Annual Report Electronic Health Records Task Force

The Electronic Health Records (EHR) Task Force has accomplished a number of activities. The Task Force researched EHR, made a presentation for the MPA Annual Convention, met with some EHR vendors, met with representatives from the Department of Health and Stratis Health, met with a multidisciplinary group of mental health providers interested in EHR, and discussed the development of a toolkit for behavioral health to assist providers in choosing the best EHR for their practices.

Plans for the coming year include coordinating trainings in how to use the toolkit, reviewing the possibility of developing a Health Information Exchange mechanism specifically for mental health that could provide additional safeguards for our patients, developing a vendor fair for members, and presentations at the MPA Annual Convention and Minnesota’s 10th Annual e-Health Summit.

Annual Report for Legislative Committee

The highlight for MPA of the 2013 Minnesota legislative session was the passage of our bill to allow psychologists to be reimbursed for consultation to primary care. Senator Julie Rosen shepherded the bill through the legislative process. A number of measures improving mental health services passed, in response to the tragic events at Sandy Hook Elementary. Examples included the extension of coverage for waivered services to individuals with a diagnosis of schizoaffective disorder and increased technical assistance to provide in-school mental health services. Gun control legislation was a major focus at the legislature, though no changes ultimately occurred.

For the 2014 session, MPA will work on having psychologists listed as a profession that can direct a health care home. This will be important when behavioral health homes come into fruition. Behavioral health homes provide primary care services to individuals with serious mental illness in settings where they are most comfortable obtaining care. Recent research demonstrated that individuals with serious and persistent mental illness die on average 25 years sooner than their same age peers. Behavioral health homes are an effort to fill this gap and ensure that people with mental illness receive comprehensive care. Other organizations will be working on some changes to the commitment statutes and adding services to engage individuals in treatment who do not meet commitment criteria, are not necessarily in a crisis, but do need to develop a relationship with providers to engage in treatment.

NAMI Minnesota to Partner with MNsure

Starting January 1, 2014, all Americans must have health insurance, with very few limited exceptions. To help make insurance affordable, tax credits are available and in Minnesota Medical Assistance was expanded to include low income adults. Many people with mental illnesses faced barriers to accessing insurance due to a pre-existing condition, no coverage for mental health treatment, high deductibles or not meeting disability criteria for Medical Assistance.

NAMI Minnesota recently received a grant to provide outreach and assistance to people with mental illnesses and their families to access insurance through Minnesota’s health care exchange MNsure. NAMI Minnesota is collaborating with mental health providers to ensure statewide outreach.

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Announcement: Nominations Open for Three MPA Teaching Awards

Nominations for each of three MPA Teaching Awards (Graduate Faculty in Psychology, Mink Outstanding Undergraduate Teacher Award, Outstanding Teaching of Psychology in Community/Two-Year Colleges) should be submitted to the MPA Office no later than Friday, February 28, 2014.  The criteria and nomination process for each award are outlined below.  Questions can be directed to Jack Rossmann at Macalester College ([email protected]).

MPA Award for Outstanding Graduate Faculty in Psychology

The Minnesota Psychological Association is seeking nominations for the MPA Award for Outstanding Graduate Faculty in Psychology. This award recognizes a faculty member who brings a special quality or commitment to working with graduate students in psychology. The award will be presented at the MPA Annual Convention. The procedures and criteria for the award are outlined below.

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New Member Spotlight: Dawn Nuss, MS

1)      What is your background in psychology (e.g., education)?

I started my education with a BS in Psychology and continued directly on from there to complete a teacher competency.  I gained licensures in Learning Disabilities and Emotional Behavioral disorders, finishing up with a MS in Special Education.  In 2005, I graduated with a MS in Counselor Education, completed 4,000 supervised hours, and currently I am a Licensed Professional Clinical Counselor.

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Minnesota's Legislature Update

Though Minnesota’s Legislature does not convene again for several months, a number of projects are underway. If you have any interest in participating in the projects, please contact the MPA office at [email protected] or 952-564-3048.

Participation in the State Innovation Model (SIM)

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Slama Talks with Students about Opportunities in Rural Practice

The University of Saint Thomas Psychology Graduate Student Organization of the College of Education, Leadership and Counseling hosted Dr. Kay Slama, Ph.D., MSS, L.P., for a presentation regarding the principles of rural culture and rural counseling competencies on Thursday, October 17. Graduate students from around the Twin Cities were able to attend the free session designed to increase awareness among urban and suburban psychology students about the needs and opportunities in the greater Minnesota region. Opportunities to obtain graduate school loan forgiveness through the National Health Service Corps program was also discussed.

