Category Archives: News Stories

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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Dr. Melissa Dufrene Named Early Career Psychologist

Dr. Melissa Dufrene has been named the 2017 Early Career Psychologist by the Louisiana Psychological Association, announced at the association’s annual convention held in June in New Orleans. Dufrene is a licensed clinical psychologist with numerous community and professional involvements. “I am honored to be recognized,” she said.

Her post-doctoral supervisor, Michael Chafetz, PhD, ABPP, said, “It was indeed a pleasure to learn that Dr. Melissa Dufrene was honored for the Early Career Psychologist award of 2017, as she is clearly deserving.”

“She is a strong and compassionate practitioner who fully understands the application of evidence-based methods to achieve desired clinical outcomes,” Chafetz said, “which she also measures. Before I met her for a post-doctoral position in my clinic, she had strong training, especially in her work in the inpatient OCD unit of Rogers Memorial Hospital in Milwaukee, Wisconsin,” he said.

“In my mind, it is this combination of scholarship and treatment sense that makes her so effective.” In 2014, Dufrene co-authored with Chafetz, “Malingering-by-proxy: Need for child protection and guidance for reporting,” in Child Abuse and Neglect.

Dr. Dufrene currently is a licensed Clinical Psychologist affiliated with the Algiers Neurobehavioral Resource, LLC, where her time is devoted to therapy and psychological evaluations. She leads the clinic’s initiatives surrounding women’s therapy, assessment, and behavioral health needs. In this capacity, she provides services to women patients for issues such as postpartum depression, general anxiety, relationship issues, abuse, and general mental

health.
Her primary areas of interest are anxiety related disorders, PTSD, OCD, depressive disorders, and child behavioral problems.

She has also serves as Adjunct Instructor at the Chicago School of Professional Psychology at Xavier University where she teaches Basic Psychopathology. She has also taught at Delgado Community College and for Instructional Connections. This year she also began working as Gratis Faculty of LSU, where she serves as a supervisor to one of the interns in the program.

She was recently named co-chair of the Early Career Psychologist Committee for the Louisiana Psychological Association. Along with her co-chair and colleague, Dr. Ashley Jefferson, she plans on engaging early career professionals. “We are focusing on increasing the level of involvement of EC’s and students across the state, and addressing pertinent issues in the field,” she said.

Dr. Dufrene serves the broader community in a number of ways. She has served as a member of the Regional Advisory Board for the Alzheimer’s Association where she contributes to community education and support efforts. In 2015 she served as chair of the annual fundraiser event for the association.

She has served as a Partner in Multiple Sclerosis Care, a segment of the National Multiple Sclerosis Society to assist patients in accessing quality care and outreach for those living with MS. She provided training on issues of stress management for those with MS.

She has also served as a Each One Save One Mentor, where she works with at risk-elementary students and with school staff to assist youngsters.

Dr. Dufrene trained at Rogers Memorial Hospital, a nationally recognized residential and behavioral health hospital, treating individuals with serious mental health disorders. At this facility, she worked in the Obsessive-Compulsive Disorder Center, one of only two residential treatment centers in the United States for males and females age 18 and older with obsessive-compulsive disorder and obsessive-compulsive spectrum disorders.

She earned her doctorate in clinical psychology from The School of Professional Psychology at Forest Institute in Springfield, Missouri. Her dissertation was Examination of Executive Functioning Among 9-12 Year Olds with ADHD, Obesity, and Comorbid ADHD/Obesity.

Along with her professional and community service, she has a very busy family life. “And just to keep things interesting,” she said, “my husband and I are expecting baby #2 in December, which will make our two-year old a big brother!”

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Governor Appoints Dr. Leah Crouch to Psychology Board

The Governor has appointed Leah Crouch, PsyD, to serve on the Louisiana State Board of Examiners of Psychologists (LSBEP) according to a Boards & Commission announcement July 21. Dr. Crouch will begin serving the five-year appointment this month, according to sources.

Outgoing chair is Darla Burnett, PhD, MP, who ended her term in June. Currently serving are Drs. Phil Griffin, Koren Boggs, Jesse Lambert, and Amy Henke. Dr. Lambert is the only medical psychologist with Dr. Burnett completing her service.

In February 2017, Dr. Crouch captured 58 percent of the votes cast in the election and Dr. William Schmitz received 42 percent. The Louisiana Psychological Association submitted both Dr. Crouch and Dr. Schmitz to the Governor, with the association’s request that Governor Edwards appoint the top vote getter, according to sources.

