State Leadership Conference

As its name implies, APA's State Leadership Conference (SLC) presents a forum for psychology's leaders to voice their concerns on relevant issues with their representatives in the U.S. Congress. This year, about 350 delegates took their expertise on parity, managed-care reform and privacy to Capitol Hill during the SLC, held March 10-13.

Advocating for improved care

The psychologists' discussion of mental health parity was a particularly timely concern, as the existing partial parity law from 1996 sunsets on Sept. 30. The delegates lobbied for the Mental Health Equitable Treatment Act of 2001, introduced by Sens. Pete Domenici (R­N.M.) and Paul Wellstone (D­Minn.), and the Mental Health and Substance Abuse Parity Amendments of 2001 by Rep. Marge Roukema (R­N.J.). The bills would close loopholes in the law that discriminate against people who require mental health services by prohibiting group health plans from providing mental health benefits differently from medical and surgical benefits. Moreover, the legislation would require parity for all categories of mental health conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.

The Practice Directorate's Director of Congressional Affairs Peter Newbould says the psychologists "were instrumental in convincing several offices" of our nation's need for a strong federal parity law.

To further ensure better patient care, the psychologists also urged members of Congress to support legislation that renders managed-care health plans accountable for decisions that impede quality health care. Such responsibility is stipulated in the Bipartisan Patient Protection Act of 2001, introduced by Sens. John McCain (R­Ariz.) and Ted Kennedy (D­Mass) and Reps. Greg Ganske (R­Iowa) and John Dingell (D­Mich). The legislation affords injured patients legal recourse and an appeals process while protecting employers from trivial or erroneous claims. Psychology is seeking to prevent a cap on noneconomic damages and to allow patients with mental injury the same access to court as those with "bodily injury."

The psychologists also pressed members of Congress and their staffs to urge U.S. Health and Human Services (HHS) Secretary Tommy Thompson to preserve the patient protections in the patient records privacy rule, which he reopened in February for further comment (see April Monitor). The rules mandate that health-care providers get patients' consent before sharing their information or psychotherapy notes for treatment, payment and health-care operations purposes. The rules state that no health-care entity could require the patient to authorize disclosure of psychotherapy notes as a condition of rendering or paying for the treatment.

Grassroots networks of state-level psychologists are organizing to petition HHS to maintain provisions protecting patients' rights to inspect and consent to the release of their records, and preventing the disclosure of psychotherapy notes for health-plan administrative purposes, in the final rule. The psychologists are also pushing to keep the non-preemption of stronger state privacy laws, which may provide patients more comprehensive records protections than the national rule.

Psychologists' work recognized

Patients and members of the mental health-care community were not alone in their appreciation of the SLC visit to Capitol Hill. Many legislators said they valued receiving psychological insight into their constituents' needs. The day after the Hill visits, Sens. Wellstone and Domenici thanked the mental health advocates who both supported the legislation and cared, said Wellstone, for "so many families and individuals with great courage."

It is expected that both parity and managed care will be voted on early this summer. Hopes are indeed high, as reflected in Domenici's parity promise to "introduce our bill today so that we can pass it this year, not five years from now."