Making changes at the national level is a slow process. I recall that it took at least 5 years to encourage Congress to make changes to the Medicare law regarding the Sustainable Growth Rate (SGR) which determined physician’s (includes psychologist’s) fees. Year after year, the SGR triggered cuts to physician fees which then required Congress to vote to negate the cuts. Years of grass roots efforts from many health-related disciplines finally convinced Congress to revise the law to stop the annual pay cut threats.
I just returned from my annual Capitol Hill visit in Washington D.C. advocating for psychology issues as delineated by the American Psychological Association (APA). The Hill visits are part of the Practice Leadership Conference (PLC) wherein psychologists from every State, Province, and United States territory gather in Washington D.C. to learn about issues affecting psychologists on a federal level and to promote advocacy on these issues. State association executive directors, federal advocacy coordinators, presidents and/or president-elects, early career psychologists, diversity delegates, graduate students and others come to represent and advocate for their respective state or territory. I have attended as the WPA Federal Advocacy Coordinator for the last ten years.
At the conference we receive advocacy training, have workshops on psychology-related topics, and learn about new governmental trends that impact our work. We also discuss issues affecting our patients such as access to mental health care and immigration. At the end of the conference, we visit Capitol Hill to meet with our respective state legislators. While we are rarely able to meet with the Senator or Representative directly, we build relationships with the legislative staff, typically the Aide who specializes in health care. We discuss our issues and may request that the Senator or Representative cosponsor a bill. It is common to present the same issue for several years. I have enjoyed watching the same legislative aide move from little understanding of the issues to being intimately knowledgeable of the minute details of the bill and to having a stronger advocacy position when the bill is presented to the legislator and in Congress.
This year our advocacy issues were the following:
1. Adding psychologists to the physician definition under Medicare. House bill: H.R. 884.
Currently, we are the only doctoral level provider, licensed to practice independently at the state level, that is not included under this definition. Being included would reduce unnecessary supervisory requirements and make us eligible for items attached to providers under that definition. For example, we were not eligible for funding to build electronic health care records, but MD’s, DO’s, dentists, chiropractors, podiatrists and optometrists were.
2. Cosponsoring the “Mental Health Telemedicine Expansion Act.” which among other things, would expand where patients can participate in telemedicine services. House bill: H.R. 1301
More patients would be able to access telemedicine directly from their homes, eliminating barriers to treatment for those who are physically limited in their ability to come to an office for treatment, such as the elderly, people with disability, or people residing in rural areas where there is a shortage of available mental health providers or clinics within a reasonable distance.
3. Preserving mental health and substance abuse services in Medicaid, private health insurance plans and under the Affordable Care Act.
There is no specific bill for this issue, but as the Government changes and adjusts insurance regulations and funding, it is important that Mental health services always be included.
I have met many people over the last 10 years at the PLC. It is by far the best conference I ever attend. I have built a wonderful network and enjoyed meeting psychologists from all over. This year, one particular lunch of six included psychologists from Puerto Rico, The Virgin Islands and Canada. The rest of us were the WI delegates and all happen to be from Waukesha County. I especially enjoy my networking with Diane Pedulla, JD, who specializes in Medicare. Diane is one of many APA Government Relations staff. She has assisted me with many Medicare related questions on behalf of Wisconsin psychologists.
Yes, making change at the national level is a slow process, but being part of that change is very rewarding. I was reminded of this when I overheard a younger and new FAC say that he wondered if these visits were effective. He felt that it was taking forever for a change to occur regarding our Medicare issues. An older and experienced FAC said that we do make a difference. He recalled going to Capitol Hill to advocate that psychologists be included in Medicare as providers. The Medicare program began in 1965 and we were added around 1990. Yes, we do make a difference and you can to. If you are interested in becoming more involved, please contact the WPA.
Dori Ann Bischmann, PhD
Federal Advocacy Coordinator
Photo caption: Amy Gurka and Dori Bischmann advocating in Washington D.C. with Gwen Moore (Representative, 4th WI district). March 12, 2019