Category Archives: Features

Community Health Centers Saved Louisiana’s Medicaid Program $645 Million, Boosted Economy by $772 Million, Report Says

According to a new report released November 26 by Capital Link and sponsored by the Louisiana Primary Care Association, 35 Federally Qualified Health Centers (commonly referred to as Community Health Centers), are responsible for an annual $772 million economic impact on Louisiana’s economy.

The authors concluded that by servicing Medicaid patients at a 24% lower cost than private providers, managing chronic conditions, keeping patients out of the emergency room, and emphasizing the importance of preventive care, Community Health Centers saved the healthcare system $868 million.

Among the report’s additional findings:

•In 2018, Louisiana’s Community Health Centers saved Louisiana’s Medicaid program $645 million.

•Health centers reinvested in their communities by engaging in $416 million in direct health center spending, resulting in an additional $356 million in indirect and induced community spending.

•Louisiana’s Community Health Centers employed 3,149 individuals and spurred the creation of 2,635 additional jobs in their surrounding communities.

•Last year, Louisiana’s Community Health Centers provided primary care, oral health, and behavioral health services to over 444,000 patients across the state.

Health centers continue to serve as the providers of choice for those who have recently gained access to health insurance coverage through Medicaid expansion.

The report said that Community Health Centers are known for providing high quality preventive and primary health care to patients, and they also work to stimulate economic growth and generate cost savings for both urban and rural communities across Louisiana.

“Year after year, health centers continue to demonstrate that they are critical components of Louisiana’s healthcare safety-net,” said Gerrelda Davis, Executive Director of the Louisiana Primary Care Association.

 “This report confirms that health centers are proven leaders in meeting the needs of patients at an affordable cost to taxpayers.  The federal government has no program with a better return on  investment than it does with the Health Center Program.”

Thirty-five Community Health Centers were included in this analysis.  Economic numbers were derived using health center audited financial statements and statistics as reported on the 2018 Uniform Data System.  An integrated economic modeling software called IMPLAN was used which applies the “multiplier effect” to capture the direct, indirect, and induced economic effects of health center business operations.  I is widely used by economists, state and city planners, universities, and others to estimate the impact of projects and expenditures on the local economy.

The Louisiana Primary Care Association (LPCA) represents 38 federally funded, private, non-profit and public Community Health Centers (including two Look-Alikes) across Louisiana that serve over 444,000 patients annually.  LPCA promotes community-based health services through advocacy, education, and collaboration with community partners. Their goal is to ensure that every Louisianan has access to affordable, quality, primary care services.  For more information, visit www.LPCA.net.

Dr. Melissa Beck Helps Lead “LSU MIND” Group

Showcased in one of the cover features of LSU Research magazine, cognitive psychologist Dr. Melissa Beck is being called a “collaborative champion,” for her skill in developing cross-discipline research and teamwork.

Dr. Beck is professor of psychology at LSU and leads the Beck Visual Cognition Research Lab, where she conducts innovative and interdisciplinary research on visual attention and memory.

Dr. Beck serves on the executive committee for the LSU MIND group, or the Multidisciplinary Initiative for Neuroscience Discovery. “She’s been described as ‘the glue’ for various cross-campus collaborations,” reported Elsa Hahne at the LSU Office of Research & Economic Development.

In an interview with Hahne, Dr. Beck said, “When I first came to LSU, I was doing basic science research with my graduate students while also doing applied collaborative research at the Human Factors Group at the Naval Research Laboratory at the Stennis Space Center in Mississippi. We were looking at how pilots allocate attention to digital maps while they’re flying and how their expertise develops. I learned how to take basic research and apply it to different areas while working with people who aren’t cognitive psychologists.”

Beck is aware of how little other disciplines know about psychologists’ skills. She told Hahne, “At all universities, silos get created. Someone in engineering might think psychology is therapy— and it is!—but there’s also this huge other area of psychology called cognitive science. It doesn’t occur to them that we have all of these people with skills and the ability to study interesting problems that are related to business or marketing or engineering. We could collaborate, but people don’t understand what our skills are, and vice versa. Not unless we have conversations.”

Dr. Beck and her team of researchers have worked to uncover the “inattentional blindness” that impacts automobile drivers, the ways that visual attention and memory work or don’t work in various situations. With the aid of grants from the United States Department of Transportation (USDOT) and working through LSU’s University Transportation Center for the Gulf Coast Center for Evacuation and Transportation Resiliency, Beck and her students are able to study human responses in a driving simulator.

Housed in the LSU Department of Civil and Environmental Engineering, “The simulator consists of a full-sized passenger car––a Ford Fusion with no wheels,” she said, “combined with a series of cameras, projectors and screens to provide a high fidelity virtual environment. Realtime Technology Inc. manufactured the simulator,” Beck explained.

“Lately,” Dr. Beck told Ms. Hahne, “I’ve been working with faculty members in construction management and architecture on a grant submission to look at how architects and engineers communicate with each other around design. People from different disciplines have different conceptualizations of what they do. For example, they might cognitively perceive a building differently. So, how do we get them to communicate well with each other? It’s kind of meta, because the very thing we want to study— cross-discipline communication—is necessary during our collaboration.”

ASPPB Quietly Advances the EPPP-2 Plan with Jan 1 Launch

Last month the Association of State and Provincial Psychology Boards (ASPPB) quietly posted a message that the new Part 2 of the national licensing exam will officially launch on January 1, 2020. ASPPB officials first announced the new test, the EPPP-2, in 2017 as optional for its member jurisdictions. Then as resistance mounted, ASPPB’s Board of Directors decided that they would combine parts and make the entire exam mandatory, this coupled with a 100% fee increase. An outcry followed, then ASPPB backpedaled and made the roll-out optional––for the time being.

The upcoming January launch begins a “voluntary adoption” program, a carrot and stick for the controversial new test product, whose scientific basis is coming under more and more scrutiny.

The new test is optional––but whether it remains that way is highly doubtful, some say. In this article we review the behind-the-scenes decisions and interests impacting the test and those hoping to become licensed psychologists.

The National Exam

The current test, called the Examination for Professional Practice in Psychology or EPPP, is the national licensing exam required for candidates seeking a state psychology license.

ASPPB purchased the rights to the exam sometime around 2013, and since then the EPPP is the top money making product for the non-profit corporation. The EPPP-2, first priced at $600 then lowered to $450, would increase testing revenues for ASPPB by 75%, boosting the firm’s yearly income by $3,750,000.

The current EPPP is expensive at $600 plus administration fees. At a recommended 50th percentile cut-off, many candidates have to take the test more than once. The test contains 225 items, with a fourhour time limit. To compare, physicians pay $605 for an eight-hour exam, and Social Worker candidates pay about $250 for a 170-item exam.

On-going criticisms about the scientific validity, the practical usefulness of the new exam, and the possible discriminatory impact of the entire EPPP selection approach, appear to have done little to deter ASPPB from its goal.

In the latest of a list of scientists voicing concerns, researchers lead by University of North Texas professor Jillian Callahan, PhD, are set to publish a critique in the flagship journal of the American Psychological Association, The American Psychologist.

Based on a pre-publication draft of the article, the authors will be addressing the need for stronger scientific methods in the EPPP-2 development, the suitability of the test for its intended use, impact on minorities, and legal vulnerabilities.

ASPPB has gone through several roll-out efforts, first to persuade and encourage member jurisdictions to accept the new test, and then to force the new exam on states.  The current effort, “voluntary adoption,” includes a fee of only $100 for Part 2 of the exam for “Beta Candidates.” After the “beta exam” closes in 2021, this fee will be $300 for early adopters. After January 1, 2022, the fee increases to $450.

It is not clear what happens to those states who refuse to accept the EPPP-2 for its candidates. ASPPB officials note, “… At this time, it is optional for licensing boards (jurisdictions) to sign on to require the EPPP (Part 2 – Skills).”

Since ASPPB owns the tests, they will likely make the combined exam mandatory again, said one insider.

Only nine of 64 possible jurisdictions have joined in to “adopt” the additional exam so far, totaling only 14% of ASPPB “members.” These are Arizona, Guam, Nevada, Newfoundland and Labrador, and Prince Edward Island. Starting in February, Missouri has signed on and starting in March, Manitoba has signed on as early adopters. Finally, Georgia has agreed to be an early adopter starting November 2020.

Show Me the Money

The ASPPB is a private, nonprofit, 501(c) tax-exempt corporation located in Tyrone, Georgia. The company states its mission is to “Facilitate communication among member jurisdictions about licensure, certification, and mobility of professional psychologists.”  The “members” are about 64 regulatory boards from across the United States and Canada. These boards pay dues to be a member of ASPPB.

Tax records indicate that ASPPB grossed $6,686,286 in 2017; $5,973,841 in 2016; and $5,284,952 in 2015.

Total revenue for 2017 was $6,645,731 and for 2016 was $5,933,473.  For 2015, revenues were $5,254,097.

Over the last five years, from 2012 to 2017, total revenues have increased from $4,274,419 to $6,645,731 or 55%.

Assets and balances for 2017 were listed at $8,629,194. In 2016 assets totaled $8,462,637, and in 2015 totaled $7,712,532.

Of total revenues in 2017, ASPPB spent 2,268,203 on salaries and other types of compensation.  Records indicate they have 12 employees and the highest compensated is the CEO, Dr. Steven DeMers, at $270,784. Another four employees’  salaries fall between $134,771 and $111,823. Board members receive between $6,800 and $12,800.

All listed compensation for 2017 together totals $839,747.  An additional $1,098,096 was paid to Pierson Vue Minneapolis for exam administration.

To compare, in 2016 they listed 12 employees, again the most highly compensated was Dr. DeMers at $243,842. Others fell between $131,949 and $125,860.

ASPPB’s main income producing product is the national exam for psychologists, with revenue of $5,378,524 in 2017. This was 80% of total revenues for the year.

In 2016 exams and related fees grossed $5,296,421, or 89% of all ASPPB venues. In 2015 this amount was $4,775,213 and in 2014 it was $4,826,421.

The company has some other products, such as the Psychology Interjurisdictional Compact (PSYPACT), a service to coordinate psychologists working across state lines. This product generated $357,708 in 2017.

The organization spends liberally on the other activities including $1,169,743 on travel, $978,143 on other salaries and wages, $240,951 on other employee benefits, $375,418 on information technology, and $240,143 on conferences.

While many members are government officials, ASPPB does not follow open meetings laws. Deliberations and decisions are private. “If you are not a member or staff of an ASPPB Member Psychology Regulatory Board or an individual member, you are not eligible to access this section of our website,” they write. Their conferences are also closed and for members only.

This arrangement––where a corporation, formed of state board representatives, operates as a test publisher, with influence and special access to government officials, and also a captive market––seems ripe for conflict of interest. The Times asked one CPA to look over the information and he said, “Of course there is influence and COI.”

