Category Archives: News Stories

Measure to Prohibit Cherry Picking by Insurance Venders Involuntarily Deferred

HB 237, a measure put forth by Rep. Chad Brown and supported by the Governor, to prohibit
discrimination by health insurance issuers in the individual market and small and large group
market based on health status, and from imposing any preexisting condition exclusion with respect to the plan or coverage, was involuntarily deferred in Committee on Insurance. The measure also took on six amendments.

The proposed law, if it would have passed, requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

“Proposed law requires a health insurance issuer offering health insurance coverage in the
individual or group market to renew or continue in force the coverage at the option of the plan sponsor or the individual, as applicable, except that the issuer may nonrenew or discontinue health insurance coverage based only on a failure to pay premiums or contributions, an act or practice that constitutes fraud or an intentional misrepresentation of material fact under the terms of the coverage, or the issuer is ceasing to offer coverage in the market.”

The new law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from establishing rules for eligibility, including continued
eligibility, of any individual to enroll under the terms of the plan based on any of the following
health status-related factors in relation to the individual or a dependent of the individual:
(1) Health status.
(2) Medical condition, including both physical and mental illnesses.
(3) Claims experience.
(4) Receipt of health care.
(5) Medical history.
(6) Genetic information.
(7) Evidence of insurability, including conditions arising out of acts of domestic violence.
(8) Disability.
(9) Any other health status-related factor determined appropriate by the commissioner of insurance.

The proposed law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage in La. from establishing lifetime limits on the dollar value of benefits for any participant or beneficiary.

Natural Chemical Helps Brain Adapt to Stress

Researchers at Vanderbilt University Medical Center have identified a natural signaling
molecule that activates cannabinoid receptors in the brain that play a critical role in
stress-resilience. The endocannabinoid family of signaling molecules that activate CB1
and CB2 cannabinoid receptors in the brain were investigated by Sachin Patel, M.D.,
Ph.D., the director of the Division of Addiction Psychiatry at Vanderbilt University
Medical Center. Patel indicated that finding ways to boost the signaling system could
represent a new treatment approach for many stress-linked disorders.

The endocannabinoids are endogenous ligands in the brain that activate CB1 and CB2.
While the endocannabinoids are a biochemistry topic too complex for this cursory look,
the effects of CB1 and CB2 have broad implications for the treatment and possible
prevention of disorders like major depression and PTSD. CB1 is found mostly in the
brain and central nervous system and to a lesser extent in other tissues. CB2 is mostly
found in peripheral organs and cells that service the immune system. CBD, which is now
generally available in several forms do not directly activated CB1 or 2; however, the
effects of CBD are foreshadowing the potential for treatment of not just mood disorders
but many other stress-related or stress-affected disorders, like diabetes, obesity,
memory, anxiety and neurodegenerative disorders.

Boosting this signaling system holds great promise. In fact, THC, the active compound
in marijuana, binds the CB1 receptor, which may explain why relief of tension and
anxiety is the most common reason cited by people who use marijuana chronically.
Patel and his colleagues previously have found CB1 receptors in the amygdala, a key
emotional hub in the brain involved in regulating anxiety and the fight-or-flight response.
They also showed in animal models that anxiety increases when the CB1 receptor is
blocked by a drug or its gene is deleted.

In the current study1 the researchers tested the effects of increasing or depleting the
supply of one endocannabinoid (2-AG) in the amygdala in two populations of mice: one
previously determined to be susceptible to the adverse consequences of acute stress,
and the other which exhibited stress-resilience. Augmenting the 2-AG supply increased
the proportion of stress-resilient mice overall and promoted resilience in mice that were
previously susceptible to stress, whereas depleting 2-AG rendered previously stressresilient mice susceptible to developing anxiety-like behaviors after exposure to acute
stress.

Taken together, these results suggest that 2-AG signaling through the CB1 receptor in
the amygdala promotes resilience to the adverse effects of acute traumatic stress
exposure and supports previous findings in animal models and humans suggesting that
2-AG deficiency could contribute to development of stress-related psychiatric disorders.
Marijuana use is highly cited by patients with PTSD as a way to control symptoms.
However, marijuana use in psychiatric disorders has obvious drawbacks including
possible addiction and cognitive side effects, among others. The Vanderbilt study
suggests that increasing production of natural cannabinoids may be an alternative
strategy to harness the therapeutic potential of this signaling system. For instance, once
levels of the endocannabinoids can be efficiently measured in humans, those identified
with low levels of the signaling system responsible for stress-related mood and anxiety
disorders could have their supply replenished without the complications of using
marijuana.

Rebecca J. Bluett, Rita Báldi, Andre Haymer, Andrew D. Gaulden, Nolan D. Hartley,
Walker P. Parrish, Jordan Baechle, David J. Marcus, Ramzi Mardam-Bey, Brian C. Shonesy,
Md. Jashim Uddin, Lawrence J. Marnett, Ken Mackie, Roger J. Colbran, Danny G. Winder,
Sachin Patel. Endocannabinoid signalling modulates susceptibility to traumatic stress
exposure. Nature Communications, 2017; 8: 14782

Governor Edwards Promotes Bi-Partisan Efforts and Announces Priorities

Governor Edwards announced his Legislative Agenda last month and said that he was excited to work in a bi-partisan manner, outlining key pieces of legislation that he would support. Included were a variety of health and education reforms.

