“When Johnny Comes Marching Home Again”

Developing the Foundation

APA President Tony Puente has a long history of being on the cutting edge of advocacy for professional psychology, especially in his efforts to effectively shape federal policies which directly impact the field's future. Tony, Randy Phelps, Neil Pliskin and Stephen Gillaspy have been working diligently for years to update the Medicare Current Procedural Terminology (CPT) codes for psychological testing. Psychology expert groups were convened and they regularly consulted with the Centers for Medicare and Medicaid Services (CMS). During the first few days of June, they represented APA at the second of three meetings of the American Medical Association CPT Editorial Panel in Boston. Years of relationship building, intimate knowledge of an extremely complicated process, and great teamwork set the foundation for regular interfacing with CMS and the CPT Panel. “Bottom line, health policy in the making sets the foundation for the future of professional psychology.”

Change Is Coming

Earlier this summer, the Association for Psychological Science (APS) held its 29th Annual Convention—also in Boston—attended by approximately 4,500 enthusiastic colleagues. APS was instrumental in establishing the Psychological Clinical Science Accreditation System (PCSAS) in 2007, as an independent psychology program accreditation body. Alan Kraut, formerly of APA and the recently retired CEO of APS, is heading up this initiative. Currently, 35 university psychology programs have obtained accreditation status. Last year, the Department of Veterans Affairs (VA), which is the largest trainer and employer of psychologists, recognized PCSAS as an appropriate accrediting body for meeting their internship and hiring criteria. Pending regulations at the U.S. Public Health Service (USPHS) would recognize PCSAS graduates for hiring also. To date, five states (New York, California, New Mexico, Delaware and Illinois) have similarly determined that such status fulfills their licensure requirements. Accordingly, one should expect an increasing number of jurisdictions to follow suit as PCSAS steadily matures and their graduates enter the profession.

Substantive Change Takes Time

A decade ago, the Traumatic Brain Injury (TBI) Health Enhancement and Long-Term Support Act of 2007 [H.R. 2199] noted:

“Brain injury has become a leading health issue for civilians and the military. According to the Centers for Disease Control and Prevention (CDC), in the United States civilian population 1.4 million individuals sustain TBI annually, resulting in 235,000 hospital admissions and 50,000 deaths. Additionally, 80,000 survive with residual long-term impairments. CDC estimates that long-term disability as a result of brain injuries affects 5.3 million Americans.”

TBI is considered by many as the “signature injury” of our current armed conflict, which is the longest in our nation's history.

The accompanying House report emphasized the issues of accessibility of mental health care services and outreach in rural communities:

“The National Guard and Reserve components have been deployed in record numbers to help fight the wars in Afghanistan and Iraq. Many of these units come from rural parts of the country. Currently, over 40 percent of the returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are from rural areas. Oftentimes it is difficult for these veterans to access quality health care and mental health services in a timely manner.”

We would ask whether our state psychological associations are working collaboratively with local veterans organizations and the VA to address this national need. Former APA President Jack Wiggins was recently installed as post surgeon for VFW Post 7507. Former APA interim CEO Cynthia Belar appointed Heather O'Beirne Kelly as APA's first ever director of military and veterans health policy, housed within the APA Practice Organization. Hurrah!

Aloha.