“With a lot of cash sitting on the balance sheet, the strategy is to maximize expenses,” said an MBA in reviewing the information for the Times. “The extra profits are likely to go into perks rather than price cuts,” he said.

Scientific Criticisms Continue to Mount 

In the latest of a series of criticisms, University of North Texas professor Jillian Callahan, PhD, and coauthors will address concerns about the scientific quality of the new exam in an upcoming issue of The American Psychologist.

In the pre-publication draft posted on the internet, the authors write, “… the EPPP Part 2 has yet to be subjected to a broader validation process, in which the suitability of the test for its intended purpose is evaluated. Implementation of the EPPP Part 2 before validation could have negative consequences for those seeking to enter the profession and for the general public …” And, “For jurisdictions implementing the EPPP Part 2, failure to gather and report the evidence required for use of a test in a forensic context may also open the door for legal challenges.”

Other critics have pointed to similar problems, one being the lack of the need for additional test hurdles.

“There is no evidence that the public is facing some sort of previously unheard of crisis in terms of safety from currently practicing psychologists,” said Dr. Amy Henke. In 2016, while serving as a director for the Louisiana Psychological Association, Henke took the lead to pass a Resolution opposing the new test. She pointed out that multiple checks on competency already exist for psychologists and appear to be working to protect the public.

“Trainees are already held to high standards through a variety of benchmarks,” Dr. Henke wrote in the Resolution, “including but not limited to: APA approval of doctoral programs, multiple practicums where competency is repeatedly assessed, completion of formal internship training (also approved and regulated by APA and APPIC), and supervised post-doctoral hours obtained prior to licensure. There is no evidence to suggest this is not sufficient for appropriate training.”

Henke and others pointed to existing multiple hurdles that candidates already must clear, including two year’s supervision, a written exam, oral exam, background check, and jurisprudence exam. Additionally, the law allows the board to require additional physical and psychological assessments whenever needed.

However, Dr. Emil Rodolfa, from Alliant University and also then a program developer at ASPPB, questioned if these standards are enough, saying that supervisors have “… difficulty providing accurate evaluations of their supervisees to others who may have to evaluate the supervisee’s competency.”

Henke also said, “I am particularly concerned about regulatory boards encroaching ownership of training standards. The goal of a regulatory board, in my personal opinion, is to provide the least restrictive amount of guidelines possible in order to protect the safety of the public.”

Rodolfa disagrees and said, “Licensing boards have a mandate to ensure that the professionals they license are competent. Competence is comprised of the integrated use of knowledge, skills, attitudes and values.”

Henke and others point out that the evidence from disciplinary statistics suggests that problems are very rare. For the most recent year with records, total reported disciplinary actions across the U.S. and Canada range from 159 to 222, with only nine to 17 licenses being revoked nationally. (See table.) Data from the ASPPB Disciplinary Data System: Historical Discipline Report show rates of disciplinary actions for psychologists to be consistently low. For an estimated 106,000 psychologists nationwide, the disciplinary rates remain around 1–2 per 1,000.

Louisiana’s rate is similar to the national average. For the year 2018–2019 there were two disciplinary actions. For the year 2017–2018 there were also two disciplinary actions. And for the year 2016–2017 there were three disciplinary actions and in 2015– 2016 there was one disciplinary action which is on appeal. And from 2014–2015 there was one disciplinary action.

Critics argue that a second test can have very little impact on such a low disciplinary rate.

Other criticisms center around the poor scientific quality of the test for making high-stakes decisions about candidates’ careers. In 2009 Brian Sharpless and Jacques Barber authored “The Examination for Professional Practice in Psychology (EPPP) in the era of evidence-based practice,” for Professional Psychology: Research and Practice.

“Professional psychology has increasingly moved toward evidence-based practice,” said the two authors. “However, instruments used to assess psychologists seeking licensure, such as the Examination for Professional Practice in Psychology (EPPP), have received relatively little empirical scrutiny.” They write, “… there is a paucity of criterion, predictive, and incremental validity evidence available.”

Dr. DeMers responded in the same journal attempting to clarify issues and giving some information not published. He agreed with some of the recommendations, according to the summary of his article.

Industrial-Organizational Psychologist Dr. William Costelloe, Chair of the I-O and Consulting Psychology Committee of LPA, told the Times, “… predictive validation studies must be conducted.” This type of research proof is not optional, he said. “Well conducted, scientifically based predictive validation studies must be conducted if the EPPP2 is intended to be used as a selection tool,” Costelloe said.

In April 2018, ASPPB CEO, Dr. Stephen DeMers, met with members of the Louisiana State Board of Examiners of Psychologists and representatives of Louisiana Psychological Association (LPA). After the meeting, Dr. Kim VanGeffen, Chair of LPA Professional Affairs, said, “Dr. DeMers acknowledged that, currently, there is not really any research on the validity of the EPPP-2,” VanGeffen said. “There do not seem to be any plans to obtain predictive validity nor does the EPPP2 committee believe that establishing this type of validity is necessary,” she said.

Dr. Marc Zimmermann, past LSBEP board member and Chair of the LPA Medical Psychology Committee, also attended. “He [Dr. DeMers] stated that there is no predictive validity,” said Zimmermann. “He also threw in that none of the national tests had predictive validity. He reported that content validity was the accepted standard because a test with predictive validity could not be constructed,” said Dr. Zimmermann. “… DeMers had the temerity to try to sell us something that does not meet the standard that psychological tests being published are expected to have.”

Other critics are concerned about the discrimination aspects of the EPPP. In a December 2018 study of New York psychologist candidates, Brian Sharpless, PhD, demonstrated that the EPPP has differing fail and pass rates for different races. Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07% and Asians had a failure rate of 24%. The difference is large enough for African-Americans and Hispanics to constitute discrimination.

The study, “Are demographic Variables Associated with Performance on the Examination for Professional Practice in Psychology (EPPP)?” is published in The Journal of Psychology: Interdisciplinary and Applied.

ASPPB’s Rough Roll-Out

Keeping its members cooperative with its product plans has been difficult for ASPPB. In 2016 the firm announced the EPPP–2 and told its members, licensing boards across the United States and Canada, that the use of the new test would be “optional.”

However, amid criticisms ASPPB did an about face in late 2017 and announced that the new exam would be mandatory after all, and be combined with the current test. And, the price would increase 100%, from $600 to $1200.

“The ASPPB Board of Directors, based on a number of factors, including feedback from our member jurisdictions and input from our legal counsel, has determined that the EPPP Part 2 is a necessary enhancement, and therefore an essential component of the EPPP,” wrote DeMers.

Objections mounted, mostly from student and early career psychologist organizations.

In July 2018, Dr. Amy Henke, now serving on the Louisiana State Board of Examiners of Psychologists (LSBEP), and LSBEP members of sent a blistering letter to the ASPPB Board of Directors, to the ASPPB members, and to the administrators of state psychology boards across the US and Canada.

Objections from Henke and others involved technical and scientific issues, but also the criticism that there is no problem that the new test needs to solve.

“LSBEP does not believe that data exists demonstrating that psychologists are not already held to high standards of competence,” they wrote. “The data that exists in terms of complaints and disciplinary actions toward psychologists also does not support the theory that competency problems abound in the field of psychology.”

The LSBEP also criticized ASPPB’s role and said that the decision is “…an overstep.”

“We are concerned that ASPPB has lost sight of their original mission, which from this board’s understanding was limited to facilitating communication between various member jurisdictions,” the LSBEP members pointed out, and that mandatory decisions on EPPP-2 do not fit this role but rather the role of a vendor providing a product.

Following this, in August 2018, ASPPB President Sharon Lightfoot, PhD, announced that the ASPPB Board of Directors voted to rescind their 2017 decision to mandate the second exam.

“We will continue toward launch of the Enhanced EPPP in 2020,” Lightfoot said, “and make it available to states and provinces interested in serving as early adopters. We are lifting the requirement for use of the Enhanced EPPP and are lifting the deadline for implementation.”

In December 2018, ASPPB decided to use a carrot and stick approach for the new exam. According to an October 24, 2018 letter from Lightfoot, if Louisiana chooses to decline the use of EPPP-2, individuals here will not be allowed to take EPPP-2 even if they wish to do so.

“Only applicants who are registered through a jurisdiction that has adopted the Enhanced Exam, and who have passed the knowledge portion of the exam, will be allowed to take the skills portion of the exam,” said Lightfoot.

Also, those test-takers from compliant states will pay reduced fees as a reward for early adoption of the additional exam, while those from late adopters will pay $450.

Sources at the Louisiana State Board of Examiners believe ASPPB is forcing states to use the EPPP-2 by prohibiting individuals from taking the exam in a state which does not require its use. They say this would make it difficult for psychologists who obtain licensure in a state which does not use the EPPP-2 to obtain licensure in a state which does use the EPPP-2. This policy, if adopted, is punitive, they say.

Is Resistance Futile?

ASPPB appears to be doggedly maintaining it’s commercial course, despite the mounting criticisms that the second exam is not scientifically well-constructed or actually needed for public safety. One source close to the state board said they see very little way to avoid having to accept the new exam eventually–– that efforts to stop ASPPB were futile.

If critics are correct, and the second exam is wasteful spending, the cost and additional regulatory hurdle will be born entirely on the backs of new psychology license hopefuls.

Dr. Kaplan Delights Audience of Psychologists and Nutritionists at Fall-Winter Workshop in BR

Dr. Bonnie Kaplan, clinical psychologist and winner of the 2019 Excellence in Complementary and Alternative Medicine award, delighted audiences at the Fall-Winter Workshop of the Louisiana Psychological Association, held November 1 in Baton Rouge.

Kaplan presented her work in nutritional mental health and laid out a convincing and interesting picture of how mental illness often involves nutritional deficiencies. LPA President, Dr. Alan Coulter, said, “Bonnie Kaplan, our keynote speaker, inspired us all with startling facts and practical recommendations.”

Nutritionists from the Louisiana Academy of Nutrition and Dietetics attended along with the psychologists from around the state. Monica McDaniels, MS, RDN, LDN, and board member on the Louisiana Board of Examiners in Dietetics and Nutrition, and Liaison to Louisiana Academy of Dietetics and Nutrition, also attended and was welcomed by Dr. Coulter.

Dr. Kaplan joined local experts including McNeese’s Dr. Linda Brannon, author of the popular textbook, Health Psychology, Dr. Susan Andrews, author of Stress Solutions for Pregnant Moms, and Dr. Charles Frey, IV, expert in chronic pain conditions, for the one-day event, “Advances in Health Psychology.”

Kaplan treated the audience to a strong theoretical argument about the prevalence of mental illness. Prior to 1750, she explained, only one percent of the population suffered from mental and emotional disorders. Now that figure has risen to over 20 percent. She said, “Is anyone still believing that this increase is solely due to more referrals and more sensitive diagnoses?”

She laid out the foundational theory and current research for the role of nutrition in the brain and the linkage and evidence for mental disorders in cognitive functioning.