Dr. Slama described rural Minnesota as existing on a continuum, from a person or family who lives and works on a farm to individuals who live and work in small towns. For individuals and families who live on farms, the impact of their vocation cannot be overstated. Dr. Slama described farming as intensive work that occurs seven days a week and is often accompanied by a sense of duty to the family’s prior generations.

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Fifth Rural Behavioral Health Practice Conference Focused on Rural Issues

Behavioral health professionals from several states joined MPA’s Rural and Greater MN Division (RGMD) October 11 for their fifth annual conference, focusing on “Advances in Rural Behavioral Health.”  Evaluations showed high satisfaction with conference content and format.  Dr. Willie Garrett, RGMD Chair and Conference Co-Chair, commented, “Rural professionals were offered an inexpensive ‘blueprint’ for success, in preparation for the new era of rural psychology practice and healthcare reform.”

Partnering with the Illinois Psychological Association was a successful experiment this year.  IPA contributed three committee members and pulled in nearly 30% of the participants.  Other partners included the Psychology Discipline at UM-Morris, the Western Interstate Commission on Higher Education, and APA’s Committee on Rural Health.

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From MPA's President Tabitha Grier-Reed, Ph.D., L.P.: Year-End Reflections

This is my last President’s Letter, and like the President before me, I am feeling grateful and thankful. I came into this year with a goal to establish stability through increased accountability and transparency in MPA. Major projects to this end included:

  • Updating the Policies and Procedures (especially those related to leadership and finances) and making these widely available.
  • Clarifying decision-making processes and the roles of the Governing Council and Executive Committee.
  • Creating two additional committee structures endowed with the ability to improve both accountability and transparency for MPA leaders and staff.  These include the Financial Consultation Committee chaired by Bruce Bobbitt responsible for internal annual reviews of financial transactions and the Leadership Development and Nominating Committee chaired by the Immediate Past President responsible for recruiting volunteers in MPA and orienting leaders to what is required of them.

This has been a productive year, and I want to say thank you to all of the people who helped to make my presidency a fruitful and harmonious one. Special thanks to those with whom I worked particularly closely: Secretary Mera Kachgal, 2013 Annual Convention Committee Chair Kate Jalma, Annual Convention Committee Member Tom Skovholt, and Public Education Coordinator Jenna Bemis. I would also like to say thank you to Dan Christensen who was a wonderful Past-President: supportive, reliable, good-humored, and grounded. And, I would like to recognize and thank Rhea Sullivan our Administrative Director who joined us in March and made all the difference for MPA — helping us attain fiscal solvency and a high level of customer service.

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From MPA's President-Elect Steve Vincent: Connecting, Protecting and Growing

As I have mentioned in previous columns, MPA’s strategic planning sessions in September of 2012 identified “Connection, Protection and Growth” as the overarching concepts under which MPA brings value to its members.   This year’s strategic planning meeting in October reviewed the progress that has been made during the past year, under the outstanding leadership of our president, Tabitha Grier-Reed, Ph.D., L.P., on specific steps that have been taken to make sure that MPA has the structure and operations to provide connection, protection and growth.  The October planning meeting also reaffirmed these overarching concepts—one might even call them ideals.

New Evidence Just In

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Answers to the Most Important Questions about Health Care Reform

The Patient Protection and Affordable Care Act (ACA) is the most important piece of health care legislation at least since the founding of Medicare and Medicaid in the 1960s, and may prove even more important than that.  Reactions among psychologists to the process that the ACA has instigated vary between dumbfounded anxiety, extreme skepticism, and cautious optimism.  Whatever your opinion of those changes, there are some questions to which you need the answers.  This article is our best effort at giving you answers to those questions.  Far more change is in the works than has occurred already, so read this article knowing that some of these answers will inevitably be outdated in the near future.

Thirty years ago I was told I was doomed if I didn’t join managed care.  I decided against it and the apocalypse never happened.  Isn’t this fear about health care reform just more of the same hysteria?  

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What is HPSP? What Does it Do?

As your representative who sits on the Advisory Board of Health Professionals Services Program (HPSP), it is time again for me to give a little information about this valuable but little known program. It provides monitoring services to health professionals with illnesses that may impact their ability to practice. HPSP promotes public safety in health care by implementing monitoring plans that are related to appropriate illness management and patient safety. A plan may include the participant’s agreement to comply with continuing care recommendations, practice restrictions, random drug screening, and support group participation.