Representative Chad Brown’s HB 237 would protect nearly 850,000 Louisianans with a preexisting condition by prohibiting health plans or health insurers from discriminating against a health insurance applicant based upon preexisting conditions or health status.

SCR 3 by Senator Blade Morrish and HCR 1 by Representative Nancy Landry provides for a
$1,000 pay raise for teachers or certificated personnel, a $500 pay raise for school support
or non-certificated personnel. Eliminating pay secrecy by prohibiting employers from taking actions against employees for inquiring about, discussing or disclosing their wages or another employee’s wages is another of the Governor’s objectives in SB 136 by Senator J.P. Morrell.

HB 391 by Rep. Franklin Foil establishes “The Veterans First Business Initiative”, a statewide
initiative designed to identify veteran owned businesses in Louisiana, create a veteran owned business designation that they can use, and produce a state database for Louisianans to search for various goods or services of veteran owned businesses.

To increase prescription drug transparency, the governor will support legislation sponsored by Sen. Fred Mills, SB 41, to provide the regulatory framework necessary for the Louisiana Department of Insurance, Louisiana Board of Pharmacy, and Louisiana State Board of Medical Examiners to respond to consumer and provider complaints against PBMs. Pharmacy Benefit
Managers (PBMs) are third party administrators, “middlemen,” contracted by health plans, employers, and government entities to manage prescription drug programs on behalf of health plan beneficiaries. The three regulatory bodies will have specific licensure requirements that must be met to be in good standing and operation in Louisiana.

For HB 243, Rep. Dustin Miller and the Governor hope to address opioid-related harm through policy change to establish an enhanced data reporting of fatal and non-fatal drug overdoses where opioids were suspected or present. This legislation will create mechanisms for rapid surveillance of overdoses in the state, and lead to data-driven decisions for targeted prevention, ntervention, and treatment in areas of the state with the most prevalent challenges.

“I am proud of the momentum we are experiencing in the state of Louisiana,” said the Governor. “We have turned the $2 billion deficit I inherited at the start of my administration into a budget surplus….”

Judge Caldwell Reverses His 2017 “Reeks” Decision

Two lawsuits involving Dr. Eric Cerwonka have resulted in decisions in recent months.

In 2017 Cerwonka appealed the results of a decision by the state board that revoked his license. At a preliminary hearing for a Motion to Stay, Judge Michael Caldwell of the 19th Judicial District Court vacated and made void the Board’s decision. Caldwell was reported to say, in a sidebar discussion, “I read the briefs and I read the pleadings. I just can’t send this up to the Court of Appeals, the violations of Due Process are rampant.”

However, in February Judge Caldwell reversed his 2017 decision.

This came after the Board’s attorney, Ms. Amy Lowe, appealed to the State of Louisiana First Circuit Court of Appeal to argue two of the due process matters: 1) the board used attorneys from the same law firm, and 2) the board’s prosecuting attorney had been previously involved with Cerwonka in a child custody case and fee dispute.

In April 2018, the Court of Appeal agreed with Lowe and the matter was then returned to district court for further proceedings.

In another lawsuit, related to the LSBEP complaint, a husband and wife brought a civil suit against Cerwonka in the 15th Judicial District in Lafayette. The plaintiffs sought damages for injuries due to alleged sexual misconduct and malpractice by Cerwonka.

That trial ended in October 2018 when the Lafayette jury concluded that there was no cause of an injury to either the wife or the husband due to Cerwonka’s actions.

However, the jury did find that “… Dr. Cerwonka was negligent, i.e., acting below the level of the ordinary employee, under similar circumstances by the members of his profession,” in his treatment of the wife. No negligent acts were attributed to Cerwonka for the husband and the jury awarded no damages to either the husband or the wife plaintiff.

On January 29, 2019, shortly before Judge Caldwell gave his February decision, the attorneys for the couple who had filed the Lafayette civil suit, submitted a Motion and Order to File Amicus Curiae Brief–a Friend of the Court, with Judge Caldwell in Baton Rouge.

In the 36-page Brief, the attorneys for the Lafayette couple, Edward Walters, Jr. and J.E. Cullens, Jr., presented arguments and opinions against Cerwonka, including excerpts from the Lafayette trial and depositions.

Currently, the LSBEP is also waiting on another legal battle over time limits, which has been on appeal but apparently dormant since 2015.

The time limits case, Dr. Cerwonka’s case, and another investigation of Dr. Alicia Pelligrin which was dismissed under the encouragement of the Board’s general council, contributed in part to skyrocketing legal fees coming out of the Board’s 2014, 2015, and 2016 complaints subcommittee.

According to public records the Board’s escalating legal fees stemmed primarily from fees from the Board Prosecutor, held at that time 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 fees from Mr. Raines.

The Board worked in closed meetings during 2018 to create reforms to its complaints subcommittee process. Mr. Raines no longer appears to be one of the Board’s contract attorneys.

