AK-PA’s Most Current Legislative Reports
Letters Submitted by the AK-PA Board
Click on the letters below to open them as a PDF in a new tab.
Re: Notice of Proposed Changes on Medicaid Behavioral Health Services Payment Rates
Submitted to DHSS Division of Behavioral Health
Re: Proposed Medicaid Reform Legislation, related to expanding psychologist services
Submitted to Senate Finance Committee
Re: Proposed Medicaid Reform Legislation, related to policy changes
Submitted to Senate Finance Committee
Re: Proposed Medicaid Reform Legislation, related to psychology doctoral interns
Submitted to Senate Finance Committee
Re: Proposed Medicaid Reform Legislation, related to telehealth services
Submitted to Senate Finance Committee
April 2012 Update
— Dr. Robert Lane, PhD, Federal Advocacy Coordinator
During our time on the Hill at SLC we were lobbying for three things. We received a warm reception in all three offices, though Senator Begich was the only politician we met directly that was only for a minute between committee meetings. Senator Murkowski was in committee and speaking on the floor pushing energy related legislation. Congressman Young was in Alaska. Here is some background and a report on the three areas we lobbied for while in DC for the SLC:
The Sustainable Growth Rate payment formula ties Medicare provider payments to factors related to the national economy. In recent years, the formula would have operated automatically to cut most provider payments if Congress had not acted to postpone the scheduled payment cuts. With Congress having blocked the SGR cut several times over the past decade, the recurring postponement has resulted in an ever-increasing percentage by which provider payments would drop if the SGR cut took effect (now up to 27.4 percent). In December a new law was enacted that prevented the 27.4 percent Sustainable Growth Rate (SGR) cut and extends the 5 percent psychotherapy payment restoration through February 29, 2012. In February another billed was passed extending the SGR block through January 2013, however, the 5 percent psychotherapy payment restoration was not continued. On our trip to the Hill we were asking our delegation to come up with another plan than SGR altogether. They all (both Senate offices and Congressman Young’s office) recognize Medicare cannot sustain that large of a cut.
Adding Psychologist to the physician definition of Medicare
Psychologists are the only doctoral level health care practitioners not already included in the definition. Changing this would remove physician oversight of treatments psychologists are trained to do and is within the scope of their practice. Senator Murkowski is the lone holdout in our delegation that has not signed on to cosponsor this bill as Senator Begich and Congressman Young have previously signed on as official co-sponsors. Her health legislative aid, Amanda Maki, cited concerns about cost, but we are also aware the Alaska Psychiatric Association had just been there lobbying against it – to protect the patient. Diane DiSantos of Sen. Begich’s office told us “the psychiatrists don’t like it, but we told them we support it because it is the right thing to do.” So if you have occasion to see or talk with Senator Murkowski, let her know you think she ought to support this and make the Alaskan contingent unanimous in support of this bill!
The Hi-tech Act
This Act provides incentives to switch over to electronic health care records. All doctors under the Medicare physician definition are eligible for this. In the event our profession is not added to the definition, this bill would allow psychologists to be eligible for the program anyway. Again, Senator Begich and Congressman Young are official co-sponsors. Only Senator Murkowski has not signed on to support psychologists here.
Should you desire more information about these issues, go to APAPO’s Legislative Action Center at http://capwiz.com/apapractice/home/
January 2012 Update
The month of January is a busy one for advocacy, at least as far as administrative work goes. In order to employ a lobbyist, AK-PA has to annually register with the Alaska Public Offices Commission (APOC) and file quarterly lobbying reports. So in January every year I see that AK-PA gets properly registered, take my on-line lobbying ethics training as the Association’s representative, and file the fourth quarter lobbyist employer’s report for last year. I’m pleased to say all those activities have been completed and that AK-PA is in compliance with APOC regulations. I would like to acknowledge the American Psychological Association Practice Organization (APAPO) whose grant funding through the Committee on the Advancement of Professional Psychology (CAPP) helps make it possible for AK-PA to have a lobbying presence in Juneau and on Capitol Hill in Washington D.C.
By the way, APAPO in part and CAPP in whole are funded through the special assessment fees that most of us pay as part of our annual dues to APA each year. It is nice to know some of that money we all pay comes back to Alaska to assist us in practicing professional psychology.This year we have a quiet agenda related to in-state lobbying. At this time we have no legislation we need to craft or lobby for passage. So most of our lobbyist’s activities this legislative session should be in monitoring legislation and providing the association notice of and information about pending legislation related to providing services within a psychologist’s or psychological associate’s scope of practice or mental health related services in general.
Phil Baker, the AK-PA State Legislative Liaison, and I do plan to visit Juneau in February on behalf of the Association where we will schedule meetings with targeted members of the House and Senate that are not likely to be affected by elections in this coming November. This allows us to further our relationships with legislators by offering to serve as a resource based on our expertise and knowledge of mental health service provision (while not having ulterior motives of seeking support for specific legislation) so that in the future when we do go to Juneau with specific requests we already have established relationships.
On the Federal level, it never seems to be a quiet year. Given the climate in D. C., I suspect you can expect a number of requests to send lobby messages to our delegation there related to specific legislation in the Senate or House. Various aspects of Medicare legislation are likely to continue to take center stage. Medicare ends up being a driver for the emphasis state’s place on their Medicaid expenditures and directly effects private insurance in a big way.
