AAP and AAP/PLAN are providing support for a number of important legislative initiatives of interest to the professional practice and discipline of psychology, psychology education and training, as well as psychological science. A brief overview of some of these initiatives follows.
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There are six current significant practice initiatives:
Although Congress restored the cuts to Medicare Mental Health Services, it is only a temporary restoration. Congress should permanently remove cuts and allow psychologists to use Medicare’s E&M codes: The new Medicare law (Public Law 110-275), the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), was enacted on July 15, 2008. Read PDF>>
Having just enacted the Mental Health Parity Bill, Congress Should insure that regulations governing the law are consistent with its intent: Vital oversight of the regulatory process related to the mental health parity bill is critical in order for the law to be effective. Read PDF>>
Congress Should Protect Patient Records Privacy in HIT Legislation: Congress should ensure that patient records privacy and security is a cornerstone of any legislation that promotes the development of health information technology (HIT) in the health care system. Read PDF>>
Medicare Should Reimburse Hospitals for Psychology Training: The Problem for Patients: Psychologists are currently ineligible for Medicare training reimbursement. While physicians and at least 19 allied health care professionals, including nurses, dietetic interns, physical therapists, radiographers and clinical pastoral counselors, are eligible for Medicare training dollars, psychologists are not but should receive funding. In fact, psychologists are the only doctoral-level providers excluded from training reimbursement. Read PDF>>
Support Continued Funding for the Mentally Ill Offender Treatment and Crime Reduction Act: Congress should continue funding for the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) for FY 2009. Senators Domenici (R-NM) and Leahy (D-VT) and Representatives Delahunt (D-MA) and Ramstad (R-MN) are circulating appropriations support letters to ask for continued and hopefully increased funding for FY 2009. Read PDF>>
Medicare Should Acknowledge the Evaluation and Management Services Already Being Provided by Clinical Psychologists: Evaluation and management (E/M) services account for a broad range of office-based and inpatient visits. According to the Centers for Medicare and Medicaid Services (CMS), E/M services are medical in nature and therefore may not be furnished by psychologists or social workers. CMS’s view, however, is outdated and does not reflect how widely psychology is now integrated with total patient health care. More and more of the work done by psychologists includes E/M services, especially in rural areas where patients being treated with psychotherapy may also be taking psychotropic medications prescribed by their primary care physicians. Read PDF>>
AAP supports many of the American Psychological Association’s Education legislative initiatives, including those that follow:
Graduate Psychology Education (GPE) Program
GPE May Get Significant Funding Boost –In June the House Labor, Health and Human Services, Education Appropriations Subcommittee marked up its funding bill for the 2009 fiscal year. In the bill, Congresswoman Rosa DeLauro (D-CT), Subcommittee member and a real champion of the Graduate Psychology Education (GPE) program included $4 million for GPE. A funding level of $4 million is a significant increase for GPE; in fact, it is more than double the amount the program received in recent years ($1.8 million for FY 2006, 2007 and 2008). The increased funding would allow for reinstating the geropsychology training grants. The Senate’s comparable Labor, Health and Human Services, Education Appropriations bill marked-up later in June provided flat funding for the GPE program; nevertheless, it included favorable report language for continuing the GPE program, which will be very helpful if there is a Conference to reconcile the differences in both bills. If there is no Conference and a Continuing Resolution is used to fund the programs under this Subcommittee, the GPE Program will remain at about the $2 million level. However, if the VA authorizing bill that contains statutory language requiring the VA to transfer $5 million to GPE for a focus on returning military personnel passes before the end of the session, the GPE funding level for FY 2009 will rise to at least $7 million. A list of current GPE programs can be found at: http://www.apa.org/ppo/gpe/fy07grants.html
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Substance Abuse and Mental Health Services Administration (SAMHSA) Reauthorization
Campus Mental & Behavioral Health Services – Education GRO staff are seeking the inclusion of S.3311, the Mental Health on Campus Improvement Act, in the SAMHSA reauthorization. S.3311 would provide critically needed mental and behavioral health services to students on campus. Through a competitive grant process, administered by SAMHSA, the Mental Health on Campus Improvement Act would enable institutions of higher education to use funds for providing mental and behavioral health services to students (prevention, screening, early intervention, assessment, treatment, management and educational services), employ appropriately trained staff; and expand training opportunities through internship, post-doctorate, and residency programs. In addition to supporting mental and behavioral health services for students, the bill outlines a National Public Education Campaign designed to focus on mental and behavioral health on college campuses as well as establishes an Interagency Working on College Mental Health.
We are also seeking the continuation of the Campus Suicide Prevention Program and an increase in its Authorization of Appropriations (increase the funding ceiling to $10 million). Authorized first as part of the Garrett Lee Smith Memorial Act and housed at SAMHSA, the Campus Suicide Prevention program is a small but effective competitive grant program that makes funds available to institutions of higher education to enhance education and outreach services to students with mental and behavioral health problems, such as depression, substance abuse, and suicide attempts. ED GRO staff is currently working to garner additional Senate support for S. 3311 as well as try and get a House companion introduced. Staff will continue to work in the upcoming 111th Congress to push for the inclusion of both programs as part of the reauthorization of SAMHSA.
