came to a close at the dawn of the new year, Jay B. Cutler, J.D., was able to look back on a legacy of contributions to critical legislation and regulatory changes that improved the lives of people with mental illness.

Honored at APA’s recent annual meeting in San Francisco with a Speaker’s Award at the Assembly meeting and a Presidential Commendation at the Convocation, as well as at an earlier Capitol Hill reception, Cutler helped shape legislation on almost every issue that touched on the care and treatment of people with mental illness.

Among the most critical of these laws were those concerning insurance parity for psychiatric disorders; patients’ rights; children’s mental health issues such as portrayals of violence on television; and most recently privacy of electronic medical records, including the successful push to ensure special protections for psychotherapy notes.

He and his staff have also worked successfully to convince Congress to increase budgets for federal agencies such as the National Institute of Mental Health, Substance Abuse and Mental Health Services Administration, National Institutes of Health, and the health care components of the Department of Veterans Affairs.

In the regulatory arena, Cutler was involved in ensuring that the federal government included key mental health care provisions in Medicare and Medicaid rules (including ongoing efforts to have Medicare’s discriminatory mental health care copayment abolished). He was instrumental in expanding Medicare’s coverage for inpatient psychiatric care and then having all discriminatory limits removed. In 1982 he and his staff worked along with several APA members to convince the Health Care Financing Administration to exempt inpatient psychiatric care from its newly developed payment system based on diagnosis-related groupings.

In addition, he led a successful effort to convince the Department of Defense to shut down its controversial experiment to train clinical psychologists to prescribe psychoactive drugs.

His efforts also played a key part in the decisions of the Carter and second Bush administrations to convene presidential commissions on the mental health care system.

Despite this impressive roster of accomplishments, Cutler told Psychiatric News that he is most proud of the fact that he knew he had “the absolute trust, confidence, and appreciation” of former APA Medical Director Melvin Sabshin, M.D., with whom he had worked for 20 years. He added that he was also proud that “every Joint Commission on Government Relations’ chair and Area leader quickly came to appreciate the political sensitivity, substantive knowledge, and advocacy effectiveness of the Division of Government Relations lobbying team as it carried out APA’s mission on behalf of psychiatrists and their patients.”

In remarks Sen. Edward Kennedy (D-Mass.) had inserted into the Congressional Record, he stated that Cutler “played an important and unique role in building bridges to increased communication and cooperation across the research, prevention, treatment, and policymaking communities. . . . Say ‘Jay Cutler’ to literally hundreds of current and former senators, representatives, congressional staff, executive branch officials, consumer advocates, newsmakers, educators, and just plain folks, and you will receive a warm smile of recognition that speaks directly to what made Jay so successful.”

Kennedy also acknowledged Cutler’s widely admired leadership of APA’s lobbying efforts. “To his eternal credit,” Kennedy stated, “throughout Jay’s tenure as director of government relations, APA could be relied upon to fight just as hard for its patients as its members. This is a model that other trade organizations would do well to follow.” ▪