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News & Press: APA News

APA Fall 2017 Assembly Recap

Tuesday, November 7, 2017  
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By Michael Peterson, MD, PhD and Clarence Chou, MD
WPA Assembly Representatives to APA

It was a pleasure to again represent Wisconsin psychiatrists at the interim APA Assembly Meeting, November 3-5, 2017 in Washington DC. A summary of action and discussion items from the meeting are outlined below, and we welcome any questions or inquiries from members.

Plenary #1 - Friday PM

  • Dr. Miskimen opened the 1st Plenary with a call to order-new members introduced themselves.
  • Dr. Batterson requested approval of the Assembly minutes of the May 19-21, 2017 meeting.
  • Dr. Anzia gave the report of the rules committee.
  • Item 4-B 18 was removed from the consent calendar. Item 6-C, special rules of the Assembly, was accepted.
  • Dr. Everett gave her report, speaking of physician wellness and burnout and innovation, 
  • Dr. Summers reported from the work group on Physician Well Being and Burnout.
    • Try the Burnout Self-Assessment tool on the APA’s new Psychiatrist Well-being and Burnout webpage.  The tool can be found at http://psychiatry.org/wellbeing and click on “Assess Yourself”.  It should take approximately 5 minutes to complete the self-assessment.
    • Swensen SJ, Shanafeldt T (2017_ An organizational framework to reduce professional burnout and bring back joy in practice, TJC Journal on Quality and Patient Safety, 43:308-313

Plenary #2 - Saturday AM

  • Dr. Miskimen opened the 2nd Plenary with a reminder about professional and collegial behavior, even when discussing contentious matters.
  • Dr. Levin, CEO and Medical Director of the APA presented his Report to the Assembly.
    • CMS TCPI SAN Grant. Training in the Integrated Care mode. Total trained to date: 1933. (1,835 Psychiatrists; 98 PCPs).
    • CMS Ligature Risks: TJC recently announced that “all ligature and slef-harm risks be corrected”. APA believes proposed CMS regulations would be overly burdensome to implement. CMS guidance is forthcoming within the next 6 months. APA participating on CMS taskforce in December.
    • Disaster Relief – APAF working with American Red Cross to provide funding, focus on mental health. APA members created Crear con Salud, non profit to provide supplies and MH resources to residents of Puerto Rico
    • APA, represented by Theresa Miskimen, shared concerns about the Graham-Cassidy Bill. APA joined by 5 other specialty medical associations (“Group of 6”). Bill ultimately failed.
    • Affordable Care Act and CHIP advocacy
    • MOC Update. APA represented on Commission to evaluate MOC Process across ABMS specialties.
    • New building in Washington DC. Status update. Open office design – 75% open work spaces; 25% offices. Large enough space to accommodate all but the largest APA meetings (Annual Meeting, IPS, Components Meeting, Assembly).
  • Report from President Elect Altha Stewart, MD. Presidential topics will include integrated care, diversity, physician support/burnout, leadership in healthcare reform including integration of the larger “house of medicine”. Mental Health Parity. Underserved populations
  • Speaker’s Award: awarded to Roger Peele, MD, DLFAPA by Dr. Miskimen.
  • Action Papers/Items from Ref Com #5:
    • 4B1 – Retain position: endorsement of US ratification of the convention of the Rights of the Child. Approved on the consent calendar.
    • 4B6 – position statement on human rights. (combination of 2 older statements) Supported as written. Assembly voted to approve.
    • Action Papers:
    • 12N – re: civil liability coverage for ethics investigations for district branches. Supported with changes. Assembly voted to approve.
    • 12O – Re: Creation of a council on women’s psychiatry. Not supported. Assembly voted to postpone until Sunday given questions on procedural appropriateness.
    • 12P – addressing the negative impact of the “Rule of 95” on dues revenue. Supported with changes. Assembly voted against.

