The Executive Officer's Report
Morgan T. Sammons, PhD, ABPP
Every four years our enjoyment of fall foliage, apple cider, and Halloween festivities is tempered by a presidential election. As vital to our democracy as this is, I confess that I’m running a bit short of patience this year. The Register is a 501c3 non-profit organization so we obviously do not take sides or make recommendations. So whoever you choose and for whatever office, I make one plea: consider the willingness to govern. You might think that a given, but apparently it’s not. In this legislative season, two important bipartisan pieces of legislation that would directly affect our patients and our practices are, for all intents and purposes, dead. In the House, the bipartisan HR 4277, the “Medicare Mental Health Access Act” has stalled, and on the Senate side, S 1945, the “Mental Health Reform Act” appears down for the count. There is a small chance that when Congress returns for the lame duck session after the election that some legislative action will be taken, but I wouldn’t bet on it. HR 4277 would have, among other things, codified in law the inclusion of psychologists in the CMS definition of “physician,” thereby putting our reimbursement structures on par with those of the medical profession. S 1945, was the omnibus mental health reform bill that I’ve discussed in prior columns (go to www.Congress.gov for details). Congress did pass the Comprehensive Addiction and Recovery Act of 2016, which deals with opiate drug use and importantly opens up Medicaid payments for inpatient treatment of adolescent substance abuse, but this frankly isn’t much when wholesale reform of our mental health system is vitally needed.
The National Register Hires!
I’m happy to report that for two years in a row the National Register has seen a record number of psychologists become Registrants. I’m not entirely sure why the Register is able to buck the common trend of declining enrollment in dues-driven organizations, but I’m fairly certain that our ability to provide you with timely and pertinent clinical information, such as the Integrated Healthcare video series (NationalRegister.org/IHTS), our advocacy efforts, and other initiatives to make your professional practice easier (e.g., our online CE banking system and Find a Psychologist locator service) are important factors. As a result of this growth, we are now able to hire another doctoral-level psychologist for the first time in the 40-plus year history of the organization. This individual will help us with our practice development initiatives, represent the Register to psychologists and consumers, and assist us in our policy and advocacy initiatives. You can see the position description on page 55 of this issue and on the job board at NationalRegister.org. If you know of a likely candidate, please don’t hesitate to refer them to us.
Also on a happy note, we are pleased to announce that our winner of the 2014 Judy E. Hall, PhD, Early Career Psychologist Award, and co-author of “Diversity in the Psychology Workforce: Challenges and Opportunities to Increase the Presence of African-American Males in Psychology Graduate Programs” in the Fall 2015 edition of The Register Report, Dr. Erlanger (Earl) Turner, is featured on the cover of the latest APA Monitor on Psychology. Earl was honored for his work in cultural competency as a “Rising Star—one of nine ECPs who are changing the world.” Well done to Dr. Turner!
Expansions to the Register’s Continuing Education Offering, Strategic Partnerships, and Licensure Mobility Program
We have completed the initial filming of our Integrated Healthcare Training Series. By the time you get this issue, at least eight of the learning modules—33 videos in all—will be available on CE.NationalRegister.org. It’s a great benefit for Registrants and I hope you’ll check it and the video series out soon. See page 8-9 for a description of the learning modules and brief presenter bios.
We are finalizing a partnership agreement with Hogrefe Publishing to make their clinically-oriented series “Advances in Psychotherapy: Evidence-Based Practice” available to Registrants and NPTRs at a discounted price. We are also going to begin to offer continuing education exams based on this series. We will include an announcement in our monthly e-newsletter when the partnership is finalized and the CE exams are activated.
I’m happy to report two licensure mobility developments. First, the Washington State Board of Psychology activated their new licensure by endorsement rules in September and we have already sent several credentials verification packages on behalf of Registrants. Secondly, the New Hampshire Board of Psychologists just completed their administrative rule making process and added the National Register mobility program for out-of-state applicants. I’d like to extend special thanks to Dr. Debi Warner, a longtime Registrant and 2013 Wellner Award winner who has done a great job advocating for this and other changes to the NH licensure requirements. The rules have gone to the legislature for final approval and we are hopeful for a November 4 adoption date. We will update our website as soon as the rules are active.