Dr. Crouch is owner of River Bends Psychology, a Private Practice located in New Orleans, where she provides psychological services to adult population. She received her PsyD from the University of Denver in 2006 in Clinical Psychology.

She is also with Tulane University, Department of Psychiatry and Behavioral Sciences, where she is a Clinical Assistant Professor and previously an Assistant Professor, and providing services on an adult, acute, inpatient psychiatric unit for those with chronic and severe behavioral illness.

Dr. Crouch has previously worked for the Department of Defense, Department of the Navy, at the Naval Consolidated Brig Chesapeake, providing services at a Joint Regional Correctional Facility, where she helped restore and prepare prisoners for return to duty or re-enter civilian society. She also worked as a psychologist at the Naval Hospital in Beaufort, South Carolina from 2010 to 2012.

In 2009 and 2010 Dr. Crouch provided services in a juvenile correctional center for Louisiana State University, Health Science Center –New Orleans, School of Public Health Juvenile Justice Program.

Dr. William Schmitz, Jr., is a clinical psychologist with the Department of Veteran Affairs and resides in Baton Rouge. He earned his PsyD from Baylor University in 2006.

Dr. Schmitz, previously served as the President of the American Association of Suicidology, and clinical psychologist, and presented in 2015 as the plenary session speaker at conference of the Louisiana Chapter of the National Association of Social Workers.

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LSBEP to Appeal Judge’s Decision

The Louisiana State Board of Examiners of Psychologists (LSBEP) will appeal a recent decision by District Court Judge Michael Caldwell, who ruled that the board’s process violated the Constitutional rights of a psychologist.

On July 27 the Times asked LSBEP Executive Director, Ms. Jaime Monic, if the Board was going to appeal Judge Caldwell’s decision.

Ms. Monic responded the following day, writing, “The Board thoroughly discussed this matter and the Order from the 19th Judicial District Court at a special meeting held on July 7, 2017. With consideration being given to the costs of a new hearing as well as the Administrative Procedures and other statutorily supported procedures that were followed by LSBEP staff, and in consultation with Attorney Amy Groves Lowe, the Board voted to appeal the decision of the 19th JDC.”

On May 2, Judge R. Michael Caldwell of the 19th Judicial District Court in Baton Rouge said that the procedures leading to the suspension of Dr. Eric Cerwonka’s psychology
license included so many Constitutional violations that the decision could not stand, according to Cerwonka’s attorney, Mr. Lane Roy, in a previous interview.

Judge Caldwell agreed to hear additional arguments from the LSBEP attorney, Ms. Amy Lowe. On June 26 Judge Caldwell heard the additional views but stood firm on his initial opinion, this time using the term, “reeks” to describe some of the process, as described by Mr. Roy.

On July 7 the LSBEP met in a special meeting at Children’s Hospital in New Orleans scheduled from 3:35 to 5:00 pm. According to the agenda the members were to have discussed two matters in executive session from 3:35 to 4:30. The agenda listed the two topics for the closed session as: “1. Review qualifications of applicants for prosecuting attorney. 2. Other in-house personnel matters.”

Also according to the published agenda, the members were then to have discussed the following matters from 4:30 to 5 pm in open session:“1. Prosecuting Attorney Contract 2017-18; 2. Complaints Coordinator II Position 2017-18; 3. 201718 Budget Recommendations; and 4. Eric Cerwonka vs. LSBEP, 19th Judicial District Court Decision.”

At the most recent regular board meeting of the Board, held July 28 at the Baton Rouge office of the LSBEP, Dr. Tom Hannie attended and asked about the appeal. Dr. Kim VanGeffen, Professional Affairs Chair for the Louisiana Psychological Association, was also in attendance. Hannie provided the Times with a recording of the discussion.

Dr. Hannie: “I have questions about that case. As I understand it, the lawyer that was running the trial also had represented Cerwonka in a previous case, and the person who was prosecuting, was a member of the same firm. I’m wondering if the attorneys were committing malpractice by not recusing themselves and if y’all have looked at that?”

Dr. Phil Griffin: “We’ve looked at every aspect of it. I, you know…His attorneys, to me, did a pretty damn good job. I was impressed with Cerwonka’s attorneys. And I don’t know, if there’d have seen something awry … that should have brought that up at the trial, in terms of our prosecuting attorney. Those things, those things quite frankly don’t even enter into what all was going on, why the guy was in the hearing in the first place.”

