Notice: the VPA Listserv is now in operation. If you haven=t already done so, sign up by e-mailing Jessa Block at: jblock@vtmd.org. Please tell other Vermont psychiatrists about the Listserv. The Listserv can be accessed at:  vpa@vtmd.org

 

 

  VERMONT PSYCHIATRIC ASSOCIATION

 

Minutes of the Executive Committee Meeting
March 19, 2004

 

Members Present:  Drs. Barton, Danielson, Deppe, Fassler, Kalibat, McMains, Porter, Rubin, Siegel and Weker; and Jessa Block, VMS.

Guest Present:  Jeff Toorish, communications consultant, Message Strategy Group

The meeting was preceded by a luncheon program addressing mental health and the law in Vermont, with emphasis on the newly-implemented drug court in Rutland


Minutes:  The minutes of the February Executive Committee Meeting were approved.


Announcements:  

1. The VPA will hold a Risk Management Seminar for Psychiatrists, to be presented by Neil Mickenberg, Esq. on Saturday, May 22, from 9 a.m. to 1 p.m. (including lunch) at the Equinox Resort in Manchester. Those interested in attending may contact Jessa Block at the VMS.

2. Thomas Simpatico, M.D. has been named as medical director of Vermont State Hospital.


Reports:  

1. Treasurer's report: Dr. Fassler reported that the VPA's net assets were approximately $60,000, final figure pending resolution of a few outstanding charges.

2. Nominating committee:  Dr. Danielson reported the following slate of candidates for today's membership meeting:

a. President: Frank Kalibat, M.D.
b. President-elect: Frank Kalibat, M.D.
c. Secretary: Jonathan Weker, M.D.
d. Treasurer: David Fassler, M.D.
e. Assembly Representative: Jonathan Weker, M.D.
f. Deputy Assembly Representative: Stuart Graves, M.D.

3. Newsletter:  Dr. Deppe expressed her delight with the number of contributions. The deadline for the next issue has been extended to April 4.

Old Business:

1. Funding crisis and patient access problems at community mental health centers:  Dr. Barton described the severe access to treatment problems in Rutland, both in the mental health center and private practice arenas. Rutland Mental Health Center has only one therapist in the adult outpatient department. Dr. McMains explained that access has been prioritized to patients in the CRT program; he would be able to facilitate applications for appropriate designation.
  Dr. Fassler presented data on per capita expenditures in Vermont and the U.S. both in the mental health centers and overall. He noted that some services, e.g. emergency, simply aren't able to bring in the revenues to cover their services; additional complications are interposed by the requirements of the multiple funding stream. The Executive Committee discussed the topic in depth, including ideas of developing model legislation, and of having a meeting with Charlie Smith, secretary of the Agency of Human Services, to discuss these issues. Separately, the Executive Committee will also consider meeting with Beth Tanzman, director of Adult Community Mental Health, about the gap between rising mental health expenditures and the constriction of mental health access.

2. VPA Membership:  Dr. McMains suggested that membership recruitment and retention remain a focus during the upcoming year.

3. Extending the Medicaid Formulary Exemption for Medications for the Severe and Persistently Mentally Ill: Dr. Fassler reported on a conference call of the psychopharmacology subcommittee of the Drug Utilization Review Board. Data show that the number of prescriptions of atypical antipsychotics and SSRIs by psychiatrists has declined over the past 2-3 years, while the number written by primary care physicians has increased. The subcommittee's unanimous recommendation was to end the sunset of the exemption and make it permanent; however, the Drug Utilization Review Board did not adopt this and instead made a more nonspecific statement supporting continuation of the exemption. The Vermont Senate passed a bill that extends the exemption for another two years; the issue goes to the House, where Drs. Fassler, Graves and Kalibat plan to testify. Mr. Toorish suggested getting patient/family testimony to "make it about people." Outreaches to VAMH and NAMI are planned.

4. Ritalin:  Representative Lisa Kirker is considering piggybacking her proposed legislation concerning prescribing of Ritalin to children to a larger Senate bill on pharmacy drug reform. Her original attempt to put forward legislation on this point died. Ms. Block did not believe that her proposal would make it as Rep. Kirker wished.


New Business:

1. NAMI presentation at UVM: The UVM branch of NAMI has requested that the VPA provide some funding support for a program this May. This will be considered.

2. State budget: Ms. Block reported that the proposed Budget is about to pass out of the House Appropriations Committee. This includes a $1.7 million increase in physician reimbursement under Medicaid.

The meeting was adjourned.

Respectfully submitted,

Jonathan L. Weker, M.D.

The next VPA Executive Committee will be held on Friday, April 16, 1:30 p.m. at the Vermont Medical Society building, 138 Main Street, Montpelier.