In January a group of psychologists from the Louisiana Association for Psychological Science submitted a complaint to the Louisiana State Board of Examiners of Psychologists saying that the Board is inappropriately using the national licensing exam in a way that discriminates against Blacks and other minorities, denying their property rights.
The crux of the matter is in the use of the 50th percentile as a pass-fail hurdle for the national examination. This cut-off automatically eliminates half of the candidates seeking a license, all of which hold doctoral degrees and are otherwise qualified. The cut-off is recommended by the Association of State and Provincial Psychology Boards ASPPB) and uniformly accepted by the states.
The authors of the complaint said that the cut-off of the 50th percentile increased the likelihood of “adverse impact” and therefore, discrimination.
Authors cited the research of Dr. Brian Sharpless, PhD, associate professor at the American School of Professional Psychology, who in 2018 used a Freedom of Information Act to obtain exam results from the New York state board of psychology.
Sharpless gathered data on 4892 applicants and their exam scores over a 25-year period and found that Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07% and Asians had a failure rate of 24%. Sharpless has found similar problems in Connecticut. Whites had a 5.75% failure rate, Blacks had a 23.33% failure rate, and Hispanics had a 18.6% failure rate.
Differences in pass rates constitute adverse impact and according to the EEOC, can be taken as discrimination, unless proven otherwise with careful research.
The request for an investigation was denied by the Louisiana board.
In this report, we review the context, conflicts of interest, and the involvement of the Association of State and Provincial Psychology Boards in the decisions of Louisiana gatekeepers.
Racial discrimination
By law, an applicant for a state psychology license must pass a national exam, but the law does not indicate the cut-off for passing. That detail is set by the rules of the state board. In 1983 the rule was that the applicant had to pass at the 25th percentile. Between that time and now the cut-off has been changed to the 50th percentile. This score fails 50% of test takers, including those who fall in the bottom half of the average range.
Several sources confirm that the higher the cut-off is set the more likely adverse impact will be found and a discriminatory result.
According to an ASPPB report, the exam is developed by creating test items coming from a sample of survey respondents who are psychologists. However, 85.4% of those responding are white, while only 2.6% responding are Black. Only 3.6% are Hispanic.
Furthermore, Louisiana contributed only 1/2 of one percentage point to the total respondents. In comparison, California contributed 21.6%, Michigan contributed 5.8%, and Ontario contributed 6.4%.
Blacks and individuals from Louisiana are significantly underrepresented in the test development process.
One Black candidate told the Times, “We’ve known for a long time that the test discriminates– we learned it in graduate school. But there’s nothing we, as students, can do about it.”
Michael Cunningham, PhD, Professor of Psychology, Africana Studies and Associate Provost at Tulane, points to potential problems with item development.
“Like all standardized exams, people with the highest pass rates tend to very similar in racial and ethnic backgrounds as the test developers,” he said. “For many standardized tests, experts examine items for bias when there is an adverse impact of a question for males or females. In these cases, when bias still exists after an item analysis, the question is excluded. I don’t think similar considerations are done for racial/ethnic or SES backgrounds.”
One business psychologist said that in the private sector the ASPPB’s approach would not be accepted. “Business owners would not take the risk of having adverse impact. We would be adjusting cut-offs and adding unbiased tests to the overall selection program, so that our clients could avoid adverse impact.”
An additional weakness in the use of the national exam is that there is no research connection to outcomes, those that score better are not proven to be better psychologists. ASPPB acknowledges the exam limitations. On their webpage officials state, “There is no suggestion that people who do better on the EPPP [the exam] will be better practitioners.”
Industrial-organizational psychologist Dr. William Costelloe, who works in the private sector, agrees. There is no other choice these days, he told the Times, “… predictive validation studies must be conducted.”
Criticisms have been mostly dismissed by officials at the ASPPB. In an answer published in the American Psychologist, APPB employees Drs. Matthew Turner, John Hunsley and Emil Rodolfa defended their decisions. “The standards emphasize that licensure/credentialing examinations are built from a content validation framework, and this framework is used for licensure examinations across professions,” they said.
In April 2018, then ASPPB CEO, Dr. Stephen DeMers, met with members of the Louisiana State Board of Examiners of Psychologists and representatives of Louisiana Psychological Association (LPA).
About the meeting, Dr. Kim VanGeffen, Chair of LPA Professional Affairs, said, “Dr. DeMers acknowledged that, currently, there is not really any research on the validity of the EPPP-2. There do not seem to be any plans to obtain predictive validity…”.
Dr. Marc Zimmermann, past LSBEP board member, also attended. “He [Dr. DeMers] stated that there is no predictive validity,” said Zimmermann. “… DeMers had the temerity to try to sell us something that does not meet the standard that psychological tests being published are expected to have.”
Additionally, there is little evidence of a public safety problem requiring a high cut-off.
“There is no evidence that the public is facing some sort of previously unheard of crisis in terms of safety from currently practicing psychologists,” said Dr. Amy Henke, who spearheaded a Resolution opposing the addition of a second exam. “Trainees are already held to high standards through a variety of benchmarks.”
Statistics support her claim. Data from their own ASPPB Disciplinary Data System: Historical Discipline Report show rates of disciplinary actions for psychologists to be consistently low. For an estimated 125,000 psychologists in the US and Canada, the disciplinary rates remain around 1–2 per 1,000.
Who Profits? ASPPB Sells the National Exam
ASPPB’s main income producing product is the national exam, generating 94 percent of their total revenues.
The ASPPB sells the EPPP, the national exam, to candidates who are required to take the exam by the state boards, and the state boards are members of ASPPB.
According to the most recent information posted by the IRS, the exam and related services generated $6,137,348 in 2018. This accounted for 94% of the Association’s 2018 income.
Exam income was $5,378,524 in 2017, and $4,916,406 in 2016. Total revenue for 2018 was $6,505,651. Revenue for 2017 was $6,645,731 and $5,933,473 for 2016. GuideStar estimates their assets at $11,013,348.
ASPPB is a 501(c) tax-exempt corporation whose official mission is to, “Facilitate communication among member jurisdictions about licensure, certification, and mobility of professional psychologists.”
The “members” are the approximately 64 regulatory boards from across the United States and Canada. These boards pay dues to ASPPB. The Louisiana Board’s records note they pay approximately $2,500 for annual ASPPB dues.
But the associations goals appear to go beyond facilitating communication. In their 2016 “Game Plan,” they listed their primary goal as, “1. offering exemplary examination and credentialing programs.”
They report a total of $2,278,482 for compensation of key employees, other salaries and wages, contributions to pension plans, employee benefits and payroll taxes.
In 2018, the CEO, M. Burnetti-Atwell, received pay and benefits of $255,936. In 2017, Dr. Steven DeMers, then CEO, received $270,784.
“With a lot of cash sitting on the balance sheet, the strategy is to maximize expenses,” said an MBA in reviewing the information for the Times. “The extra profits are likely to go into perks rather than price cuts,” he said.
Examples of this appear to include items like travel, which includes travel for spouses or companions. The organization spent $949,483 on travel in 2018 and $1,169,743 on travel in 2017.
Some years ago, ASPPB appears to have embraced a more aggressive corporate strategy. An insider told the Times, “In 2010 or somewhere around that time they [ASPPB] were in New Orleans and they implied that they would be making a lot of money on the new test.”
In a Letter of Agreement from ASPPB to the boards in late 2012, ASPPB wrote that the exam is “made available as a service to psychology licensure boards that are ASPPB members in good standing as signified by payment of membership dues.” ASPPB owns the intellectual property rights to the EPPP and the data generated by the testing program, the authors also explained.
Prior to 2013 ASPPB contracted with Professional Examination Service (PES) for delivering the EPPP. Each state or jurisdiction had a contract with PES. But in 2013 ASPPB informed the boards
that their contracts with PES were being “replaced with a contract between your jurisdiction and the Association of State and Provincial Psychology Boards.”
In the letter, ASPPB officials wrote, “ASPPB and PES have agreed that it would be simpler and more appropriate for ASPPB to contract directly with the 64 psychology regulatory agencies that are members of ASPPB.”
ASPPB said that the change would be “mutually beneficial because ASPPB can now provide a simplified agreement that is more specific to the needs of psychology licensure boards. In addition, the renewal of contracts is expected to be more efficient…” And, “Finally, as voting members of ASPPB, each jurisdiction exercises more oversight of this important examination service by contracting directly with ASPPB for examination services.”
One undisclosed insider thinks the corporate objective for ASPPB is to be a central source for regulation of psychologists. “They want to ultimately do all the licensing and regulating for psychology,” said the insider. “They want to regulate all the telepsychology.” And, “They want to be the Walmart.”
ASPPB protects its turf. “If you are not a member or staff of an ASPPB Member Psychology Regulatory Board or an individual member, you are not eligible to access this section of our website,” they write. Their conferences are also members only.
They communicate a strict policy of confidentiality, “The authority to correspond with other individuals, committees or organizations and express the opinions or position of the Association is reserved for the current President of the Association and/or the Chief Executive Officer or his designee and/or the Board of Directors.
“To ensure acknowledgment of this Spokesperson Policy, and to verify necessary confidentiality compliance, the Association requires a signed confidentiality agreement by all Committee/Task Force and chair members, …”
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Who profits from the 50th percentile cut-off? Not the public. There is no evidence of a safety problem that would be corrected by a high cut-off score. On the contrary, this situation has contributed to the severe shortage of psychologists in Louisiana, with only one for every 6,000 citizens.
Who profits? The IRS notes that the 501(c) 6 “… may not be organized for profit to engage in an activity ordinarily carried on for profit (even if the business is operated on a cooperative basis or produces only enough income to be self-sustaining).” The ASPPB is profitable.
These problems might start with the ASPPB, but legally and morally they land at the doorstep of every state psychology board. The situation hits Louisiana particularly hard. While only 4% of licensed psychologists nationwide are African-Americans, Louisiana has a 34% Black population, a group chronically underserved by mental health professionals. Louisiana is specifically in need of psychologists who understand the Black experience.