The Interdivisional Healthcare Committee (IHC) held its summer meeting at the recent APA Convention. IHC is a coalition of APA divisions which have health as part of their mission. It has been meeting for over 20 years and has made significant impact on health such as being the group to originally vision the health and behavior codes. Division 31 joined this group two years ago with the rationale that much of healthcare policy is determined at the state level. IHC meets twice yearly in January and at the APA Convention. We have two representatives, myself and Paul Korte, PhD. One of the founders of the IHC and its chair for almost two decades, Rob Glueckauf, PhD announced his desire to step down and Ravi Prasad, PhD was named the new Chair with the addition of a Co-Chair, Dan Bruns, PhD.
The meeting reported on several new future opportunities for expanding psychological practice and using psychological research. One issue which has been in process for many years relates to a collaboration between Dan Bruns, PhD, (recent Heiser Award recipient for his advocacy work in Colorado) and Katherine Mueller, MD representing the disability medicine association, to implement a structure for physicians to use functional not just biological measures to determine disability for benefits decisions. A model was developed to take into consideration a person’s lived experience with their disability and changing the paradigm to consider function in this context. This is an inter-professional collaboration to impact the AMA Guides on Impairment.
Erin Swedish, PhD, Director of Health Integration reported that APA is developing a Integrated Specialty Care Advisory Group in The Office of Health & Healthcare Financing. This group will serve an advisory role like that of the Integrated Primary Care Advisory Group. APA has accepted nominations from relevant Divisions with Kathleen Ashton, PhD serving as Division 31’s nominee.
Paul Korte, PhD reported on the Division 31 Rural Health Initiative, his Presidential initiative. He reported on planning for virtual Rural Health Summit.
The APA pain management curriculum and video training has received a small (only 8) responses from the SPTAs to present this video training. States can still reach out to use these free videos to supplement their CE programs and profit from all of the fees collected from participants. I would strongly encourage SPTAs to make use of this opportunity. Understanding issues of pain and pain management was not taught in most graduate psychology programs yet is one of the most ubiquitous issues in patient treatment. Since SPTAs have under-used this opportunity, there are plans to share with divisions and training programs who have requested to share in this opportunity. I encourage our SPTA members not to lose out on this opportunity.
An Opioid Response Network presents opportunities for collaboration with psychology. Based on 100k deaths last year, a SAMHSA grant created it. One goal is to train professionals to deal with opioids and to list resources and consultants in states. Originally overdose issues focused solely on substance abuse. Addictionologists were the primary focus but through psychological input, SAMHSA recognized that it was a pain problem at core. With an addiction mindset, some hospital systems wanted to totally ban opioids despite important uses for pain management. Adding the focus on pain management allows patient pain to be addressed responsibly. On Sept 29 there will be a summit about opioid use. Dan Bruns will be the first speaker. They may use the APA curriculum. There would be a need to identify experts in every state in pain. Again, it is an opportunity for psychologists to train for both the addiction and the pain paradigm. There is also room for specialties to create training on their approach to pain, further broadening psychology’s expertise in areas such as pediatric pain, issues of pain in aging populations, pain in rehabilitation, etc.
Gillaspy reported on the success for psychology in impacting the Physician fee schedule proposed rule. Last year psychologists represented 50% of the responses CMS received, which focused more of their attention on our issues. APA got our action center up and running quickly which made the difference as did the strong response from SPTAs.
It is key for all of us to respond when these requests are made. This year proposed rule was focused on mental health. We see a proposed 19% increase for work values for psychotherapy codes over 4 years. We are asking for increases for the other codes. Reimbursement for telehealth at the same level was used in requests. A new code for crisis intervention when in the field was proposed at a higher rate. There is a new code for social determinants of health and health assessment and community health workers, but the index visit has to be an E and M code (restricted currently to physicians.) Other issues APA is following; CMS is looking at creating policy for digital CBT codes, and conundrum that CMS increases are based on work values and practice expense, but low practice expense hurts psychologists compared to specialty medical providers.
Native American child health collaboration with APA was discussed. Pediatric psychologists will do site visits for pediatrics to include a focus on behavioral health with this population.
Finally, a potential issue of bias at internship sites favoring Clinical over Counselling applicants. APPIC will be researching this question.
All of the above represent increased opportunities for psychological practice and research.