[Many speaking at same time…]

Dr. Amy Henke: “I would encourage anyone who has questions about these hearings, please come. See what you think. They’re open to the public. Julie was there. I encourage LPA, someone from the association, to see what you think. Watch what we watch, and see what you would do.”

Dr. Kim VanGeffen: “… At least as I understand it, it was not so much the hearing itself, but what led up to the hearing.”

Ms. Monic: “Unfortunately, complaint investigations are confidential. There are avenues for reviewing the board’s policies and procedures. The Inspector General could certainly come in and take a look at that case and how it was handled. That wasn’t an option that was pursued and so now we’re in litigation. Whether or not, as an administrative agency, we acted properly administratively, I believe we did.”

[Many speaking]

Dr. Hannie: “I understand that you, you’re shackled, but when I see that the board is going to appeal I look at the cost of appealing, and sometimes when you appeal, you not only pay your legal fees but you pay the other person’s legal fees and it can get outrageous.” He described an unrelated example where an appeal may be costing $100,000 or more.

“In some of these cases they get six figures, paying on an appeal, just paying the other person’s fees, not just their own.”

Dr. Henke: “We worry about costs too, but our number one charge is public safety. We can’t not pursue something, we can’t just say it’s too expensive–– ‘we’re not going to protect the public on this one because it’s too expensive.’ ”

At the May 12 meeting of the LSBEP, following Judge Caldwell’s initial opinion on May 2, the minutes indicate that the board members discussed the alternatives to either appeal the ruling or to conduct a rehearing of the case involving Dr. Cerwonka. The minutes noted:

“Petition for Judicial Review: Eric Cerwonka vs. Louisiana State Board of Examiners of Psychologists: No. C656587 Section 24 – The Board reviewed the Petition for Judicial Review in this matter and the Summary Report provided by Attorney Amy Groves Lowe concerning the Status Conference held on April 21, 2017. The Board approved moving forward with a judicial review before the 19th Judicial District Court in lieu of rehearing.”

Discussion items for that meeting also included the review of Legal Contracts for 2017–2018. The minutes listed the following:

“1. Taylor, Porter, Brooks & Phillips (TPBP) – By motion of Dr. Griffin, the Board unanimously approved an amendment to the July 1, 2016 – June 30, 2019 contract with TPBP to add an additional $12,000, needed for continued legal services.” Taylor Porter is the firm for the Board’s General Council, which includes Mr. Lloyd Lunceford and Ms. Amy Lowe.

The minutes also noted: “2. Breazeale, Sachse & Wilson (BSW) – The consideration of this contract was tabled until July 2017.” BSW is the firm for Prosecuting Attorney, Mr. James Raines.

And the other items were: “3. Roedel, Parsons, Koch, Blanche, Balhoff & McCollister – The consideration of this contract was tabled until July 2017. 4. Other – The Board designated Dr. Amy Henke and Ms. Jaime Monic to conduct interviews for additional legal counsel for the 2017-18 Fiscal Year.” The Roedel firm is the firm for Ms. Deborah Harkins, the attorney often hired for legislative issues.

According to public records the board has had escalating legal fees which stem primarily from charges from the Board Prosecutor, held at one point by Mr. James Raines. Over 2015 to 2016, and into January 2017, Mr. Raines prosecuted 16 cases. Three of these 16 cases amounted to $146,987 of charges from Mr. Raines.

This past legislative session the LSBEP helped pass legislation that removed a oneyear time limit for investigations from the psychology licensing law. The measure also gave the board’s complaints subcommittee the ability to charge fees to psychologists being investigated for activities that do not reach the hearing level.

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Behavioral Health Key to Louisiana’s Problems in Corrections says Director

Dr. Raman Singh, Director, Medical and Behavioral Health, Louisiana Department of Public Safety & Corrections, told psychologists last month that the leverage for dramatic changes in the state’s incarceration rate was to institute behavioral health reforms in the Louisiana criminal justice system. The legislature passed laws in its 2017 session to begin the reforms that Governor Edwards said was a top priority, and some of the key changes Singh explained were needed to overhaul the problems Louisiana has in its corrections and justice system.

Singh, a medical doctor and cardiologist by training, spoke to a packed session at the Convention of the Louisiana Psychological Association (LPA) held June 2 and 3 in New Orleans.

