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APA Division 40 Executive meetingWinter 2018Practice Advisory Summary ReportThe following represents a summary of the PAC activities from July, 2017 through February, 2018:Federal Advocacy Coordinator for SCNThis position has been served by Dr. Laura Renteria since 2014. Dr. Renteria has decided to step down after four years of service. SCN thanks her for her service. We are in the process of finding a replacement coordinator.Participation with the IOPC: The PAC continues to collaborate closely with AACN, APAPO, NAN, and ABN on issues of local, regional, and national importance through the Inter- Organizational Practice Committee (IOPC). Specific activities since the last meeting include:Position Paper on Third Party Observers (TPO):History: SCN is taking the lead on a joint IOPC effort to Chair a white paper working group to protect psychological test integrity in courts with collaboration of APADr. Marc Norman from SCN nominated to lead the Committee TaskforceUpdate: ?paper at a stand still pending another APA CPTA TPO paper submission on a similar topic (by other authors) which could take a year per Marc NormanTexas Licensed Psychology Associate (LPA)History: a 2017 ruling by the TSBEP has allowed Master’s-level LPAs to practice psychology independently.?This is very important because it can set the precedent for other states to follow suit.Update: Texas Psychology Association filed a lawsuit against TSBEP in January, 2018. A hearing is pending. TPA is pulling emergency funds to make the lawsuit possible. TPA is also working on the legislative side of things to see if they can pass legislation to reverse the TSBEP rule change, but legislature isn’t in session again until 2019, so in the meantime these Master’s-level clinicians will be practicing psychology independently.There also was a TSBEP-initiated workgroup established to determine competency requirements for independent practice in specialty practice areas (e.g., neuropsychology). TSBEP invited Pete Stavinoha, PhD a TPA representative to workgroup, Munro Cullum PhD is representing NAN, and David Cox PhD is representing ABPP/ABCN. In their letter inviting representatives, TSBEP retained the right to make its own final determinations Participation with the Committee for Advancement of Professional Practice (CAPP) - Dr. Joanne Festa in attendance – November, 2017. Here is a brief summary of highlights below:CMMI Grant for transforming Clinical Practice Initiative- Doug Tynan – Director of Integrated HealthcareOverall CMS CMMI project. The goal is to support clinicians in practice transformation work to integrated health, improve health outcomes for millions of CHIP beneficiaries and other patients, reduce unnecessary hospitalization for 5 million patients, and generate $1 to $4 billion in savings to the federal government and commercial payers. The Integrated Health Care Alliance is funded by CMMI/ CMS as part of transforming clinical practice initiative. Project goals include developing sharing and adapting comprehensive quality improvement strategies in conjunction with other healthcare and professional orgs.Developing a broad network of thought-leader clinicians dedicated to the project.? The CECP Training model licensing was previously raised and is now again being discussed. CAPP wants to have input into the discussion about changes in timing of practica hours toward licensure.Master’s level psychology providers.?? There was a Master’s Summit in December 2016.??There continues to be great trepidation about Master’s level providers as independent practitioners.?? Communications division includes: They created an online toolkit on APA site. Guide to Innovative Practice Models – divided into chapters (see APA practice website). There are embedded videos from workshops. There was a relaunch of the website in January with more information about CAPP and voting. They added information about benefits. Number of users and sessions on the website are both increased.Launched a podcast this year on social media. The APAPractice listserv is increasing in membership. They launched a webinar series. The newsletter has been revamped and one goes out to APA members that are not APAPO members to promote the APAPO.Professional Practice Guidelines Update and discussionTest User Qualifications: Fall 2016 a joint workgroup came together to discuss sunset of test user qualification guidelines. Brought all stakeholders together to discuss issues around tests and user guidelines. Will develop a new professional practice guidelines. It will address gaps in old document and gaps in standards for psychological testing. They decided what they wanted the document to cover. Wrote a needs rationale and guidelines statements based on content areas that were identified (validity/reliability, competency, etc.). The group is making progress. PTSD clinical practice guidelines were adopted, now they want professional practice guideline to go along with it. Addresses issues related to common factors that impact treatment. It is intended to complement clinical practice. Discussed distinction between clinical practice guidelines (systematic research review – evidence based standards) and professional practice guidelines (what to do with patients who come in with the diagnostic problem). Clinical are high level research standards, professional are how professionals behave. The practitioner needs guidelines about how to treat the problem – describe decision making with a particular patient. Qualified Clinical Data Registry (QCDR) for CMS Collaborative initiative across many departments in APA. It is an outcomes registry. CMS is aware that people are frustrated with their outcomes measures. CMS allows other associations (like APA) to create the outcomes measures. APA then can decide what is a quality outcome. It needs to meet regulatory guidelines. This product allows the psychology practitioner to evaluate their individual outcomes and use as a quality outcomes tool. This can be a research tool as well.APA practice organization is working with Healthmonix to develop the behavioral health-specific QCDR. There is a committee at APA to develop the outcomes. They reviewed available measures from multiple sources and made recommendations about the measures and dissemination of them. Measures were submitted by Nov 1, 2017. There are 39 measures (i.e., adult major depressive disorder, suicide risk, functional outcome assessment). There are 4 new outcomes measures. Healthmonix is ready to submit the measures and then CMS will determine if it can be used. In the next year the workgroup will look at further outcome measures, social determinants, sleep, etc. There are no current neurospych assessment outcome measuresInter-Healthcare Committee – IHC SCN liaison – Scott Porter, Ph.D. in attendanceClinical Guidelines updates:? The Clinical Practice Guideline and Qualified Clinical Data Registry (QCDR) is up and running from APA.? Neuropsychology can participate in this initiative. They have only done PTSD, Childhood Obesity and Depression.? SCN might consider its own outcome measures. Collaboration on evidence based practice with other organizations within APA and outside of APA is starting to take root. We discussed integrated care.Functional Outcome ModelDiscussed function in disability as a major important factor of focus.? Insurance focuses on symptom relief, but APA is pushing for a focus on functional outcomes.? Neuropsychology can be an important part of this initiative. The current model financially incentivizes poor care. Neuropsychology can play an important role.? We often are instrumental in decisions for SSDI and Workman’s Comp.? The idea is to promote people getting off of disability and becoming productive where possible.??CPT codes. ?Discussion of RVU rate and potential restriction of the codes to appropriately qualified Neuropsych practitioners. That is how CMS can save money. ??Discussion of the issue of the difference of neuropsychological assessment vs. cognitive screenings?40 PAC Members: Scott Porter Scott.Porter@; Steve Honor shonorphd@; David Salisbury DSalisbury@bir-; Darrin Aase daase@govst.edu; Ben Johnson-Markve ben.neuro@; Robert Fabiano rfabiano@; Ryan Schroeder ryan.w.schroeder.psyd@; Mark Barisa a12569@BaylorHealth.edu; Jon Thompson JCThomp1@; Michael Westerveld westerm@; Joanne Festa jfesta@Respectfully submitted,Maggie Lanca, PhD.Chair, Practice Advisory Committee, SCN ................
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