SAMHSA Campus Suicide Prevention Program Grants – On September 10th, new grants were announced by SAMHSA as part of the Campus Suicide Prevention grant program. To date, there have been 72 grants (approximately $20 million) to institutions of higher education to assist colleges and universities in their efforts to prevent suicide and enhance educational services for students with mental and behavioral health problems that place them at risk for suicide. These grantees are working on campus to raise awareness and provide education to the campus community about the risks and warning signs of suicide. Further, they are communicating with each other and sharing best practices nation-wide with their colleagues in other colleges and universities. http://www.samhsa.gov/newsroom/advisories/0808203705.aspx
Workforce Development – Education GRO staff are taking the lead on promoting workforce issues for the SAMHSA reauthorization. Proposed are a number of new or improved workforce initiatives including: authorizing the Minority Fellowship Program (MFP), expanding the workforce data collection& analysis capability, and establishing a loan repayment program. Despite raising awareness about these issues and garnering a great deal of support, the draft Senate bill only contained language to allow for funding of interns and fellows. Fortunately the bill died and the reauthorization will be taken up again in the next Congress giving us another chance to pursue workforce development issues.
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Center for Deployment Psychology
The Center for Deployment Psychology (CDP) was recently incorporated into the newly established Department of Defense Center of Excellence (DCoE) for Psychological Health and Traumatic Brain Injury. The CDP will be the military arm for training health professionals for meeting the mental health needs of returning military personnel and their families. As an established permanent program, the CDP is expected to receive continued annual funding as part of the DCoE and will no longer need a separate Congressional appropriation each fiscal year. Nevertheless, Congressman Bill Young (R-FL) got report language in the Defense Appropriations bill that directs the Department of Defense to continue funding the CDP as part of the DCoE.
CDP Hill Briefing - In May, Education GRO collaborated with Public Interest GRO, the International Society for Traumatic Stress Studies (ISTSS), and the Iraq and Afghanistan Veterans of America (IAVA) to co-sponsor a congressional briefing entitled “Addressing the Mental Health Needs of Service Members, Veterans, and their Families: Innovative Strategies for Prevention, Treatment, and Recovery”. This event was hosted in collaboration with Representatives Grace Napolitano (D-CA) and Tim Murphy (R-PA) and the Congressional Mental Health Caucus. Briefing presenters included APA members Bonnie Green, PhD, Georgetown University; William Saltzman, PhD, UCLA/National Child Traumatic Stress Center; Lt. Col. Jay Stone, PhD, Defense Center of Excellence for Psychological Health and Traumatic Brain Injury; Amy Street, PhD, National Center for PTSD, VA Boston Healthcare System; and Iraq veteran, Tom Tarantino, representing IAVA. Briefing presenters spoke about a variety of important initiatives, including the work of the DoD Center for Deployment Psychology; the VA National Center for PTSD and their efforts focused on women veterans; and the National Child Traumatic Stress Network and their work with families of deployed soldiers. Further information about the CDP can be found on its website: http://deploymentpsych.org/
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The Higher Education Act Reauthorization
HR 4137, the Higher Education Opportunity Act – the bill reauthorizing the Higher Education Act (HEA) of 1965 – was passed by large majorities in the U.S. House of Representatives and the U.S. Senate on July 31, 2008. It was signed into law on August 14, 2008. The HEA includes many provisions of interest to members of APA. Education GRO worked with Congress and in partnership with other Associations to ensure the adoption of many of these provisions.
Accreditation was an issue of major importance during the reauthorization. The Education Directorate was heavily involved throughout all steps in the process and showed leadership in educating Congress about accreditation, which ensured that the new law included language that maintains the integrity and independence of the accreditation process. The final legislation includes APA's definition for "teaching skills" with minor modifications. This definition ensures that greater consideration and required resources will be given to teaching the critical skills needed to deliver important content knowledge to students.
Finally, the HEA now includes a new discretionary loan forgiveness program entitled, Loan Forgiveness for Service in Areas of National Need. Mental health professionals are eligible to participate in this program. A recipient could receive $2,000 of an outstanding loan forgiven for each year employed in a specified field, with a maximum amount forgiven of $10,000. More specific guidelines for the program, as well as regulations, will be established by the Department of Education. For further information visit: http://www.apa.org/ppo/education/hea-reauth-0808.html
Community Health Center - Primary Care Initiative
The Education Government Relations Office teamed with the Practice Organization’s Committee on Rural Health to host an all-day meeting on September 19, 2008 on the role of psychologists and psychology trainees in Federally Qualified Health Centers (FQHCs). Also invited were APA members with expertise in rural health care, urban health care, and integrated health care, as well as representatives from the Bureau of Primary Health Care, the National Association of Community Health Centers and Primary Care Associations (PCAs). The goals of this meeting included: 1) Learning what has worked to create positions for psychologists and psychology trainees in FQHCs; 2) Creating an action plan to translate lessons learned in other states; and 3) Building the foundation for a partnership among state psychological associations, state primary care associations, relevant federal agencies and national organizations, and the American Psychological Association to further the initiative.For more information on the meeting, go to www.apa.org/ppo/education/integrated1008.html
The Science Legislative agrenda is described below. You can also download a PDF of this document.