So I hope you will consider taking the two minutes it takes to send lobbying messages this year when I forward “Action Alerts” on from the APAPO’s Government Relations division. APAPO is thought to have one of the premier grassroots lobbying organizations in the country and it’s all because thoughtful, involved, and concerned individuals like you are willing to take that two minutes and tell our elected officials how you would like to be represented through their votes. Regardless of how you might feel about any or all of our delegation members in Washington, AK-PA has had remarkable success in obtaining their votes to support the professional practice of psychology.
2011 Federal Advocacy Summary
— Dr. Robert Lane, Federal Advocacy Coordinator
The Federal Advocacy Coordinator (FAC) is one of the very few invitees to the State Leadership Conference (SLC) with airfare and hotel paid for by APA’s Practice Organization (APAPO). To give credit where credit is due, the conference is actually funded by the Committee for the Advancement of Professional Psychology (CAPP) which is funded in part (if not in whole?) by the practice assessment we pay when we pay our APA dues each year. CAPP also awards AKPA an organizational grant each year that helps us fund the Executive Director and lobbyist positions. Alaskan psychologists have actually done well in seeing a relatively large percentage of the practice assessment fees paid come back to them in the form of grants to help fund our state association’s budget. But back to the SLC, as the FAC, I attend several meetings that are related to advocacy in general. The advocacy workshops are typically about building and maintaining a grassroots advocacy network and then the importance of political giving. The same was true this year.
General Advocacy – The APAPO is consistently nationally recognized in the field of advocacy as having one of the best grassroots lobbying networks for an organization it’s size. Tens of thousands of emails are generated from those “Alert – Action Required” emails I have forwarded to you over the years. FACs are encouraged to develop personal relationships with our congressional delegation and also to identify “key contacts” who also have a relationship members of congress or key staffers. As the emails are hitting, the FACs and key contacts are directly making those contacts with the same message. It has proved to be an effective grassroots lobbying force. A goal for AKPA has been to mimic what APAPO has taught us to do on the federal level here on the state level. There are a number of issues effecting psychologist on the state level where being more politically active will be necessary to bring about change. Along these lines – if you have a relationship with a federal or state house or senate member or key staffer and would be willing to serve as a “key contact” for us, please contact myself (firstname.lastname@example.org) or Phil Baker (email@example.com). The health care field is changing and the ways that psychology can play a part are evolving. Being actively involved with those who make the laws and formulate the regulation can only benefit us as a profession; if we aren’t at the table, someone else will be.
One big change to my duties was strongly emphasized during the advocacy work shop had to do with how I have been contacting you through email. I have been advised that to stay in compliance with FEC regulations, in the future FACs should not be using their state listserves for any thing that could be considered lobbying. From this point forward, I’ll be passing along the action alerts I feel you need to see via my personal email address. To be fully in compliance the APAPO gave me an email list of all APA practice assessment payers who live in Alaska and it is only email addresses on that list that I can send action alerts to.
Political Giving – originally pitched as the third leg of the political action stool (along with lobbying and grassroots contacts), political giving was again a topic for FAC workshops. One need look no further than last Fall to see the effects large sums of money can have on a candidates ability to campaign. But political giving should not be conceived of as limited to the hundreds of thousands of dollars given by teaparty constituencies and corporate consortiums as in the last senate election. For example, APAPO’s political action committee, the Association for the Advancement of Psychology twice in the last election cycle sent representatives to $1,000 a plate fund-raising luncheons for Senator Lisa Murkowski. But it doesn’t necessarily take huge sums of money. FACs are encouraged to arrange fund-raising events to help keep elected officials stay in place who support our issues or otherwise help fund a candidate who will. Getting 10 or 20 psychologist together to interact with a candidate and support with money doesn’t buy votes, but it does open up lines of access that might not otherwise be there. Members of the House are always running for election and Senate races tend to be more expensive, so even if they have longer terms, they are still constantly racing money for the next election. Political giving works to provide time and opportunities to establish the ground for relationships with legislators that may bear fruit later in the form of sponsoring or supporting legislation we have had the opportunity to well educate the member about.
The three-legged stool metaphor makes sense to me in terms of describing an effective attempt to influence the course of political action. And I have personally seen the amount of instant recognition I have received from state candidates for giving as little as one hundred dollars. But I have also seen research that says that psychologist as a profession are way at the bottom of the list of professions and their related sums of political giving. If you are interested in supporting psychology at the federal level, consider a membership in the Association for the Advancement of Psychology (www.aapnet.org/). You might be surprised at the breadth of their interests. As I noted above, money has come back to our delegation in the form of political giving.
Extend Medicare Cut Restoration for outpatient mental health services – asking that legislation be passed to extend the 5% cut restoration beyond the end of this year and preferably until after the new recommendations from the Center for Medicare and Medicaid Services (CMS) are ready to be reviewed.
Adding Psychologists to the Medicare Definition of Physician by legislation – this would allow psychologists to be independent practitioners under the Medicare system. This could also have some implications in the Medicaid system as Medicaid often follows Medicare’s lead. There are bills in each house to add psychologists to the definition this session.
HITECH Act extended to Psychologists – the HITECH Act allows for incentives to bring file and case management systems in line with what is envisioned as a national health care data base(s) that allow for disparate services to be collected into one client record. Current legislation does not prohibit this, but has been interpreted as not including psychologists, so we were asking for Congress to provide that direction. Note this would not be necessary if number 2 above could be passed and enacted.