Category Archives: News Stories

Gov. Edwards Issues Statement on Court Overturning Roe V. Wade

In a June 24 press release, Gov. John Edwards issued a statement about the Dobbs v. Jackson Women’s Health Organization ruling by the United States Supreme Court, which overturned  Roe v. Wade.

Gov. Edwards said, “I am and have always been unabashedly pro-life and opposed to abortion. However, I understand that people on both sides of this complex issue hold deeply personal  beliefs, and I respect that not everyone, including many in my own party, agrees with my position.

“While we are still reviewing the decision issued by the Court this morning, Louisiana has had a  trigger law in place since 2006 that would outlaw abortion, without exception for rape and  incest, should the United States Supreme Court overturn Roe v. Wade.

“I asked the Legislature to include exceptions for rape and incest in the legislation most recently passed. While the bill that passed expanded the exceptions from the 2006 law to include  instances of medical futility and treatment of ectopic pregnancies, these important exceptions  were not included.

“As I have said many times before, I believe women who are survivors of rape or incest should  be able determine whether to continue with a pregnancy that is the result of a criminal act.

“And, to be clear, the legislation I recently signed protects all forms of contraception, including emergency contraception, which remains fully legal and available in Louisiana.

“Being pro-life  means more than just being against abortion. It means providing the necessary resources and implementing policies that provide real options and not just lip service to the children, women,  and families we are blessed to serve. Now more than ever, it’s critical that Louisiana funds  services to support women, children, and families throughout their lives, which is why I have  expanded health care through our Medicaid program and lobbied for measures to make sure workers are paid better and more fairly. It’s also why I’ve supported better funding for  Louisiana’s public education system, including early childhood education. I believe all people  should have the opportunity to succeed and that starts with providing a strong foundation early in life.

“Make no mistake, there is much more that we can do to support women, children, and families, and I hope that my fellow pro-life public officials will join me in these efforts in the  coming months and years.”

 

 

 

 

 

 

Legislative Auditors Review Strengths, Weaknesses of State Psychology Board

A performance audit by the Louisiana Legislative Auditors Office has found problems in the  complaints process of the state Psychology Board. The audit, led by Ms. Emily Dixon, Performance Audit Manager, and begun in August 2021, examined the Board’s processes for  licensing, monitoring, and enforcement. The performance of the board was compared to the requirements set forth in the Psychology Practice Act, and found to be in compliance with “most best practices.”

However, the auditors found numerous problems with the complaints committee performance. They said that the average time for resolving a complaint was 338 days and that the Board had  no internal time frames for accomplishing its investigations. The auditors also stated that the  board had no “disciplinary matrix,” and no way to track the nature and outcomes of complaints  or to analyze the data. They also found numerous errors, inconsistencies, and lack of follow up.

The auditors sampled internal documents from fiscal years 2019 through 2021. During this  three year time, LSBEP received 71 complaints and closed 63 of these complaints. Eight, or 12.7%, resulted in a public, disciplinary action. There was one, non-public, impaired psychologist procedure and 11 Letters of Education, also nonpublic. According to this data, 43 of the cases  were dismissed with no action. A total of 85.7% were either dismissed or received a letter with  educational information.

The auditors found that the board required an average of 338 days to resolve a complaint. The  time ranged from eleven days to more than three years. Eight (12.7%) of the 63 complaints took more than two years to resolve, and an additional 13 (20.6%) of the complaints took more than  one year to resolve.

” […] LSBEP has not established internal timeframes for resolving complaints, and its process for tracking complaints does not record accurate and complete information. As a result, the Board  cannot ensure that it is investigating and resolving complaints in a timely manner,” they said.

The auditors found that LSBEP’s process for tracking complaints included inaccuracies and inconsistencies.

“LSBEP tracks complaint information in a spreadsheet, an investigation log, and a complaints  log. However, we compared these three documents to each other and to LSBEP’s paper  complaint files and Board meeting minutes that contain complaint outcomes, and found that  none of the tracking documents were accurate or complete. For instance, the spreadsheet did  not include all complaints, incorrectly listed some closed complaints as open, and did not  include all instances of disciplinary action.