Plenary #3 - Saturday PM

  • Report of the Treasurer, Dr. Bruce Schwartz. Net income 12M, down from almost 15M in 2016.
  • Operating revenue down 410K; Annual meeting revenue up 615K
  • Operating expenses lower by 1.7M
  • Action Papers/Items from Ref Com #5(cont’)
    • 12P – Vote to reconsider given conflict re: voice vote at Plenary 2. Assembly voted against reconsideration.
  • Action Papers/Items from Ref Com #4
    • Action Paper 12M – Joint Meeting of the Council on Minority Mental Health and Health Disparities and the Assembly Committee of Representatives of Minority/Underrepresented Groups. Supported.  Assembly voted to approve.
    • 4B9 Proposed position statement re: human trafficking. Supported. Assembly voted to approve.
    • Action Paper 12K – Congruence between AMA and APA ethics papers. Supported with changes. Assembly voted to approve.
    • Action Paper 12L – re: creating a position statement re: implementation of Mental Health Parity and Addiction Equity Act (MHPAEA) supported with changes. Assembly voted to approve. Motion to send directly to BOT was
  • Action Papers/Items from Ref Com #3
    • 4B10 – police interactions with persons with mental illness. Supported as written. Assembly voted to approve.
    • Action Papers:
    • 12G – re COI not limited to pharmaceutical companies. Supported with changes. Assembly voted to approve.
    • 12H – re: non-physician registration fees for annual meeting. Supported with changes. Assembly voted to approve.
    • 12I – re: creating a position statement with a recommendation for 12 weeks of paid parental leave. Supported as written. Assembly voted to approve.
  • Action Papers/Items from Ref Com #2
    • 4B3 – Retire position statement. Support. Assembly voted to approve.
    • 4B11 – Proposed position statement against lengthy sentences without paroled for juveniles. Supported. Assembly voted to approve.
    • 4B12 – Retire position statement on review of sentences for juveniles (replaced by 4B11). Assembly voted to approve.
    • 4B15 – Position statement re: firearms access and inquiries in clinical settings. Approved on consent calendar. Discussion about whether statement conflicted with constitution. Assembly voted to approve.
    • 4B18 – Position statement re: homicide prevention and gun control. Vote to retain. Assembly voted to approve.
  • Special election for Assembly Recorder (vote by strength and priority)

Plenary #4 - Sunday AM

  • Dr. Miskimen opened the 4th Plenary at 8:10am.
  • Announcement of Special election for recorder results: Paul O’Leary was elected as Recorder of the Assembly.
  • Dr. Akaka presented the report from the APA PAC, showing increased percentage of Assembly members who contributed, but encouraging more global involvement.
  • Action Papers/Items from Ref Com #2 (cont’)
    • 12D – re: state medical board licensure questions. Supported with changes. Assembly voted to approve.
    • 12E – “Efficiency and Sufficiency”; re: MOC related issues. Supported with changes (removing some of the “resolved” statements). Addition of a “resolved” that MOC should not be part of the licensure requirements for interstate compacts. Assembly voted to approve.
    • 12F – re: survey of “medical aid in dying”. Not supported. After vigorous discussion, assembly voted against. A motion to reconsider was also voted down.
  • Action Papers/Items from Ref Com #1
    • 12A – Designation of Psychiatry as Primary Care for Medical School Scholarships. Supported as written. Assembly voted to approve.
    • 12B – Medical school loan repayment subsidies for psychiatrists in Community Mental Health and State Psychiatric Facilities. Supported as written. Assembly voted to approve.
    • 12C - Transitional Care Services Post-Psychiatric Hospitalization. Supported as written. Assembly voted to approve.
    • 4B2 – “Long term care” facility statement. Did not support given concern for wording and potential for confusion. Assembly voted to reject.
    • 4B7 – Position statement re: domestic violence against women. Supported. Assembly voted to approve.
    • 4B8 – Position statement re: prevention of violence. Supported. Assembly voted to approve.
  • Reference Committee #5
    • 12O – Re: Creation of a council on women’s psychiatry. Not supported. Return to discussion postponed from prior Plenary, given questions on procedural appropriateness. After additional discussion and change in title to “Women’s Mental Health”, the Assembly voted to approve.
  • Report on the APA Foundation from Dan Gillison
    • Over 30K raised from Assembly members this weekend, including over 6K donations to the Disaster Relief fund.
    • Assembly engagement in APAF donations is up to 54%
  • Dr. Axelrad gave the report of the Assembly Committee on Procedures. It was a short meeting, but it will be dealing with developing a Council on Women’s Health (with direction from the Association of Women Psychiatrist). There is a new edition of Sturgis out. 29 states will be reviewed by the committee.
  • Report from the Committee on Public and Community Psychiatry: 28 members participated in the meeting on Saturday.
  • Report from the Committee on Psychiatric Diagnosis and the DSM
  • Report from the Committee on Access to Care.
  • Report from the Committee on Maintenance of Certification.
  • Report from the Assembly Liaisons to the Committee on Practice Guidelines.
  • Unfinished Business:
    • 180 Assembly members completed the survey on Physician Burnout.
    • Action Paper 14A. Addressing the Negative Impact of New Joint Commission and CMS Policies on Ligature Risk on Inpatient Psychiatric Units. Assembly voted to approve.
  • Dr. Levin returned to announce the ‘ribbon cutting’ for the new APA Headquarters in March. The next assembly in November will also overlap with another opening on the Sunday evening of the Assembly.
  • Dr. Miskimen asked for input on Dr. Nelson’s Assembly Notes.
    • Input regarding awareness and use of his Assembly Notes to communicate with DBs.
  • Dr. Miskimen closed the 4th Plenary and this meeting of the APA Assembly.