“Louisiana’s incarceration rate contributes to over-representation of the mentally ill in the criminal justice system,” Singh told the audience, noting that the United States has the highest per capita incarceration rate in the world and that Louisiana has the highest per capita incarceration rate in the US. Dr. Susan Tucker, clinical psychologist and the Assistant Warden at the Bossier Parish Medium Security Facility, and in-coming President-Elect of LPA, introduced Dr. Singh and explained the significance of comprehensive psychological programs in the corrections and justice system. Tucker developed the Steve Hoyle Intensive Substance Abuse Program which has earned national recognition for excellence. In 2016 the Louisiana Legislature commended Tucker and her team in a House Concurrent Resolution pointing to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs designed by Tucker. Dr. Singh is responsible for the functional supervision of medical and behavioral health staffs who coordinate on-site care for 19,000 offenders assigned to state prisons, for all off-site health care needs for 38,000 DOC offenders and 16,000 local offenders housed in all state prisons and 104 local jails or detention centers. Singh explained to the audience of psychologists and professors that the reasons for over-incarceration in Louisiana is well-established. Based on a 2016 Louisiana Legislative Auditor’s review Singh said the top reasons were mandatory sentences and habitual offender laws, high rates of local incarceration without treatment programs, and “not addressing issues driving criminal behavior such as substance and mental illness.” Singh said that the 599 criminal statute and 164 mandatory minimum sentences contribute to over-incarceration in Louisiana, which are sentences without benefit of probation, parole or suspension. He said that 55 percent of mandatory minimum sentences are for non-violent crimes and that these minimums “shift sentencing discretion from judges to prosecutors.” Another serious factor is the high rates of local incarceration in Louisiana where there is no treatment. Jails and prisons have a disproportionately high number of persons with mental health issues and people with a serious mental illness (SMI), Dr. Singh explained. He noted that of the mentally ill in society, greater than 40 percent have been arrested and the majority of these are brought in for minor offenses. Those with mental illness spend two to five times longer in jail. Singh told the attendees that there was a complex interplay of multiple societal factors stemming from problems in education, stressed family structures, socio-economic challenges and lack of job opportunities. He pointed out that the unemployment rate in the mentally ill adults in Louisiana is 88.3 percent.

And while 16 percent of the DOC prison population has been diagnosed with a SMI, 82 percent are diagnosed with a substance use disorder. “Incarceration of mentally ill exacerbates symptoms of mental illness. Rarely does incarceration of the mentally ill lead to an improvement in their mental status,” said Singh. His vision is to reduce the criminalization of those with mental illness and to resolve the crisis with a comprehensive solutions that provide treatment to those who need it. He promotes the Medicaid expansion and mental health parity. He said that 43 percent of the entire eligible Medicaid Expansion population in Louisiana has a mental health condition, and that offenders with mental illness or substance use disorder can be treated effectively. He wants more outpatient mental health care, more Rapid Stabilization Centers, and emerging models that prevent arrest and incarceration of adults with mental illness, called the Forensic Assertive Community Treatment Programs. To help create alternatives to incarcerating those with mental illness, Dr. Singh said that Forensic Diversion Facilities are needed to help alternative sentencing for offenders with mental health issues and who have committed a minor crime. Expansion of the Mental Health Courts are essential, especially because a majority of offenders are incarcerated for “crimes of survival” such as theft of food or breaking in to find a place to sleep. He wants to strengthen family and communities and help judges divert nonviolent offenders away from jails with better mental health legislation. Dr. Singh serves on the Louisiana Governor’s Drug Policy Board, Louisiana Task Force on Telehealth Access, Louisiana Re Entry Council, Louisiana Medicaid Quality Committee, Louisiana Commission on Preventing Opioid Abuse as well as chairs the Louisiana Commission on HIV/AIDS and Hepatitis C. He has also been appointed by Governor Edwards to be his liaison to the White House Data Driven Justice Initiative project.

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Judge Caldwell Stands Firm on LSBEP Ruling

In an ironic twist of events, the Louisiana State Board of Examiners of Psychologists (LSBEP) has shepherded a bill through the legislature giving them more time to investigate complaints and more authority to charge fees. At the same time a District Court Judge has ruled that the board’s investigation and complaints subcommittee blatantly violated a defendants’ constitutional rights of Due Process.

“It is a huge issue and a major decision,” said Lane Roy, attorney for defendant Dr. Eric Cerwonka, “because it flies in the face of the procedure that we know this board has used time and again.”

