xxAACP Newsletter, Volume 16, Number 3, Spring 2002
Board of Directors' Report
The AACP Spring Board
Meeting was held in conjunction with the Annual APA meeting May 18-19, 2002 in
Philadelphia, PA. It was an extremely busy meeting with multiple guests, heated
debate and a significant work accomplished.
ANNOUNCEMENTS
New Board Members
Dr. Huffine announced that
the newly elected board members: Tony Ng, Paulette Gillig, Satya Chandrigiri,
and Pamela Weinberg, would begin their terms following the membership forum at
the 2002 annual meeting.
Appreciation
Dr. Feldman thanked Drs
Crocker, Goisman, Giles and Rohland for their years of dedication and service on
the Board.
Winter Meeting
The Board will meet Saturday
and Sunday, February 8-9 in conjunction with the public psychiatry meeting to be
held in Charlottesville, February 7-9, 2003. The conference and meeting are
being organized by Dr. Everett.
AACP appointments to APA
components
Dr. Pollack has been
appointed to the Council on Advocacy & Public Policy. Drs Pumariega and
Thompson have been appointed to the Council on Social Issues & Public
Psychiatry. Dr. Faison is a corresponding member to the Component on BMS
Fellowship Selection and the Committee on Ethnic Minority and Elderly.
APA Speaker’s Awards
The APA Speaker of the
Assembly Awards were presented at the May meeting to public psychiatrists
"who serve as models of service and advocacy for our most vulnerable
patients." Recipients included Cliff Tennison, Joel Feiner, Steve
Goldfinger, David Cutler, David Pollack and Steve Moffic, all AACP members.
.
GUESTS
Dr. Paul Appelbaum,
APA president elect:
Topics addressed during a
lengthy conversation included the future of the IPS Meeting, APA component
restructuring, prescribing privileges, and APA affairs and priorities in
general. He reported on the reorganization of the council/component structure.
Three areas of new emphasis include: public sector psychiatry, minority issues,
and membership issues. He announced that "access to care’ would be the
primary focus of his presidency. Dr. Appelbaum emphasized his personal support
for continuing the IPS, and stated his desire that AACP play an integral role in
refocusing it.
Dr. Al Gaw, APA
speaker elect
Dr. Gaw expressed
appreciation to AACP for providing initiative and assistance with development of
the Assembly task force report on the Seriously and Persistently Mentally Ill (SPMI).
He reported that the work plan/action items from the task force report will be
assigned to the Council on Public Sector Psychiatry under the leadership of Dr.
Jeffrey Geller. Anita Everett and Dr. Larry Miller will co-chair the Committee
on the Care of the Seriously Mentally Ill. The action plan will include
commitment of funds by APA. The next Assembly Speaker, Dr. Prakash Desai, shares
Dr. Gaw’s enthusiasm for advancing the SPMI agenda.
Dr. Steve Mirin, APA
Medical Director
Dr. Mirin requested AACP
Board assistance in identifying psychiatrists and consumers from key states to
lobby for parity. He also requested AACP assistance in connecting with
psychiatrists around scope of practice challenges. The Board engaged Dr. Mirin
in a discussion of the linkage between scope of practice and access to care
issues. Suggestions were made that APA advocate for improved access to
psychiatric care by 1)supporting telepsychiatry in rural areas, 2)advocating for
increased training of rural psychiatric practitioners, 3)advancing the use of
nurse extenders, and 4) fighting for retention of J1 visa programs.
Dr. Jim Thompson,
APA Director of Medical Education
Dr. Thompson commented on a
variety of issues related to the APA/AACP interface including supporting formal
collaboration between APA and AACP for IPS. He reported that the APIRE
fellowship program has been successful and is continuing.
CALOCUS
Dr. Ted Fallon,
representative from the American Academy of Child and Adolescent Pscyhiatrists (AACAP),
participated in an extended discussion of the 11-item proposed working agreement
between AACP and AACAP for the distribution of CALOCUS. There was an extended
and heated debate by Board members on the merits of AACAP’s proposal,
primarily focusing on the tension between public needs and scientific/academic
rigor. The primary controversy was about public access to CALOCUS. AACAP wished
to discontinue free downloading of the instrument from the AACP website. AACAP
proposed that the instrument be distributed only in combination with the
training manual, and that users be charged for the package. This would allow
AACAP to maintain linkage with CALOCUS users for purposes of follow-up and
quality control. The Board voted to reject the AACAP proposal and to submit a
counter-proposal including a provision that the instrument be available on the
web site with required, but free, registration. However, in subsequent
renegotiation meetings between Dr’s Feldman, Huffine, Purmariega and AACAP,
the counter proposal was not accepted by AACAP, and the CALOCUS work agreement
remains unresolved.
