Critical Issues for APA

Each of us, as a psychiatrist, is facing major changes in everyday practice, in the systems of healthcare where we work, in the systems of payment for our services and in the technology of psychiatric care.  We must work collaboratively with multiple professionals while maintaining our unique role and identity as psychiatrists. We are also in an era of growth in effective psychiatric treatments that need to be available to all whom they may help. 

We are faced with numerous social and economic challenges in working with our patients, and for those of us in public psychiatry, the challenges are great. The social determinants of health are challenges we must face as well as the growing number of our patients in the criminal justice system.  Mental health is still grossly under resourced and we need to be the voice for resources for all our patients.

The APA must be proactive in its support of members and in the care of our patients.  A few specific and effective measures will help make the APA more relevant and supportive.

1. The APA has a long and rich history in advocating at the national and state level for psychiatrists and their patients.  Parity legislation was such a victory.   It now becomes increasingly important that the APA increase efforts at the state level, as insurance exchanges and parity battles become more local, and as Medicaid cuts to state mental health funding grow.  Psychiatrists need APA support and expertise, and to be taught the necessary skills to be effective in their advocacy.  More active support needs to be available and effective at the local level.  In NY we have successfully passed parity legislation that will require state approval of medical necessity criteria and regular reporting of benchmarks on utilization and adequacy of networks.  The APA has been and must continue to be a strong and effective advocate for real Parity in both services and payment!
2. The APA must continue to be a voice to end discrimination against the mentally ill so that all those living with mental illness can live their lives to the fullest.
3. The APA needs to continue to expand its role of being the bulwark for the best practice of psychiatry with current and frequently updated guidelines for care, innovation in development and training for collaborative care and telepsychiatry, leadership in training the next generation of psychiatrists as leaders in medicine, developing new and innovative practices in the public sector to decrease the criminalization of the mentally ill, and state of the art psychotherapy and psychopharmacology.
4. The APA needs to expand its work to diversify its membership and leadership.  We need to expand and diversify our workforce to meet the growing changes in demographics in our society.  We need to expand our outreach to colleges and high schools to engage the full spectrum of our society in our future workforce.
5. Our members need to be connected to their organization with meaningful, regular communication that includes their voice as well as information.  Electronic methods are now available for real dialogue between members and governance and staff. We need to work with members to develop the most effective way to design communication for the different interest groups in APA such as ECP, MITs, practice groups and identity groups.
6. APA needs to support its state associations and chapters so that they can become an active link to members.  The Assembly needs to be more effective in making such connections and the APA needs to work in partnership with state associations, particularly in small states with limited membership, to assist members with the changes in health care reform.   APA needs to provide guidance and support directly to members on electronic records, new coding changes, changes in practice arrangements and payment for their services. Such education and support needs to be timely and accessible.
   
   
7. The APA must remain financially strong and viable.  It is critical that dollars be spent in line with our mission and that the mission is aligned with the goals and needs of our profession and our patients.

As an officer of the APA I would work to bring these and other initiatives forward.  My experience in the APA as current Chair of the Finance and Budget Committee and past Speaker of the Assembly and Area 2 Trustee to the Board, as well as my participation in numerous committees including Conflict of Interest, JRC and a membership and strategic planning task force, has given me deep knowledge of the successes, issues and potential of the APA.  

My extensive administrative experience, including form my day job as Commissioner of the NY State Office of Mental Health where I work daily with the pressures facing practicing clinicians and our patients, has given me the skills to implement necessary changes.

The APA is first of all a member organization that provides services for our members and advocates for our members and our patients.  In these changing times, being relevant and timely in providing the services needed for our members is critical.