The most recent hearing was held on Monday, June 26, with Judge R. Michael Caldwell of the 19th Judicial District Court in Baton Rouge. This latest ruling followed a May 2 review where Caldwell informed both sides that he considered the LSBEP procedures to violate Constitutional rights of the defendant.

On May 2 the LSBEP attorney, Ms. Amy Lowe, urged Judge Caldwell to allow her to present additional arguments and Caldwell agreed.

However, Mr. Roy did not see any meaningful additions presented by Ms. Lowe at the recent June 26 hearing. “She had nothing,” said Mr. Roy. “Zero.”

Mr. Roy also told the Times that Judge Caldwell used the term “reeks” three times at the June 26 hearing to describe his [Caldwell’s] views.

“The Judge ruled in open court and he used the phrase three times–– ‘This matter reeks with denials of Constitutional rights. I don’t care what he did or didn’t do. I can’t put up with this. As a Judge, I can’t,’ reported Mr. Roy. “He [Caldwell] was resolute. He said it was not a close call. That it was basic.”

Mr. Roy also said that the issues ruled on by Judge Caldwell are so basic that there is no possibility that the LSBEP attorneys do not know of these requirements.

“These are good people from good firms,” said Roy. “They all know the laws in these areas. What it tells me, is that they are bold enough to do it anyway.”

“The statute gives the board authority, but how can you have an administrative person, staff workers, who decide, who make decisions that affect the livelihood of people?” said Roy. “It’s the first step in taking the legs out from under the defendant. The defendant is concerned with their livelihood and ability to make a living, and can lose employment, before anyone on the board has even heard their case.”

“They run the costs up so high,” said Roy, “and put them [defendants] under political pressure and economic pressures. In Baton Rouge, where all the boards are, it is a cottage industry for attorneys.”

The Times asked Mr. Roy if he thought that the LSBEP would appeal. “She [Ms. Lowe] said she would appeal. I can’t imagine that this board would appeal, but I’ve been surprised by their decisions before.”

The District Court is not a court of publication explained Roy, but the Appeals Court is. Decisions handed down from the Appeals Court are widely distributed. “If they go to the Court of Appeal, they invite everyone to see their mistakes.”

On May 2, Judge Caldwell mentioned some of what he viewed as Constitutional violations, such as the hearing officer being the law partner of the board attorney and also someone entering Cerwonka’s home illegally to attempt to gather evidence. Another of these issues was that Cerwonka had previously been a client of the LSBEP prosecuting attorney, Mr. James Raines.

Mr. Roy noted in a Pre-Hearing Memorandum, “The prosecuting attorney for the Board had represented Dr. Cerwonka in a hotly contested custody dispute, had obtained much personal information about his then client, and provided information obtained to his Board client, all without authority or consent.”

“The Administrative Law Judge, Lloyd Lunsford, the person who at the hearing made all rulings on questions of law, admissibility of evidence, what was relevant and not relevant, and generally acted as ‘judge’ at the hearing, was and still is the law partner of Amy Lowe, who represented the Board at the hearing and who in fact, is representing the Board in this appeal,” wrote Roy in the memorandum.

Mr. Roy said in an interview with the Times, “It doesn’t mean that the board can’t go back and do it again. They have to do it in the correct way. My opinion is that if they do that, they will not be successful,” he said.

“The interest is not to police the profession, it is some other interest,” said Roy. “Some say it is political, but whatever the interest is, it is not to police the profession.

” The Complaints Committee of the LSBEP is a subcommittee that operates without direct oversight of the board members. The reason for this is so board members will avoid being exposed to information prior to disciplinary votes.

The Policy & Procedures for investigations have been changed dramatically over the last decade, so that once staffed by experienced psychologists and past board members, now there is a Private Investigator and a Prosecutor.

According to public records the board has had escalating legal fees which stem primarily from charges by the Board Prosecutor, held currently by Mr. James Raines. Over 2015 to 2016, and into January 2017, Mr. Raines prosecuted 16 cases. Three of these 16 cases amounted to $146,987 of charges for Mr. Raines.

After seeing the legal charges in this case, Mr. Roy said in a previous interview, “I was shocked at these fees. I’ve never seen these types of fees. It clearly is punitive,” he said. “I’m convinced that they don’t want anybody to appeal.”