TREASURER’S REPORT
Dr. Goisman circulated and
discussed the proposed budget for 2002 — 2003 totaling $54,500, which is
slightly lower than the prior year’s. Dr. Goisman observed that 55% of income
now comes from dues (an increase), and that the proportion of income from
corporate sponsors has declined from 38% two years ago to 11.9%, a change felt
to be in line with AACP’s desire to decrease reliance on corporate
sponsorship. However Dr. Goisman also observed that recent income includes a
‘bubble’ created by the new multi-year memberships. The Board thanked Dr.
Goisman for his efforts and grace in handling his duties and transition as this
was his final Board meeting as Treasurer.
ASSEMBLY UPDATE:
Dr. Robert Ronis, AACP
liaison to the APA Assembly, reported on Assembly actions of particular
relevance to AACP: At the most recent Assembly meeting the APA Committee on
Public & Community Psychiatry presented the report of the Speakers Task
Force on SPMI/Public Psychiatry. This new Task Force was established by Speaker
Nada Stotland in 2001 to re-emphasize APA’s mission to seriously mentally ill
individuals receiving care in the public system. AACP was richly represented in
the Task Force membership. (See related article by Dr. Everett on page 2)
Dr. Ronis observed that with the endorsement of this report, the whole tone of
the Assembly agenda has changed. In particular, the Assembly is now eager to
endorse related AACP products. The AACP Board voted unanimously to endorse the
SPMI Bill of Rights and the principles operationalized in the 10 action items,
and to encourage their further development.
OLD BUSINESS
AACP, APA Interface
Drs. Feldman and Huffine
reported on the March meeting with leadership of APA regarding collaboration on
the IPS Meeting. The APA is open to an expanded AACP role in planning the
meeting and ultimately the AACP will be able to compose the faculty. The APA is
interested in increasing attendance. The AACP is interested in increased
multi-disciplinary attendance and less expensive venues .
NYC HHC letter on
formulary
At Dr. McQuestion’s
request, the AACP wrote a letter to NYC’s health care financing agency (HHC)
opposing proposed formulary restrictions that would affect psychotropic
availability for seriously mentally ill individuals. With the help of this
letter, and an outpouring of opposition from many stakeholders, HHC backed down
from this plan.
Industry support
proposal for Winter meeting
Dr. Feldman has been
informally contacted by a pharmaceutical company that is interested in
sponsoring a pre-meeting symposium to help launch a new product. The Board
engaged in a lengthy debate on the merits/ethics of accepting such a proposal
with potential windfall income for AACP. At the end of the discussion the Board
remained strongly divided on the issue and unable to proceed with a decision.
Dr. Feldman announced that she would attempt to learn more from the product
sponsor about proposal details and options. The decision will then be
re-presented to the Board, and specific input will be sought from the Ethics
committee
Moffic Award for
Ethics
This years awardees are
Christie Cline, Medical Director in New Mexico and James Sabin. Awards will be
presented at the AACP Membership Forum during the IPS Meeting.
NEW BUSINESS
J1 Visas
The issue of Federal
proposals to limit J1 visas was discussed. The Diversity Committee was assigned
the task of developing a policy statement on this issue.
COMMITTEE REPORTS
Persons with Mental
Illness Behind Bars
The committee is beginning
work on a new position paper on " Psychiatry and Social Control" which
will address the limits of psychiatric authority for social control both inside
and outside of correctional institutions, and will specifically address issues
that involve minorities. The group will collaborate with the ethics committee on
this project.
Ethics
The committee is developing
a position paper on industry relationships. This product is targeted for draft
completion by the IPS meeting in October. It will include guidelines for AACP to
use when accepting industry contributions, and outline what AACP expects
contributors to agree to before donating money.
Psychosocial Rehab
Dr McQuestion presented the
draft of the committee’s position paper on Representative. Payeeships After
the paper is approved by AACP, it will be sent to the APA Assembly. (The
Representative Payeeship position paper was subsequently approved by e-mail vote
on 6/17/02. See page 4.)
Communications/Publications
Newsletter: An
e-mail membership survey was conducted on preferences for newsletter
distribution. Responders were evenly split on preference for mail vs. electronic
distribution. The newsletter is currently sent to non-AACP members
working at CMHCs at an annual expense of $2000. The Board agreed to replace this
mail distributionwith cost free web access.
Website:
The Board voted to increase the money paid for monthly website maintenance. Dr.
