Mental Health Problems Need Mental Health Specialists: Support Prescribing Psychologists!
Almost 86% of prescriptions for psychotropic drugs in Tennessee are written by primary care physicians. In part, this is because the wait for a first appointment with a psychiatrist in Tennessee can be almost 3 months, and up to 30% of psychiatrists are not taking new patients. And so many people with psychological difficulties are "over-medicated and under-treated." The solution is comprehensive treatment: Prescribing Psychologists, who have completed several years of additional training in psychopharmacology after their doctoral degree, who can provide both psychotherapy along with appropriate medication as needed. Learn more about TPA's public information campaign, "Becky's Story," based on a true story, depicting the tragic consequences of the current lack of comprehensive mental health treatment in Tennessee:
APA Division 55 2009 Mid-Winter Conference/TPA National RxP Advocacy Conference A Tremendous Success!
Dual Keynote Addresses by James Bray, Ph.D., APA President and Pat DeLeon, Ph.D., former APA President and Godfather of the National RxP Movement
Deborah Chandler Baker, J.D., APAPO Director for Prescriptive Authority
Morgan Sammons, Ph.D., APA Division 55 President
And many other national and state leaders in RxP
TPA 2008 Convention, Another Smashing Success!
This year's convention offered a stellar line-up of presenters! Here are some of the highlights:
Dr. Katherine Nordal, new Executive Director of APA's Practice Organization: Keynote Speaker & "Town Hall Meeting"
Dr. Christopher Fowler, Director of Research, Erik H. Erikson Institute: Redefining Treatment Reisistance in Clinical Practice: Evidence of Treatment Response in a Challenging In-Patient Group
Dr. Yossef Ben-Porath, co-Director, MMPI II Workshops: Introducing the MMPI-2 RF (Restructured Form)
Dr. Irving Weiner, Univ. of South Florida: Rorschach Assessment Meets Psychoanalysis, Psychometrics, and the Courtroom
Dr. Elaine LeVine, New Mexico RxP pioneer and Prescribing Psychologist: Psychologists' Prescriptive Authority: Present Success and Future Promise
Dr. Howard Pollio, Professor Emeritus of Psychology, UTK: Life in a Time of Terror
Dr. William Black, Director, Northeast Neurobehavioral Services: Forensic Neuropsychology: An Introduction to Logistics and Ethical Considerations
Dr. Christina Sparks, Pearson Assessment Consultant: Seminars on both the WAIS-IV and Bayley III
Make Your Life Easier: Make Managed Care Companies Approve at least 12 Sessions at a Time
This past legislative session, TPA was successful in passing a utilization review bill that no other state yet has passed. The bill "trumps" ERISA, so that insurance companies cannot claim that they are exempt from the bill because of their ERISA status. The bill says that, if an insurance company engages in utilization review on one of your patients, then it has one of two choices: it can take the position that no further treatment is medically necessary (in which case you appeal the decision), or they can approve more sessions. IF they approve ANY more sessions, then they must approve A MINIMUM OF 12 SESSIONS prior to the next utilization review. The bill went into effect July 1, 2007.
Our initial experience, as we suspect is yours, is that managed care companies (many of them out of state) are either ignorant of the bill or are ignoring it. To that end, we would like to provide you a tool with which to make your life easier: a letter to attach to all your utilization review requests in the short term, informing the managed care company of their obligations under Tennessee law. We hope that if we all use this, it will markedly improve their "compliance" with our new law.
To download a copy of the letter from the TPA Legislative Directorate to send with your utilization review forms, just click here (pdf format).
If you would like a copy of the new legislation itself, listing the revisions to the original utilization review law, just click here (pdf format).