Mr. Roy said that he has a good deal of experience with boards and that costs average around $10,000. A previous review of public documents suggested that fees for the Cerwonka case had come to $78,000 for the LSBEP. Mr. Roy noted a total of over $100,000 was closer.

During the recent legislative session, the LSBEP put forth legislation, SB 37 now Act 234, that removed a one-year limit on investigations from the psychology law. The measure also provided for fees to be charged for the investigations subcommittee. The bill was eventually amended so that the subcommittee fees would be capped at $10,000.

The Times asked for comments by the LSBEP after Judge Caldwell’s latest ruling, but has not received comments by publication time. The LSBEP has a policy of no interviews with the press.

[Editor’s Note: See “Judge Says Psych Board Procedures Unconstitutional,” in June issue of the Times. Also see “What’s Behind Door No. SB 37?” in the April Times.]

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LSBEP Publishes Rules for Ethics, Fees, Supervision

The Louisiana State Board of Examiners of Psychologists (LSBEP) published its final version of the new Chapter 13. Ethical Standards of Psychologists,” composed of ten pages of guidelines based largely on the ethics code of the American Psychological Association. The Rules was published in the June issue of the Louisiana Register.

Sections include: Preamble, Resolving Ethical Issues, Competence, Human Relations, Privacy and Confidentiality, Advertising and Other Public Statements, Record Keeping and Fees, Education and Training, Assessment, and Therapy.

The psychology board also published a new Rule for Chapter 6 of the Louisiana Administrative Code (LAC) on Fees. License renewals are increased from $320 to $350 and the Emeritus category will go up from $150 to $175. Reinstatement fees drop from $570 to $550.

Additional changes to Chapter 7 on Supervised Practice Leading toward Licensure, includes “Postdoctoral supervised practice hours can begin accruing after the date on which all requirements for the doctoral degree are met, …” For Licensed Specialists in School Psychology, a change is made to Chapter 33, Definition of Applicant for Licensure as a Specialist in School Psychology. Included is, “5. has completed an internship of at least 1200 hours and nine months in duration, …” with 600 hours in a school setting; .. Also, one year of employment or experience, obtained as part of an acceptable internship may be applied toward required supervision.

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Legislature Wraps Up

Financial issues dominated the legislative session but some bills drew the community’s attention. A measure by the state psychology board aimed to help the regulatory board deal with its mounting legal fees, passed with amendments. An effort by the Counselors to remove the Rx consultation clause moved through after some initial bumps with the psychologists.

Senator Mills’ bill to reform the health boards’ disciplinary hearings and create oversight, bit the dust. One source reported that a board member said, “We killed it.” A new commission was created for prevention of human trafficking and limits were placed on prescriptions for opioids.

In this review we summarize a few of the actions of the 2017 Legislative sessions.

Legislature Finally Passes Budget

Legislators were called to another special session to pass a budget they had failed to negotiate before the regular session, a sign of continuing problems for the state. A $1.2 billion shortfall is expected next July, according to the Advocate.

For now, higher education fared better than expected, and was funded at higher levels than in the last decade. Mental health in Medicaid took a severe cut. State workers, especially the lower paid employees were given a 2 percent increase, amid concerns that employees such as prison guards would not be retained due to low comparative rates.

Governor Edwards warned that the fiscal cliff is coming. He said that if the conservatives would not renew taxes in 2018, it would result in the closing of hospitals and universities, reported the Advocate.

SB 37 (Act 234) Gives LSBEP More Leeway In Investigations

Senate Bill 37 by Senator Martiny, a measure to remove the current one-year time limit for disciplinary investigations at the Louisiana State Board of Examiners of Psychologists and to allow the psychology board to collect fees when psychologists are being investigated by the subcommittee, was signed into law as Act 234 on June 14.

The measure allows for the board to start charging fees for informal hearings, including fees incurred by the board for a disciplinary action that is resolved by settlement, consent decree, or other informal resolution, including its investigator, staff, and legal fees. Previously they were allowed to charge only for formal hearings.

The measure was amended in committee to cap the fees for informal hearings at $10,000.

Previously psychologists enjoyed a one-year limit for the board to bring them to a hearing over a complaint, and in the original version the board would have been exempt from all time limits. However, in the Senate Committee, the measure was amended to conform with the time-limits set out in R.S. 37:21.

At the November 2016 LSBEP Long-Range Planning meeting, the board had said it would work collaboratively with the community to develop administrative Rules, not a new statute, to deal with its problems. In early March, the board sprung the news on the Louisiana Psychological Association (LPA) that it was crafting legislation for the 2017 session.

SB 38 (Act 235) Frees Counselors from Rx Consultation Clause

A measure removing a consultation clause for counselors and marriage & family therapists passed the House floor with 88 yeas and 2 nays on June 1, and returned to the Senate and was approved 33 to 0. The measure was signed by the Governor on June 14.

The bill became law upon signing and relieves those under the Licensed Professional Counselor board of a burden to consult with a professional who prescribes and who is licensed under the state medical board.

The measure hit a snag when psychologists objected to what some viewed as an opening to psychological testing, even though counselors said testing was not part of the bill.

At the June 23 meeting of the House Health & Welfare Committee, author Senator J.P. Morrell told members, “Working with the association of psychologists we came to a compromise in which, working with those groups over a period of time, there was an agreement that the testing provision for a variety of those different conditions would remain with the psychologists and the testing provision would be removed from the practice act.”

“So we removed the language that requires the consultation but we changed the practice act to say that the testing provision should be in the purview of psychologists while the diagnosis and treatment will remain with the mental health counselors and with marriage and family therapists.”

Morrell said that with this change the association of psychologists removed its opposition. The committee reported the bill favorably with an 11 to 0 vote. Then it was passed in the House with 88 yeas and 2 nays.

SB75 Stalled Out in Committee

Senator Fred Mills’ effort to reform and curtail boards’ powers when it comes to disciplinary hearings 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.”

This is a lot less costly Mills said, with the Administrative Law Judge costing on average from $1,500 to $2,000 for a hearing. The measure would have also added a consumer member to those boards that do not currently have one.

“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 board members helped derail the effort.

SB42/Act 181 Creates the Human Trafficking Prevention Commission

The measure creates a 17- member commission with a variety of legal, law enforcement, educational, social and other leaders, and also an Advisory Group, to prevent human trafficking in the state.

Act 162 Limits Service on Medical Board

Amends present law, instead of repealing it, and limits service to three consecutive terms.

SB216/Act 254 PEC Expanded

Prior law authorized any physician, psychiatric mental health nurse practitioner, or psychologist to execute an emergency certificate after an actual examination of a person alleged to be mentally ill or suffering from substance abuse who is determined to be in need of immediate care and treatment in a treatment facility because the person is determined to be dangerous to self or others or to be gravely disabled. Act 254 expands this authority to (1) Physician assistants when acting in accordance with their respective clinical practice guidelines; (2) Nurse practitioners with or without a clinical specialization who act in accordance with a collaborative practice agreement and receive verbal approval from a collaborating physician for executing the certificate.

SB192/Act 82 Limits Prescribing of Opioids

The measure prohibits a medical practitioner from prescribing more than a seven-day supply to an adult for outpatient use or to a minor at any time.

HB341/Act 369 Changes Terminology from Mental Health to Behavioral Health

The measure changes the heading of Title 28 of the La. Revised Statutes of 1950 from “Mental Health” to “Behavioral Health,” and defines “behavioral health” as a term which is used to refer to both mental health and substance use.

HB79 to Act 266

A measure which prohibited the administration of corporal punishment to students with exceptionalities, was signed into law.

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SB 38 Proposed by Counselors and MFTs to Remove Wording Requiring Consult for Medical Board Professionals and Rx

The-Psychology-Times-Vol-8-No-4.pdf

Senator J.P. Morrell has proposed a measure that will remove language requiring that counselors and marriage and family therapists consult and collaborate with physicians, psychiatrists, medical psychologists, advanced practice registered psychiatric nurses, when treating or assessing individuals with “serious mental illness.”
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Dr. Tucker’s Work Honored

Legislators commended the results of the Steve Holye Intensive Substance Abuse Program and other programs created by psychologist and Assistant Warden, Dr. Susan Tucker, in a House Concurrent Resolution (HCR3), signed by the Speaker on February 25.

The HCR3 authors pointed to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs designed and delivered by Tucker and her team at the Bossier Sherriff’s Office, Medium Correctional Facility, located between Benton and Plain Dealing, Louisiana. Dr. Tucker has been working on reducing the rates through her comprehensive, innovative, and evidenced-based programs, to improve lives, families and community safety.

The legislators also noted that, while the programs were effective in shortening sentences of certain offenders, these efforts also helped offenders reintegrate into their families and communities and lower the risk of repeat offenses.