Dr. Moore Top Vote Getter for State Psychology Board

Dr. Michelle Moore received the top number of votes in the recent election to fill an upcoming seat on the Louisiana State Board of Examiners of Psychologists. The position is the 2019–2014 opening left by the normal completion of service by current Chair Dr. Jesse Lambert.

Dr. Moore received 111 of the 225 votes cast, of a possible 791 who received ballots. Dr. Gina Beverly received the next highest number of votes, 73. Drs. Lauren Rasmussen and Lisa Tropez-Arceneau received 35 and 24 votes respectively. Dr. Moore will be recommended to the Governor by the Louisiana Psychological Association, as the top vote getter, sources said.

In a related story, current LSBEP member Dr. Leah Crouch will be resigning due to an upcoming relocation to Korea this May, as was announced at the most recent LSBEP meeting. Another election will be scheduled, reported Dr. Kim VanGeffen.

Dr. Michelle Moore has been a consistent figure in the psychology community and holds several prestigious positions including Clinical Associate Professor of Psychiatry, LSU Health Sciences Center, New Orleans, LA, Department of Psychiatry, Section of Psychology, and Training Director of Clinical Psychology Internship Program.

From 2016 to present her research and scholarship has included: Working with ReNEW Charter School Network to provide needed clinical services to students either in special education or seeking evaluations for possible special education services; Primary Investigator and Mentor, Asian-American Mental Health among Medical Students; and Primary Investigator, Collaborating with Community Partners Collaborating with other psychology faculty at LSUHSC to assess the effectiveness of utilizing professionals in the New Orleans community to train psychology interns on various specialty topics.

Her publications include “An Examination of an Interactive Substance Abuse
Prevention Program for High School Students,” Journal of Child and Adolescent Substance Abuse; “Finding Your Voice Through Publications.” Louisiana Psychological Association; and Colorful Emotions: A Workbook to Help Children Express Their Feelings.

She is a member of the American Psychological Association; Association of Psychologists in Academic Health Centers; Louisiana Psychological Association; Southeastern Psychological Association; and Association of Psychology Postdoctoral and Internship Centers.

“In my current role as Training Director for the internship program at LSU Health Sciences Center, School of Medicine,” Dr. Moore said in her statement, “I have the pleasure of directly training students and trainees who are the future of our profession. Being in this position, I would bring a unique perspective to the Board from the graduate program applications we review, the training of psychology interns and fellows and how we are preparing individuals for independent practice. […]”

And, “Our licensing requirements exist to protect the public and ensure that we are bringing ethically minded psychologists into practice in Louisiana. We also want the public to feel confident about the practice of psychologists across the state and for all of those currently practicing to have great respect for upholding their responsibility as a psychologist. As psychologists, we should always ensure that we have a seat at the table and are ready to have our voices heard.”

Gov. Announces Work Training Program For Medicaid Recipients

Gov. Edwards announced the creation of a work training program for Medicaid recipients. He joined Dr. Rebekah Gee, secretary of the Louisiana Dept. of Health (LDH) and Louisiana Delta Community College Chancellor Dennis Epps to sign a Memorandum of Understanding (MOU) to officially create a collaborative pilot work training initiative between LDCC in Monroe and LDH. The overall goal of the pilot is to develop a work training promotion program model that can be customized by communities across Louisiana.

“We are excited to be able to announce this pilot program that will build on the existing success of the State’s Medicaid Expansion efforts,” said Gov. Edwards. “It offers a practical and Louisiana-specific approach to connect expansion recipients to viable training opportunities that will lead to better jobs and better-earning potential. Creating a program that is helpful but not punitive is something we have consistently been working on. State lawmakers came together and spoke loud and clear on this issue. And with the recent court decisions against the faulty design of similar programs in other states, we are even more convinced that this is the correct path to take. I want to thank everyone who has made this possible and especially Rep. Katrina Jackson and Representative Frank Hoffman for their leadership and guidance in this effort.”

The pilot will include two LDCC campuses – the main campus in Monroe and the campus in the city of West Monroe. The first invitations to participate will be distributed this summer and will continue throughout the year. The pilot will be implemented in two stages, and the time participants will have to complete the program depends on which course of study they select. A total of five training programs will be offered:

Certified Nurse Assistant (CAN)/Behavioral Health Technician (239 Hours); Commercial Vehicle Operations (CVO) (160 Hours); Environmental Services Technician (120 Hours); Forklift & OSHA 10 (Wagner Special) (24 hours); Mortgage Documents Specialist (18 Hours)

Argosy University Folds; APA Pledges to Support Doctoral Students Caught Up

Officials at the American Psychological Association said they will do what they can to support students at the 10 doctoral programs at Argosy campuses across the country following the closing of that university in March.

“With the mandated closing of Argosy University, the American Psychological Association has pledged to do everything it can as an accreditor to facilitate the transition of psychology doctoral students into other APA-accredited programs at the institutions standing ready to receive them,” noted the press release by K. Mills on March 10.