If you would like to review the original legislation regarding minimum standards for "Utilization Review Agents" (TCA 56-6-705), click here for a link to Tennessee Code Annotated (regrettably, this only works reliably with Internet Explorer)
TPA OBTAINS TWO IMPORTANT ADVISORY OPINIONS FROM BOE REGARDING MEDICATIONS, SLEEP DISORDERS
At the suggestion of the legislative directorate, the TPA Board recently voted to seek, and just recently obtained, the following two Advisory Opinions, which have been approved by the State Office of General Counsel:
DISCUSSING AND RECOMMENDING MEDICATIONS, ETC. The first BOE Opinion reads as follows:
Practitioners of psychology may discuss with an established patient and/or patient family member and/or recommend to a patient’s physician any drug(s), laboratory test(s), or any medicine(s), devices(s), or treatment(s) including controlled substances rational to the practice of psychology, when such recommendation is within the boundaries of his or her competence based on his or her education, training, or appropriate professional experience. It is then incumbent on the physician, based upon all of the evidence before him or her, including the recommendations of the psychology practitioner, to decide what, if any, medication or medical assessment and/or treatment to prescribe. While practitioners of psychology may discuss medication issues with a patient, these practitioners of psychology acknowledge that a patient’s physician is the only person who may lawfully prescribe the medication or other medical test or treatment for the patient.
This opinion, which endorsed the language proposed by TPA, makes Tennessee the 14th state to date to obtain explicit permission for its practitioners to discuss medications and other medical issues with their patients. We are also proud of the fact that the wording of this statement is the strongest and broadest in the nation to date.
SCOPE OF PRACTICE: SLEEP DISORDERS: The second BOE Opinion reads as follows:
That it is fully within the scope of practice of a practitioner of psychology, as defined by TCA 63-11-203, to evaluate and treat, without supervision, the full range of “sleep disorders” as defined by the most current edition of The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM) (within the restrictions on methods of treatment delineated in TCA 63-11-204).
It is recognized that some Psychologists have developed specialty knowledge and skills relevant to sleep disorders as reflected by their acquisition of status as a Diplomate of the American Board of Sleep Medicine (D,ABSM). It is fully within the scope of practice of a Psychologist in Tennessee, who is a Diplomate of the American Board of Sleep Medicine, to “read” or interpret, without supervision, a polysomnogram (NPSG, MSLT, MWT, or other “sleep study”), including making recommendations to physicians regarding treatment options indicated based on the findings of said sleep study.
This opinion, which also endorsed the language proposed by TPA with very minor revisions, was requested by TPA based on the experience of some members who have been told by hospital credentialing committees and/or by insurance payors that sleep disorders were outside our scope of practice. This statement unequivocally rebuts this assertion.
We are very pleased by these opinions—they reflect a BOE which is enlightened both about contemporary psychology practice and also about what is truly in the best interests of the citizens of Tennessee. If you have any questions regarding these opinions, please feel free to contact us at legislative.advocacy@tpaonline.org.
Volunteers Wanted!
We are always looking for members who are willing to volunteer their time to help make TPA an even more effective organization. Currently we are particularly looking to fill the following positions; if you are interested, please contact us at: admin@tpaonline.org
Members willing to help in TPA's political advocacy work (Legislative Advocates)
Ethics Committee Members, especially Senior LPE's
Key Constituents (members willing to serve as designated liasons between TPA and their own legislators)
Disaster Response Network (DRN) members
Click above to Identify your State and US Senators and Representatives, and to respond to Legislative Action Alerts!
Advertise With TPA!
Website Newsletter Convention Brochure
For further information contact sales@tpaonline.org.
Important Note: Acceptance of advertising does not imply endorsement
Special Offers Exclusively For TPA Members:
Lower your merchant fees!
Support TPA!
$1,000 Discount on FDU's Post-Doctoral Master's Degree Program in Clinical Psychopharmacology
$225 Discount on purchase price of Therapist Helper Software
Download Free Adobe Acrobat Reader--for all PDF Files
Tennessee Psychological Association
P.O. Box 281296
Memphis, Tennessee 38168
