State Leadership Conference

More than 500 psychologists from 59 states, provinces and territories gathered March 1-4 in Washington, D.C., for the APA Practice Organization's 2003 State Leadership Conference--an annual event that helps set psychology's policy agenda at the federal and state levels.

According to APA Executive Director for Practice Russ Newman, PhD, JD, the conference theme, "Leading psychology forward: staying the course in uncertain times," was chosen to reflect the current political and economic climate--which may hamper priorities such as mental health parity and health-care reform--and to strengthen psychologists' resolve to continue to lobby for such needed reforms.

"Growing problems with this nation's health-care systems have hardly been priorities in a Congress whose agenda is understandably preoccupied with national security, terrorism, enemies abroad and the possibility of imminent war," explained Newman at the conference's opening session. Moreover, he said, a poor economic climate and budget woes in many state governments are "more likely to result in resources being taken away from health care than to produce creative solutions for an already ailing health-care system."

Despite such a climate, the past year yielded many successes, Newman said:

  • Prescription privileges. New Mexico became the first state to enact a law authorizing appropriately trained psychologists to prescribe medication.

"I continue to be impressed by the optimism about psychology's growth and future that I hear in those states where prescriptive authority efforts are occurring--something we cannot overlook at a time in which much else in health care is pessimistic and at a standstill," said Newman. In fact, from 1986 to 2002, a total of 13 states filed prescription privileges legislation, but 12 states are pursuing legislation at the same time this year.

  • Improved state laws. Georgia resolved a conflict over the licensing of master's-level practitioners, and Virginia enacted an improved confidentiality law that prohibits lawyers from accessing mental health records.

Moreover, New York state law now outlines psychologists' scope of practice. Previously, only the title of psychologist was protected, allowing anyone to provide "psychological services."

  • Virginia's fight against managed care. After many delays, a lawsuit filed in 1998 by the Virginia Academy of Clinical Psychologists against Blue Cross/Blue Shield of the National Capital Area and its mental health carve-out, formerly Value Options, to protest unfair managed-care practices was slated to go to trial last month--but the parties settled out of court on March 14 with significant concessions for the psychologists and consumers who filed the suit (see April Monitor ).

"Battling the insurance and managed-care industry is an expensive proposition, but a battle that we can ill-afford to forgo," said Newman.

  • Growth of the Psychologically Healthy Workplace awards program. Twenty-nine state associations have joined in this project to increase the business community's awareness of psychological issues and the value of psychological services.

  • Further development of APA's Road to Resilience campaign. The campaign to promote resilience in difficult times has produced a television documentary, sent more than 1,000 tool kits to psychologists, facilitated 80 public forums and disseminated 100,000 brochures to the public. And the Practice Directorate is continuing to develop additional materials that focus on resilience for children and in times of war.

  • Action by APA's Disaster Response Network. The network responded to tornadoes in Ohio, Tennessee, Alabama and Maryland, flooding in West Virginia and the sniper shootings in Washington, D.C.

Forging ahead

The successes of last year are only a start, though, said Newman. There are many challenges ahead--among the biggest will be health-care reform.

"While the problems of increasing numbers of uninsured and rising health-care costs are clear, there is no clear or agreed upon solution to these problems anywhere on the horizon," he said, explaining that the diversity of the various proposals makes it difficult to know which will actually emerge as viable options.

"I would predict that, while many proposals for reform will be raised, and some even debated by Congress, definitive action over the next two years is unlikely." What's more probable, he said, is that health-care reform will play a role in the upcoming presidential campaign.

Newman urged psychologists to "stay the course" through several strategies, such as:

  • Pressing for mental health parity.

  • Educating the public and policy-makers about the role of psychological services in preventing such conditions as cardiovascular disease, diabetes, obesity and HIV.

  • Integrating mental and physical health services.

  • Holding managed care accountable for "their choice to put profits before patients" and ensure that any new health-care system has "accountability at its core."

  • Ensuring that psychological services are included in reform and preserving adequate reimbursement rates for psychological services.

Further Reading

An excerpt of Newman's speech appears on page 80.