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Association News
Assembly Members Tackle Wide-Ranging Agenda
Psychiatric News
Volume 39 Number 23 page 14-15

While APA Assembly members deliberated a variety of issues at their November meeting in Washington, D.C., the future of organized psychiatry in Texas was the topic of much discussion during the plenary sessions as well as during Area Council meetings and informal discussions.FIG1

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Richard Kaye, D.O., wins the APA Assembly's 2004 Profile of Courage Award for his fight against Virginia's plan to close inpatient beds at state psychiatric facilities. Kaye feared the plan would leave many indigent patients without access to treatment for serious mental illness and increase the number of people with mental illness who end up in jails and prisons." I never thought that patient advocacy would become a major part of my practice," Kaye said. 

Assembly Speaker James Nininger, M.D., set aside an hour after the first plenary session ended to provide a forum in which members could quiz the Texas representatives about the details and impact of a controversial restructuring for organized psychiatry in that state that has drawn substantial opposition from both the Board and Assembly (Psychiatric News, November 19).

Later in the three-day meeting, the Assembly voted to ask the Board of Trustees, which meets later this month, to hire an independent mediator, at an estimated cost of $12,000 to $15,000, to see whether Texas district branch and APA leaders can reach some agreement that would satisfy both sides of the dispute. The Assembly chose that option over doing nothing, supporting the Texas "experiment," or allowing the Board of Trustees to" de-link" the Texas district branch from APA and replacing it with a new district branch.

The Assembly also passed several action papers concerning patient-care issues.

The members voted, for example, to support federal legislation or regulatory efforts to eliminate a 30-patient limit on the number of opioid-dependent patients that can be treated with buprenorphine in an outpatient practice. The representatives were not persuaded by arguments that removing the limit could lead to the establishment of "prescribing mills" by physicians who passed the mandatory buprenorphine-prescribing course but had little other addiction treatment experience.

They also backed a proposal that urges APA to "develop and regularly update procedures to apply the principles of medical necessity to the practice of psychiatry." The action paper states that the motivation underlying the proposal is the belief by some members that APA is not adequately monitoring how managed care companies are defining medical necessity and applying their definitions to coverage decisions. This calls on APA to take a more "proactive" role and meet more often with insurers about their medical necessity principles and with district branches about their efforts to deal with insurers in setting medical necessity standards for psychiatric care.

Nininger also devoted one plenary session to workforce issues in psychiatry. The presentations will be described in the next issue of Psychiatric News.

In other actions, the Assembly voted to

A summary of the Assembly's actions is posted in the "Members Corner" section of APA's Web site at<www.psych.org/members/gov/assembly/maynovmtg/nov04final.cfm>.

Anchor for JumpAnchor for Jump

Richard Kaye, D.O., wins the APA Assembly's 2004 Profile of Courage Award for his fight against Virginia's plan to close inpatient beds at state psychiatric facilities. Kaye feared the plan would leave many indigent patients without access to treatment for serious mental illness and increase the number of people with mental illness who end up in jails and prisons." I never thought that patient advocacy would become a major part of my practice," Kaye said. 

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