APA’s Science Directorate Advocacy Priorities
The APA Science Directorate’s Government Relations Office (SGRO) serves as a liaison between psychological science and the federal government’s legislative and executive branches. In addition to training psychologists to better advocate for their own research and engage in the policy-making process, SGRO staff work with Congress and federal agencies to further three broad goals:
- increase federal funding for psychological research;
- ensure that results of relevant research are incorporated into legislation and policy decisions; and
- strengthen the scientific infrastructure (e.g., through protecting the peer review process and making sure that the regulation of science is fair and transparent).
SGRO tracks and advocates for federal investments in psychological research across multiple agencies, including: the National Institutes of Health, National Science Foundation, Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration and National Aeronautics and Space Administration, as well as the Departments of Education, Defense, Transportation, Commerce, Homeland Security and Veterans Affairs.
The following are examples of SGRO’s current advocacy initiatives that fall within the three overall priority areas:
Leading Coalition Efforts for Child Development Research
SGRO is taking a lead in advocating for a 6.6 percent increase for research at the National Institute of Child Health and Human Development (NICHD) in Fiscal Year 2009. In coalition with other health groups, SGRO has submitted appropriations testimony, met with Congressional appropriations committee staff, and sponsored a Congressional briefing to highlight the cutting edge research the institute funds in intellectual and developmental disabilities. Lobbying efforts for NIH biomedical and behavioral research support will continue throughout the 110th Congress.
Bringing the Concerns of Psychological Science to the Table As NIH Modifies its Peer Review Process
The fairness and transparency of peer review systems is of major importance to the support and maintenance of psychological science. For the past year, staff and committees of the National Institutes of Health (NIH) have carefully examined the two-tiered peer review system through which NIH rates and ranks grant applications. During 2007, NIH working groups collected input and ideas for enhancing the peer review system from all stakeholder communities, and in June, 2008, an implementation plan for various modifications to the important system was released. At each step along the way, SGRO has ensured that psychology is at the table. APA has sought feedback from its member scientists to bring into the NIH discussions, and been present during meetings, conference calls and webcasts to bring the latest information to psychologists.
Briefing Congress on Psychology's Central Role in Combating Substance Use Disorders
On behalf of the Friends of NIDA (National Institute on Drug Abuse) coalition, SGRO works to elevate the profile of substance abuse research on Capitol Hill via an educational briefing series. Over the past four years, the coalition has held over ten briefings covering a range of topics including the genetics of drug abuse, the treatment of tobacco dependence, comorbidity, blending research and practice, prevention science, prescription drug abuse, methamphetamine addiction, HIV/AIDS, and the treatment of offenders in the criminal justice system. All of the briefings have highlighted the importance of psychological science in NIDA’s research portfolio by pairing APA psychologists with the NIDA Director, Dr. Nora Volkow.
Increasing Behavioral Research Funding at the National Institute of Justice
The National Institute of Justice (NIJ) is the research, development, and evaluation arm of the Department of Justice. It funds research in a range of scientific disciplines, including behavioral and social science research aimed at identifying evidence-based solutions for reducing crime and increasing public safety. NIJ’s funding was cut dramatically last year and the Administration has proposed flat funding for Fiscal Year 2009. SGRO submitted testimony urging Congress to reverse this trend of budgetary neglect, and also is working with Senate Judiciary Committee staff regarding language in the reauthorization of the Juvenile Justice and Delinquency Prevention Act that would strengthen the peer review process and define and promote the use of evidence-based practices within the Department of Justice.
Highlighting Psychological Research in Support of National Defense Needs
For decades, psychologists have played vital roles within the Department of Defense (DoD), as providers of clinical services to military personnel and their families, and as scientific researchers investigating mission-targeted issues ranging from airplane cockpit design to distance learning. SGRO advocates on behalf of psychological research sponsored by DoD and echoes recommendations made in the new National Research Council report on Human Behavior in Military Contexts (2008) calling for a doubling of the current budgets for basic and applied behavioral and social science research “across the U.S. military research agencies.”
Boosting Behavioral Research at NASA
The NASA research budget has gone down steadily over the last 20 years, especially in the areas of human performance and aviation safety, forcing NASA centers to cut jobs and university grants. Space exploration is expanding at about the same rate, and longer space missions place increasing demands on psychological health and performance in space. SGRO advocates for increased behavioral research funding at NASA to enable psychological scientists to meet these challenges head on, through computational systems that can improve human decision-making and allow humans to function in extremely challenging environments, such as space flight.
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Association for the Advancement of Psychology (AAP)
P.O. Box 38129, Colorado Springs, CO 80937-8129
Karen Rivard - Administrative Director
Stephen M. Pfeiffer, Ph.D. - Executive Director
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