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      VERMONT PSYCHIATRIC ASSOCIATION

 

Minutes of the Executive Committee Meeting

March 21, 2003

 

Members Present:  Drs. Barton, Danielson, Deppe, Fassler, Graves, McMains, and Weker; and Ms. Block.  Guest Present:  Madeline Mongan, J.D., VMS

 

Minutes:  The minutes of the January 2003 and February 2003 Executive Committee Meetings were approved.

 

Announcements: 

 

1.         VPA Annual Meaning:  The date of the annual spring meeting has been set for Saturday, April 5 at the Mist Grill in Waterbury.  Deborah Black, MD will be presenting a lecture on “Neurobiology of Hysteria.” Please contact Jessa Block by March 31 to RSVP!

 

2.         Membership Dinner Meetings:  The VPA has scheduled a series of dinner meetings over the course of the year. One remaining meeting is scheduled for:

 

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

 

The dinner meeting is scheduled for 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.

 

3.         HIPAA Preparation:  Information and specific materials are available on both the APA and VMS websites.

 

4.         APA Art Association:  Dr. Barton is president of this association. She invited VPA members to become involved at the APA annual meeting.

 

5.         UVM Grand Rounds:  All grand rounds take place on 10:30 to 11:45 a.m. in Austin Auditorium, FAHC

 

a.     Ivan Miller, Ph.D., will be presenting psychiatric grand rounds at the University of Vermont on April 18 on the topic of “Ethical Issues of Practicing Inside and Outside of Managed Care.” He will also be presenting a talk to the Vermont Psychological Association that afternoon about the nuts and bolts of practicing outside of Managed Care.

 

b.    Dr. McMains, Dr. Graves and Madeline Mongan will be presenting psychiatric grand rounds about physician impairment on May 23, 2003.

 

6.         Third Annual Governor’s Summit on the Employment of People with Disabilities: UVM and VAMH will present a joint program on April 7 at the Sheraton Conference Center in Burlington. “60 Minutes” newscaster Mike Wallace will present the keynote luncheon speech at 12:30 concerning his experience with depression. The fee for the program is $40.

 

 

Reports:

 

1.         Legislative Report:  Updates were provided on the following issues:

 

a.     Death with Dignity:  Dr. McMains reported on the VMS Council’s consideration of this issue. He indicated that the majority of the expressed opinion was negative to the proposal. He noted that when he presented the VPA Executive Committee’s support of the concept in principle, that action was greeted with disappointment. No legislation is likely to move forward on this issue this year.

 

b.    Medical Marijuana:  Dr. Fassler reported that this bill passed the Vermont Senate by a strong margin; it is unclear wether this pill would be introduced to the House Health & Welfare Committee. He noted that the Vermont Psychological Association and the Vermont Chapter of the National Association of Social Workers endorsed our VPA’s position that such matters should be open for consideration by an individual patient and clinician.

 

c.    Medicaid Formulary:  Dr. McMains reported that the Vermont Association for Mental Health (VAMH) and the National Association for Mental Health will present a “town meeting” conference on this issue. As the mental health exemption expires next year, discussion will focus on the future approach to the prescription of medication for mental illness. Medicaid formularies are being implemented nationwide, in much more draconian form in some states. Different psychiatrists have had different experiences with the appeals process.

 

d.    Certificate of Need and Hospital Boards of Directors:  Ms. Block reported on the two most viable bills among the many introduced on these issues. The house bill, written by Rep. Anne Donahue, was the more comprehensive of the two; it has been modified to exclude individual physician offices, mental health centers, group homes, intermediate facilities for the retarded.

 

e.     Agency of Human Services Reorganization:  Dr. McMains reported that the several House committees involved have backed off the original proposal and is now looking more cautiously at a process for considering what changes to make and by what process. He indicated that the likelihood of ultimate change is great.