“[…] we found that three Letters of Education were sent to the licensees more than five months  after the Board voted to send them.” And, “… we identified five complaints that LSBEP did not ensure were fully closed. These five complaints included one licensee who was never sent a Letter of Education that the Board voted to send in June 2019 about mandatory reporting of  abuse.” The auditors sound that four complaints were never presented to the Board for closure.”

The auditors also found that “LSBEP has not adopted a disciplinary matrix that aligns with  regulatory best practices to ensure that disciplinary actions are consistent and appropriately  escalated based on the number and/or severity of violations.”

 The auditors found the following categories and percentages of allegations. (See Audit Exhibit below.) The most frequent category of 25% came in from allegations of “Substandard Care,  Negligence, or Malpractice.” This was followed by 20% for “Unprofessional Conduct, Discrimination, or Rude Treatment.” Next was “Failure to Maintain or Provide Accurate Patient  Records” at 16%, “Multiple Relationships or Conflict of Interest,” and ‘Practice Without  License, Misrepresentation of Credentials, or Practice Outside of Scope,” both at 14% of allegations.

The auditors noted, “According to LSBEP, staff create separate spreadsheets to track the compliance of each disciplined licensee and use calendar reminders for monitoring specific  activities.

“However, these processes are not formalized in policy and staff have not followed them consistently. In addition, the Board does not have a process for systematically and periodically  monitoring whether all disciplined licensees have performed required corrective actions,  reimbursed disciplinary costs as ordered, and continue to comply with ongoing Board restrictions.”

The auditors noted that, “LSBEP did not report four (44.4%) of the nine adverse actions it issued during fiscal years 2019 through 2021 to the NPDB in accordance with federal law.”

The auditors recommended that the Psychology Board require all licensees to undergo a background check, Instead of just new licensees. And, they recommended that the Board query  the National Practitioner Data Base for enforcement information when making license decisions and for continuous monitoring.

The auditors also indicated that the Legislature may want to authorize the Psychology Board to  impose fines for discipline and administrative noncompliance.

In a response, the Board agreed with all the auditors’ recommendations. Specifically, they  agreed to “… establish a system where complaints are prioritized and investigated on a case-by- case basis considering risk to the public in accordance with the Audit, the Act, LAPA, and other  applicable law and oversight. This system will ensure complaints are processed within reasonable time periods, factoring in the complexity of the case. These procedures are  currently in practice, but not explicitly stated in policy. Additionally, the board has recently hired two full-time employees including in-house counsel whose primary focus is on the complaint  adjudication process. Timeframes for internal monitoring will be determined to ensure compliance.”

The Board agreed to “… establishing a process for tracking complaints that includes  documenting the status, nature, and outcome of all complaints; periodically reviewing open  complaints; and regularly analyzing complaint data to assess compliance with agency policy and identify opportunities for improvement. Over the past 3 years, the board has worked to  improve financial stability in order to employ staff who can develop these processes understanding that this is vital to operations and best practice.”

The 37-page report is available online at https://app.lla.state.la.us/publicreports.nsf/0/dd11af03beda7797862588540052a678/$file/0002f3.pdf?openelement&.7773098

 

 

 

 

 

Governor Announces “Internet for All” Initiative Jointly with NTIA

Along with the U.S. Department of Commerce’s National Telecommunications and Information  Administration (NTIA), Governor Edwards announced that Louisiana will participate in the  “Internet for All” initiative, a program designed to provide high-speed internet for all Americans at an affordable cost. The initiative, which will build internet infrastructure, provide pertinent  technology, and teach digital skills to community members, will invest $65 billion in the project  and will be funded through the Bipartisan Infrastructure Law.

“Partnering with Commerce/NTIA will allow Louisiana to achieve what we thought was  impossible. We will now have the financial resources necessary to once and for all eliminate the  digital divide in Louisiana. We are grateful to both Secretary Raimondo and Assistant Secretary Davidson of NTIA for their leadership and partnership. Over the past several years, our Broadband Office (ConnectLa) has worked hard to align resources between federal, state, and  local officials to take full advantage of this historic broadband funding opportunity. We look forward to partnering with the people of Louisiana to make closing the divide a reality,” said  Gov. Edwards.

Louisiana plans to invest $5 million in planning funds, and each state will be awarded support  from dedicated NTIA staff to catalyze and complete the project. Each participating state will  receive at least $100 million in funds to help implement the scope of the project.

“Generations before us brought electricity to rural America and built the interstate highways,”  said Alan Davidson, Assistant Secretary of Commerce for Communications and Information. “Our generation’s task is to connect all Americans online. […]”

 

 

 

 

 

 

 

OBH Expanding Opioid Treatment Services to Shreveport, Hammond

Louisiana Department of Health (LDH) Office of Behavioral Health (OBH) announced it is expanding opioid use disorder treatment in the Northwest and Northshore regions of  Louisiana. Accessible, evidence-based, 24/7 treatment is now available in Shreveport and is  coming to Hammond in June of this year. These areas were chosen because of their high rate of  opioid prescriptions and are available at Behavioral Health Group (BHG) Shreveport, 1303  Line Avel, Suite 600, by calling 844-535-7291. Between 4:00 a.m. and 5:00 p.m., services are  provided by calling 318-349-2451.

These new services are made possible by the expansion of funds earmarked to increase the workforce in these areas and come from the federal entity, Substance Abuse and Mental Health Services Administration (SAMHSA) through the Louisiana State Opioid Response (LaSOR) 2.0  Grant. The LDH has developed a business plan designed to combat opioid substance abuse by  providing outpatient treatment utilizing Medication for Opioid Use Disorder (MOUD), supplying  clients with effective, evidence-based treatments that allow them to live their daily lives.

Currently, almost all Opioid Treatment Programs only provide treatment during daytime hours.  This can be detrimental to individuals battling opioid addiction. “The road to recovery is  different for everyone, and for some that may require unconventional hours to accommodate  those with young children or who work on later shifts. We are proud to expand around-the- clock opioid treatment in Louisiana, meeting families where they are when they most need it,”  said LDH Secretary Dr. Courtney N. Phillips.

According to federal research done in 2019, only 1 in 20 Louisiana residents affected by opioid addiction received the help they needed that year. The national average is 1 in 9. “For those  seeking help for the first time, the need for care often strikes at night,” said Natashia Cheatham, regional director of operations for BHG. “Waiting for the nearest treatment center to open can  be a matter of life or death for people living with opioid use disorder (OUD). We are looking  forward to working with the Caddo Parish community to provide the full spectrum of opioid  treatment services.”

Authors from the Lancet’s, “Responding to the Opioid Crisis in North America and Beyond: Recommendations of the Stanford-Lancet Commission,” published in February, said that in the  USA and Canada, 2020 was the worst year on record for fatal opioid overdoses. The US overdoses rose 37%.

The Centers for Disease Control and Prevention (CDC) said that provisional data analysis estimates for the 12 months ending in May 2021, there were 75,387 deaths from opioid  toxicity.

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of  drug overdose deaths, said the CDC, with 72.9% of opioid-involved overdose deaths involving synthetic opioids. And, overdose deaths involving psychostimulants such as methamphetamine  are increasing with and without synthetic opioid involvement.

Also in February, Medscape reported a surge in the rate of Black Americans dying from a combination of opioids and cocaine, an increase of 575%. The rate for White Americans  increased by 184%

 

 

 

 

 

 

 

Dr. Constans Recognized for Contributions

Dr. Joseph Constans, clinical psychologist and Senior Manager for Suicide Prevention within the Department of Veterans Affairs, has been recognized by the Louisiana Psychological Association for the 2022 Contributions in Psychological Science Award.

Presenting the award and spokesperson for the association, Dr. Amanda Raines explained that  this honor is given to those in the psychological community who have used their time and resources to expand and propagate the knowledge of psychological concepts through rigorous research and the publication of these findings.

“Dr. Constans was recently promoted to Senior Manager for Suicide Prevention within the Department of Veterans Affairs where he manages the suicide research portfolio for the Office  of Research and Development,” Dr. Raines said.