Kaplan said that the role of nutrients in the brain is not a mystery and should be taught in elementary school or at least in medical school, but it is not.

She pointed out that 48% of the caloric intake of all Canadians, and likely even higher for Americans she said, is completely empty of nutrients. She asked the question, “What happens when we eliminate one half of the nutrients in our diets?”

Kaplan made the case that depression, irritability, social withdrawal, self-mutilation, inability to concentrate, and other mental health symptoms originate after six months of nutrient deprivation.

Her work revolves around multiple nutrients supplements and she made the case that magic bullet thinking it’s not helpful. Multi-nutrients are required as a foundation because the nutrients are synergistic and in work in combination. Past research has resulted in the misleading idea that single nutrients are not effective or less effective than desired. The situation is compounded by individual differences, which also can impact results.

Benefits of nutritional treatment for mental conditions especially include resilience to stress PTSD and ADHD, she explained. Kaplan reported on post-disaster research with victims of earthquakes, floods, massacres, and fires and how nutritional treatment was equal or better to other types of support.

Kaplan also spoke about the emerging field of nutritional mental health as it relates to inflammation, the microbiome, oxidative stress and mitochondrial function in patients. She encouraged the audience to think of epigenetic effects of nutrients and the importance of these elements in total health.

Her message included the idea that an individual presenting with a psychiatric disorder should be evaluated for suboptimal nutrition as a first step, and assured psychologists and the nutritionists in the audience that this is within the scope of practice for all those wanting a thorough review of the origin of the symptoms.

Dr. Kaplan lives in Canada and lectures internationally on the importance of improving nutrient intake to prevent and treat psychiatric symptoms. As a researcher, she questioned the longstanding paradigm of single nutrient research to establish the scientific basis for a broad spectrum micronutrient approach, eschewing industry funding in order to safeguard the integrity of her research. She has published widely on the biological basis of developmental disorders and mental health – particularly, the contribution of nutrition to brain development and brain function. She has also established two charitable funds in support of nutrient research, so far distributing $750,000 for clinical trials at universities in Canada, the United States and New Zealand.

Dr. Kaplan is a professor emerita in the Cumming School of Medicine at the University of Calgary. In the late 1990’s, she challenged the conventional model of psychiatric research by studying the role of nutrition in mental illness and brain disorders. She dealt with skepticism and attacks on her work for over fifteen years, resolutely meeting and exceeding calls for evidence. Her research provided the initial groundbreaking data showing that treatment with a broad spectrum of micronutrients, carefully formulated, could be used instead of psychotropic drugs to treat bipolar disorder and ADHD.

In 2013, Dr. Kaplan became one of the founding members of the International Society of Nutritional Psychiatry Research (ISNPR.org), an organization that emphasizes the importance of nutrition “above the neck.” In 2016, she retired from full-time academic work, but is still passionate about supporting young researchers who are studying nutrition and mental health. To help them do so, Dr. Kaplan has established two donor-advised charitable funds, one in Canada and one in the United States.

Endowed Chair of Psychology Established at University of Tampa Honoring Dr. Janet Matthews

In November, Dr. David Stern, University of Tampa Provost, announced the creation of the Janet R. Matthews Endowed Chair of Psychology, established by Dr. Lee Matthews, honoring his wife, Janet, who passed away in March.

According to the official announcement, the endowed chair is the first in the University’s history to be named after a UT alumna or alumnus, and the first endowed chair outside the Sykes College of Business. The endowment will be used to support a new faculty chair position in the Department of Psychology, within UT’s College of Social Sciences, Mathematics and Education.

Dr. Stern said that the creation of an endowed chair in psychology is a “wonderful addition to one of our strongest and most popular programs.”

“It will enable us to recruit an accomplished teacher-scholar whose work will enhance our reputation, attract students who want the opportunity to study and collaborate in research with the chair holder and will be a fitting honor for two of our alumni who have had nationally renowned careers in psychology,” Stern said.

The honor commemorates Janet and Lee Matthews meeting as freshmen at The University of Tampa (UT) in 1962, where they married as undergraduates and went on to become established and renowned clinical and academic psychologists. More than 55 years after meeting, Janet and Lee had planned to make a significant gift to UT and, in honor of Janet, established the Endowed Chair, said Stern.

Jack Geller, dean of the College of Social Sciences, Mathematics and Education, said the gift will substantively impact both faculty and our students in psychology.

“The Janet R. Matthews Ph.D. Endowed Chair of Psychology, along with the associated Drs. Janet and Lee Matthews Psychology Student Award, is by far the most comprehensive gift to date in the College of Social Sciences, Mathematics and Education,” Geller said.

In recognition of the gift, UT has also established the Drs. Janet and Lee Matthews Psychology Award, which will be given annually to an outstanding rising senior psychology major.   “Endowed chairs are among the most generous and critical gifts in higher education and support academic excellence,” said Ronald Vaughn, UT president. “And having it named after two esteemed psychologists brings prestige to the University and will certainly help us attract outstanding faculty.

Dr. Lee Matthews spoke at the ceremony. “This gift is to honor all of our former professors at The University of Tampa, who not only encouraged us, but set an example of the meaning of what it was to be an undergraduate teacher and mentor,” Dr. Matthews said. “And, the ‘non-academic lessons’ that Janet and I obtained such as supporting the local community, building
relationships and supporting future generations were all values that we learned at The University of Tampa.”

“Janet’s experience at UT resulted in her becoming a mentor to generations of undergraduate students,” Matthews said. “After 35 years of teaching, more than 37 of her former undergraduates had doctoral degrees in psychology, and at the time she became Emerita Professor, there were another 19 former students in doctoral programs. In addition, around 25 of her former students obtained other graduate degrees, in counseling, psychology, and social work.”

“Janet’s vision for the endowed psychology chair was so that future generations of UT students would have the same opportunities to be encouraged and mentored to pursue further education in psychology and/or related fields as was provided to us by our former professors,” he said. “It was not only academically, but the ‘nonacademic lessons’ we obtained such as volunteer involvement in the local community, a sense of responsibility, a ‘can I help you’ attitude, building relationships, and supporting future generations. I hope you can see that these were all values that we learned at the University of Tampa and still exist to this day in the current students and why we are donors.”

Dr. Janet Matthews, “cherished and esteemed” colleague to many in the psychology community, died March 31, 2019, in Metairie, Louisiana, after a struggle with cancer. The outstanding service and accomplishments of her life left an “indelible mark on her colleagues, her students, her profession, and her community,” said a message from the Louisiana Psychological Association upon her passing.

Dr. Matthews was a clinical and neuropsychologist, and held the diplomat in clinical from the American Board of Professional Psychology. She served as Full Professor at Loyola University, served on the Board of Directors of the American Psychological Association, and was named Distinguished Psychologist by the Louisiana Psychological Association, among many other achievements.

How Do You Save A Trillion Dollars?

by Julie Nelson

Imagine that a patient with psychosis is given nutrients. She improves her quality of life to such a degree that she no longer needs yearly hospitalizations, which, along with other expenses, amounted to $500,000 of medical and disability costs over a fiveyear period.

Dr. Bonnie Kaplan, Professor Emerita in the Cumming School of Medicine at the University of Calgary, and expert in the field of nutritional mental health, says this type of prevention might save lives and money. Kaplan publishes widely on the biological basis of developmental disorders and mental health – particularly, the contribution of nutrition to brain development and brain function. She will speak to Louisiana psychologists this November.

In her “Hospitalization cost of conventional psychiatric care compared to broad-spectrum micronutrient treatment,” in International Journal of Mental Health Systems, Kaplan points to dramatic savings for those patients that respond to nutritional interventions.

Nutrition is one of the innovations in illness prevention that has been neglected for decades. Other neglected approaches include behavioral treatments for lifestyle based illnesses, equally as cost-effective.

Prevention requires tools that are often unfamiliar because educational, behavioral, and social interventions, not usually considered to be part of medicine, may be most effective for many diseases,” said Hamilton Moses and co-authors in, “The Anatomy of Health Care in the United States,” in an article of the Journal of the American Medical Association.

While medical costs are driven by chronic disease, these costs are not due to an aging population, even though age is often cited as the cause. Moses shows that about 80 percent of the total health care cost is accounted for by individuals under 65, and relate to psychological, social and behavioral factors. The CDC estimates that three lifestyle factors––poor diet, inactivity, and smoking––account for 80 percent of heart disease and stroke, 80 percent of type 2 diabetes, and 40 percent of cancer.

“Behavioral intervention is the foundation for lifestyle medicine,” writes Dr. John Caccavale, author of Medical Psychology Practice and Policy Perspectives. “Of the top four classes of medical problems in America–– metabolic disorders, respiratory disease, cardiovascular disease, and mental disorders––physicians will have great difficulty demonstrating that they are improving patient health by utilizing medications as a first-line treatment for these classes of disorders,” writes Caccavale.

“I think wellness/prevention are areas where there is tremendous need in primary care,” said primary care psychologist Dr. Michelle Larzalere. But, rarely is this need addressed.

“For both physical and mental health, the need to work on active problems is often so high that wellness/prevention get shorted on attention,” Larzalere said.

“The health habits that most reduce the preventable component of the most prominent causes of morbidity and mortality in the US––for example, refraining from smoking, eating a healthy diet, getting regular exercise, and limiting alcohol consumption––are behaviors that psychologists can really impact positively. Unfortunately, at least in my experience, other needs are so great that it is hard to make time for wellness/prevention initiatives unless there is a specific plan put in place.”

Author of Health Psychology, Dr. Linda Brannon said, “The division of health into mental and physical health is a false dichotomy that we need to get over. I think that many providers address the presenting problem to the extent that they do not look beyond it.”

For decades now, psychological scientists have known that behavior is the key to costs. Larzelere explained that psychological scientists have repeatedly shown that resulting savings by including prevention behaviors can produce savings between 30 and 60 percent in medical use costs.

To put this in perspective, a 10 percent reduction in medical/surgery costs nationwide––by treating the mental or behavioral component––would exceed the entire current national mental health budget, she explained.

She is correct. According to federal agency, The National Health Expenditure Accounts, healthcare spending reached $3.5 trillion in 2017, for both public and private sources. This is $10,739 per person, and accounts for 17.9 percent of the Gross Domestic Product.

A 10% savings, as Larzelere suggests, would result in a savings of $350 billion. The U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration estimates treatment spending from all public and private sources to total $280.5 billion in 2020.

Estimating at the low end of the range of expected savings, a conservation goal of 30%, would come to $1 trillion.

Gains in quality of life and productivity would be added on top of that.

Some Current Problems

Is all this spending doing anyone any good?

A pattern of poor health outcomes and high costs reflects the country as a whole. The United States ranks 50th out of 55 industrialized countries in a measure of life expectancy and medical care spending, according to Bloomberg, who concluded the U.S. is the “least-efficient” health-care system in the world.