Thompson has proposed setting up an electronic forum on the AACP listserv for
discussion of lead articles in the Community Mental Health Journal. Dr.
Cutler will discuss this with the publisher.
Journal:
Dr. Cutler announced that the October 2003 issue of the Community Mental
Health Journal will be a special issue commemorating the 40th
year anniversary of the Community Mental Health Center Act of 1963. Dr. Cutler
is soliciting manuscripts related to the history, curre nt state, and future of
the community mental health movement.
Disaster
Dr. Thompson reported on the
development of the July 2002 conference with CMHS for community psychiatrists on
terrorism/disaster. 25-30 individuals were invited to attend. The intent was to
create a curriculum for subsequent national dissemination to prepare
psychiatrists for a mass casualty event.
Healthcare Systems
Dr. Minkoff reported that
the committee has completed much of its recent agenda and now is deliberating
future agenda topics. In addition to working on updated principles of formulary
management (see below), the committee is considering the following
additional work items: 1) access to mental health care in impoverished, rural
and underserved areas, 2) mental health benefits in a time of new Medicaid
waivers.
Formulary Management
(sub-committee of Healthcare Systems)
Dr. Everett is leading an
effort to re-develop guidelines for formulary management in public mental health
systems. When the document is written, it will be shared with SAMSHA, NASMHPD,
all state Medicaid directors and consumer entities in an attempt to influence
the ubiquitous efforts by states to economize on Medicaid medication expenses.
Training
1) A training resource
section has now been constructed on the AACP website. It contains an initial
list of community psychiatry program descriptions and curricula that will be
gradually expanded.
2) Several plans emerged in
the committee meeting to solidify the relationship between AACP and BMS fellows,
including outreach to new BMS fellows by area reps, sharing lists of activities,
increased mentorship at APA, and involvement of fellows in AACP committees.
3) The committee reviewed
responses from the recent membership survey indicating interest in post-graduate
training. The committee discussed expanding its mission to include development
of CME activities for practicing community psychiatrists. The Board approved the
formation of a CME subcommittee to be co-led by Drs. Gibson and Forster.
Membership
Current membership is 534
paid members. Dr. Primm compared the 1998 and 2001 membership surveys and
reported that the diversity of the responding membership has increased
considerably. The committee discussed the need to increase exposure of AACP to
ECPs. The committee discussed ways of recruiting ECPs, including the possibility
of decreasing dues for residents.
Task Force to Fight
State Mental Health Budget Cuts
Dr. Forster was joined by
UCSF psychiatry resident John Young to report on the progress of this newly
formed AACP taskforce on the development of a national strategy to combat
rampant cuts in state mental health budgets. Drs. Young and Forster are
currently developing an ‘Advocacy Toolkit’ containing background facts,
strategies, and advocacy success stories. When completed, the toolkit will be
placed on the AACP website, and distributed via the AACP listserv.
Program
AACP members Ken Thompson
and Jules Ranz have been selected to give lectures at the 2002 IPS meeting. The
official AACP submissions for the 2003 APA meeting will include a symposium on
"Disaster Psychiatry: the role of public sector psychiatry after 9/11"
and a symposium on interventions in early psychosis. In addition, plans are
being considered to offer regular courses on LOCUS and CALOCUS at both the
annual meeting and IPS.
Diversity
The committee organized a
symposium for IPS on the Surgeon General’s Report on Mental Health, Culture,
Race, and Ethnicity. Dr. Ng will begin work on a report on how different
cultural groups cope with disasters. The Committee will begin to collect
information on the issue of J1 Visas.
Primary Care
The committee will offer
AACP expertise to the APA Board of Trustees (BOT) to promote improved
psychiatry-primary care organizational communication. Dr. Pollack has drafted a
letter to the BOT suggesting specific strategies for improving collaboration
with which AACP might help. Dr. Pollack also circulated the draft of a position
paper on "Principles of Working Effectively with Primary Care
Providers".
Quality Management
The Continuity of Care
guidelines will be published in the American Association Addiction Psychiatry (AAAP)
newsletter. The Committee is now developing guidelines for quality assessment of
recovery oriented services. Presently they are identifying quality indicators
and domains. Drafts will be distributed and edited by the next Board meeting.
The committee has also agreed to work on Quality Management implications of the
Patient Bill of Rights recently adopted by the APA Assembly.
Consumer Advisory
Board Task Force
A priority has been set for
AACP to increase diversity, and a commitment to improving our interaction and
partnership with advocacy groups to carry out our mission. Dr. Sowers moved that
a task force be appointed to make recommendations to the Board on how most
effectively to incorporate advocacy/consumer input.
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