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      VERMONT PSYCHIATRIC ASSOCIATION

 

Minutes of the Executive Committee Meeting

     Burgess Hall, Fletcher Allen Health Care

       January 17, 2003

 

Members Present:  Drs. Barton, Coghlan, Danielson, Deppe, Emmons, Fassler, Graves, Kalibat, McMains, Naylor, Siegel, and Weker; and Ms. Block.

 

Guest Present:  Judith Gerber, Ph.D.

 

The meeting was preceded by a luncheon. Those present included:  Drs. Bernstein, Grant, Jones, Kloster, Laser, Peirson, Pierattini, Rawat, and Wehry.

 

Minutes:  The minutes of the December 2002 Executive Committee Meeting were reviewed and accepted as amended.

 

 

Announcements: 

 

1.         Membership Dinner Meetings:  The VPA has scheduled a series of dinner meetings over the course of the year. Remaining meetings are scheduled for:

 

a.     Burlington (restaurant to be announced), on Thursday, February 20; and

b.    The Alden Country Inn in Lyme, New Hampshire on Thursday, April 24.

 

All dinner meetings are at 6 p.m. Members and non-member psychiatrists interested in attending either of these meetings are asked to RSVP to Jessa Block by e-mail at: jblock@vtmd.org or by phone at the VMS.

 

2.         VPA Annual Meaning:  The date of the annual spring meeting has tentatively been set for Saturday, April 5.  Deborah Black, MD will be presenting a lecture on “Neurobiology of Dissociative States.”  The location of the meeting will be announced.

 

 

Reports:

 

1.         Treasurer’s report: Dr. Fassler reported that the VPA’s present assets are over $50,398.48. These comprise a 3-year CD, a 6-month CD, a money market account and a checking account.

 

2.         Disaster Preparedness:  Dr. Barton reported on her education by the state’s Department of Health regarding various potential disasters.  The Bush Administration is seeking to vaccinate the entire population against smallpox despite prevailing medical opinion against doing so.

 

3.         Ethics Committee:  Dr. Graves reported that there was no report.

 

 

Old Business:

 

1.         Fletcher Allen Health Care Psychiatry:  Dr. Fassler updated the planning process for FAHC inpatient service.  The hospital’s commitment to keep the service on the campus remains firm.

 

 

New Business: 

 

1.         VPA and Members-in-Training:  The Executive Committee engaged several UVM residents and faculty in discussion of issues relevant to postgraduate training.  These included the potential value of mentors, especially vis-a-vis transitioning from residency to subsequent practice; and of legislative and other governmental activities that bear upon residency activity.

 

2.         2003 Legislative Agenda:  Dr. McMains discussed various mechanisms for tracking legislative activity (liaisons with Department of Developmental and Mental Health Services; Vermont Medical Society).  He presented several issues of possible legislative significance:

 

a.     Possibility of sponsoring a bill to restrict who can call him/herself a psychiatrist: currently, physicians in Vermont can designate themselves as psychiatrists regardless of board-eligible or board-certified status. The Board discussed the pros and cons of seeking to change this through legislation.

b.    Certificate of Need process reform:  Ms. Block noted that a couple of bills are being drafted by several legislators.

c.    Medical Marijuana:  Dr. Fassler discussed his research and involvement in the legislative consideration of this issue last year (in conjunction with VMS consideration of the issue). A legislative summer study group came out in support of medical use of marijuana. A bill to this effect will likely be re-introduced this year. It was moved and seconded that the VPA support in principle the concept of a physician’s right to prescribe marijuana for medical purposes when he/she deems it appropriate and in the patient’s best interest; and that the VPA will evaluate specific legislative initiatives as they are put forth. It was moved and seconded to table the motion.  The motion to table was defeated, 4-5. The original motion was passed with no opposing votes and two abstentions.

d.    Proposed creation of a separate Department of Substance Abuse:  This proposal has been designated the top priority by Rep. Tom Koch, chair of the House Health & Welfare Committee.  Dr. Fassler testified on this measure before that committee yesterday regarding psychiatric research supporting the inclusion of substance abuse in mental health and medical treatment, and on child/adolescent substance use issues, underscoring the extent to which this problem is inadequately addressed.  Because the bill is worded ambiguously such that it could be interpreted as restricting evaluation and treatment of these disorders to licensed alcohol and drug counselors, it was moved and seconded that the VPA ask the medical society to add language to the bill stating, “Nothing in this bill shall be construed or interpreted to limit or restrict the right or ability of physicians of mental health professionals duly licensed by the state to provide evaluation and/or treatment services for individuals with substance abuse disorders to represent to the public that they are qualified to provide such services.”  The motion passed unanimously. The VPA will continue to monitor this bill.

e.     Restructuring of the Agency of Human Services:  Dr. McMains briefly noted that the Douglas administration is seeking to reorganize AHS in a way that would combine different services so that people can more readily access a broad array of human services.

f.     Death with Dignity:  Several committee members reported receiving a mailing from three Vermont physicians advocating for death with dignity legislation in Vermont (similar to existing law in Oregon). The Executive Committee discussed various aspects of this issue. It was moved and seconded that the VPA support in principle legislation that provides for Death with Dignity, incorporating the provisions and safeguards of the existing Oregon law, and that the Executive Committee will monitor specific legislation on this issue as it is introduced. The motion passed with one abstention.  Next, it was moved and seconded that the Executive Committee communicate this action to the three Vermont physicians who initiated the Death with Dignity legislative effort, and that the VPA allocate $100 to support this effort. It was accepted as a friendly amendment to separate this motion into two parts. The first of these two parts (namely to inform the promulgators of the VPA’s support) was  unanimously passed. Regarding the section part (financial support of this effort), it was moved and seconded to increase the amount of the proposed contribution from $100 to $300; this motion passed with three abstentions. The motion for the VPA to send $300 to support the efforts of the initiators of the Death with Dignity legislative effort was defeated 4-5, with one abstention.  Supporting this effort financially thus remains a decision for each individual VPA member to make.

 

3.         Fellowship selection issues:  Dr. Rawat raised questions about how residents might go about considering whether and how to choose a fellowship. This dovetailed into a discussion of psychiatric career development.

 

4.         CIGNA Lawsuit:  Ms. Block reported that VMS has joined over 20 other state medical societies in a class action lawsuit against CIGNA based upon alleged RICO violations in purported delay of payments, down-coding, bundling, overruling “medical necessity” determinations, and other practices.  VPA members who have concerns about CIGNA practices should contact Madeline Mongan at VMS.

 

 

The meeting was adjourned.

 

Respectfully submitted,