Louisiana typically falls at the bottom of the states in health ranking. In the most recent report from America’s Health Rankings, an annual analysis of the United Health Foundation, Louisiana ranked No. 50. The state ranked last in both behaviors and community & environment categories, No. 47 in clinical care, and No. 48 in health outcomes.

Louisiana has its challenges. Nearly 21% of the population of the state is at the poverty level or below, when only 12-1/2% of the citizens nationwide fall at this level. Over 41% of the citizens in Louisiana fall at 200% of the poverty level or below, compared to 29.75% nationwide.

Health is woven into a complex set of social and psychological behaviors, not a single cause. “Socioeconomic status is one of the most powerful predictors of all cause mortality,” says Dr. Chris Leonhard, health psychologist and Professor at the Chicago Professional School at Xavier. “New Orleans is a startling example of this,” Leonhard said. “Life expectancy at birth in the Tremé where the average household income in 2010 was about $26,000 is 55 years, while in Lakeview, the average 2010 household income was $75,000, and life expectancy at birth is 80 years.”

But money is flowing. The state paid $10.7 billion on behalf of about 1.9 million Medicaid recipients, according to the Louisiana Department of Health. During the fiscal year 2017– 2018, about 39.6 percent of Louisiana’s citizens were enrolled in the Medicaid program and payments were made on behalf of 1,876,908 recipients.

Using other federal data, this time from Medicare, a concerning picture emerges. According to an analysis by Blake Kruger and Jeremiah Brown, Louisiana spends the most on Medicare beneficiaries per capita than any other state. At the same time, Louisiana reports greater disparities in health status and death rates than other states.

Kruger and Brown investigated the associations between healthcare intensity, healthcare spending, and mortality in Louisiana Medicare beneficiaries. They defined healthcare intensity to be synonymous with the hospital care intensity index, a combination of inpatient days and physicians’ services.

The researchers found no association between healthcare intensity and spending. Nor did they find any association between spending and mortality.

“We also observed no association between health-care spending and age, sex, and race-adjusted mortality,” the researchers wrote. And, when they compared healthcare intensity to age, sex, and race-adjusted mortality, they could find no meaningful associations. Nor did they find that more spending made any difference in survival when adjust for smoking, inactivity, or obesity.

While the lack of an association between healthcare intensity and spending could indicate that outpatient care in Louisiana is becoming more highly utilized, the findings could also reflect that spending more on healthcare in Louisiana does not improve rates of survival or health outcomes for Louisianans.

Healthcare: Designed for You by Special Interests

The sheer size and complexity of the healthcare industry would suggest that innovations like nutrition or lifestyle therapy would be challenging, and new treatments even more unlikely because of the political power yielded by the industry giants. Over the last years the pharmaceutical industry, Blue Cross/Blue Shield, the American Hospital Association, and the American Medical Association were the some of the highest contributors to Congress.

Psychology and other groups have not been able to garner a place at the medical table to push for new methods. California Attorney David Ries of Human Capital Specialists tried to persuade federal Rule makers to include psychologists in the bonus plan for Accountable Care Organizations (ACOs) but failed. He told the Times that the final Rules were very disappointing, and said, “The broad recognition of the importance of behavioral health to overall wellness indicates that ACOs are unlikely to achieve their treatment objectives …”.

These special interests exert themselves not only through direct lobbying, but the medical-pharmaceutical-hospital-insurance industrial complex has a firm hold on the prices and services in this country, through the “CPT Codes” and the “Relative Value Scale Update Committee” or RUC. These groups decide what services are allowed and how much they are reimbursed.

The CPT codes, short for Current Procedural Terminology, control what services are allowed and reimbursed. The codes are created by three hundred “Advisors and Experts,” primarily from the American Medical Association’s House of Delegates, representing medical specialties, who work to influence an “Editorial Panel,” composed of representatives from medical societies, insurance companies and government. This panel conducts secret meetings to decide on which healthcare services are paid for, and which are not.

Dr. Tony Puente, Past-President of APA, was one of the two outsiders allowed to participate in the CPT process. “Essentially,” he said, “the CPT tries to divvy it up in a way that is theoretically and empirically, and diplomatically and politically, correct.” Participants must sign a strict AMA (American Medical Association) confidentiality agreement declaring, “I will not disclose, distribute or publish confidential Information to any party in any manner whatsoever.”

The CPT system is dominated by organized medicine. “Every seat at the table has a vested interest, mostly not supporting your proposed code,” said Dr. Travis Thompson, professor, psychologist, and leader in the Association for Behavior Analysis International. It took him and colleagues three years to muscle through codes for the treatment of autism.

While the CPT approval is a first leg of a long journey, another element of this behindthe-scenes influence is the panel known as AMA/ Specialty Relative Value Scale Update Committee, or RUC. Since 1991 members of the RUC establish the value or price for the CPT codes. Somehow this is not considered price-fixing.

To decide on reimbursement, 28 voting members of the RUC, representing medicine specialties such as anesthesiology, cardiology, neurology, neurosurgery, obstetrics, oncology, psychiatry, and so on, meet and decide how much each service is worth, and how much will be paid.

Control of the CPT and RUC have helped shaped health care toward high technology and high prices, less primary care, and no prevention.

A dramatic example of flawed decisions in the medical/pharma industrial complex is the opioid crisis. Twenty years after a marketing blitz convincing physicians that opioids were safe and effective, now one of the deadliest medical mistakes of modern times.

Despite the flood of legal opioids into the society, the CDC reported no change in pain that would meaningfully have ever driven the prescribing: “…there had not been an overall change in the amount of pain that Americans reported.”

The CDC did find that psychological and physical treatments for pain were beneficial, but these non-medical approaches are rarely integrated into treatment programs. Behavioral approaches were often the more appropriate treatment. “It is now widely accepted that pain is a biopsychosocial phenomenon,” clinical health psychologist and Past-President of the Southern Pain Society, Dr. Geralyn Datz said, and that must be treated as such.

Louisiana Follows the Leaders

Louisiana may have the most to gain from prevention and innovations, but there is a long way to go from where the state is currently.

In the most recent Louisiana Medicaid Annual Report, the top 10 provider types, ranked by payment, were first, hospitals, at $1.3 billion, and second, pharmacy, at $726 million. Dentists were third at $162 million, then mental health rehabilitation at $140 million, nurse practitioners at $115 million, and behavioral health rehabilitation agencies at $114 million. Distinct psychiatric hospitals were next at $76 million and freestanding mental health hospitals at $69.7 million.

In comparison, all other providers, which include chiropractic, personal care attendants, physical and occupational therapy, psychology, social work, and other services, totaled only $917,000.

In a 2018-2019 Combined Behavioral Health Block Grant Plan, published in late 2017, the state noted that the number of persons being served was only 3.29% of the estimated prevalence. The estimated number of children/youth with serious emotional disorders was 38,803 and only 1,370 had been served. The prevalence estimate for adults with serious mental illness was 192,019 and only 7,590 had been served.

Access to care and rates have been a problem nationally, with nearly half of all providers not offering services to Medicaid patients. Nationwide, Medicaid fees are about 72 percent of Medicare, which is about 80 percent of private pay. And this amount comes to an even smaller portion of what some practitioners charge in a fee-for-service setting.

In a list of “Specialized Behavioral Health Services CPT Code” and reimbursements, effective last year, the fee structures provide little in the way of reimbursement for health and behavior, or any clear mechanism for integrated services. The “health and behavior” services pay between $12 and $15 and are only listed for a psychiatrist, nurse/physician’s assistant, medical psychologist, or a psychologist. None were listed for clinical social workers or counselors.

Some codes and fees are listed for psychotherapy. Individual psychotherapy is reimbursed at $69.76 for psychiatrists for 45 minutes, $55.81 for nurse practitioners and physician assistants, $55.81 for psychologists, and $48.83 for social workers, counselors, and marriage and family therapists. And group therapy, a valuable therapy mode for many issues, is paid at only $23.23 to $18.58 and there is no reimbursement for the social worker or counselor listed on the current fee schedule. The low pay may account for why only about 130 psychologists are listed as providers on the current Medicaid rolls, and many of these are agency staff.

These misaligned incentives seem likely to impact those who have the least options to find better care in the private sector.

Finally, physician researcher Dr. Martin Makary has shown that medical error, unrelated to the illness or injury, is the third cause of death nationwide, following only heart disease and cancer deaths.

To conclude, Louisiana spends more than other states while there is no positive relationship between the money spent and health outcomes. Nationwide, the costs are staggering, while many chronic diseases are on the rise. Overall, the system looks to be more like a money-laundering scheme than a set of effective health services.

States like Louisiana with a high percentage of citizens at or near the poverty level, would benefit most from prevention and new, inventive treatments. “A bright new future of understanding, preventing, and treating mental disorders awaits us,” writes Bonnie Kaplan.

But just how long is that wait going to be?

Dr. Coulter, Dr. Reuther to Serve as President, President-Elect for Louisiana Psychological Association

Top: Dr. Alan Coulter at a conference. He is currently serving as President of the LPA. Below: Dr. Erin Reuther presenting. She is the current President-Elect

The Louisiana Psychological Association announced its newly elected officers to their Executive Council, who began serving last month. The 2019–2020 Council are Drs. Alan Coulter (President), Dr. Erin Reuther (President-Elect), and two new Directors, Dr. Christopher Parkinson and Dr. Amanda Raines. Returning officers are Dr. ValaRay Irvin (Secretary), Dr. William Costelloe (Treasurer), Dr. Bridget SonnierHillis (Director) and Dr. Kim VanGeffen (Director).

Dr. Alan Coulter will serve as the 2019– 2020 President. He is the Director of Program Area for the School of Allied Health Professions, Human Development Center, at LSU Health Sciences Center. He is the Director of Educational Innovations for the Human Development Center and LAS*PIC, and the Principal Lead for the TIERS Group. Dr. Coulter served on the President’s Commission on Excellence in Special Education, was a member of the National Monitoring Stakeholders Group, a recipient of Child Advocacy Award from the National Association of School Psychologists, and a past president of the National Association of School Psychologists.

Dr. Erin Reuther will serve as PresidentElect. She is a Pediatric Clinical Psychologist at Children’s Hospital-New Orleans and obtained board certification (ABPP) in Clinical Psychology in 2015. Dr. Reuther earned her doctoral degree from Louisiana State University in Baton Rouge where she focused on research in anxiety and cognitive-behavioral treatment with children and adults. She completed her clinical internship at the University of Florida-Shands Hospital in the child/pediatric track, where she further specialized in exposure with response prevention for OCD, CBT for anxiety, and health psychology working with inpatient and outpatient pediatric and adult clients with medical illnesses including gastroenterology disease, pediatric diabetes, and those preparing for surgery.