“Previously he served as the Associate Chief of Staff for Research at the Southeast Louisiana  Veterans Health Care System where he successfully led the activation of our state of-the-art  research program following the devastation caused by Hurricane Katrina. Dr. Constans’ own  program of research involves understanding and modifying belief systems in trauma-exposed  individuals prone to either homicidal or suicidal violence,” she said.

“In his role as the Senior Manager for Suicide Prevention at the Department of Veteran Affairs,  Dr. Constans is instrumental to the Office of Research and Development, where he maintains  the suicide research portfolio,” said Dr. Raines.

She also explained that Dr. Constans has published over 50 peer-reviewed manuscripts and  book chapters, serves as an ad hoc reviewer for over 20 peer reviewed journals and has secured funding for over $12 million in grants.

“I’m truly honored,” Dr. Constans told the Times, “that my colleagues selected me as the  recipient for the Louisiana Psychological Association 2022 Contributions in Psychological  Science Award. The Boulder model served as the framework for my graduate education in  clinical psychology, and I continue to strongly support the scientist/practitioner approach.  Therefore, I am particularly grateful to have received this award.”

Dr. Constans is also Clinical Professor in the Department of Psychiatry and Neurology at Tulane  University School of Medicine, and a Clinical Assistant Professor in the Department of Psychiatry at Louisiana State University School of Medicine.

He is a member of the Tulane University  Violence Prevention Institute (VPI), which focuses its research on violence both in the local  community and across the globe. The Violence Prevention Institute mission is to be “an equity- focused hub supporting communities to foster transformative research, training, and advocacy  to address systemic, structural, and interpersonal violence.” Local research has shown that the prevalence of sexual assault and domestic violence in the New Orleans area needs to be  addressed with research and community collaboration.

Dr. Constans is a member of both the Internal Advisory Committee at the Louisiana Clinical and  Translational Science Center, whose objective is to transform the clinical and translational  research efforts of our region away from the status quo, to a unified, comprehensive approach  targeting the theme of “prevention, care and research of chronic diseases in the underserved  population.”

He also serves on the Advisory Board at Louisiana Violent Death Reporting System in the  Louisiana Office of Public Health.

Dr. Contans is also the President of Louisiana Veterans Research and Education Corporation.  Dr. Constans’ evidence-based methods utilized to combat anxiety disorders are rooted in  Cognitive Behavioral Therapy (CBT) for which he publicly advocates. He is passionate about  serving his clients and the psychological community through research and treatment. His  federally-funded research program is designed to understand and treat emotional disorders,  and his extensive training with some of the early pioneers of CBT, including Drs. Andrew Mathew and Edna Foa, grant him the expertise which catalyzes this research.

In addition to his boots-on-the-ground work, Dr. Constans has been able to gather the  Resources needed to fund research integral to his expertise. To facilitate his research surrounding trauma-exposed individuals, where he studies the thought process behind their  belief systems and strives to achieve modification in this area, Dr. Constans has procured over  $12 million in grants. This research is instrumental in preventing homicidal and suicidal  violence, and his commitment to this work is evidenced in the 50-plus peer-reviewed  manuscripts and book chapters he has published to date.

Working with the VA and Department of Defense, he has served as the Principal Investigator or  Co-Investigator on countless studies and has been an ad hoc reviewer for over 20 peer- reviewed journals. He also has reviewed various grants funded by both the federal government  and private entities.

Dr. Constans’ research includes the following major areas.

Understanding attention, judgment, and memory bias in pathological anxiety:

Constans, J. I. & Mathews, A. M. (1993). Mood and the subjective risk of future events. Cognition  and Emotion, 7(6), 545-560.

Constans, J. I., Foa, E. B., Franklin, M. E., & Mathews, A. (1995). Memory for actual and imagined  events in OC checkers. Behaviour Research and Therapy, 33(6), 665-671.

Constans, J. I., Penn, D. L., Ihen, G. H., & Hope, D. A. (1999). Interpretive biases for ambiguous  stimuli in social anxiety. Behaviour Research and Therapy, 37(7), 643-651.

Peters, K., Constans, J. I., & Mathews, A. (2011). Experimental modification of attribution  processes. Journal of Abnormal Psychology, 120(1), 168-173.