The functions of HPSP include:

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Land of 10,000 Lakes and Exceptional Vision

Having the 121st Annual APA Convention in Honolulu, Hawaii was extraordinarily memorable for the 11,400 registrants and HPA.  The vision, vitality, and enthusiasm of the next generation were infectious.  From a health policy perspective, it was especially gratifying to see the extent to which new career psychologists and graduate students were actively embracing the notion of integrated, patient-centered care which is the hallmark of President Obama’s landmark Patient Protection and Affordable Care Act (ACA).  Unprecedented change, driven primarily by historically escalating costs and a new appreciation for the potential contribution of the advances occurring in communications technology (i.e., electronic health records, comparative effectiveness research, and telehealth), is rapidly impacting the nation’s healthcare environment.  Cynthia Belar described how from the APA Education Directorate’s vantage point, psychology’s training institutions and internship sites are successfully adapting to the changing demands of the 21st century.  Personally, one of the most gratifying presentations at the convention was the symposium chaired by Patti Johnson, who has now served in the U.S. Army for over 20 years, addressing the unique psycho-social needs of military families and especially their children.  The nation’s protracted conflicts have had a significant impact upon the behavioral health of military children and youth.  Patti’s panel discussed a number of innovative programs that were making a real difference.  All of psychology owes President Don Bersoff our gratitude for his vision and passion in developing special Presidential programmatic initiatives focusing upon how psychology can contribute to the nation’s responsibility for our Wounded Warriors and their families.

I currently have the opportunity of serving at the Uniformed Services University of the Health Sciences (USUHS) (DoD) where psychology and nursing have made a special, and in my judgment visionary, commitment to fostering true interdisciplinary training.  “As a graduate student in the clinical psychology doctoral program at USUHS, I study alongside advanced nursing students.  Participating in interdisciplinary classes has taught me that psychology and nursing share similar goals and pursue complementary research questions.  When looking for allies to improve the health care of our warriors and our nation, nurses and psychologists have to look no further than to each other.  And, by collaborating in our formative years, we maximize our impact as team-based healthcare providers (Joanna Sells).”

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New Member Spotlight: Allison Richards

1)      What is your background in psychology (e.g., education)?

I received a bachelor’s degree from Middlebury College (Vermont) with a major in psychology. I then completed a master’s degree from the counseling and student personnel psychology program at the University of Minnesota. I am currently working on my doctoral degree in counseling psychology at the University of Iowa.

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From MPA's President Tabitha Grier-Reed, Ph.D., L.P.

Strategic Updates

I am now entering the last quarter of my Presidency, and am happy to share with you the strategic accomplishments MPA has achieved this year. The objectives for 2013 included identifying gaps and strategies to strengthen four major areas: organization structure and operations; fiscal solvency; leadership and governance; and, member engagement. First, let me tell you that at this point MPA is financially solvent.  In addition, the 2013 Governing Council has worked to review and approve policies to secure the foundation for financial stability and organizational health into the future in all four major areas of MPA. For example, with respect to leadership and governance, the organization has instituted board training for each Governing Council as well as clear documentation of Governing Council Members’ Duties and Responsibilities. Similar documents have been developed and approved for MPA Division Chairs and Committee/Task Force Chairs. Moreover, to increase oversight, MPA has passed a Whistle Blower Policy as well as an Annual Audit Policy. We have also updated our Travel, Reimbursement and Expenditure Requests policies and forms. Finally, we have increased our membership to close to 700 members, and we are focused on continuing to work toward the protection, connection, and growth of psychologists.

Connection, Protection, and Growth

MPA exists for the protection, connection, and growth of psychologists, and we need you to effectively serve this function. Many of you may be aware of changes occurring within Blue Cross/Blue Shield (BCBS) who recently implemented a drastic fee reduction affecting psychologists and switched to the Mihalik Group’s Medical Necessity Review Criteria for Behavioral Health. As a result psychologists have complained about difficulty getting access to the manual.

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From MPA's President Tabitha Grier-Reed, Ph.D., L.P.

Strategic Updates

I am now entering the last quarter of my Presidency, and am happy to share with you the strategic accomplishments MPA has achieved this year. The objectives for 2013 included identifying gaps and strategies to strengthen four major areas: organization structure and operations; fiscal solvency; leadership and governance; and, member engagement. First, let me tell you that at this point MPA is financially solvent.  In addition, the 2013 Governing Council has worked to review and approve policies to secure the foundation for financial stability and organizational health into the future in all four major areas of MPA. For example, with respect to leadership and governance, the organization has instituted board training for each Governing Council as well as clear documentation of Governing Council Members’ Duties and Responsibilities. Similar documents have been developed and approved for MPA Division Chairs and Committee/Task Force Chairs. Moreover, to increase oversight, MPA has passed a Whistle Blower Policy as well as an Annual Audit Policy. We have also updated our Travel, Reimbursement and Expenditure Requests policies and forms. Finally, we have increased our membership to close to 700 members, and we are focused on continuing to work toward the protection, connection, and growth of psychologists.