For her service, Dr. Reuther will focus on “… communication of all that LPA does to advocate for the profession, including direct coordination and communication with APA and national efforts, interacting with governmental agencies to educate and advocate for the profession, keeping psychologists in Louisiana informed of best practices, and organizing psychologists together.”

Newly elected were Dr. Christopher Parkinson and Dr. Amanda Raines.

Dr. Parkinson is a Clinical Psychologist with an emphasis in Health Psychology from Rosalind Franklin University of Medicine & Science. He completed his internship at the Gulf Coast Veterans Healthcare System and his postdoctoral residency in Health Psychology and Pain at the Southeast Louisiana Veterans Healthcare System. He currently holds a staff position at the SLVHCS as the Palliative Care Psychologist engaged in clinical care, program development, training, and research. He also serves as adjunct clinical instructor within the Department of Psychiatry and Behavioral Sciences of the Tulane University School of Medicine. He is the 2018 recipient of the LPA Early Career award.

Dr. Raines serves as a Clinical Investigator at the Southeast Louisiana Veterans Healthcare System and as Assistant Professor in the Department of Psychiatry at Louisiana State University. Her doctorate is in clinical psychology from Florida State University and her internship and residency was with LSVHCS. Her research focuses on identifying and empirically examining risk and maintenance factors as well as the development of novel interventions that can be used to treat and prevent anxiety and related pathology. She has published over 75 peer-reviewed manuscripts and was the Early Career Psychologist delegate to the 2019 Practice Leadership Conference of the American Psychological Association.

Dr. Bianchini (L) and Dr. Greve (R) receive awards from Dr. Chafetz. The two were honored last month for their distinguished contributions in psychological science by the Louisiana Psychological Association

Psychologists Honored for Distinguished Contributions

The Louisiana Psychological Association has named Dr. Johnny Matson, Drs. Kevin Bianchini and Kevin Greve, Dr. Susan Tucker, Dr. Julie Nelson, and Dr. John Sawyer for their outstanding contributions in the psychology community. The awards were announced at the 71st Annual Convention and Business Meeting of the Association, held June 14 and 15 in Metairie.

For the prestigious 2019 Distinguished Psychologist Award, the association named Dr. Johnny Matson of Louisiana State University (LSU). Dr. Matson is Professor of Psychology and Distinguished Research Master at LSU and a top cited scholar who has been named by Thompson Reuters as one of the “Most Influential Scientific Minds of our Time.”

Dr. Matson is an expert in autism, mental disabilities, and severe emotional disorders in children and adolescents, and has produced more than 700 publications and 38 books. He has authored the International Handbook of Autism and Pervasive Developmental Disorders, Practitioner’s Guide to Applied Behavior Analysis for Children with Autism Spectrum Disorders, Practitioner’s Guide to Social Behavior and Social Skills in Children, and many others.

He has served as Editor-in-Chief for Research in Autism Spectrum Disorders (Oxford England), Editor-in- Chief for Research in Developmental Disabilities (Oxford, England), and Associate Editor for Journal of Mental Health Research in Intellectual Disabilities (London). Among his many professional activities, Matson has been a guess expert on ABC’s 20/20, consulted with the Alabama, California, Georgia, Illinois, Iowa, Louisiana, Missouri, Virginia, and the US Departments of Mental Health. He has been a guess expert on CBS Eye-to-Eye and consulted for the DSM III-R Educational Testing Service. He has served on the President’s Committee on Mental Retardation, and consulted to the US States Department of Justice, and the US Department of Education.

The state psychological association named Kevin Bianchini, PhD, ABN and Kevin Greve, PhD, ABPP, as the 2019 recipients of the Contributions to Psychological Science Award.

The joint award acknowledged the two applied scientists and their roles in the systematic development of validity science based upon criterion-groups research, and the development of the rules for malingered pain related disability, explained Dr. Michael Chafetz, Awards Committee Chair. “Their scientific influence in our field has had considerable impact, and we are grateful for their outstanding contributions,” said Chafetz.

Dr. Kevin Bianchini is a board certified Neuropsychologist and Clinical Psychologist who has been in practice in Louisiana for 23 years. He was the Director of Neuropsychology for Bancroft NeuroHealth, a residential brain injury rehabilitation facility in Louisiana. He has remained involved in the rehabilitation of patients with acquired brain injury and pain throughout his career. He is actively involved in research and has published more than 75 articles in peer-reviewed professional journals on psychological factors and work related injuries, neurological rehabilitation, brain damage, neuropsychological assessment and symptom validity assessment.

Dr. Bianchini is a Diplomate of the American Board of Professional Neuropsychology. He holds adjunct faculty appointments at Tulane University Medical School, Department of Psychiatry and Neurology, and at the University of New Orleans, Department of Psychology. He is the managing partner of Jefferson Neurobehavioral Group, which has offices in Metairie, New Orleans, Baton Rouge, Lafayette, and Houston.

Dr. Kevin Greve has published more than 110 papers in peer-reviewed neuropsychology, psychology, and medical journals including papers on the assessment of the effects of traumatic brain injury and chronic pain. He is also the author of 10 chapters in edited books and has made more than 100 scholarly presentations at state, regional, national, and international conferences. Dr. Greve has served on the editorial board of The Clinical Neuropsychologist, Archives of Clinical Neuropsychology, and Assessment. He periodically serves as an ad hoc reviewer for several other journals.

He retired from full-time employment in the Department of Psychology at the University of New Orleans in May 2012, at the rank of University Research Professor after 21 years of service. He continues to be affiliated with the University of New Orleans as Emeritus Research Professor and holds a number of other academic positions. Dr. Greve is now in the full-time practice of clinical psychology and clinical neuropsychology. He conducts approximately 150 psychological evaluations a year typically related to traumatic brain injury, chronic pain, dementia, depression, post traumatic stress disorder, and the psychological effects of medical illness.

Dr. Susan Tucker is the 2019 recipient of the Award for Psychology in the Public Interest. Dr. Tucker, has been a key figure in reforms in the state correctional system. She is Psychologist and Assistant Warden at the Bossier Sheriff’s Office, where she has focused on treatment and research showing innovations that reduce recidivism and that are based in the fact that most inmates have a substance abuse problem but few get the right kind of treatment. She launched the Steve Hoyle Intensive Substance Abuse Program at the facility to offer intensive treatment, skill development, educational opportunities, and post release support and care. “We thank her for her outstanding work that is certainly in the public interest,” said Chafetz.

Her effective and creative treatment approach has achieved a significant reduction in recidivism, from an expected first year rate of 18 percent to only 3 percent. Tucker has earned state and national recognition for these achievements, including from the Vera Institute of Justice who said the program “…should be a model for the nation.” Dr. Tucker’s work was also honored by the Ash Center for Democratic Government and Innovation at the John F. Kennedy School of Government at Harvard.

Dr. Tucker was commended by Louisiana legislators for her work and the related cost savings of $15 million by earned “good time credits” through participation and successes in the psychological programs designed by Tucker. Legislators pointed to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs.

Julie Nelson, PhD, received the award for Distinguished Service in Psychology. She was cited for her service as LPA President and for her journalism and publishing of The Psychology Times. She is a consulting psychologist and owner of PSI, Inc. and serves the petrochemical industry in Gulf south region providing validity research and organizational development activities.

Dr. John Sawyer was named Early Career Psychologist. John Sawyer, PhD, ABPP is a board-certified neuropsychologist trained to evaluate children, adolescents, adults, and geriatrics. He is the Co-Director of the Cognitive Disorders and Brain Health Program at Ochsner Health System, where he has led several clinically-focused research projects aimed at using telehealth and electronic medical record technology to provide care to individuals with dementia and their care partners while limiting the need for disruption of routine for hospital or clinic visits. His work will be presented at the upcoming meeting of the National Academy of Neuropsychology.

The LPA Awards Committee is chaired by Dr. Chafetz and committee members include Drs. Kim VanGeffen, Beth Arredondo, and Brian Mizuki. LPA is the state affiliate of the American Psychological Association.

Dr. Tony Puente and Dr. Art Graesser Keynote Speakers at LPA Convention

Dr. Antonio Puente, the 2017 President of the American Psychological Association, and Dr. Art Graesser, Professor in the Psychology Department and the Institute of Intelligent Systems at the U. of Memphis and Honorary Research Fellow at Oxford, will lead off keynote addresses for 2019 Annual Convention of the Louisiana Psychological Association, to be held in June 14 and 15 at the Sheraton Galleria in New Orleans–Metairie.

Dr. Puente will deliver the Janet and Lee Matthews Invited Address on the opening day, a sentimental event following the death of community leader Dr. Janet Matthews in late March.

Puente, who will speak on “Making a Difference: Psychology’s Identity & Contributions in the Coming Decades,” has been at the forefront of changes in the profession, and the first and only psychologist ever to serve on the CPT committee, a key working group that helps define how healthcare services are structured through the codes and definitions. He lectures around the country about the issues affecting psychologists now and in the future.

Dr. Graesser is an expert in cognitive science, discourse processing, artificial intelligence and learning, who will deliver the Century Members Invited Address on Saturday, “Collaborative Problem Solving, Communication, and Comprehension in the 21st Century.”

Graesser is the lead author for “Advancing the Science of Collaborative Problem Solving,” the recent issue of Psychological Science in the Public Interest, published by the Association for Psychological Science.

Dr. Puente has presented his insider knowledge and thoughtful views about the sweeping changes in healthcare, tracking the payment changes such as those impacting issues of chronic diseases, care transition groups, team and interdisciplinary care, and population management. He has pointed to a “tsunai of change” before it started and follows the shifts to comprehensive care, uniformity, and integrative care, and the focus on performance.

Puente has said that the current and future paradigms include boutique services, prevention, integrative & multidisciplinary, and performance based reimbursement and a shift from federal to state.

For 15 years, Puente was the APA representative to the CPT system and was the person responsible for the adding the words, “Qualified Healthcare Professional,” to healthcare terms. For reasons that were very complicated and that he doesn’t fully understand, he ended up on the select, 17person team, CPT Editorial Panel. He was the only psychologist in that group, the only psychologist that’s ever been on the panel, and only the third non-physician that has ever been on the panel.

Dr. Graesser, who will deliver the Saturday keynote, says that collaborative problem-solving is a 21st century skill that is critical to efficiency, effectiveness, and innovation in the modern world.

Collaborative problem-solving is needed, not for routine work, or even team work, but for that event when a group must solve a novel problem where little or no plan for success exists and where team members are interdependent, each with different resources and knowledge, he has explained.

“CPS is an essential skill in the home, the workforce, and the community,” he writes, “because many of the problems faced in the modern world require teams to integrate group achievements with team members’ idiosyncratic knowledge. CPS requires both cognitive and social skills.” He and others note that we are in a new age, an age where rapid growth in information and technology is creating complexity in social, political, and economic systems. Everything is affected–– education, healthcare, big industry, small business and even family and home life. Problems are larger and more complex, they span disciplines, people and geography. What was once simple is no longer simple or routine.

Psychological scientists have made a distinction between shallow knowledge––the kind of cognitive information useful for solving simple, routine problems––and deep knowledge.

“Deep knowledge,” writes Dr. Art Graesser, expert in both collaborative problemsolving and artificial intelligence, “is achieved to the extent that learners comprehend difficult technical material, construct mental models of systems, solve problems, justify claims with evidence and
logical arguments, identify inaccurate information, resolve contradictions, quantify ideas precisely, and build artifacts.”

Deep knowledge can be trained into each individual, says Graesser. But another, and sometimes more efficient approach is to train individuals “… to better participate in collaborative problem solving so that groups can collectively master and implement deep knowledge.”

Ψ We Remember Dr. Janet Matthews

Dr. Janet R. Matthews, “cherished and esteemed” colleague to many in the psychology community, died March 31, 2019, in Metairie, Louisiana, after a struggle with cancer. She was 73.

Dr. Matthews was known to be a remarkably competent person in all of her many roles–– educator, mentor, leader, author, and professional psychologist. She gave generously of her time, knowledge, and experience to others, and attracted them to her with her knowledge, wit and wisdom. Her strength, kindness and common sense made her a rock of the community.

“Janet was a powerful force in my professional life from my time at Loyola until the present day. I will always carry her with me,” wrote Dr. Laurel Franklin Harlin, colleague of Janet’s.

Dr. John Robinson, now Professor Emeritus at Howard University in Washington, DC, said, “Janet was my supporter…. my colleague…….my mentor…….and my dear friend.”

“Janet was as an absolute giant in psychology,” wrote Dr. Christoph Leonhard, “not just in Louisiana but nationwide. I personally was lucky to benefit from her wise and warmhearted council on many occasions and will forever be indebted to her …”.

The outstanding service and accomplishments of Dr. Janet Matthew’s life have left an “indelible mark on her colleagues, her students, her profession, and her community,” said a message from the Louisiana Psychological Association.

Dr. Matthews was a clinical and neuropsychologist, and held the diplomat in clinical from the American Board of Professional Psychology. She served as Full Professor at Loyola University in New Orleans until retirement.

Her contributions included extensive professional service, including the Board of Directors of the American Psychological Association (APA) and president of multiple APA divisions and organizations. She was honored as a Distinguished Practitioner by the National Academy of Practice and earned both the Mentoring award from Section IV (the Clinical Psychology of Women) of the APA Division of Clinical Psychology and later the Lifetime contribution to clinical psychology award.

She was named the 2011 Distinguished Psychologist by the Louisiana Psychological Association for life achievements.

A Full Professor at Loyola University in New Orleans, she served the university in numerous areas, including the Faculty Senate, the Arts & Sciences Awards Committee, the Psychology  Department Curriculum Assessment Committee and the Advisory Board for University Honors Program. She was the faculty advisor for the Psychology Club and received her university’s award for Excellence in Advising.

Janet published five books including Introduction to Clinical Psychology published by Oxford University Press and Your Practicum in Psychology: A Guide for Maximizing Knowledge and Competence published by APA. She was a contributing author for 13 book chapters including
“Clinical psychology: Ethics of Therapists,” in The Handbook of 21st Century Psychology, published by Sage.

She has published over 80 journal articles, including her many contributions to Journal of Personality Assessment, Journal of Medical Education, Teaching of Psychology, Professional Psychology, and American Psychologist. And she presented over 100 professional presentations.

Dr. Matthews reviewed for PsyCRITIQUES and for Teaching of Psychology. She was a textbook reviewer for APA Publications, Harper Collins, Macmillian, McGraw-Hill, John Wiley, Harcourt Brace and others. She served as Consulting Editor for Teaching of Psychology.

Janet also served as an item writer for the Examination for Professional Practice in Psychology, and she worked on the Advisory Panel for the G. Stanley Hall Lecture Series at APA.

She served on the Advisory Board of the American Board of Assessment Psychology and was Associate Editor of Professional Psychology: Research and Practice.

Dr. Janet Matthews “loved professional service,” she said in 2009, explaining her long-standing involvement and depth of service in the American Psychological Association, punctuated by a position on the APA Board of Directors.

Janet also served as Chair of APA’s Board of Educational Affairs. She was President of Division 31, President of Division 2, and Division 12 sections IV & IX, and Secretary-Treasurer of Division 2 and Secretary of Division 12. She was a Fellow in APA Divisions 1, 2, 12, 29, 31, 35, 40, 42, and 52.

She was Chair of APA’s Committee Undergraduate Education, Board of Professional Affairs, Policy & Planning Board and Membership Committee, on the Council of Representatives for both Division 2 and Division 12, Ethics Committee for Division 2, Committee on Adulthood & Aging Division 42, and Fellows Committee Division 12, among many other contributions.

Janet was a member of Southwestern Psychological Association where she has served as President, President-elect, and as Secretary-Treasurer. She was a longtime member of the Louisiana Psychological Association, the Southeastern Psychological Association, the Association of Women in Psychology, the National Academy of Neuropsychology, and the International Neuropsychological Society. She was a member of the International Council of Psychologists, and the National Academies of Practice – Psychology, and member of the former New Orleans Neuropsychological Society, and served as president & secretary.

She served a full five-year term on the Louisiana State Board of Examiners of Psychologists, including chair.

At Loyola, Dr. Janet Matthews was able to do what she truly loved. “I love teaching,” she said in 2009. “Teaching is the focus of my university. I love mentoring and keeping in touch with my students. I can tell you where dozens of my former students are now as practicing psychologists, because we keep in contact– constantly.” Her love of teaching and mentoring was reflected in the number of her former students who remained in regular contact with her.

She held a strong belief in the value of learning psychology. In 2015 she said that psychology enriched students’ lives and that was why it was so popular. “The material can be applied to a myriad of life experiences,” she said. “Thus, they have immediate relevance rather than something which needs multiple layers and future application.” It was important for today’s young adults, she said, “Because it can be used to better understand their world.”

She is survived by her beloved husband of 53 years, Dr. Lee H. Matthews of Kenner, also a very accomplished psychologist.

“I got into psychology in a somewhat atypical way,” Janet once explained. “I married a psychology major.” As an undergraduate at the University of Tampa, set to study law, she became engaged to her husband and soul mate, Lee, a psychology major, and “that was it.”

Their lives together took them to Trinity University and then to Kent State, and three during the Kent State shootings. Janet did not know for hours if Lee was safe. After that, Janet packed them up immediately and the couple headed back to San Antonio and Fort Sam Houston. The next years took them to North Carolina and Pembroke State University, then to Old Miss for doctoral degrees in clinical psychology, internships at U. of Oklahoma Health Sciences Center, to a
teaching position at Creighton University, -and finally to New Orleans and Loyola.

Janet once explained how the couple always worked flexibly with the demands of dual careers, “That’s who we are. Its so much of what we do.” Janet and Lee wrote together on the subject: “A professional pair at the job market,” in American Psychologist, and “Husband/Wife psychologists describe life in post-hurricane Louisiana” in The National Psychologist. They authored their book Dual Career Couples, “Going shopping: The professional couple in the job market;” and a book chapter in Your Career in Psychology.

The Louisiana Psychological Association recently passed a resolution to honor Janet, writing, “…to acknowledge with gratitude the outstanding service and accomplishments of her life and the indelible mark she has left on her colleagues, her students, her profession, and her community.”

“… the members of the Council, and on behalf of the membership of the Louisiana Psychological Association, do hereby express sincere sorrow at the death of Dr. Janet Matthews whose loss leaves a void in our community and in our hearts, and extend posthumous tribute to her distinguished career of excellence and her commendable service to the community and her colleagues.”

Dr. Bill McCown, said, “Janet was indeed one of our few true legends. Her immense intelligence and wisdom were only equaled by her commitment to our profession–and by her heart. She always seemed to represent the best of what Psychology could be, even in our worst times. Perhaps her legacy needs to be for us to somehow come together more fully and rededicate our efforts towards the memory of this remarkable professional and human.”

“Janet was a friend and most respected colleague,” wrote Dr. Michael Chafetz. “She was a shining star in her leadership in the Psychology community as a teacher, researcher, mentor, noted author, organizer, leader, and just all-around Mensch!”

Janet was born September 2, 1944 in New York City, the daughter of the late Eugene Travis and Louise Baker Rogers. She is survived by her beloved husband of 53 years, Dr. Lee H. Matthews of Kenner, LA and their cat Judy as well as two cousins, Dr. Philip Rogers and wife Dr. Rima Salys of Boulder, CO, and Ms. Denise Rogers of Jackson, NJ.

The family invites you to share your thoughts, fond memories, and condolences online at www.lakelawnmetairie.com

Legislature to Convene April 8

The 2019 regular Legislative Session will convene at noon, Monday, April 8. Bills currently being prefiled include a variety of issues. Below are some of those with interests to psychologists.

HB 53 by Representative Moss sets requirements for youth suicide prevention, intervention, and postvention, in-service training for school employees and services available to
students. Proposed law requires the governing authority of each public and approved nonpublic secondary school that issues student identification cards to have printed on the cards the phone numbers for the National Suicide Prevention Lifeline hotline, the Crisis Text Line, and a local suicide prevention hotline. Proposed law is applicable to charter schools. Present law requires BESE to adopt guidelines for in-service training of school employees in suicide, and the board is to identify suitable programs and requires coordination with LDH in identification of such programs.

HB 193 by Rep. Bacala revises procedures relative to students investigated for making threats of violence or terrorism. The present law provides relative to a student reported to a law enforcement agency for a threat of violence or terrorism and provides for a judicial hearing on whether the student should undergo a mental health evaluation. Present law requires the law enforcement agency to file a petition with the appropriate judicial district court for a mental health evaluation. The proposed law instead provides that if the law enforcement agency determines that the threat is credible and imminent, it shall report it to the district attorney, who may file such a petition.

HB 211 by Rep. Horton limits the number of hours per day of certain behavioral health services reimbursable by Medicaid. “CPST services” means community psychiatric support and treatment services and “PSR services” means psychosocial rehabilitation services. The proposed law limits Medicaid reimbursement for behavioral health providers who furnish CPST and PSR services by providing that the following types of providers shall be limited to a maximum combined total of 12 reimbursable hours of CPST services and PSR services per provider, per day, regardless of the number of patients seen by the provider for those services: (1) Psychologists. (2) Advanced practice registered nurses. (3) Physician assistants. (4) Licensed clinical social workers. (5) Licensed professional counselors. (6) Licensed marriage and family therapists. (7) Licensed, certified, or registered addiction counselors.

HB 237 by Rep. Chad Brown prohibits discrimination by health insurance issuers in the individual market and small and large group market based on health status, from imposing any preexisting condition exclusion with respect to the plan or coverage. And the proposed law requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

HB 248 by Rep. Chad Brown provides for parenting coordinators in child custody proceedings. Present law (R.S. 9:358.1) authorizes the court to appoint parenting coordinators in certain child custody cases for one-year terms and apportion the cost between the parties. Proposed law authorizes the appointment of parenting coordinators prior to entering a judgment establishing custody and extends the initial term of appointment to up to two years. Present law (R.S. 9:358.2) prohibits the appointment of a parenting coordinator in family violence cases unless there is good cause shown. Proposed law instead allows the court to name a parenting coordinator when there has been domestic abuse or a history of perpetrating family violence if the parties consent after consultation with an attorney or domestic violence advocate. Present law (R.S. 9:358.3) provides the qualifications for parenting coordinators and requires three years post degree experience and 20 hours of continuing education every two years. Proposed law changes present law to five years post-licensure experience and 10 hours of continuing education and further extends the qualifications to include Louisiana attorneys.

HB 296 by Rep. Hoffmann provides for the training of peace officers and first responders with respect to interacting with Alzheimer’s and dementia patients. Proposed law requires the bureau of emergency medical services and the Council on Peace Officer Standards and Training to create a dementia training program in cooperation with the Department of Health. Provides for the creation of an initial training program and updates to the continuing education program.

HB 320 by Rep. Simon provides for student access to applied behavior analysis providers in schools. Present law prohibits a public school governing authority from denying student access to behavioral health service providers at school during school hours if requested by the student’s parent or legal guardian. Proposed law adds “applied behavior analysis providers” to present law definition of “behavioral health service provider” in order to allow access to such providers for students in school upon the parent’s request. In addition, proposed law requires public school governing authorities to make their policies available to the public, that behavioral health evaluations include recommendations for applied behavior analysis services. Provides that present law and proposed law shall not supercede present law relative to the licensing of behavioral health services providers or any regulation of the La. Dept. of Health related thereto or present law relative to the practice of behavior analysts.

HB 336 by Rep. Lyons adds certain school-based psychologists and social workers to those providers exempt from behavioral health provider licensing requirements––the Behavioral Health Services Provider Licensing Law. Proposed law retains present law and also exempts from behavioral health services licensure requirements an individual who provides school-based health services through a public school governing authority and who meets both the following criteria: (1) He is a certified school psychologist or a licensed master’s social worker. (2) He is enrolled in the La. Medicaid program under the Early and Periodic Screening, Diagnostic, and Treatment program.

HB 541 by Rep. Cox amends the Post-Conviction Veterans Mentor Program for incarcerated veterans. With regard to the purpose of the program, those veterans who are eligible and willing to participate in the program could serve as mentors for military to civilian transition services programs or to first-time offenders housed in a parish jail, and could serve as parish jail HiSET tutors. The secretary of DPS&C is to establish the Post-Conviction Veterans Mentor Program for incarcerated veterans, and adopt regulations and guidelines as it deems necessary for administration of the program. If the offender is granted parole and released, the offender shall be required to participate in all programs and services available to veterans that are determined to be necessary for the offender by the committee on parole and comply with other requirements specified in proposed law.

SB 19 by Senator Boudreaux. Present law authorizes the Louisiana State Board of Medical Examiners (LSBME) to regulate perfusionists, medical psychologists, genetic counselors, and polysomnographic health professionals. Proposed law provides that the LSBME, in addition to any other requirements established by regulation, shall require an applicant, as a condition of licensure to submit a full set of fingerprints, in a form and manner prescribed by the board, permit the board to request and obtain state and national criminal history record information on the applicant, and pay, in addition to all other applicable fees and costs, such amount as may be incurred by the board in requesting and obtaining state and national criminal history record information on the applicant.

SB 78 by Sen. Martiny. Present law provides for student behavioral health services to be provided during school hours if requested and paid by a student’s parent or legal guardian. Proposed law retains present law and adds “behavior analyst” to the definition of “behavior health provider” and “evaluator.” Further includes “applied behavior analysis” in
the definition of “behavioral health services.”

SB 107 by Senator Gatti proposes that any benefit payable to a sheriff or deputy sheriff which provides coverage for temporary or permanent disability to all sheriffs or sheriff’s deputies who suffer an injury or disease arising out of and in the course and scope of their employment shall include coverage for post traumatic stress injury. Proposed law provides that the following definitions shall apply to benefit payable to a sheriff or deputy sheriff: (1) “Post traumatic stress injury” means those injuries which are defined as “post traumatic stress disorder” by the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. (2) “Psychiatrist” shall have the same meaning as it is defined pursuant to present law. (3) “Psychologist” shall have the same meaning as it is defined pursuant to present law. Proposed law provides that any sheriff or deputy sheriff who is diagnosed by a psychiatrist or psychologist with post traumatic stress injury, either during employment or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his employment.

SB 139 by Sen. Gatti provides for the “Louisiana Healthy Workplace Law” which prohibits workplace bullying or harassment. Proposed law provides for the following purposes: (1) To provide legal relief for employees who have been harmed, psychologically, physically, or economically, by deliberate exposure to abusive work environment; (2) To provide a legal incentive for employers to prevent and expeditiously respond to abusive mistreatment of employees in the workplace.

SB 160 by Sen. Boudreaux provides for definitions regarding opioid addiction, its treatment and those healthcare professionals certified to conduct such treatment. Proposed law provides for the responsibilities of the licensing boards for nurse practitioners and physician assistants to become certified to administer medically-aided treatments for those addicted to opioids. Proposed law provides for the outline of treatment offered for opioid addiction through the program sanctioned by the U.S. Department of Health and Human Services.

Chafetz Named Outstanding 2019 Tulane Alumnus

The Tulane School of Science and Engineering has named Dr. Michael Chafetz for its prestigious Outstanding Alumni Award for 2019, announced last month by Dean Kimberly Foster and program director Candise Guedry. The selection was made by the Science & Engineering Board of Advisors Alumni Awards Committee, chaired by the Science & Engineering Board President Shep Perrin.

The alumni awards ceremony will be held on Thursday April 4, 6 PM – 8 PM in the Lavin-Bernick Center for University Life.

Michael Chafetz, PhD, ABPP, is principal and director of Algiers Neurobehavioral Resource, LLC. His research and clinical activities involve forensic matters, and he is frequently asked to provide neuropsychological expertise in state and federal courts in Louisiana and Texas. He has provided neuropsychological expertise in over a dozen capital cases, several other criminal cases, and in highly contested civil litigation matters.

Chafetz’s research has focused on the use of validity instruments in low IQ individuals and has led to numerous forensic publications in neuropsychology, forensic psychology, and child abuse journals. His book  Intellectual Disability: Criminal and Civil Forensic Issues was published in 2015 by Oxford University Press in the American Academy of Clinical Neuropsychology Workshop Series. This book has been used by neuropsychology colleagues across the country who have testified in capital cases involving validity issues in low IQ individuals.

His research came to the attention of U.S. Senator Tom Coburn in 2012, and Dr. Chafetz consulted with a senior staff member on Senator Coburn’s 2013 letter to then Social Security Commissioner Michael Astrue on the need to provide more accurate psychological assessment in Social Security Disability cases. The Chafetz research had shown that a high proportion of Social Security Disability claimants were feigning impairments. Through specific comparisons, it had become clear that the low IQ Social Security claimants who had failed validity tests were not false-positives who had been mislabeled as feigners, as similarly low IQ individuals motivated to appear normal easily passed these same tests. Senator Coburn was especially concerned that the Social Security Administration (SSA) had removed the use of these validity tests from the disability arena.

In their Congressional Response in September 2013, the Office of the Inspector General for Social Security affirmed the Coburn letter, essentially saying that it would be wise for SSA to further evaluate their policy on the use of validity testing in disability cases. This prompted SSA to call for an Institute of Medicine (IOM) committee to study the problem. The IOM published their favorable statement on the use of validity testing for SSA disability cases in 2015, the same year that Chafetz was the lead author on an American Academy of Clinical Neuropsychology sponsored paper giving guidance to SSA on the same topic.

Dr. Chafetz is a Fellow at the National Academy of Neuropsychology. He served on the Board of the American Academy of Clinical Neuropsychology from 20122017. He was the 2012 Distinguished Psychologist for the Louisiana Psychological Association and the 2018 LPA awardee of the Contributions to Psychological Science award. He provided consultation and expertise for the Association of Administrative Law Judges in their Grievance against SSA in 2016. Through his work on illness-deception, he has been invited to speak at various state psychological associations, APA, NAN, AACN, administrative law judge conferences, and internationally at the Karolinska Institute in Sweden.

National Psychology PAC to Host Louisiana Senator Cassidy in Washington DC

Dr. Lacey Seymour, Louisiana Federal Advocacy Coordinator and Past-President of the Louisiana Psychological Association, announced in late February that the national Psychology Political Action Committee has chosen Louisiana Senator Bill Cassidy as its honoree for 2019.

Senator Cassidy will be the guest of honor at a dinner to be held March 10, in Washington, DC, coinciding with the leadership conference for the American Psychological Association.

“Senator Cassidy has been a supporter of mental health legislation on both a federal and state level,” Dr. Seymour told psychologists in a recent letter. “Since his election, Senator Cassidy has championed legislation that addresses access to mental health care for our most vulnerable citizens by removing barriers to care.”

Among his achievements, Senator Cassidy worked to design and pass the “Helping Families in Mental Health Crisis Reform Act of 2016” and first advocated mental health reforms while he served in the House of Representatives. In 2015, he introduced mental health reform legislation that became the template for the Mental Health Reform Act of 2016. He helped strengthen accountability at HHS by creating an Assistant Secretary of Mental Health and improved interdepartmental activities related to those with serious mental illness.

The measures Cassidy promoted have helped access to services through integration of primary and behavioral care, and helped establish grants that provide screenings for young children at risk of developing a serious mental illness. Cassidy’s efforts helped ensure that federal funded programs are evidence based and use best practices.

Working with a bipartisan group of senators, he introduced in 2017 the Treat and Reduce Obesity Act to require Medicare coverage for intensive behavioral therapy provided by psychologists and other mental health professionals.

Last year he worked to get a resolution adopted in the Senate recognizing suicide as a serious public health problem and expressing support for September as National Suicide Prevention Month. Also in 2018, he co-sponsored the COMBAT Act to provide certified opioid treatment services to be covered by Medicare.

“This fall,” said Seymour, “Senator Cassidy hosted the Louisiana Mental Health Summit, bringing together federal, state, and local leaders to discuss and promote the implementation of proven methods to improve mental health care in Louisiana and the country. He is currently raising awareness of the impact of dyslexia and mental health issues on incarcerated individuals in an effort to decrease recidivism,” she said.

“Dr. Cassidy has been an ardent champion for mental and behavioral health in Congress and was the lead Senate sponsor of major mental health reform legislation enacted in 2016. Last year he led the fight to preserve Medicare payment for psychological and neuropsychological testing services,” said Seymour.

“I am thrilled that the Psychology PAC has chosen to honor Senator Cassidy,” Dr. Seymour said. “It is a privilege to have a congressman from our state chosen to be recognized with this prestigious honor. It is important that we work together to represent psychologists across our state in showing our gratitude for the work Senator Cassidy has done and to elicit support for the important work in mental health that is yet to come.”

Senator Cassidy is a physician, specializing in gastroenterology. Before entering politics, he co-founded the Greater Baton Rouge Community Clinic, providing free dental and health care to the uninsured. He began his political career in 2006 in the Louisiana State Legislature and won election to the U.S. House of Representatives in 2008, before becoming a Senator in 2014.

Dr. Seymour is heading up a group of psychologists who will attend the fundraiser on March 10, to show support for Cassidy in his re-election bid. Dr. Seymour is asking for contributions and involvement by Louisiana psychologists. She can be reached at LaceyLSeymour@gmail.com

Interview with Dr. Heather Pedersen Brain–Health a Growing Concern as Boomers Age

The Center for Disease Control (CDC) announced their State and Local Public Health Partnerships to Address Dementia, The 2018- 2023 Road Map, as part of the CDC Healthy Brain Initiative. The Road Map helps chart a course for state and local public health agencies to prepare their communities to deal with the ever expanding need for brain-health concerns.

According to CDC and their Healthy Brain Initiative, there are at least five to six million people currently living with age-related dementias in the U.S. This translates into one out of every six women and one out of every 10 men, who live past the age of 55. As the population increases, and more Baby Boomers reach older ages, these numbers are expected to rise.

The CDC wants to stimulate changes in policies, systems, and environments. They convened experts who developed 25 actions for public health leaders to promote brain health, better care for people with cognitive impairment, increased attention to caregivers, and efforts to build public health capacity.

“Dementia is a devastating condition that impacts millions of people annually,” said Dr. Heather Pedersen, a board certified clinical neuropsychologist at the Algiers Neurobehavioral Resource, LLC, located in New Orleans.

“Dementia,” she said “is a generic term that refers to when an individual is experiencing cognitive problems––such as memory loss, difficulty with logic, or trouble with language––to such an extent that they cannot manage aspects of daily life.”

According to the CDC, while there are various forms of dementia, around 70 percent of cases are due to Alzheimer’s and the next most common type is vascular dementia. African Americans, Hispanics, and women are particularly at risk of developing Alzheimer’s and other dementias. More than 95% of people with dementia have one or more other chronic conditions. And, one in three Alzheimer’s caregivers report their health has become worse due to care responsibilities.

“There are many diseases and conditions that can lead to dementia,” Pedersen said, “with Alzheimer’s disease being the leading cause of dementia. Per the CDC, the number of adults with Alzheimer’s disease is expected to triple over the next 40 years. Alzheimer’s disease and other dementiacausing diseases impact individuals, families, friends, caregivers, health-care agencies, and communities in wide-ranging ways,” Dr. Pedersen said.

According to the CDC, they seek to promote the use of effective interventions and best practices to protect brain health, address cognitive impairment, and help meet the needs of caregivers for people with dementia. They aim to improve inclusion of healthcare quality measures that address cognitive assessments, improve the delivery of care planning to people with diagnosed dementia, and improve outcomes.

Another of the CDC’s goals is to educate public health professionals about the best available evidence on dementia, including detection. CDC Director Robert R. Redfield, MD, said. “Early diagnosis is key to helping people and their families cope with loss of memory, navigate the health care system, and plan for their care in the future.

“The importance of early detection and intervention for many dementia processes cannot be overstated,” Dr. Pedersen explained. “Some medications are more effective when started earlier and compensatory strategies can often be put into place so as to be more useful in the long run. However, in order to be able to put these interventions into place, an individual has to first be diagnosed with dementia.”

What are some of the benefits of early diagnosis of dementia?

“Early diagnosis of course allows for individuals to begin appropriate medication earlier on in the process, as there are medications for certain diseases, like Alzheimer’s, that can slow down the disease process. But, early diagnosis also allows for individuals and their families to begin to adjust and adapt their lives in ways to make good years last as long as possible,” Dr. Pedersen said. “By making slight changes to schedules, home management, or other systems, individuals can maintain independence for as long as possible.”

Can neuropsychologists’ findings help with treatments and/or treatment planning?

“Absolutely,” Pedersen said. “By helping with an accurate diagnosis, neuropsychologists can also help other providers make informed decisions about treatment options. Neuropsychologist evaluations also help by determining individual’s cognitive strengths and weaknesses,” she said.

“By maximizing strengths to compensate for weaknesses, neuropsychologists can help make suggestions to make tasks more efficient or easier to complete.”

Neuropsychologists can often help caregivers better understand issues for their loved ones and better cope with and adjust to the caring role.

“It is often very helpful for caregivers and other family members to understand the basics about what is causing the cognitive problems or dementia,” Dr. Pedersen explained. “As part of the evaluation process, clients and loved one’s are provided with feedback about what is likely causing their cognitive problems. We spend time discussing the causes, prognosis, treatments, and other strategies that might be helpful in maximizing the client to live their best life.”

In today’s medical culture, the approach is often the quick screening rather than the comprehensive assessment. Is this a concern? A quick screening may not be able to determine the cause of an individual’s cognitive problems, Pedersen explained.

“A comprehensive assessment is critical in the accurate diagnosis of dementia. There are many conditions that can masquerade as dementia and given the permanent, progressive nature of some dementias, it is vital that one isn’t falsely diagnosed,” she said. “There are many different diseases and conditions that cause dementia, some of which are treatable and some of which are not. Depression and some metabolic conditions can ‘look like’ dementia, but in fact are treatable conditions.”

The American Academy of Neurology (AAN) has recommended neuropsychological testing since 1996 for patients who may have experienced a traumatic brain injury, a stroke, Parkinson disease, multiple sclerosis, a neurotoxic exposure, or dementia. Neuropsychological testing “is particularly valuable in distinguishing between normal aging and mild dementias,” they AAN noted.

Dr. Pedersen, who earned her PhD from the University of North Dakota, and completed her postdoctoral fellowship in clinical neuropsychology at the Memphis Veterans Affairs Medical Center and UT Health Sciences Center Consortium, is licensed in Louisiana, Minnesota, and Arizona.

Among her training and research achievements, Dr. Pedersen has co-authored “The next major neuropsychological and neuropsychiatric breakthrough: Alzheimer’s disease,” for the Handbook of Neuropsychiatry Research. She also co-authored research on concussions for American Journal of Alzheimer’s Disease and Other Dementias, and co-authored “Later life health optimism, pessimism, and realism: Psychosocial contributors and health correlates,” published in Psychology and Health.

“Each person who walks through my door is a unique constellation of traits, strengths, and weaknesses, who is looking for some sort of assistance,” Dr. Pedersen said. “I find it very satisfying to come along side each client to work with them in their treatment goals.”

“That process of collaborating with my clients is a very enjoyable process for me,” she said.

New Study Shows EPPP Can Discriminate Against African-Americans, Hispanics

A new study demonstrates that the Examination for Professional Practice in Psychology, known as the EPPP, has differing fail and pass rates for different races, and that the difference is large enough for AfricanAmericans and Hispanics to fall into “disparate impact” discrimination, as described in Title VII of the Civil Rights Act of 1964.

The study, “Are demographic Variables Associated with Performance on the Examination for Professional Practice in Psychology (EPPP)?” is published in The Journal of Psychology: Interdisciplinary and Applied, October 22, 2018. The author, Brian Sharpless, PhD, is associate professor at the American School of Professional Psychology. To collect data, he used a Freedom of Information Act (FOIA) to request test results and demographics from the New York state board of psychology for its candidates.

Dr. Sharpless gathered data on 4892 applicants and first-time EPPP takers. He obtained “Records of all doctoral-level psychology licensure applicants from the previous 25 years with EPPP scores, gender, ethnicity, and degree type were requested.”

He found that Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07% and Asians had a failure rate of 24%.

New York uses converted scores for the EPPP, from 0 to 100, with 75 as the passing score.

The differences in minority candidates’ selection rate violates what is known as the “four-fifths rule.” This means that the pass rate for minority groups fails to reach at least 80% of the pass rate for the majority group.

Typically, when a test has this impact, industrialorganizational psychologists exercise very careful methods to set cut scores, seek additional validity or research, and investigate possible replacements with less disparate impact.

Dr. Sharpless wrote, “… given the ethnic performance discrepancies and limited validity evidence, additional psychometric investigation of the EPPP appears warranted (e.g., in terms of criterion and predictive validity testing),” Sharpless also wrote. “Further, it is recommended that the EPPP Step-2 should undergo similar assessments prior to implementation.”

“Additional empirical attention should be devoted to the cut score (i.e., a scaled score of 500, roughly corresponding to 70% correct).” He noted that “…the determination of the ‘passing’ score is one of the most important, yet difficult, psychometric tasks in testing …”

And he noted that “… passage of the EPPP carries serious professional ramifications for applicants. There appears to have been limited discussion of the theoretical and/or empirical justifications for the current cut off score in the publicly available EPPP literatures…”

While regulatory boards aren’t employers, the principles of employee selection may apply. Employers using tests often fall under Title VII of the Civil Rights Act of 1964 which prohibits employers from using neutral tests or selection procedures that have the effect of disproportionately excluding persons based on race, or other protected characteristics. Test
New Study Shows That EPPP Can Discriminate,developers and users must demonstrate that the use is necessary and related to relevant characteristics.

Industrial-organizational psychologists, who help companies show business necessity when a company is paying for employee performance, with a legitimate business goals of seeking top performing employees, may point out that regulatory boards do not have this same business necessity.

Regulatory boards concern themselves with the lower end of the distribution of performers, those likely to exhibit gross negligence or in some way endanger the public. Denying a license to a candidate because they perform at the average range, or even below average, might conceivably violate that candidate’s property rights and have no impact on safety.

Dr. Sharpless noted similar issues. “… if the EPPP is found to lack acceptable validity evidence (or if a decision is made to not submit the measure to further empirical testing), then it will remain open to charges of being a potentially arbitrary barrier in an already protracted path to professional independence…” Sharpless wrote.

He notes the lack of Blacks and Hispanic psychologists and suggests that these issues could be related.

And, he said, “… psychologists have always been at the forefront of developing tests of individual differences with valid and reliable scores…” And he wrote, “A case could be made that psychology gained recognition, as well as a more coherent professional identity, through such testing efforts. Therefore, it only makes sense that we submit our own licensing exam to these same high levels of scientific scrutiny.”

Brian A. Sharpless is an associate professor at the American School of Professional Psychology at Argosy University, Northern Virginia. He received his PhD in clinical psychology and MA in philosophy from Penn State University and completed post-doctoral fellowships at the University of Pennsylvania.

To link to the article go to: https://doi.org/10.1080/00223 980.2018.1504739