Sources stated that Argosy has been struggling financially for some time. On February 27 the Washington Post reported, “Court documents attribute the missing money to the financial unraveling of Dream Center Education Holdings, a nonprofit group that acquired Argosy, South University and Art Institute campuses in 2016. The Los Angeles company struggled to turn the for-profit colleges into thriving nonprofit schools, and spent months trying to close and sell campuses to meet financial obligations. When it fell short, Dream Center in January entered into receivership, a form of bankruptcy.”

The court-appointed receiver sent a letter to the Education Department showing cash flow where Argosy used $4.2 million of financial aid funds to pay staff, $2.1 million to pay vendors, and $1.7 to fund operations, according to the Post.

Dr. Margaret Smith, now with the Chicago School at Xavier, said, “I previously taught for 10 years at the Illinois School of Professional Psychology at Argosy University Chicago and have been concerned since students reached out to me when the receivership occurred. It’s been a highly traumatic experience for the doctoral students enrolled in the program, as well as faculty who’ve been there prior to it ever being Argosy, when they were a free standing program.”

According to the APA press release, “The American Psychological Association has been working with programs, institutions and the Department of Education in an effort to ensure that psychology doctoral students affected by Argosy’s alleged misdeeds are able to complete their degrees,” said APA President Rosie Phillips Davis, PhD. “Our No. 1 concern is that these students and their teachers are not further penalized by the rapid demise and closing of the Argosy campuses. Some of these students were months away from graduating and entering the workforce to provide mental health care and other vital contributions to society. The top priority for the Department of Education and institutions around the country must be to ensure that the futures and the investments by these students are not jeopardized.”

Responding to calls and emails from affected students, faculty, and other concerned parties. APA established a Psychology Student Action Center (psychstudentactioncenter@a pa.org and 202-336-6014) to direct members of the Argosy community to appropriate resources and created a webpage with referral information and FAQs.

New Rule Allows More Private-Sector Care for Veterans

New regulations being considered by the Veterans Affairs will allow Veterans who live more than 30 minutes from a VA medical clinic or those who must endure a delay more 20 days for health care will be allowed to use private-sector medical services. If approved, Veterans who must drive for 30 minutes to get to a Veterans Affairs facility will be allowed to seek primary care and mental health services outside the department’s system.

The proposed regulations are open for public comments.

In an article in Military Times, Leo Shane reported that new rules would replace the current standards now in place, for 40 miles and 30 days and “dramatically expand the number of outside health care appointments that VA will have to fund in coming years.”

The standards also would allow Veterans to receive urgent care outside the VA system.

VA Secretary Robert Wilkie said, “Most Americans can already choose the health care providers that they trust, and President Trump promised that veterans would be able to do the same,” Wilkie said. “With VA’s new access standards, the future of the VA health care system will lie in the hands of veterans, exactly where it should be.”

“Strict and confusing qualification criteria like driving distances and proximity to VA facilities that don’t offer needed services will be replaced by eligibility guidelines based on what matters most: the convenience of our veteran customers,” Wilkie said in his statement.

The report by Shane noted that some in Congress are concerned that the changes may negatively impact the VA. “… shifting too many VA resources to outside clinics and doctors’ offices could slowly drain away needed resources from the department’s facilities and lead to privatizing VA’s core mission of providing health care for veterans.”

The changes come as part of the “access standards” signed into law under the MISSON Act last year.

According to the new standards, eligibility criteria and final standards were based on VA’s analysis of all of the best practices both in government and in the private sector and tailored to the needs of our Veteran patients. Included are:

• Access standards will be based on average drive time and appointment wait times.

• For primary care, mental health, and noninstitutional extended care services, VA is proposing a 30-minute average drive time standard.

• For specialty care, VA is proposing a 60-minute average drive time standard.

• VA is proposing appointment wait-time standards of 20 days for primary care, mental health care, and non-institutional extended care services, and 28 days for specialty care from the date of request with certain exceptions.

Eligible Veterans who cannot access care within those standards would be able to choose between eligible community providers and care at a VA medical facility.

Lawmakers were to be briefed on the new draft standards but that “Capitol Hill staffers and several prominent Veterans groups have complained that much of the work in writing the standards in recent months has been done behind the scenes, without sufficient input from the larger veterans community,” said the report.

New APA Guidelines Spark Debate, Criticism

The American Psychological Association has triggered debate with its Guidelines for Psychological Practice with Boys and Men, published in August 2018 and followed with an essay posted on the APA website CE Corner in January, with a statement that “… traditional masculinity is psychologically harmful …,” by Stephanie Pappas.

According to the authors, the Guidelines provide “general recommendations for psychologists who seek to increase their awareness, knowledge, and skills in psychological practice with boys and men.” Other beneficiaries of the guidelines include all consumers of psychological practice including clients, students, other health professionals, institutions and agencies, write the authors.

The Guidelines are authored by Fredric Rabinowitz, Matt Englar-Carlson, Ryon McDermott, Christopher Liang, and Matthew Kridel, with assistance from Christopher Kilmartin, Ronald Levant, Mark Kiselica, Nathan Booth, Nicholas Borgogna, and April Berry.

“Masculinity ideology is a set of descriptive, prescriptive, and proscriptive of cognitions about boys and men,” write the authors.

