Tag Archives: Federal Advocacy Coordinator

The Importance of Advocacy

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

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The Structure of Advocacy in the Practice of Psychology

Advocacy is an important function in today’s society.  Those that speak the loudest and/or make the largest donations are able to affect important governmental changes.  Psychologists play an important role in advocacy because we not only advocate for our profession, but we advocate for the mental health needs of our patients and improvements in society at large. We are fortunate to have an advocacy structure set up for us.

APA has the Practice Organization (known as APAPO) which advocates for psychologists and the people we provide services to.  Among the many issues that APAPO might advocate is:  improved mental health care, increased funding for mental health care, improvements to insurance that facilitate access to mental health care, advocating the inclusion of psychologists (and good mental health care) into healthcare initiatives (Affordable care act), parity, changing Medicare law to facilitate psychological services/access and much more.

In order for advocacy to be effective, it is imperative that many psychologists, at the grass-roots level, be involved in sending messages to legislators.  APA has a system  in place that makes it easy for every psychologist to advocate.

Every state, territory and district of the United States has a psychologist designated as the Federal Advocacy Coordinator (FAC).  I am the Wisconsin FAC.  In the FAC role, I represent both APA and WPA and have a variety of responsibilities.  First, through a data base provided by APA, I send out action and information alerts to Wisconsin psychologists.  The alerts are written by APA and then sent out to the FACs for distribution.  You are in the data base if you are a member of APAPO or have previously used the APA (Capwiz) political action portal.

I encourage you to write to your legislators, at the very minimum, when you receive an action alert.  This is the cornerstone of grass-roots advocacy and it really does make a difference.  When a message avalanche hits the hill, legislators and their offices take notice. APA makes it easy by putting a clickable button in the action alert that will take you directly to the advocacy portal.  Enter your zip code to identify your specific federal legislators and then send emails.  APA provides a sample letter for you to use; you can edit the letter any way you wish or send it as written.  Even if you disagree with the APA stance on an issue, I encourage you to make your voice heard and write what you think the legislator should do to address the issue.

A second FAC responsibility is to attend the annual Practice Leadership Conference in March.  The conference provides several days of workshops on cutting edge issues related to the practice of psychology and health care in general. We also receive advocacy training.  On the last day of the conference, we go to Capitol hill in Washington D.C.  We meet with as many Wisconsin legislators as possible while the  other FAC’s meet with their respective legislators.  We essentially blanket the hill advocating the specific agenda delineated by APA.

This year we advocated to include psychologists in the “physician definition” under Medicare law.  We are the only doctoral level providers, licensed to work independently in our states, that are not included under this definition.  Chiropractors, dentists, podiatrists and optometrists are included under the physician definition.  This is important because many Medicare initiatives have been tied to providers that fall under “physician” such as funding to develop electronic health records, use of E & M codes and the ability to be independent in all places of service under all insurances.  Currently, it is required that psychologists have an MD sign off in some places of service for our work with Medicare fee for service beneficiaries. In contrast, MD sign off is not required when the patient has commercial insurance, Medicaid or Medicare advantage plans.  We also advocated to keep mental health services included in Medicaid and other health plans as congress continues to address the affordable care act and Medicaid.

A third responsibility for FAC’s is to meet with, write to or in other ways be active with legislators when they come to their Wisconsin districts.  I go to town hall meetings, listen to Facebook town hall meetings and write to the legislators and their aides.

Finally, the FAC brings this information back to you via education at annual conference, newsletter articles and this blog.  I also communicate with Wisconsin psychologists who have questions about action alerts.

At times, this is a huge responsibility (i.e. when major changes in health care bills are being voted on), but it is rewarding and important work.  I am proud of the role I play in affecting change at the governmental level.   Perseverance and patience are required because change does not occur quickly.  For many years in a row we go to the hill with virtually the same agenda items. Over time, you witness a slow, but important change occurring and then suddenly, or so it seems, the advocated change occurs!

If you have any questions or suggestions, please do not hesitate to contact me.  Thank you for all the help you have given me over the years by contacting your legislators!  Keep it up, we are making progress.

Dori Ann Bischmann, PhD

Federal Advocacy Coordinator

APA and WPA

Capwiz: an online advocacy program developed by Capitol Advantage that allows users to send advocacy messages and alerts to members.  APAPO is a member of Capwiz and utilizes this system to send alerts to psychologists.

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