 

f.     Involuntary Care in Hospitals:  Dr. McMains presented a bill to codify the Department of Developmental and Mental Health Services’ policies on seclusion, restraint and involuntary medication. The Department is opposing this on the grounds that these decisions needs to be kept in the clinical realm, not codified in law.

 

g.    Criminalization of Ritalin Possession:  Dr. Fassler reported that the Senate version of this bill, previously thought to be quiescent, is being heard by the Senate Education Committee next Thursday (March 27). Dr. Weker will be available to testify, and additional testimony by a child psychiatrist is being sought.

 

2.         Disaster Preparedness Committee:  Dr. Barton will be attending a meeting for DB disaster committee persons following the APA meeting. She will be presenting the Vermont Health Department’s physician committee on bioterrorism and preparedness.

 

3.         By-Laws Committee:  Dr. Danielson reported on the committee’s deliberations in reconciling the VPA’s old by-laws and the model version promulgated by the APA.

 

4.         Nominating Committee:  Dr. Danielson reported that the following names will be put forth: Dr. Kalibat, for president-elect; and Dr. Weker for secretary.

 

5.         Treasurer’s Report:  Dr. Fassler reported that the VPA’s conservative investment policy has precluded any stock market losses. The current balance is $51,634.

 

6.         Media Training Grant:  Dr. Fassler reported that a joint proposal from Maine and Vermont was approved by the APA for media training, advocacy and lobbying. These efforts help to preclude psychologist prescribing efforts by promoting psychiatric staffing and services in underserved areas.

 

7.         Newsletter Report:  Dr. Deppe reported that she is gathering materials for a spring issue. She is eager to receive contributions from other members.

 

8.         Ethics Committee:  Dr. Graves reported on the aftermath of the committee’s handling of an ethics complaint and possible future items for the committee.

 

9.         Hospital and Community Psychiatry: Dr. McMains reported that Janice Van Dyke of First Health, the appeals organization for the Medicaid formulary, attended the meeting and provided feedback on the process. The HCP group suggested that Medicaid produce an information sheet listing costs of commonly prescribed medications.

 

10.      Area I Council Report:  Dr. Weker presented highlights from the Area I Council Meeting.

 

 

Old Business:

 

1.         Membership:  Dr. McMains reported on his follow-up with various former members who were listed as being dropped from APA/VPA membership. The Executive Committee also approved the letter proposed by David McKay, M.D. re: encouragement of applications for APA distinguished fellowship.

 

2.         Fletcher Allen Health Care Psychiatry:  Dr. Fassler reported that FAHC has submitted a revised certificate of need request, including the psychiatry proposal to the Department of Banking, Insurance, Securities and Health Care Authority. FAHC. was asked 54 questions by BISHCA and submitted many pages of response. Hearings on the CON will take place on June 24-26.

 

3.         UVM Department of Psychiatry Chair Search Update:  Dr. McMains reported that there are two viable candidates for the position.

 

 

New Business:

 

1.         Nominating Committee nomination: the executive committee approved the nominations as presented.

 

2.         Insurance Committee:  Dr. McMains reported that this committee has been reactivated. Dr. Pierrattini has been appointed as chair.

 

3.         Media Forum:  Dr. Fassler proposed that the VPA convene a forum for journalists to attend a session at an Executive Committee meeting to help educate them about mental health issues and enhance our relationships with them.

 

4.         Proposed Legal Consultation/Training Sessions: Drs. McMains and Fassler reported on an offer from a Burlington law firm, Mickenberg, Dunn et al., offering these services. After discussion, it was moved and seconded that the Executive Committee work with the law firm to develop a proposal to present one or two risk management seminars and to offer a reduced fee for legal consultation services for VPA members. The motion was passed.

 

5.         Involuntary Care in Hospitals: It was moved and seconded that the VPA oppose legislation to codify in law standards on involuntary seclusion, restraint and emergency administration of medication, as evolving clinical practice should not be mandated by statute. The motion was passed.

 

6.         War:  It was moved and seconded that the VPA Executive Committee endorse the following statement: