Category Archives: News Stories

Several Bills Focus on Occupational Regulation

A number of bills are being reviewed by lawmakers that concern the occupational boards, regulations, supervision, and other matters.

Representative Julie Emerson’s bill to review and control occupational licenses was adopted on the House floor and is now HB 748. The bill was heard in committee and reported by substitute in a 14 to 0 favorable vote. It is scheduled for floor debate on April 5.

The proposed law creates the office of supervision of occupational boards “office” within the office of the governor. According to the digest, the measure causes a review of occupational licenses and reports to the legislature and attorney general so to recommend the legislature enact legislation that may do any of the following: (a) Repeal occupational regulations; (b) Convert the occupational regulations to less restrictive regulations as defined in R.S. 37:42; (c) Instruct the relevant licensing board or agency to promulgate revised regulations reflecting the legislature’s decision to use a less restrictive regulation. One aim is to increase economic opportunities, promote competition, and encourage innovation.

SB 494 is pending and would establish the Occupational Licensing Review Act. The measure is proposed by Senator Thompson and similar to HB 748. The proposal creates the office of supervision of occupational boards with the office of the governor and provides for repeal of occupational regulations and less restrictive regulations, similar to HB 748. Proposed law provides for interpretation of statutes and rules Proposed law provides for interpretation of statutes and rules so that occupational regulations shall be construed and applied to increase economic opportunities, promote competition, and encourage innovation; that any ambiguities in occupational regulations shall be construed in favor of working licensees, aspiring licensees, and persons aspiring to work in regulated occupations, and that the scope of practice in occupational regulations is to be construed narrowly so as to avoid its application to
individuals who would be burdened by regulatory requirements that are only partially related to the goods and services they provide.

Senator Fred Mills’ bill to restructure health care boards remains pending in the Senate Health and Welfare Committee.

He has paired down last year’s effort to restructure the health care boards, and is proposing SB40 which contains several of the components of last year’s SB75, including adding a consumer member to each board and removing the professional associations from
the board’s nomination process.

SB40 would transfer the extensive list of boards, commissions and agencies to the Louisiana Department of Health (LDH). Included will be the boards for psychology, counselors, social workers, and the other 22 healthcare boards. These are the boards for dentistry, nursing, optometry, pharmacy, medicine, physical therapy, speech-language, addictive disorders, vocational rehab, behavior analyst and others.

The proposed law adds at least one consumer member to any board that did not previously have one and provides standardized eligibility criteria of consumers to serve on any board.

Present law provides for professional trade associations and other entities to select and submit nominees to the governor for board appointment.

The proposed law opens board nomination eligibility to any member licensed by the board who is interested and eligible. Proposed law requires the board to send notice to its licensees to fill board positions and submit the names of those interested and eligible to serve to the governor for board appointment.

Representative Connick has put forth HB 372 aimed to also address aspects of the anti-trust matters surfaced by a 2015 Supreme Court decision.

The measure would create the Occupational Board Compliance Act. Policies provided in proposed law, are intended to ensure that occupational licensing boards and board members will avoid liability under federal antitrust laws. If passed the law would create the Occupational Licensing Review Commission to be composed of the governor, the secretary of state, and the attorney general or his respective designee. Establishes the governor as the chairman of the commission and the secretary of state as the secretary.

HB 372 would establish the commission’s responsibility for active supervision of state executive branch occupational licensing boards controlled by active market participants to ensure compliance with state policy in the adoption of occupational regulations promulgated by an occupational licensing board, according to the digest.

The present law provides for licensing of behavioral health services providers by the Louisiana Department of Health. The proposed law adds definitions for certified mental health professionals, community psychiatric supportive treatment (CPST), mental health rehabilitation, and psychosocial rehabilitation (PSR) to the definition provisions of present law.

If passed the law would be named the “Behavioral Health Services Provider Licensing Reform Law.” At this point is would focus on qualifications for providers for CPST and PSR for Medicaid reimbursement.

“Proposed law provides that only a certified mental health professional or an individual who is not certified, but who met present law criteria for providing PSR services and did so on a full time basis for a year prior to August 1, 2017, may provide PSR services and be reimbursed by the department for providing the services.

“Proposed law provides that CPST shall be provided by a certified mental health professional with a master’s or doctorate in counseling, social work, or psychology from an accredited university or college.

“Proposed law provides that in order to receive Medicaid reimbursement for CPST or PSR services, the provider agency, certified mental health professional, or other individuals allowed by law, shall have a national provider identification number, be fully accredited by a nationally recognized accrediting organization, be licensed by the department, and be credentialed by the Medicaid managed care organization in which the provider intends to submit claims for services.”

CPST is a face-to-face intervention with the individual present. A minimum of fifty-one percent of CPST contacts must occur in community locations where the person lives, works, attends school, or socializes. “Mental health rehabilitation” means outpatient behavioral health services which are medically necessary to reduce the disability. These services are home- and communitybased and are provided on an as-needed basis. PSR is designed to assist the individual with compensating for or eliminating functional deficits and interpersonal or environmental barriers associated with mental illness.

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Suicide Prevention Act Passes House Vote

HB 148 by Representative Reid Falconer, the “Louisiana Suicide Prevention Act,” was reported favorably in a 9 to 0 vote out of committee on March 22 and passed the House this week in an 85 to 0 vote.

The initiative requires the office of behavioral health to ensure that administrators of all healthcare facilities licensed by LDH and that all healthcare professionals licensed by any Louisiana board or commission have ready access to informational resources and technical assistance necessary for implementation of the zero suicide initiative.

The office of behavioral health is to examine and coordinate the use of existing data to identify priority groups of patients, improve the quality of care for persons who are suicidal, and provide a basis for measuring progress in the ongoing operation of the zero suicide initiative.

According to the Legislative Fiscal Office, the proposed law will increase SGF expenditures for the LA Dept. of Health, Office of Behavioral Health by an indeterminable amount. Cost estimates provided by OBH indicate that expenditures are anticipated to total approximately $748,950 in FY 19 with a phaseup of to approximately $792,900 in FY 20 before leveling off at approximately $790,000 in FY 22 and in subsequent years.

OBH reports a need for 2 positions for expanded personnel associated with the initiative. The 2 positions contemplated are a program manager ($123,617 salary and related benefits annually) and a program monitor ($108,015 salary and related benefits annually) for annual total costs of approximately $232,000. Personnel expenditures will be prorated for 9 months in FY 19, which will total $174,000. A majority of the projected recurring expenditure increases ($438,000), will be undertaken by the Human Services Districts and Authorities that will implement the initiative at the local level statewide via interagency transfers from OBH, reported the Fiscal Office.

If passed, the proposal will require a “State Suicide Prevention Plan” to be created and office of behavioral health shall collaborate with criminal justice and health systems, including mental health and behavioral health systems, primary care providers, physical and mental health clinics in educational institutions, colleges and universities, community mental health centers, advocacy groups, emergency medical services professionals, public and private insurers, hospital chaplains, and faith-based organizations to develop and implement all of the following, which shall be included as elements within the state suicide prevention plan.

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Magistrate Says Lack of Federal Jurisdiction in Cerwonka v LSBEP

Magistrate Judge Carol B. Whitehurst of the U.S. District Court Western District has recommended that a federal lawsuit against the state psychology board filed by Dr. Eric Cerwonka, be dismissed based on lack of federal jurisdiction.
In August 2017, Cerwonka filed a lawsuit in federal court against the Louisiana State Board of Examiners of Psychologists (LSBEP) alleging violations of his Constitutional rights. This followed a July 2017 ruling by 19th Judicial District Court Judge Michael Caldwell negating a February 2017 LSBEP disciplinary decision against Cerwonka, on grounds that the board’s methods “… violated the Constitutional rights of Dr. Cerwonka.”

In Whitehurst’s “Report and Recommendation,” filed March 26, she finds that the Louisiana State Board of Examiners falls under the umbrella of state immunity provided by the Eleventh Amendment.
Dr. Cerwonka and his attorney have fourteen days from service of the Report and Recommendation to file specific, written objections.

In Whitehurst’s Report, she wrote, “The Eleventh Amendment bars an individual from suing a state in federal court unless the state consents or Congress has clearly and validly abrogated the state’s sovereign immunity,” wrote Whitehurst. Citing Fairley v. Louisiana, (5th Cir. 2007), a lawsuit involving the state medical board, Whitehurst wrote, “A suit against a state agency or department is considered a suit against the state under the Eleventh Amendment.”

Whitehurst recommends that the motion to dismiss for lack of federal jurisdiction be granted, and that the plaintiff’s claims against the Board be denied and dismissed without prejudice. (In a civil case, dismissal “without prejudice” is a dismissal that allows for refiling of the case.)

Since Whitehurst recommends dismissal on jurisdictional grounds, she explained that she makes no recommendation on the LSBEP’s request for a dismissal based on failure to state a claim.

“When a district court finds it lacks subject matter jurisdiction, its determination is not on the merits of the case, and does not bar the plaintiff from pursuing the claim in a proper jurisdiction,” she wrote.

In the Report, Whitehurst stated that the party asserting jurisdiction bears the burden of proof for a 12(b)(1) motion to dismiss, such that, “the plaintiff constantly bears the burden of proof that jurisdiction does in fact exist.”

“The plaintiff’s argument that the Board’s financial autonomy prohibits the Board from being a state agency is not persuasive,” wrote Whitehurst.

“A legally sufficient complaint must establish more than a ‘sheer possibility’ that plaintiffs’ claim is true. Id. It need not contain detailed factual allegations, but it must go beyond labels, legal conclusions, or formulaic recitations of the elements of a cause of action.”

“Although acknowledging there is no jurisprudence directly finding that the Louisiana State Board of Examiners of Psychologists, which was created by the Louisiana Department of Health and Hospitals (“LDHH”), is a state agency, defendant argues the Board is similar to the Louisiana
State Board of Medical Examiners, which was also created by the LDHH, and which has been held to be a state agency entitled to Eleventh Amendment immunity. Because the Board argues it has not waived its immunity from suit, it asserts the plaintiff’s claims against it are barred.

In Fairley, the Fifth Circuit recognized that the Louisiana State Board of Medical Examiners is a state agency for purposes of Eleventh Amendment Immunity.

“The Louisiana State Board of Examiners of Psychologists argues that the statute creating its existence and the statute creating the Board of Medical Examiners are similar, with similar powers and rights being granted to each Board, and with each Board being subject to the provisions of La. Rev. Stat. 36:803.4. Each board is created within the Louisiana Department of Health and each is given oversight over their respective fields.”

Attorney for Cerwonka, Brown Sims attorney Mr. L. Lane Roy, had argued in the “Opposition of Plaintiff to Defendant’s Motion to Dismiss,” filed on November 30, 2017:

“An important case for this Court’s consideration on the issue of the Eleventh Amendment Immunity is the United States Supreme Court decision in the matter of North Carolina State Board of Dental Examiners vs. Federal Trade Commission, 135 Sup. Ct.1101(2015). While the North Carolina State Board case involves as one of its principal issues federal anti-trust laws, one of the main topics decided by the court was whether the State of North Carolina possessed Eleventh Amendment immunity from application of the federal law and its being subject to suit before the federal courts. In a lengthy discussion, the court found that North Carolina did not possess Eleventh Amendment immunity.” […]

“Here, there is absolutely no showing whatever that the State of Louisiana had active control over the Board in this matter and in fact, the exact opposite is correct.”

“The State has virtually no control of this agency as shown by the decisions that its rendered in this matter, not involving a state person but private attorneys hired for the persons, private investigators, private members of the community acting as judges at the hearing before the Board, private employees acting as persons, though illegally, who made decisions on interim suspension without a hearing whatsoever,” Mr. Roy wrote.

Counsel for the LSBEP, Attorney General Jeff Landry, signed for by Jeremiah Sams, Assistant Attorney General, wrote that, “Under the Eleventh Amendment of the United States Constitution, an unconsenting state is immune from any lawsuit seeking monetary damages or equitable relief brought in federal courts by her own citizens or by the citizens of another state …” And, he wrote, “The Board is an agency of the State of Louisiana.”

In another section of the Attorney General’s “Motion to Dismiss,” Sams wrote, “Alternatively, Plaintiff has failed to state a claim against the Board under 42 U.S.C. §1983, as the Board is not a “person” under the meaning of §1983.

“To state a claim under §1983, a plaintiff must establish that a person, acting under color of law, deprived him of some constitutional right.

“State agencies and state officials acting in their official capacity are not ‘persons’ within the meaning of the statute, and it is a well settled point of law that a state is not capable of being sued under 42 U.S.C. § 1983, as the state is not a “person” under 42 U.S.C. §1983.34” […] “Accordingly, Plaintiff’s §1983 claims against the Board should be dismissed.”

Cerwonka also filed an amendment to the complaint adding Ms. Jaime Monic, current Executive Director, to the lawsuit.

The matter of state supervison of the boards has been a topic for some legislators since the 2015 Supreme Court decision. In 2016 Senator Fred Mills put forth a measure creating the Task Force on Meaningful Oversight to help address compliance with the North Carolina v. FTC and minimize exposure to antitrust claims. In the Task Force’s report, in this case having to do with antitrust laws, authors wrote, “a board must satisfy two prongs in order to claim state action immunity.” One involves the “inherent, logical, or ordinary result of the exercise of authority delegated by the state legislature.” The second prong is “active supervision,” satisfied by having a state review and approval of board’s policies. Mills put forth legislation in 2017 to help remedy the supervision issue and also this year, in his SB 40.

According to a report by the Louisiana Legislative Auditor published in 2017, individuals can file general liability claims against the state because Louisiana waived sovereign immunity in the 1974 Constitution. State law limits damages to $500,000 for personal injury and wrongful death claims. However, there is no cap on economic damages or medical expenses, according to the report, “Types and Costs of General Liability Claims, Office of Risk Management.”

Between 2010 and 2015 the state paid over $42M in Constitutional and Civil Rights violations, the Auditor reported.

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What Happened to Beverly Stubblefield?

by JNelson

In 2016 a respected member of the Louisiana psychology community and past member of the state psychology board, Dr. Beverly Stubblefield, entered a plea agreement of guilty in a Medicare fraud case. Dr. John Teal, a Louisiana medical psychologist, was also charged. Both Stubblefield and Teal pleaded guilty to one count of Conspiracy to Commit Health Care Fraud, surrounding the high profile case against Mississippi psychologist Dr. Rodney Hesson and his business partner, Gertrude Parker, an occupational therapist and Hesson’s mother.

Hesson and Parker owned and operated regional companies, Nursing Home Psychological Service and Psychological Care Services. They marketed to nursing homes in Louisiana, Mississippi, Alabama and Florida, and built on requirements in federal regulations, 42 CFR 483.20, a law requiring nursing home residents be evaluated every three months in a “…comprehensive, accurate, standardized, reproducible,” manner.

At the trial, Hesson said that his company served up to 72 nursing homes and that the company was “…inundated with referrals.” He said that at times the company had to cap how many people could be seen.

Physicians ordered the assessments and nursing homes needed them. According to the regulation, evaluations were to include information about “cognitive patterns,” “mood and behavior patterns,” “communication,” and “psychosocial well-being.”

Hesson designed a service that paired each contract psychologist with an assistant, called a “clinical coordinator.” The total units/hours billed was a sum of both the psychologist’s and the assistant’s procedures. The companies billed Medicare between three and eight hours of CPT code 96101, psychological testing, for which Medicare reimbursed an average of $80 per unit/hour.

Hesson testified he typically employed between 23 and 26 psychologists and between 18 and 20 clinical coordinators. One of the prosecutors stated that the firm has assessed 9,000 individuals and was one of the top billers for psychological testing in the country.

Contract psychologists were paid a flat fee of between $90 and $100 per case. Psychologists would go to a nursing home and see as many as 10 residents in a day, or more, along with the assistant.

In an interview with Dr. Stubblefield, she explained that the evaluation process was standard and set by the company. The evaluation included six components with tests, behavioral observations, review of chart information, and meeting with staff. She explained that the goals were often to “… get them off meds or increase functioning.”

In his testimony, Dr. Teal said the coordinator would complete information for the psychologist’s review and then prepare the “formalized report”
which the psychologist would review and edit.

The prosecution argued that the service was fraudulent because it was a screening, because it was not medically necessary, and because the time the psychologist provided in face-toface client contact was exaggerated and inflated.

At trial Hesson testified that Medicare had audited the design of the service in 2011 and the approach passed. He said, “When I was audited, we were billing 96101 and — 36 claims is a lot of claims, to my knowledge, to get in an audit,” he said. “Within those claims, we were billing 96101. Within those specific records, it was evident that there was an assistant…,” he said. “Under the diagnostic tests provision, all diagnostic tests are assigned a certain level of supervision,” he said, reading from the Medicare rules.

The defense attorney asked, “Did you rely on that in making your decision whether you could bill 96101?”

“Yes,” Hesson said, referring to Federal Code 42 CFR 410.32 for diagnostic tests. Under this regulation psychological testing is payable if “… personally furnished by a clinical psychologist, or “Furnished under the general supervision of a physician or a clinical psychologist.” And under Louisiana law, a psychologist may utilize assistants but billing must “… not be in the name of an assistant.”

Despite the fact that the evaluations were ordered by medical doctors, the Government prosecutors said that the defendants’ actions were fraudulent, “… by scheduling repeat tests for the same nursing home residents at three- to fourmonth intervals, notwithstanding Medicare’s stipulation that re-testing is not medically necessary unless it is required for a diagnosis or continued treatment.”

“The prosecution insisted that we were doing screening instead of testing,” Dr. Stubblefield explained to the Times, “and therefore we committed fraud and everyone who was compliant with the procedure was a conspirator. That is the gist of things.”

The Government presented other issues at trial, producing several individual cases where it was clear that cognitive testing had to be discontinued because the resident was too disabled to participate.

One attorney asked Dr. Teal, “Looking back on it, sir, was there a benefit to these patients for the tests you were performing on them?”

Teal said, “In general, that kind of testing could be helpful once perhaps, but the benefit of continuing to do that repeatedly over time the way we did it is limited and certainly questionable as far as how clinically useful it could be.”

The prosecution also presented charts where, based on Medicare data, large numbers of hours had been billed for a single psychologist. According to Hesson’s testimony this was due to locum tenens, where one doctor bills under another.

Also presented by the prosecution at trial was the Medicaid fraud case against Hesson from Mississippi that occurred in 2012. He had pleaded guilty to billing patients on one day when the services had been delivered on another day.

Dr. Stubblefield said that Hesson had described this as a bookkeeping error, but “Now, I’m not so sure,” she said.

Charges against all four defendants were elevated to “conspiracy,” which carries some of the harshest legal treatment that Government prosecutors can bring to bear on defendants, through laws that allow pre-trial and pre-conviction seizing of assets and property.

“Conspiracy” laws originate from prosecution of individuals in organized crime and terrorists. “Federal prosecutors can, and should, use civil forfeiture to enhance criminal cases and further the Department of Justice’s (Department) goal of effective law enforcement,” writes Craig Gaumer in the U.S. Attorney’s Bulletin, “A Prosecutor’s Secret Weapon: Federal Civil Forfeiture Law.”

Based on documents, prosecutors seized all assets from Hesson’s company, personal bank accounts, cash and real estate, including the family home, immediately once charges were formal.

According to Stubblefield, her home and accounts, including her retirement accounts, were seized. She said her elderly father placed a second mortgage on his home and that money allowed her to hire an attorney.

“I didn’t have the money to fight it,” she told the Times. “I never had the chance to defend myself against the conspiracy charge. Federal courts cost two or three times as much as other courts. It takes $100,000 just as a start. I only had $75,000.”

The “conspiracy” charge may also relate to areas of harsh treatment. “I never had my Miranda rights read to me,” she said. “I didn’t even know I’d been indicted until a client saw it on the news and contacted me.”

The FBI came to her office and she didn’t know why. In an email to this reporter, she wrote, “The FBI interviewed me without stating why they were there and I was under the assumption that they were there regarding a high profile rape case who was a former patient because my office administrator said that someone was coming in regard to that case.”

It appears that Stubblefield and Teal may have been included in the indictment because of their friendships with Hesson and Parker, and because both accepted company titles for a time.

Teal accepted the title of “clinical education coordinator.” Stubblefield accepted the title of “Clinical Director,” when Hesson asked her to in 2012. This was after Hesson pleaded guilty to Medicaid fraud in Mississippi and was not allowed to work with Medicaid/Medicare. She resigned from that role after five months but she said, “It was too late.”

“I was flattered,” she wrote, “but the position was just a ‘figurehead’ title. I really didn’t get to direct anything but was set up to be the ‘bad guy’ and ‘fall guy’ if things didn’t bode well. Emails to that effect were interpreted by the prosecution as conspiring to commit fraud by encouraging a psychologist to bill as they have done for NHPS…”

Overall, Stubblefield worked contract for the Hesson companies, part-time for about five years. She was paid $448,000 total or $89,000 per year. Her restitution is over $2M.

Teal worked full-time, for four and ½ years. He testified that he made approximately “… $200,000 a year, some of the years–– one year as much as $300,000.” His restitution is over $3M.

According to testimony neither had information regarding the billing procedures. Both testified that they relied on Hesson and Parker to understand the laws regarding the CPT codes. Stubblefield told the Times, “I never saw the billing. I didn’t want anything to do with that part of the service. I was preparing to retire. I wanted everything simple.” “When I went to work for in NHPS I was an employee because I didn’t want to file any claims or do any ‘business’ paperwork. I just wanted to be a psychologist.”

In their plea agreements, Stubblefield and Teal agreed that they: 1) documented services that had been “… in fact, provided by unqualified persons working with them; 2) administered tests to residents who were non-responsive; 3) billed for time when they were not present.

Dr. Stubblefield was sentenced to serve 30 months for 1 count. Two counts were dismissed. Her sentence began April 25, 2017. She must pay restitution of $2,181,378 and upon release at least $200 per month. Payee is Medicare.

Dr. Teal was sentenced to serve 24 months for 1 count. Two counts were dismissed. His sentence also began April 25, 2017. He must pay restitution of $3,505,137 and upon release at least $200 per month. Payee is Medicare.

Gertrude Parker was found guilty of three counts and sentenced to 84 months for Count 1 and 60 months for Count 2, to be served concurrently. She began serving September 2017. Ms. Parker is to make restitution of $7,313,379 and $200 per month. Payee is Medicare.

Dr. Hesson was found guilty of three counts and sentenced to 120 months for Count 1 and 60 months as to Count 2, to be served concurrently. He began serving September 2017. He is to make restitution of $13,800,553 and $200 per month. Payee is Medicare.

Beverly was sentenced to 30 months incarceration at the Federal Prison Camp in Aliceville, Alabama. This, she explained to the Times, was not the hardest part of what has happened to her.

“The worse part is losing my psychology license,” she said. “This…the time, this is just something to be dealt with, something I had to do.”

In February Dr. Stubblefield wrote a letter to past-president of the American Psychological Association (APA), asking that APA take a stand for sentencing reform in regard to white collar, first offenders.

“In regard to white collar crime,” she wrote, “there are many innocent professional women her who have been charged with the ill-defined ‘castnet’ of conspiracy, when the only thing they’ve done was to comply with company procedures or file data given to them. If they went to trial, the sentence was automatically doubled,” she wrote. “Losing one’s license and livelihood is punishment enough, but the Department of Justice seizes or places a lien on everything owned including your home and retirement accounts because judges set unrealistically high restitution of millions of dollars never received by the people charged. The people charged are primarily MDs, PhDs, CPAs and NPs who have licenses, Medicare/Medicaid numbers, and ethical standards or responsibilities, not office managers or company owners who may be the ones submitting faulty claims.”

Dr. Teal said at trial, “I had concerns. I look back on all that time with tremendous regret because of exactly what you just said. I should have. I should have done due diligence and called the Medicare hotline or hired a lawyer and asked him. I should have done those things. Lord knows, I wish I had.”

At trial Dr. Stubblefield, after she was surprised to hear the number of hours billed under her name, was asked how she felt to testify against Ms. Parker.

“Dismayed, disgusted, betrayed, still in shock about everything, remorseful about the whole situation, regretful that I ever went to work for another agency.”

How does she cope? “I use my cognitivebehavioral skills,” she said, “and prayer. I couldn’t get through this without my faith.”

Were you naïve? “Absolutely,” she said.

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Senator Fred Mills Renews Efforts to Restructure Boards

Senator Fred Mills has paired down last year’s effort to restructure the health care boards, and is proposing SB40 which contains several of the components of last year’s SB75, including adding a consumer member to each board and removing the professional associations from the board’s nomination process.

SB40 would transfer the extensive list of boards, commissions and agencies to the Louisiana Department of Health (LDH). Included will be the boards for psychology, counselors, social workers, and the other 22 healthcare boards. These are the boards for dentistry, nursing, optometry, pharmacy, medicine, physical therapy, speech-language, addictive disorders, vocational rehab, behavior analyst and others.

SB75 would also remove repealed and obsolete cites and references and categorizes those entities statutorily created within the department.

The proposed law adds at least one consumer member to any board that did not previously have one and provides standardized eligibility criteria of consumers to serve on any board.
Present law provides for professional trade associations and other entities to select and submit nominees to the governor for board appointment.

The proposed law opens board nomination eligibility to any member licensed by the board who is interested and eligible. Proposed law requires the board to send notice to its licensees to fill board positions and submit the names of those interested and eligible to serve to the governor for board appointment.

Last year, SB75 included sweeping changes in the disciplinary processes of the boards, his measures fueled in part by the 2015 anti-trust decision of the Supreme Court, and Mills’ own views that boards have “virtually no detectable oversight.”

Mills’ previously explained to the Times, “… there has to be
a place for consumers and practitioners to go when they feel they haven’t gotten a fair shake from their boards.”

Perhaps the most dramatic change Mills proposed in 2017, missing from this year’s SB40, is in disciplinary hearings. Last year the Senator wanted to remove final adjudicatory hearing authority from the boards and transfer that to the division of administrative law. The Division of Administrative Law will preside over hearings in which a final action of the licensee is being pursued by the board.

For the 2017 failed proposal by Mills, “… final adjudicatory proceedings shall be transferred to the division of administrative law, that administrative hearings shall be held in the administrative law location closest in proximity to the licensee, and that venue for appeal of the administrative law judge’s ruling shall be the district court for the parish in which the licensee is domiciled.”

Another of Mill’s efforts in 2017 aimed to restrict board investigations to a one-year time limit. “If a board does not issue notice of an adverse or disciplinary action within one year from the date upon which a sworn complaint is received or, if no sworn complaint is received, within one year from the date the board voted to commence an investigation, the matter shall be dismissed. The one-year period shall be prescriptive.”

Senator Mills’ 2017 effort was stopped in the House Health & Welfare Committee after passing the Senate. At the committee meeting Mills said that there had been some misinformation and he clarified that the measure did not affect the duties or powers of the boards, or the scope of practice that some members of the boards had believed. He said that the changes are not new ideas. “Forty-four states have Administrative Law Judges for disciplinary hearings,” he said. “We don’t want you to be the sheriff, the DA, and the judge.”

“We revised the Ethics laws in 2008 and said that, as a body, we don’t want the sheriff and
the DA to be the judge and the executioner,” said Mills. “This bill is for the little man and the little woman. If you have to go in front of a full hearing, you should not go in front of a hearing that are those who’ve been investigating you.”

One source told the Times that psychology board members helped derail Mill’s 2017 effort. And sources said other boards also helped derail SB75. Ironically, in about that same time, a District Judge found that the psychology board’s investigation methods to be violations of due process.

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“Hoffman Report” Defamation Suit Continues in Washington, DC Defendants Claim Free Speech Rights; Plaintiffs Point to Leaks as “Actual Malice”

A dispute involving the ramifications of the “Hoffman Report,” a document prepared by the Chicago attorney David Hoffman and commissioned by the American Psychological Association (APA), during conflicts over the role of military psychologists, APA ethics decisions, and human rights policies in APA, was filed in Washington D.C. in late August, immediately following dismissal by an Ohio judge who said the case was not in his jurisdiction.

Motions put forth in the Ohio pleadings and in the new D.C. litigation indicate that the defense attorneys may be positioning themselves to argue that the report falls under free speech protections.

The defamation lawsuit is being brought against David Hoffman, his law firm, and APA, by retired Colonels and psychologists Morgan Banks, Debra Dunivin and Larry James, and also two psychologists who are former employees of the APA, Drs. Stephen Behnke and Russ Newman. The lawsuit alleges reckless disregard for the truth and false statements in a 2015 Hoffman Report.

In December, defense attorneys filed a motion seeking the Court to compel arbitration based on the employment agreements of Drs. Behnke and Newman with APA. Hoffman’s law firm, Sidney, also filed a request that Behnke and Newman arbitrate the dispute with Hoffman’s firm.

In both Ohio and D.C., the defendants filed motions asking for dismissal based on free speech protection laws, called Anti-SLAPP laws. “SLAPP” or “strategic lawsuit against public participation” are lawsuits without merit which are aimed to intimidate or silence free speech, according to the Public Participation Project.

The defense wrote, “Here, APA’s publication of the Report constitutes an ‘[a]ct in furtherance of the right of advocacy on issues of public interest.’ Id. § 16-5501(1). The publication of the Report is a ‘written . . . statement’ that APA allegedly made ‘[i]n a place open to the public or a public forum.’”

The motion to dismiss also says that the Plaintiffs are public officials or limitedpurpose public figures, calling for the higher standard of not only false statements but of the level of “actual malice,” to be met.

The Plaintiffs filed a Motion for Discovery, saying that they are entitled to limited discovery and that the Plaintiffs are private citizens and plaintiffs should not have to show “actual malice.” AntiSLAPP laws narrow discovery provisions.

The Plaintiffs’ attorneys say that the report was given to James Risen, a New York Times reporter, prior to review and publication, and these actions are evidence of actual malice, said the attorneys.

Mr. Hoffman was hired by APA in 2014 to review interactions between military psychologists, APA officials, and the Bush administration. Then APA president Dr. Nadine Kaslow sought to resolve ongoing accusations that APA was involved in supporting unethical behavior by military psychologists.

The accusations were voiced by human rights activists and psychologists, and had been outlined in several publications, including a book by New York Times’ journalist, James Risen, Pay Any Price.

Hoffman said that communications of a 2005 APA members’ task force amounted to “collusion” with military psychologists and therefore with the Department of Defense. A media furor commenced following publication of the Report, splashing the issue of “torture” and APA across national news outlets. APA paid Hoffman $4.1 million for the Report, according to sources.

In February 2017 plaintiffs filed the defamation lawsuit in Ohio, alleging how the expansion of the investigation was hidden, how Hoffman over-relied on the accusers and aligned with the accusers’ goals, and that Hoffman failed to consider and follow evidence that contradicted the final conclusions.

The attorneys also allege that APA failed to adequately review the Report, failed to give Plaintiffs an opportunity to respond to allegations, and failed to respond to evidence of the mistakes and errors in the Report.

The Complaint states, “The false light in which the Plaintiffs Behnke, Dunivin, and James have been placed would be highly offensive to the reasonable person,” and has caused mental anguish, emotional distress, and “severe personal and professional humiliation and injury to their reputations in the community – reputations they have built over many years.”

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State of Louisiana, BRF, Ochsner Health System, LSU Sign Letters of Intent

Ochsner/LSU Jointly Plan to Operate Health System in Shreveport and Monroe

On December 19, the Governor announced that the State of Louisiana, the Board of Supervisors of Louisiana State University (LSU) on behalf of Louisiana Health Sciences Center Shreveport (LSUHSC-S) and the LSUHSC-S Faculty Group Practice, the Biomedical Research Foundation and Ochsner Health System announced that they have signed Letters of Intent to create a new, long-term, Public Private Partnership agreement in Shreveport and Monroe.
Under the proposed agreement, LSU and Ochsner will jointly form a new University Health System (UHS) structure to coordinate activities between the school and the healthcare delivery system.

“Both Ochsner and LSU are proven partners who are committed to leading the advancement of healthcare in our state,” said Governor John Bel Edwards. “LSU has significant strengths in medical education and research while Ochsner, also committed to academics and research, has tremendous expertise in operating hospitals and supporting the clinical activity of large physician groups. Working together, in a more integrated fashion, we plan to successfully deliver quality, cost-effective patient care in an environment that is optimal for the continued teaching and training of our state’s future doctors and healthcare professionals.”

The UHS structure under consideration would be governed by a new UHS board of directors made up of Ochsner, LSU and community board members from Shreveport and Monroe and in addition a Community Advisory Board made up of Shreveport and Monroe community members, and representatives from Ochsner, LSU and BRF to provide insight into the healthcare needs of the greater Shreveport and Monroe region.

 

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APA Finds Political Stress Significant

The American Psychological Association (APA) conducted its annual “Stress in America” survey to examine how Americans feel and how much stress they are experiencing and why.

Of those surveyed, 63% said that the future of the nation is a significant source of stress, 62% indicated that money stresses are significant, and 61% said that work was a significant source of stress, according to the news release.

APA has conducted the annual survey for more than a decade, and money and work
have consistently topped the list of stressors. In 2017, however, after adding a question with a list of additional stressors, the survey revealed a common new source of significant stress: the future of our nation. While the public’s overall stress level remains the same, on average,
compared to last year, Americans are more likely to report symptoms of stress, which include anxiety, anger and fatigue, said the announcement.

The survey was conducted by Harris Poll on behalf of APA.

The full report is available at http://www.apa.org/news/press/releases/stress/index.aspx

The APA Help Center also includes: 10 tips for dealing with the stress of uncertainty and Managing conversations when you disagree politically.

Data was weighted to reflect proportions in the population. The online survey included 2,047 women, 1,376 men with political affiliations of 1,454 Democrats, 698 Republicans, and 672
Independents.

Race of the respondents was 1,088 White, 810 Hispanic, 808 Black, 506 Asian and 206 Native American adults.

About a third (1,122) fell at or below 200 percent of the federal poverty level and 2,087 were above.

Parents made up 1,182 and those without children were 2,258.

Data was collected online. Because the sample is based on those who were invited and agreed to participate in the Harris Poll online research panel, no estimates of theoretical sampling error can be determined.

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Gov Edwards Meets with President Trump to Address Opioid Crisis

Gov. John Bel Edwards and Dr. Rebekah Gee, secretary of LDH, attended a listening session at
the White House with President Trump on October 26 to discuss the growing opioid crisis. Also participating were Governors Bill Walker from Alaska, Chris Christie from New Jersey, Matt Bevin from Kentucky and others.

According to the press release, Gov. Edwards also met privately with Acting Drug Czar Richard
Baum to discuss drug and addiction trends in Louisiana, Gov. Edwards’ priorities related to
drug use, and opportunities to collaborate with the White House in the future.

Edwards praised a decision by Trump to declare the opioid crisis a national public health emergency. President Trump indicated that he intended to file a lawsuit against opioid
manufacturers for their role in escalating the national crisis. In September, Gov. Edwards and
the Louisiana Department of Health (LDH) filed a similar lawsuit.

“I appreciate President Trump’s commitment to this issue,” said Gov. Edwards. “This problem has escalated in Louisiana at a rapid pace, and we are taking action to combat the opioid crisis. The president’s declaration will put more tools at our disposal, and will allow us to help more Louisianans who’ve fallen victim to opioid abuse. This is going to take time, and my  administration and I are committed to working with the Trump Administration to provide assistance to as many people as we can.”

According to the White House, declaring a public health emergency will mobilize additional federal resources, including:

• Allowing for expanded access to telemedicine services, including services involving remote
prescribing of medicine commonly used for substance abuse or mental health treatment,

• Helping overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the Department of Health and Human Services to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation’s ongoing public health emergency,

• Allowing the Department of Labor to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding, and

• Allowing for shifting of resources within HIV/AIDS programs to help people eligible for those
programs receive substance abuse treatment, which is important given the connection
between HIV transmission and substance abuse.

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Gov. Edwards Makes Several Board Appointments in Oct

Gov. Edwards announced in October that he reappointed Kathryn A. Steele, Ph.D., of
Metairie, to the Louisiana Licensed Professional Counselors Board of Examiners. Steele is a
licensed professional counselor, licensed marriage and family therapist, and professor of counseling at New Orleans Baptist Theological Seminary. Dr. Steele was nominated by the
Louisiana Association for Marriage and Family Therapy and will serve as a licensed
marriage and family therapist on the board.

The Louisiana Licensed Professional Counselors Board of Examiners is responsible for the regulation of Provisional Licensed Professional Counselors or PLPCs (formerly Counselor
Interns), Provisional Licensed Marriage and Family Therapists or PLMFTs (formerly MFT Interns), Licensed Professional Counselors or LPCs, and Licensed Marriage and Family Therapists or LMFTs.

The Governor also reappointed Paul M. Schoen, of Covington, to the Addictive Disorder Regulatory Authority. Schoen is a licensed addiction counselor and certified compulsive gambling counselor in private practice. Additionally, he is a veteran of the United States Navy
Reserve. He was nominated by the Louisiana Association of Substance Abuse Counselors and Trainers, Inc., and will serve as a member with significant experience and knowledge in the area of compulsive gambling.

Gov. Edwards also appointed Kerri L. Cunningham, of Lafayette, to the Addictive Disorder Regulatory Authority. Cunningham is a licensed clinical social worker, licensed addiction counselor, and the Clinical Director of Victory Addiction Recovery Center.

As required by statute, she was nominated by the Louisiana Association of Substance Abuse Counselors and Trainers, Inc.

The Addictive Disorders Regulatory Authority licenses and regulates addictive disorder counselors and prevention professionals in the State of Louisiana.

Also in October Gov. Edwards appointed Antoinette Q. Bankston, of Baton Rouge, to the Human Trafficking Prevention Commission Advisory Board. Bankston is a licensed clinical social worker and the Executive Director of the Baton Rouge Children’s Advocacy Center. As required by statute, she was nominated by the Louisiana Chapter of the National Association of Social Workers.

The Human Trafficking Prevention Commission Advisory Board provides information and
recommendations from the perspective of advocacy groups, service providers, and trafficking victims to the Human Trafficking Prevention Commission.

Bambi D. Polotzola, of Opelousas, was reappointed to the Louisiana Developmental Disabilities Council. Polotzola is the Director of the Governor’s Office of Disability Affairs and will serve as its representative on the council.

The Louisiana Developmental Disability Council’s mission is to lead and promote advocacy, capacity building, and systemic change to improve the quality of life for individuals with
developmental disabilities and their families.

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Louisiana Department of Health Files Suit Against Opioid Manufacturers

On September, the Louisiana Department of Health announced a law suit filed against several leading opioid manufacturers for their role in escalating the opioid crisis in Louisiana. The lawsuit, filed in the 19th Judicial District Court in East Baton Rouge Parish, alleges that the drug
companies engaged in fraudulent marketing regarding the risks and benefits of prescription opioids, which helped fuel Louisiana’s opioid epidemic.

“These drug companies led prescribers to believe that opioids were not addictive and even suggested that treating physicians prescribe greater dosage units to those who had already
become addicted to opioids,” said Gov. John Bel Edwards. “As evident by the hundreds of Louisiana families that have lost loved ones due to this crisis, nothing could be further from the truth. We intend to hold these  pharmaceutical companies responsible for the lasting damage they have caused upon our people and the millions of dollars their wrongful claims have cost our state.”

The Louisiana Department of Health is seeking damages for the amounts it has already paid for excessive opioid prescriptions and treatment costs as a result of those prescriptions.
Louisiana joins dozens of other cities, counties and states that have filed similar lawsuits in response to the alarming number of cases of opioid addition and opioid-related deaths
throughout the country. Lawsuits were also filed last week by local sheriff’s offices in Avoyelles, Lafayette, Jefferson Davis and Rapides Parishes.

“By all means necessary, we are fighting the opioid epidemic in Louisiana. All indicators of this problem – opioid prescriptions, overdoses and deaths – are up. Recognizing that a key
contributor to opioid addiction is prescription medications, where 110 prescriptions for opioids are written for every 100 Louisiana residents, we are addressing a fundamental cause of this
problem,” said Dr. Rebekah Gee, secretary of the Louisiana Department of Health.

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Dr. Rizutto Leads Rebuilding Project

Dr. Tracey Rizzuto and colleagues are helping those in the hardest hit storm affected areas to rebuild the local business communities, through a group composed of leadership and members of the Society for Industrial-Organizational Psychology and the Society of Consulting
Psychology, two Divisions of the American Psychological Association.

The effort began recently as the Harvey Organizational Psychology Effort or HOPE, Dr. Rizzuto told the Times. However, the project quickly evolved into an effort between the two Divisions of APA, to be called the Catastrophe Aid and Rebuilding Effort, or CARE.

The group “… is now positioned to respond to a broader range of disaster events,” said Rizzuto, Associate Director, School of Leadership and Human Resource Development, at the LSU College of Human Science & Education.

The interdivisional APA taskforce is working to provide pro bono business recovery services to those in the stormaffected areas, explained Rizzuto. The growing taskforce has over 30
volunteers at present and is working to link with regional leaders in the hardest-hit areas, she said.

The original group, HOPE, started working to connect to local Industrial-Organizational psychologists in the Texas and Louisiana area, to local government administrations, and to
identify businesses in need of services, she explained.

“We’re reaching out to our professional base to inquire about needs for assistance,” such as  housing/food donations, replacing books, assist with academic lectures if possible,” said
Rizzuto.

The current project is modeled after Rizzuto’s work on the Katrina Aid and Relief Effort,” called KARE, Rizzuto said. In the wake of Hurricane Katrina, the leadership of the Society of
Industrial-Organization (SIOP) called on its membership to deliver needed resources to people and businesses affected by the storm. “The Katrina Aid and Relief Effort (KARE) became SIOP’s
first outreach taskforce designed to deliver pro bono business consulting services with the goal of aiding disaster recovery,” explained Rizzuto.

Along those same lines, the current effort will likely help with a host of services including emotional management, hiring/selection tools, training programs, recruitment, etc.

According to a report in Industrial-Organizational Psychology, KARE provided assistance in managing stress and adversity, change, motivation, and healing from the disaster. Also some of
those served voiced interest in hiring, leadership, training, team management and general business issues.

KARE received commendations from the Louisiana State Senate, the American Society of Association Executives, and the Center for Association Leadership for the work.

Dr. Rizzuto and her team are welcoming voluteers. CARE group volunteers will be placed in complementary teams composed of individuals with a wide range of experience and expertise. Dr. Rizzuto explained that volunteers will work alongside colleagues. “You will not be alone,” she said. The group meets every Wednesday on Zoom.

For those interested in volunteering, the site for the Castastrophe Aid and Rebuilding Effort (CARE) site is: https://www.facebook.com/CARECatastropheAidandRebuildingEffort

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Dr. Leonhard Meets with Medicaid Task Force to Support Innovations

Dr. Christoph Leonhard, PhD, ABPP, Professor in the clinical PsyD program of The Chicago  School of Professional Psychology at Xavier University of Louisiana, met recently with the Medicaid Integrated Assessment Task Force, a group created by Representative Barbara Norton and others, with the goal to “make a thorough study and evaluation of Louisiana’s current statewide system of healthcare delivery for Medicaid enrollees with serious mental illness.”

Dr. Leonhard is a member of the Louisiana Psychological Association’s task group to study innovations in healthcare, a committee chaired by Dr. Lacey Seymour. Leonhard is also the Chair of the Health Psychology Interest Area for the Psychological Association.

Representative Norton’s 2017 House Concurrent Resolution No.55 created the Medicaid Task Force, and had noted, “…the mental health and well-being of the residents of Louisiana is a vital issue that affects not only quality of life, but also the health of communities, families, and economic stability.”

According to the Department of Health and the Resolution, the purpose of the Medicaid Integrated Assessment Task Force is to study and evaluate Louisiana’s current statewide system of healthcare delivery for Medicaid enrollees, and especially with concern for those with
serious mental illness.

The task force members should strive to “render objective, fiscally feasible recommendations to the legislature for the implementation of policies that could be adopted by the state for the delivery of integrated primary and behavioral health services for Medicaid enrollees,” according
to the agency officials.

Data from the Substance Abuse and Mental Health Services Administration indicates that people with mental illness are more likely to have chronic health conditions, such as high blood pressure, asthma, diabetes, heart disease, and stroke, than those without mental illness, and those individuals are more likely to use costly hospitalization and emergency room treatment.

Individuals with primary health conditions such as asthma and diabetes report higher rates of substance use disorders and serious psychological distress.

According to the Centers for Medicare & Medicaid Services (CMS):
1) Fifty percent of Medicaid enrollees have a mental health diagnosis;

2) People diagnosed with mental illness and common chronic health conditions have healthcare costs that are 75% higher than those without a mental health diagnosis;

3) for individuals with a co-occurring mental illness or substance use disorder and common chronic condition, the cost is two to three times higher than what an average Medicaid enrollee pays for healthcare;

4) and costs of treating those with diabetes is as much as four times higher when a cooccurring
condition such as depression or alcohol addiction is untreated.

The members of the Task Force will be asked to give ideas for innovations that can address these and other issues, and work with the existing programs where feasible.

Dr. Lacey Seymour will be working with a group of psychologists, including Dr. Leonhard, to develop responses for the Medicaid team, according to several sources.

Dr. Chris Leonhard is a health psychologist and originally earned his degree from University of Nevada and completed his internship and postdoc at Harvard Medical School (McLean and Mass General Hospitals). He is Board Certified in Behavioral Psychology and currently is
conducting research in Behavioral Medicine and physical activity promotion

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Psych Board Debt to Reach $400K for 2018

According to Boards and Commission budget tracking for the Louisiana Board of
Examiners of Psychologists (LSBEP), the psychology board is projecting a fund
balance of minus $400,595 for 2018.

This comes after several years of overbudget spending that appears to be due in
large part to legal fees. The psychology board is self-funded, and it operates with
income supported by license fees and other service fees.

Based on the budget and financial tracking provided at the Boards & Commissions
website, the LSBEP stayed approximately within budget for most years and carried a
“fund balance” of around $100,000, which appears to function as a savings reserve.
For 2014, the board took in $262,582 and spent $249, 517. The fund balance was
$144,709.

And in 2015, the board took in $263,691 in fees and spent $275,147. For 2015, the fund
balance was listed at $120,188.

However, in 2016, the board spent $336,677 while proceeds remained steady at $265,945. Budget tracking indicates a fund balance of minus $214,818.

The change in the fund balance from 2015 to 2016 is not clear, based on the tracking numbers as given.