Connection, Protection, and Growth

MPA exists for the protection, connection, and growth of psychologists, and we need you to effectively serve this function. Many of you may be aware of changes occurring within Blue Cross/Blue Shield (BCBS) who recently implemented a drastic fee reduction affecting psychologists and switched to the Mihalik Group’s Medical Necessity Review Criteria for Behavioral Health. As a result psychologists have complained about difficulty getting access to the manual.

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From MPA's President-Elect Steve Vincent: Calling All Psychologists

The Easily Observed Contributions

A quick scan of MPA’s home page shows a wide variety of events, information and opportunities for all psychologists.   These include the upcoming Fifth Annual Rural Behavioral Health Practice Conference showcasing Advances in Rural Practice (October 11), the Annual President’s Conference on the Jigsaw Puzzle of Cognition and Affect (November 11), the  accompanying pre-conference workshop on  November 9 on the topic of cultural influences and individual differences, and multiple excellent First Friday Forums.  MPA continues to present excellent learning opportunities and the ability to earn useful CEs for licensed psychologists.  MPA serves psychology and all of the citizens of Minnesota, just as our Mission Statement says.

More Happening Behind the Scenes

Also, MPA continues to advocate effectively with state agencies and with payers.  Currently the State of Minnesota is developing its criteria for Behavioral Health Homes, a form of medical home aimed at meeting all health care needs of people with chronic mental illness.  The state has developed an advisory council to work on these criteria, and MPA has a member on that council.  MPA has been present and actively involved with legislative and regulatory affairs.   We want to ensure that psychologists are able to lead behavioral health homes. Without MPA’s previous and on-going involvement, psychology would not be represented.  Simultaneously, MPA is working with payers and regulators to ensure that the public has access to medical necessity criteria.

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Electronic Health Records Update

MPA’s work with Electronic Health Records issues

MPA is working to find decision-making tools and financial assistance for members to select, acquire, and implement electronic health records. The State Innovation Model grant may provide this assistance.

Timeline to adopt Electronic Health Records

In discussions with state officials, it has been communicated that while the deadline in statute for implementing electronic records is January 2015, they would prefer that mental health professionals get the product that is right for their practice, even if it means that a product is not in place on the deadline. This is in recognition that there are currently few appropriate products for small mental health providers. They prefer that psychologists get something that will meet their needs, rather than purchasing anything for the sake of meeting the deadline. Officials anticipate that more appropriate products will be forthcoming. An electronic health record must eventually be purchased, and consequences for failure to adopt an electronic record will be coming at some point.

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Industry News: SafeTALK

Did you know that suicide has surpassed car accidents as a leading cause of death in our country according to the Centers for Disease Control and Prevention?  Or that suicide is the second leading cause of death among 15-34 year olds in Minnesota, higher than the national rate for that age group?  Also, the Minnesota Department of Health reports that 16.5 % of ninth graders in 2010 reported having thoughts of killing themselves. While suicide is often thought of as an individual problem, it actually impacts families, communities and our entire state in both human and economic ways.

Attention is being focused on the rising rate of suicide, and our communities are recognizing that we can no longer afford to avoid or dismiss this serious public health concern as a weakness that can only happen in other families.  Suicide is everyone’s problem, not only because it can happen in any family, but because when it does, we are all affected.

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A Review of Cultural Disparities Regarding Suicidal Behavior in At Risk Populations

Adolescent suicide remains a debilitating and tragic phenomenon in the United States. Suicide is the third leading cause of death among adolescents, accounting for a greater number of fatalities than the next seven leading causes combined for 15- to 24-year-olds (Centers for Disease Control and Prevention [CDC], 2006). Distinct ethnic groups show unique patterns of suicidal behavior. “At risk” populations are those with elevated rates of suicide death, attempt, or ideation, among them being Latinos, African Americans, and American Indian/Alaska Natives. Latino adolescents have shown a tendency to be at greater risk for depressive symptoms, suicide ideation, and suicide attempts than other racial/ethnic minority adolescents (Canino & Roberts, 2001; Hovey & King, 1996; Zayas, Lester, Cabassa, & Fortuna, 2005). Across the lifespan, the median age of suicide death is approximately a decade earlier for African American suicide victims than for other ethnic groups (CDC, 2006), and among American Indians between the ages of 15 and 19, suicide accounts for nearly 20% of deaths (CDC, 2006).

Culture-specific beliefs and behaviors can act as either hazardous or preventive agents on self-injurious behaviors. Analysis of the literature has produced five salient motifs accounting for cultural disparities in suicidality: family, cultural environment, history, identity, and religiosity.

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