This Issue: Preparing to Work with Unique Populations
The theme of this issue is preparing psychologists to work with unique patient populations. Contributors address the special expertise needed to work with military populations, children with celiac disease, patients with legal issues, and in a heartfelt and highly personal way, those with terminal illnesses. I will discuss these articles more fully in a bit. But first, as always with the fall issue of The Register Report, we are pleased to include former board member and law school Dean Steve Smith’s comprehensive survey of the recent Supreme Court term. Although this year’s term did not include any earthshattering decisions for psychologists, it remains required reading, as some forensic case law was settled and other precedents established. The major case had to do with the application of the False Claims Act to the Medicare and Medicaid claims submissions process. This case involved a major provider of psychological services (Arbour Counseling Services) and a major HMO, Universal Health Services. The court held that misrepresentation in billing amounts to a violation of the False Claims Act. In the past year, several psychologists have been found guilty of major billing fraud regarding Medicare and Medicaid payments. As we grow as a healthcare profession, this unfortunately is a component of practice we shall need to address.
In his article, Dean Smith acknowledged the assistance of recently-retired APA chief legal counsel, Nathalie Gilfoyle. I want to echo Dean Smith’s appreciation for Nathalie’s work. She was instrumental in putting psychology “on the map” in terms of Supreme Court decisions by developing and submitting amicus curiae (friend of the court) briefs on behalf of issues important to psychology and our patients. On more than one occasion, such as in the landmark case of Obergefell v. Hodges, the court commended APA for the helpfulness of these briefs in reaching a decision.
Back to the theme of special populations, Drs. Paula Domenici, Matthew Sacks, and Debra Nofziger of the Center for Deployment Psychology and the Uniform Services University of the Health Sciences discuss the necessity of cultural competence when dealing with members of the military, veterans and their family. Military culture is unique in many respects, and it’s vital for psychologists treating this population to have some familiarity with this culture.
Former National Register board member Dr. Linda Berg-Cross graciously encouraged four of her doctoral students to share a project with us. They have provided us with an excellent compilation of apps for a variety of conditions, from stress management to serious mental illness. Thanks to doctoral students Kanesha Simmons, E’leyna Garcia, Mary Katherine Howell, and Sharlene Leong for providing this annotated bibliography.
Dr. Mi-Young Ryee of Children’s National Medical Center has provided us with an extremely helpful guide to assist psychologists working with children suffering from gluten intolerance, or celiac disease. Although rare, celiac disease is a disabling disease that may be missed in initial assessment by physicians or mental health providers. Dr. Ryee’s informative article alerts us as to what symptoms may be pathognomonic of celiac disease, and the need for considering this in a comprehensive child assessment. Dr. Ryee goes further into this topic in one our “20 minute consult” videos, which will soon be available on our CE website.
Psychological practice commonly intersects with the legal system, as Dean Smith’s article attests, but psychologists may not be adequately prepared to work in this arena. Register board member Dr. Sarah Shelton, along with our public representative board members Josh Henry and Jesse Goldner (both attorneys), have provided a concise and cautionary overview of issues psychologists should, but occasionally do not, address when working with patients with legal or forensic issues. Child custody evaluations are always a contentious area, and they address this in their survey of legal and ethical pitfalls at the intersection of psychology and the law. I’d like to take this opportunity to extend congratulations to Dr. Shelton who has recently been voted in as President-elect of the Kentucky Psychological Association.
Finally, I’d like to direct your attention to an extremely compelling submission by Drs. Lauren Behrman, Josephine Johnson, Jana Martin, and Ms. Elizabeth Giamatti. This work is based on a submission to this year’s APA conference about working with patients with terminal illness. Ms. Giamatti has produced a film chronicling the death of a friend and colleague and asks us “how do you create a work of art in the face of a life-threatening illness”? This inspires the psychologist authors to contribute their perspectives on working with terminally ill patients.
In closing, let me remind everyone once again of our Internship Partnership Fund, our joint effort with the American Psychological Foundation to help create more accredited predoctoral training sites. We are ready to start funding sites in 2017, and we would love to see this initiative continue in the future. When you get this issue of the Report, end-of-year charitable giving will probably be something you’re considering. I thank all of you who have generously contributed. Donations—both new and repeat—are welcome. Thanks again and Happy Fall!