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

November 21, 2003

 

Members Present:  Drs. Emmons, FauntLeRoy, Fassler, Graves, Kalibat, Siegel, and Weker; and Jessa Block, VMS.

 

 

Minutes: the previous Executive Committee minutes were not reviewed.

 

 

Announcements: 

 

1.         Upcoming VPA Website: Ms. Block announced that a VPA website will soon be operational.

 

2.         A dinner will be held in Montpelier on Thursday, December 18 in conjunction with Jeff Toorish=s appearance at the Vermont Association of Mental Health=s annual meeting. Mr. Toorish is advising the VPA on media relations under an Advocacy Grant provided by the APA. The specific time and location of the dinner will be announced.

 

3.         The VPA will hold a regional dinner meeting on Thursday, January 22 in Burlington. The specific time and location will be announced.

 

4.         The first Gibbard Memorial Lecture will be given by Dr. Jeremy Holmes at Austin Auditorium on Friday, January 23 from 10 a.m.-12 noon. on the topic of ADealing With Difficulties: How Psychoanalytic and Attachment Theory Can Help Us Think about Borderline States.@ Following lunch, a VPA Executive Committee meeting will be held.

 

 

Reports:  

 

5.         Ethics Committee:  Dr. Graves reported on his meeting with APA district branch ethics committee chairs from around the country. He reported that the annotations of the AMA ethics pertaining to psychiatry were being revised. A new option when an ethics complaint has been lodged is to prescribe a monitored educational remedy for more minor or indeterminate situations, as an alternative to proceeding with a hearing and punitive response. Dr. Graves also proposed an ethics column in the newsletter as well as establishment of an ethics listserv.

 

Old Business:

 

6.         VPA Advocacy Grant:  Dr. Fassler reported that under the auspices of this grant, funded by the APA, the VPA along with the Maine Psychiatric Association engaged Jeff Toorish, a media consultant. Mr. Toorish had an initial meeting with several VPA members and VMS government affairs representative Madeline Mongan on November 11 in Burlington; he also met with UVM Associate Dean Mimi Reardon, M.D. of the Area Health Education Council. and Ken Libertoff of VAMH. Mr. Toorish will be back in Vermont for several additional visits and will be doing surveying in Vermont concerning attitudes about psychiatry and mental health. He will also be holding a media training for Vermont psychiatrists.

A psychology prescribing bill was subsequently introduced in Maine, and responding to a request from the Maine representatives to the APA Assembly and from the APA Commission for Advocacy and Litigation Funding, the VPA agreed to return one-half of the grant to Maine to address this. The Executive Committee discussed various parameters of this issue.

 

7.         Mental Health Managed Care Report Card 2000-2002: Dr. Fassler presented a report by the committee established by Act 129 to issue a report card on mental health Managed Care companies in Vermont. He reported one finding, namely that $3,000,000 in profits to mental health Managed Care companies left the state in 2001. It was discovered that Managed Care closed networks and slashed reimbursement to outpatient providers by 40%.

 

8.         Vermont State Hospital: The Executive Committee discussed PCG=s investigation into the future of the hospital. Dr. Fassler noted that mental health advocates have come out in favor of closing the Waterbury location in favor of moving those services to a new location. The Executive Committee asks that VPA members please submit their feedback as to whether they believe the VPA should go on record advocating that the state construct a new facility (or facilities) that would provide state hospital services in an appropriately designed, adequately staffed environment with immediate, direct access to general medical center services.

 

9.         Medicaid Preferred Drug Formulary Exemption: The Executive Committee agreed to advocate in the legislature for elimination of the July 1, 2004 sunset of this exemption. Ms. Block discussed legislative strategic considerations.

 

10.     FAHC Inpatient Psychiatry:  Dr. Fassler reported that the FAHC certificate of need (CON) was approved yesterday. The conditions of the CON mandate FAHC=s ongoing involvement and collaboration with the VPA and other interested parties.

 

 

New Business:

 

11.     FAHC Mental Health Parity Benefit:  The Executive Committee discussed the recent extension of this provision and requested that Ms. Block further research the details of the benefit.

 

12.     Mental Health Law Courts:  Dr. FauntLeRoy presented her observations about the inconsistent nature in which mental health issues are handled by the Vermont legal system. She raised the idea of a multidisciplinary conference involving law enforcement officers, lawmakers, and mental health clinicians to look comprehensively at law and mental health issues in Vermont, with a possible eye towards developing mental health law courts. The Executive Committee will explore this idea further.

 

13.     Improving Support for Independent Practitioners:  Dr. Emmons raised concerns about the paucity of support for independent practitioners (i.e., those who do not participate in Managed Care). The Executive Committee discussed how these concerns might be addressed on various levels. Dr. Emmons suggested three proposals for the VPA:

 

1.    Surveying the membership to find out their experiences both in and out of Managed Care;

2.    Eliciting support to persuade the VMS to bring in physicians from around the country in other specialities who have been successful in independent practice to present a workshop; and

3.    Clarification from the VPA as to whether it=s acceptable to advance legislative agendas that cause economic harm to some members.

 

Regarding the first of these proposals, the Executive Committee agreed to include questions about experience in and out of Managed Care in an upcoming membership survey.

 

Regarding the second proposal, it was moved, seconded and passed that the VPA would agree to cosponsor a conference concerning independent practice and asks its delegate to the VMS council to request similar co-sponsorship and administration support for such a conference by the VMS.

 

Regarding the third proposal, the Executive Committee formulated the following statement: AThe VPA acknowledges that certain of its policies may cause economic harm to some members and pledges to address such issues openly and proactively in discussing future initiatives.@

 

14.     Internship in Mental Health Advocacy/Public Affairs:  Dr. Fassler introduced a proposal for the VPA to create a one-to-two month internship for a medical student, resident and fellow interested in pursuing a specific issue to research. The VPA approved the internship in concept, pending further exploration of details by the VMS and its government affairs staff.

 

 

The meeting was adjourned.

 

Respectfully submitted,

 

Jonathan L. Weker, M.D.