For the current year of 2017, expenses are projected to be $388,903. Income continues at the same general level, projected to be $263,265.

The budget figures indicate that board’s projected budget for 2018 will be a fund of minus
$400,595. Expenses for 2018 are projected to be $327,871 with income again holding
steady at $269,755.

The Boards & Commissions site also provides information and various breakdowns of the
budget items, with data from 2010 to the present.

According to the tracking of expenditures from 2014 to 2017, the employee salaries
and benefits have increased from $125,839 in 2014 to $148,946 in the current year.
This amounts to an 18 percent increase.

Over this same time, operating expenses decreased from $66,974 in 2014 to $57,858 in
2017, a drop of 13.6 percent.

Professional services, another category of expense, has increased from $56,704 in 2014
to $135,767 for 2017. This is an increase of 139 percent. For 2018 the total for professional
services is projected to be $182,099, or an increase of 221 percent.

For the budget figures, the professional services category includes four subcategories:
Accounting, Management Consulting, Legal, and Other. From 2014 to 2017 all increased, while legal increased the most at 247 percent.

In 2014 Accounting was $1,331, Management Consulting was $4,495, Legal was $37,882, and Other was $12,996.

For 2017, Accounting is projected at $9,849, Management Consulting is $15,600, Legal is $131,500, and Other is $25,150.

This information is available at

https://wwwcfprd.doa.louisiana.gov/boardsAndCommissions/home.cfm

At the LSBEP regular meeting, held on June 16 at the offices in Baton Rouge, Chair Dr. Darla
Burnett reported that she reviewed the bank and financial records.

According to the minutes, “Dr. Burnett also reported that she had reviewed the current financial state of the Board with Ms. Monic, noting the two biggest expenses are employees and
legal fees. Dr. Burnett thanked Board Members for waiving their Per Diem and Travel
reimbursements in FY 2016-17 to attend Board meetings, committee meetings, and LPA,
and recommended, in an effort to remain fiscally responsible, that the Board continue to waive reimbursement and travel in the 2017-18 fiscal year given the anticipated deficit.

“Dr. Burnett further recommended that the Board continue to actively consider revenue
development initiatives including review and approval of continuing education programs, inactive status, additional licensure types or registration of psychological assistants, providing continuing education workshops, and as a last resort, changes to staff.”

The LSBEP called a special meeting July 7, held in New Orleans, and met in Executive Session, apparently to deal with personnel and financial matters. According to the agenda and
minutes, “The Board reviewed and discussed applicant qualifications for prosecuting
attorney. The Board reviewed and discussed layoffs. The Board reviewed and discussed
qualifications and affirmed the current list of evaluators as approved to perform
psychological/neuropsychological evaluations/fitness for duty examinations under LA R.S. Ch.
37 §§ 2356, 2356.1, 2356.2, and 2356.3: […]”

“The Board reviewed proposals for a contract for prosecuting attorney for the 2017-18 Fiscal
Year due to the current financial status of the Board. Dr. Henke reported receiving proposals and vitas from three well qualified prosecuting attorneys. By motion of Dr. Henke, the Board voted to award the contract to Attorney Courtney P. Newton beginning July 7, 2017 – June 30, 2018, in an amount not to exceed $28,000. The fee schedule should reflect the following rate of pay: $100 per hour plus travel and expenses that are preapproved in accordance with
Policy and Procedure Memo 50.”

Previously the prosecuting attorney, Mr. James Raines, charged $250 hour. While unclear, it appears that Mr. Raines may no longer be with the board.

The July 7 minutes also note, “The Board revisited the need to have a second contract for
Complaints Coordinator. Dr. Boggs moved to offer a contract not to exceed $5,000 for an
auxiliary Complaints Coordinator to Dr. Joseph Constans for overflow or for matters unable to
be handled by Dr. Lambert.”

The board also moved to lay off the administrative assistant. According to the minutes, “The
Board continued discussing its current financial status and outlook. Recognizing that the
Board could no longer delay action given the current financial state versus the time it will take to recover and/or further develop revenue sources, Dr. Henke, moved that in addition to the
recommendations presented in June 2017, the Board temporarily layoff the Administrative Assistant position. The motion passed unanimously.”

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National Group Petitions Federal Drug Administration to Ban High-Dose Opioids

A group of state officials and health advocates are petitioning the
Food and Drug Administration to ban the production of high-dose
opioid medications, saying that the pills when taken as directed
are a daily dose of 90 milligrams of morphine.

The petition was signed by leaders of the Association of State
and Territorial Health Officials (ASTHO), reported ABC News.

The ASTHO is national nonprofit organization representing public
health agencies in the United States and over 100,000 public
health professionals these agencies employ. ASTHO members,
the chief health officials of these jurisdictions, formulate and
influence sound public health policy and work to guide statebased
public health practice.

Parham Jaberi, MD, MPH, Assistant Secretary for Public Health
in the Louisiana Department of Health, is listed for the Louisiana
representative.

The petition was also signed by Physicians for Responsible
Opioid Prescribing, the National Safety Council and the American
College of Medical Toxicology. Dr. Andrew Kolodny, physician
advocate for opioid reform, said, “The existence of these
products implies that they’re safe. They’re not,” said Kolodny,
founder of Physicians for Responsible Opioid Prescribing and an
outspoken advocate for opioid reform.

More than 15,000 people died from overdoses involving
prescription opioids in 2015. Various sources report that 80
percent of those addicted to illegal opioids became hooked
through a legal prescription

In June Governor Edwards signed measures to help curb the
opioid crisis in Louisiana, where more prescriptions are written
each year than there are residents in the state. Louisiana ranks
#7 in the states with opioid problems.

Louisiana lawmakers passed legislation this year to help deal
with the problems. Act 76 forced limitations on prescribers of
opioids. For acute pain conditions, prescriptions are limited to a
seven-day supply.

Act 76 also restricted prescriptions to minors. “… a medical
practitioner shall not issue a prescription for an opioid to a minor
for more than a seven-day supply at any time and shall discuss
with a parent, tutor, or guardian of the minor the risks associated
with opioid use and the reasons why the prescription is
necessary.”

Another new law, Act 82 set up a monitoring program and
requirements and continuing education requirements. Physicians
must review the patient’s record in the Prescription Monitoring
Program prior to initially prescribing opioids.

In House Concurrent Resolution 21, lawmakers urged health
officials to help undo the attitude changes from drug company
marketing that began in 1996, branding pain as a “5th vital sign”
and a problem to be medicated aggressively.

Authors of the Resolution point out that the Veterans Health
Administration, the Joint Commission on Accreditation of
Healthcare Organizations, and the Federation of State Medical
Boards all embraced the marketing, now resulting in an epidemic
of 180 thousand deaths from overdose, from 1999 to 2015, and a
quadrupling of prescriptions, according to the CDC.

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