“I am very proud of our program and that we accomplish two goals which save taxpayer money but also provide rehabilitation to the substance abuse incarcerated offenders as well as their families,” Dr. Tucker told the Times. “With successful completion of our intensive treatment program, certain offenders can earn up to one year off their sentence. This is a significant savings to the public,” she said.

Fifteen hundred offenders have graduated from the nine-month program and an additional six hundred have graduated from the six-month program since it was moved to Bossier, after the Forcht Wade Correctional Center was closed due to budget cutbacks in 2012.

The Resolution authors noted that Tucker’s Substance Abuse Program has awarded more than five hundred thousand days of “good time credit” to offenders and saved the state nearly $13,000,000 during the January 2013 to December 2015 time period.

Another group of offenders have earned credits of nearly 50,000 days credit, saving the sate more than $1,000,000. And, those successfully participating in the Family Recovery Program earned 75 days of credit. Over time the program has awarded 55,000 days of credit, a $15,000,000 savings in reduced incarceration time.

“THEREFORE, BE IT RESOLVED,” the authors wrote, “that the Legislature of Louisiana does hereby commend and recognize the Steve Hoyle Intensive Substance Abuse Program for its success in shortening the sentences of certain offenders, while better preparing those offenders to reintegrate into their families and communities without a return to substance abuse and incarceration.”

Tucker has previously explained in an interview what she views as the basis of the program’s success: the innovations, the comprehensive approach, and the evidenced-based methods. “The philosophical approach to our treatment,” Dr. Tucker explained, “includes focusing on the thinking patterns, emotional reactions, and behavioral events that often lead to self–defeating patterns and eventually to criminal activity. We utilize psychological assessment instruments to illuminate areas of concern, including low cognitive ability, personality disorders or features, mood disorders, and thought disorders. We individualize a treatment program for that offender and he works closely with his assigned counselor to meet the goals of that treatment plan.”

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Henke First in LSBEP Election Returns

Dr. Amy Henke has captured 62 percent and Dr. Leah Crouch, 38 percent, of votes from the licensed psychologists casting votes in the election for a seat on the state psychology board, the Louisiana State Board of Examiners of Psychologists (LSBEP).

The position to be filled by either Henke or Crouch is that of outgoing medical psychologist, Dr. Marc Zimmermann, who completes his term this June. The final choice between the two candidates will be made by the Governor.

The election was the first in recent years without a member of the Louisiana Academy of Medical Psychologist (LAMP) seeking a position on the board. The LSBEP has routinely been composed of three medical psychologists in the five members, despite the fact that medical psychologists make up only about 5 percent of all licensed psychologists and are not required to hold a state psychology license.

In the current election, Dr. Henke received 183 votes, Dr. Crouch, 113 votes, and 27 of those casting votes, abstained.

President of the Louisiana Psychological Association, Dr. Lacey Seymour, reported the results to the Office of the Governor in a letter on January 25, obtained from the president.

In the letter, addressed to Ellen Palmintier, Director at Boards and Commissions, Seymour asked that the Governor appoint the individual with the top number of votes. She wrote, “As per our current policy, we respectfully request that the Governor appoint the psychologist who obtained the majority of the votes in the election. Therefore, we urge Governor John Bel Edwards to appoint Dr. Amy Henke.”

By law, the Governor may appoint either nominee on the list provided by LPA.

Sources in the community have said they are curious about the absence of a LAMP member on the list to the governor, which usually results in the appointment of that individual.

Last year an effort was pushed by the LAMP dominated psychology board to remove the wording from the psychology practice law. The law currently gives the Louisiana Psychological Association (LPA) the right to construct the “list” from which the Governor makes appointments.

The effort failed because the Senator sponsoring the bill refused to advance it if there were any conflicts over the substance of the legislation. The LSBEP dropped the effort to delete LPA’s role in the “list.”

LAMP is known to be a political powerhouse. The group donated more money to legislators in 2014 than any other political action committee in healthcare, including the much larger state medical group, for that same year.

Dr. Amy Henke is a clinical psychologist with the Louisiana State University Health Sciences Center and Children’s Hospital in New Orleans. She is a member of APA Divisions for Pediatric Psychology and Health Psychology, and a member and Director for the Louisiana Psychological Association.

Dr. Crouch is a clinical psychologist with membership in the Divisions for Psychologists in Independent Practice, and also for Trauma Psychology. Dr. Crouch is also a member of the Society of Personality Assessment.

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