“Although there are differences in masculinity ideologies, there is a particular constellation of standards that have held sway over large segments of the population, including: antifemininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence. These have been collectively referred to as traditional masculinity ideology (Levant & Richmond, 2007).”

“The present document articulates guidelines that enhance gender- and culture sensitive psychological practice with boys and men from diverse backgrounds in the United States,” write the authors.

For its definition section the Guidelines cover topics of gender, cisgender, gender bias, gender role strain, masculinity ideology, gender role conflict, oppression, privilege, psychological practice, and gendersensitive.

In the 30 plus page document, available at APA, the 10 Guidelines are: 1) Psychologists strive to recognize that masculinities are constructed based on social, cultural, and contextual norms; 2) Psychologists strive to recognize that boys and men integrate multiple aspects to their social identities across the lifespan; 3) Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.

And, 4) Psychologists strive to develop
a comprehensive understanding
of the factors that influence the interpersonal relationships of boys and men; 5) Psychologists strive to encourage positive father involvement and healthy family relationships; 6) Psychologists strive to support educational efforts that are responsive to the needs of boys and men; 7) Psychologists strive to reduce
the high rates of problems boys and men face and act out in their lives such as aggression, violence, substance abuse, and suicide.

And also, 8) Psychologists strive to help boys and men engage in health-related behaviors; 9) Psychologists strive to build and promote gender-sensitive psychological services; 10) Psychologists understand and strive to change institutional, cultural, and systemic problems that affect boys and men through advocacy, prevention, and education.

Dr. Edward Adams, past president of Division 51 on Men and Masculinities of the American Psychological Association, defended the guidelines as supporting cooperation, respect, appreciation, and courage.

Dr. John Grohol, founder of the popular PsychCentral published a review of the guidelines with a neutral, positive, and brief explanation of the meanings.

Primary author, Fredric Rabinowitz, Professor of Psychology at University of Redlands, links to two January media articles, “Traditional Masculinity Can Hurt Boys, Say New A.P.A. Guidelines,” a The New York Times, and “Traditional masculinity’ labeled ‘harmful’by major psychologist organization,” reported by public radio in Southern California.

However, the guidelines and essay attracted criticism from various groups. In a January article in National Review, “Grown Men Are the Solution, Not the Problem,” David French wrote “We are in the middle of an intense culture war focused around men.”

In another report, Steven Pinker, a professor of psychology at Harvard, criticized the Guidelines saying that the authors reject biological and genetic factors, and also embrace a folk myth that expressing negative emotions is better than restraining them with selfcontrol.

Andrew Sullivan, in a critique in the New York Intelligencer, titled “The Pathologized Male,” noted “It felt demeaning to read. To tell you the truth, it reminded me of the way psychologists used to treat gay men: as pathological, dangerous, and in need of reparative and conversion therapy.” And he wrote, “If this document were designed to encourage men to seek psychotherapy, it is a catastrophe.”

Similar comments appeared across the web. “We should be able to celebrate masculinity and its positive attributes while making it clear that there are behaviors that are unacceptable, without insulting and demonizing men.” And another said, ” I don’t think we should be shaming anyone for who they are.”

On January 14, APA tried some damage control with, “A Closer Look at the APA Guidelines for Psychological Practice with Boys and Men,” with a section on “Embracing Masculinity.”

“Psychologists who treat men and boys already know that their male clients aren’t stereotypes. They have feelings, needs and desires. They’re adaptable. They possess many positive masculine characteristics. The guidelines are designed to give psychologists a framework to help men and boys embrace their masculinity in ways that are helpful, rather than harmful, to their health and quality of life.”

APA “In the News” links to an article “How ‘Traditional Masculinity’ Hurts Those Men Who Believe in it the Most,” by a Washington Post columnist.

And APA gives the headline, “Many people responded as if APA’s guidelines were an indictment not of rigid, traditional masculinity but of all masculinity, and of men themselves.”

The essay by Pappas appears to be removed from the January APA news, and in CE Corner the learning objective about traditional masculinity being harmful has been noted to be edited for clarity from the original version.

CDC Year End Report: Mortality Rates Higher in Most Causes of US Deaths

A year end CDC analysis of data reveals that life expectancy for Americans continues to decline. Despite U.S. health costs being the highest around the world, mortality rates increased for 7 of the 10 leading causes of death in the U.S. reported the CDC in a review for 2018.

Drug overdoses continued to increase – 47,600 drug overdose deaths involved any type of opioid, including heroin and illicit opioids, representing over two-thirds of all overdose deaths. U.S. overdose death rates linked to synthetic opioids, likely from illicitly manufactured fentanyl (IMF), increased more than 45 percent from 2016 to 2017 while death rates from heroin and prescription opioids remained stable and high.

CDC said suicide rate among the U.S. working-age population increased 34 percent between 2000 and 2016. Additionally, suicide rates rose in nearly every state between 1999 and 2016. Suicide is the 10th leading cause of death and its rise has contributed to lowered life expectancy.

CDC released data showing a steep and sustained increase in sexually transmitted diseases (STDs), including nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis.

New cases of STDs surpassed the previous record by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these STDs.

Chronic disease continues to remain a priority, said the report. Heart attacks, strokes, heart failure and other related conditions caused 2.2 million hospitalizations, resulting in $32.7 billion in costs and 415,000 deaths, according to CDC.

Officials noted these health problems are largely preventable. Many of these events were in adults ages 35-64.

According to the latest data for Louisiana, 2014, the leading causes of death were heart disease, then cancer, accidents, respiratory disease, stroke, and Alzheimer’s disease. Louisiana ranks 5th, 4th, 12th, 23rd, 4th and 6th respectively in the nation for these causes of death.

Gov. Appoints Mr. Heller To Psychology Board as New Consumer Member

On December 27 the Governor appointed Amitai Heller, of New Orleans, to the Louisiana State Board of Examiners of Psychologists. Heller is an attorney with the Advocacy Center of Louisiana. He will serve as a private citizen and consumer member on the board, a new reform put forward in the 2018 legislative session by Senator Mills.

Mr. Heller works in the legal division of the Advocacy Center, an organization that serves people with disabilities and senior citizens. According to their website, “The Advocacy Center of Louisiana protects, empowers, and advocates for the human and legal rights of people with disabilities and seniors living in Louisiana, in order that they may live an integrated life in the community, free from abuse, neglect and exploitation.”

“The agency was founded pursuant to a federal law establishing protection and advocacy systems in each state and territory in the U.S. The mandate of the protection and advocacy systems is “to pursue legal, administrative, and other appropriate means to ensure the rights of persons with development disabilities in the state.” Since 1977, we have added other populations to our client base including persons with other mental and physical disabilities and senior citizens

Rural Health Focus On Opioid Deaths

The Louisiana Department of Health announced in September 2018 that it had received a Federal grant of more than $24 million toward addressing the opioid epidemic in our state, said Dr. Tiffany Jennings, licensed psychologist in Shreveport, and Louisiana Psychological Association (LPA) Rural Health Coordinator for the American Psychological Association, and chair of the LPA the Rural and TeleHealth Services Committee.

According to the United States Department of Agriculture (USDA) almost 200 people per day died from drug overdose in 2017, more than 72,000 Americans during the year. The overwhelming majority of these overdose deaths involved an opioid. The Centers for Disease Control and Prevention said that the rates of drug overdose deaths are rising in rural areas, surpassing the numbers in urban areas.

“This grant was funded from the Center for Disease Control and Prevention and the US Dept. of Health and Human Services,” said Dr. Jennings. “The money will be used for improving access to treatment, prevention strategies, improving surveillance data and to enable health centers and other agencies to expand integrated services treatment.”

“But we’ve still got a long way to go,” said Jennings. “Mental Health America ranked Louisiana 45th for access to mental health care. In 2016, the Medicaid expansion did provide insurance coverage for more than 430,000 people, it’s difficult to obtain mental health services. Many doctors and agencies will not accept Medicaid due to reimbursement issues and low reimbursement rates. Agencies that do take Medicaid have a waiting list,” she said.

Dr. Jennings has previously served as a neuropsychologist at Overton Brooks Veterans Administration Medical Center in Shreveport and also neuropsychologist for the U.S. Army’s Traumatic Brain Injury Clinic in Fort Polk in Leesville, Louisiana.

As Rural Health Coordinator for APA and LPA, Dr. Jennings has said that one of the goals of her committee is to “develop an ongoing community where those in rural areas, or who serve rural populations, can collaborate with each other.” She said that sharing experiences as to how to set up various telehealth services and also to review current guidelines will be important goals ….”

“Another objective in mind is initiating and continuing the conversation regarding the opioid crisis,” said Dr. Jennings previously. “… it’s a major focus of concern.”

“Telemedicine has been gaining more ground in treatment, particularly for those in rural areas where treatment services may be limited, or non-existent,” she said. “University Health in Shreveport was highlighted in the local media (KTBS.com) highlighting the advantages of telemedicine –such as cost, reduced transportation burden–and that telemedicine can be as effective as traditional in-person treatments,” said Jennings.

This past fall the USDA launched an interactive data tool aimed to help communities build grassroots strategies to stem the opioid epidemic, to help rural leaders make data-driven decisions for their communities.

The USDA invites leaders to see the many ways your community can partner with USDA to meet immediate needs in this fight. According to the USDA, their program resources can help rural communities address many of the deeper, systemic, and long-term issues making these places vulnerable to the opioid crisis in the first place, the agency notes. Their infographic illustrates how USDA can help rural communities respond to the opioid epidemic by addressing some of the root causes.

ASPPB Uses Carrot & Stick for New EPPP2

Members of the Louisiana State Board of Examiners, at their November 30 meeting in Baton Rouge, discussed how the Association of State and Provincial Psychology Boards (ASPPB) has adopted a reward and punishment program for those state boards still resisting adopting the controversial second examination a psychology license, the EPPP2.

Complaints about the new exam had been growing and escalated when officials at ASPPB decided in August 2017 that the new test was to be mandatory. Following that move and resulting controversy, ASPPB backpedaled somewhat and on October 24 notified its members that they would have an option to use the EPPP but without the EPPP2.

However, there are penalties associated. Some members said they view this as an attempt to coerce states into compliance.

According to the October 24 announcement from Dr. Sharon Lightfoot, President of the ASPPB Board of Directors, if Louisiana chooses to decline the use of EPPP2, individuals here will not be allowed to take EPPP2 even if they wish to do so. Also, those test-takers from compliant states will pay $300 as a reward for early adoption of the additional exam, while those from late adopters will pay $450.

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

“January 1, 2020 through December 31, 2021 is designated as an early adoption period. All jurisdictions who decide to adopt the Enhanced EPPP at any point during this time frame will be offered reduced fees for their applicants,” wrote Lightfoot.

In October, LSBEP members Drs. Amy Henke and Greg Gormanous, and Executive Director, Jaime Monic, attended the annual meeting of ASPPB in Salt Lake City, Utah. The EPPP-2 was discussed in depth.

Henke has been critical of the move since she lead opposition and the passage of a Resolution in the Louisiana Psychological Association. Sources say that some consider the ASPPB to be more in the mode of a “sales” organization and that there was little opportunity given for the ASPPB member jurisdictions to voice concerns.

One source said that ASPPB appears to be going around its board members and marketing the new test to internship programs and state legislatures. It was reported that they have also said that student groups support the new test when that is not the case.

Through 2016 and 2017 objections to the EPPP2 mounted, mostly from student and early career psychologist organizations.

In 2016, Dr. Henke, then a Director on the Executive Council of the Louisiana Psychological Association (LPA) and Co-Chair of the LPA Early Career Psychologists Committee in LPA, put forth a Resolution to oppose the EPPP2 for Louisiana, which passed unanimously. Dr. Henke is now serving on the state psychology board.

Objections, from Henke and others, involve technical and scientific issues, but also the criticism that there is no problem that the new test needs to solve. “There is no evidence that the public is facing some sort of previously unheard of crisis in terms of safety from currently practicing psychologists,” said Dr. Henke in 2016.

The Examination for Practice of Professional Psychology (EPPP) is privately owned by the ASPPB, which claims to serve its 64 members, regulatory boards of psychology. In a plan that appears to have been in place for a number of years, the ASPPB has decided to double the content and the price of its main product, the EPPP, from $600 to $1200, plus administration fees.

LSU’s Dr. Frick and Dr. Matson Named World Class Scholars

In two separate reports, Louisiana State University Psychology Professors, Dr. Paul Frick and Dr. Johnny Matson, have been designated as top scholars in comparison to all others worldwide.

In an October report from LSU News, Dr. Paul Frick was noted to be one of only four researchers from LSU who achieved an h-index over 100, based on the Google Scholar Citations database. Only 3,160 scholars worldwide reach this level of significance.

Dr. Johnny Matson, professor of psychology and Distinguished Research Master, was noted for his interdisciplinary achievements, as one of only three LSU researchers who were among the top cited scholars by Clarivate Analytics this year, based on a review of journals indexed in the Web of Science Core Collection 2006-2016. According to LSU News, this measure takes into account the top 1% within each of 21 broad fields, over a specific period of time.

Dr. Paul Frick holds the Roy Crumpler Memorial Chair and is professor of psychology at LSU. His research investigates the many interacting factors that can lead children and adolescents to have serious emotional and behavioral problems, such as aggressive and antisocial behavior.

The h-index measures both productivity and impact of published papers. The score measures the researcher’s total number of papers as well as how many times each paper is cited by other scholars. An h-index over 100 amounts to 100 research papers each cited over 100 times.

“It’s quite an honor to be on this list,” Frick told LSU. “In my research, we have looked at kids with behavioral problems and developed ways of identifying them and treating them. Once your scale or system of how a disease or problem is classified and diagnosed is picked up by entities such as the World Health Organization and the American Psychiatric Association, you tend to get a lot of citations because everyone who uses your measure and has to cite you to justify theirs.”

Dr. Matson was included in the Clarivate Analytics 2018 list of only 6,078 scholars worldwide and one of only 2,020 in the new, interdisciplinary category.

This is the first year that Clarivate Analytics has looked specifically at cross-field citations, “…as frontier areas of research are frequently interdisciplinary, it is even more important to identify scientists and social scientists working and contributing substantially at the CrossField leading edge.”

Dr. Paul Frick is the inaugural recipient of the Roy Crumpler Memorial Chair in Psychology at Louisiana State University, Baton Rouge campus. Frick most recently served as the Department Chair in Psychology at the University of New Orleans.

In 2017, he was named the Editor-in-Chief for the prestigious Journal of Abnormal Child Psychology, the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.

Frick is a leading international authority in child and adolescent diagnosis and behavior and his work focuses on the pathways by which youth develop severe antisocial behavior and aggressiveness. He has published over 180 manuscripts in either edited books or peer-reviewed publications and he is the author of 6 additional books and test manuals. He has been Distinguished Professor and Chair of the Department of Psychology at the University of New Orleans, and was named the recipient of the Robert D. Hare Lifetime Achievement Award by the Society for the Scientific Study of Psychopathy.

Dr. Frick’s research has been funded by the National Institute of Mental Health, Office of Juvenile Justice and Delinquency Prevention, and the John T. and Catherine D. MacArthur Foundation. In 2008, he received the MacArthur Foundation’s Champion for Change in Juvenile Justice Award for the state of Louisiana. He has been the editor of the Journal of Clinical Child and Adolescent Psychology, is past president of the Society for the Scientific Study of Psychopathy. He has an Honorary Doctorate from Orebro University in Orebro, Sweden in recognition of his research contributions in psychology. He is also Professor in the Learning Sciences Institute of Australia at Australian Catholic University.

Dr. Matson is expert in autism, mental disabilities, and severe emotional disorders in children and adolescents, and has produced more than 700 publications and 38 books. Just a few of his titles are the International Handbook of Autism and Pervasive Developmental Disorders, Practitioner’s Guide to Applied Behavior Analysis for Children with Autism Spectrum Disorders, Practitioner’s Guide to Social Behavior and Social Skills in Children, and Assessing Childhood Psychopathology and Developmental Disabilities, and Treating Childhood Psychopathology and Developmental Disabilities.

Matson has served as Editor-in-Chief for Research in Autism Spectrum Disorders (Oxford England), Editor-in- Chief for Research in Developmental Disabilities (Oxford, England), and Associate Editor for Journal of Mental Health Research in Intellectual Disabilities (London).

Through the years he has served on 80 editorial boards, both US and International, including as Editor-in-Chief for Applied Research in Mental Retardation and the Official Journal of the American Association for University Affiliated Programs. He has also served as guest reviewer for over 50 journals, both US and International. And, he has visited as a professor around the world, including Canada, Sweden, and India.

Among his many professional activities, Matson has been a guest expert on ABC’s 20/20, consulted with the Alabama, California, Georgia, Illinois, Iowa, Louisiana, Missouri, Virginia, and the US Departments of Mental Health. He has been a guess expert on CBS Eye-to-Eye and consulted for the DSM III-R Educational Testing Service. He has served on the President’s Committee on Mental Retardation, and consulted to the US States Department of Justice, and the US Department of Education.

“This is really about having a few decent ideas but mostly about having a goal and working and working to reach it,” Dr. Matson said to the Times.

“Maintaining that level of focus over that period of time is not easy,” he said, “at least it wasn’t for me. In my case, largely it has been about getting researchers and clinicians to be made aware of and to have the tools to identify co-morbid challenging behaviors and psychopathology in persons with autism and/or intellectual disabilities,” he said.

“If I have been able to do that, in some small way, then it will mean better care for many persons with developmental disabilities.”

CDC Data Points to Higher Psychological Distress in America

The CDC reported new numbers last month in both deaths by suicide and drug overdoses that point to the worsening psychological well-being of America’s citizens. The CDC Director said the sobering statistics should be a wake up call.

Robert Redfield, M.D., CDC Director, said, “The latest CDC data show that the U.S. life expectancy has declined over the past few years. Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide. Life expectancy gives us a snapshot of the Nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.”

In its newest report, the CDC notes that the age-adjusted suicide rate increased 33% from 10.5 per 100,000 in 1999 to 14.0 in 2017.

The rate of suicide among females increased from 4.0 per 100,000 in 1999 to 6.1 in 2017, while the rate for males increased from 17.8 to 22.4. Compared with rates in 1999, suicide rates in 2017 were higher for males and females in all age groups from 10 to 74 years, said the CDC.

For 2017, the age-adjusted suicide rate for the most rural counties (20.0) was 1.8 times the rate for the most urban counties (11.1).

The rate for the most rural counties in 2017 (20.0) was 53% higher than the rate in 1999 (13.1).

The age-adjusted suicide rate for the most urban counties in 2017 (11.1 per 100,000) was 16% higher than the rate in 1999 (9.6).

Since 2008, suicide has ranked as the 10th leading cause of death for all ages in the United States. In 2016, suicide became the second leading cause of death for ages 10–34 and the fourth leading cause for ages 35–54.

Another report for 2017 figures from the CDC indicated that there were 70,237 drug overdose deaths in the United States, 9.6% higher than the rate in 2016.

The age-adjusted rate of drug overdose deaths increased from 6.1 per 100,000 standard population in 1999 to 21.7 in 2017. For each year, rates were significantly higher for males than females.

Rates of drug overdose continued to increase. In 2017, the age-adjusted rate of drug overdose deaths was 9.6% higher than the rate in 2016 (21.7 vs 19.8 per 100,000), although the percentage increase was lower than that seen from 2015 to 2016, when the rate rose by 21% (from 16.3 to 19.8 per 100,000).

The rate of drug overdose deaths in 2017 was 3.6 times higher than the rate in 1999. Rates increased for both men (from 8.2 in 1999 to 29.1 in 2017) and women (from 3.9 in 1999 to 14.4 in 2017). In 2017, the highest rates of drug overdose deaths occurred among adults aged 25 to 54 years.

From 1999 to 2017, the greatest increase in drug overdose death rates occurred among adults aged 55 to 64, from 4.2 to 28.0 per 100,000, a more than six-fold increase.