Cognitive bias and neuropsychological deficits associated with PTSD:

Constans, J. I., Foa, E. B., Franklin, M. E., & Mathews, A. (1995). Memory for actual and imagined events in OC checkers. Behaviour Research and Therapy, 33(6), 665-671.

Constans, J. I., Penn, D. L., Ihen, G. H., & Hope, D. A. (1999). Interpretive biases for ambiguous  stimuli in social anxiety. Behaviour Research and Therapy, 37(7), 643-651.

Peters, K., Constans, J. I., & Mathews, A. (2011). Experimental modification of attribution  processes. Journal of Abnormal Psychology, 120(1), 168-173.

The prevention of death, including homicide and suicide:

Wamser-Nanney, R. A., Nanney, J. T,  & Constans, J. I. (2019). PTSD Symptoms and Attitudes Towards Guns. Journal of Interpersonal Violence.

Wamser-Nanney, R. A., Nanney, J. T., Conrad, E., & Constans, J. I. (2019). Childhood Trauma  Exposure Among Victims of Gun Violence. Psychological Trauma: Theory, Research, and Policy, 11(1), 99-106.

Wamser-Nanney, R., Nanney, J. T., & Constans, J. I. (2019). The Gun Behaviors and Beliefs Scale:  Development of a new measure of gun behaviors and beliefs. Psychology of Violence, 10(2),  72–181.

Wamser-Nanney, R.A., Nanney, J.T, & Constans, J.I. Trauma Exposure and Attitudes Towards  Guns. Psychology of Violence. Manuscript submitted for publication.

Dr. Constans told the Times, “When I began my professional career in the Veterans Health Administration 1993, I thought I’d last about 5 years in the organization. Now, almost 29 years  later, I’m still a VA employee. Reflecting on why my prediction was so inaccurate and why I have  stayed with this organization for so long, I can say that a primary reason is because of the  opportunities that the VA provided me in pursuing a career as a clinician scientist,” he said.

Dr. Constans specializes in the non-medical treatment of a variety of emotional disorders  including Post Traumatic Stress Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Social Anxiety Disorder, Generalized Anxiety Disorder, mild to moderate depression, and stress- related emotional issues.

After completing his undergraduate studies in Psychology at Louisiana State University (LSU),  Dr. Constans went on to receive his M.S. at Colorado State University and a PhD in Clinical  Psychology from LSU. He then completed his internship at the Medical College of Pennsylvania.

What does he view to be his most important contributions? “There have been three phases in  my career as a clinician scientist,” Dr. Constans said. “For the first 15 years of my career, I  investigated how biases in judgment and attention served as causative or maintaining factors  for psychopathology, particularly posttraumatic stress disorder.

“In the second phase, beginning approximately 10 years ago, my focus evolved from studying  the sequelae of trauma to one that is concerned with prevention. My interests became and remain the prevention of suicide and homicide with a particular emphasis in understanding  how beliefs and behaviors surrounding firearms contributes to violent death,” he said.

“The third part of my career was and is as an administrator for scientific endeavors. I served as  the Associate Chief of Staff for Research at the New Orleans VAMC from approximately a year after Hurricane Katrina until October of 2021. In this administrative position, I was able to  advance and grow the scientific mission in our healthcare facility, and hopefully during this  time, I served as a particularly strong advocate for psychological science,” he said.

“Now, I working for Office of Research and Development in VA’s Central Office, developing and  managing the suicide prevention research portfolio, allowing me to assist in the advancement  of psychological science to address an important public health issue,” Dr. Constans said.

 

 

 

 

 

 

Dr. Cohen’s Newest Research in Clinical Psychological Science

Dr. Alex Cohen, clinical psychologist and professor at Louisiana State University (LSU), continues his efforts to adapt behavioral technologies for investigating a wide range of clinical issues,  including suicidality, depression, psychosis, mania, and anxiety. His newest publication is “High Predictive Accuracy of Negative Schizotypy with Acoustic Measures,” published recently in the  flagship clinical journal, Clinical Psychological Science. He is widely recognized for his work using automated computerized analysis of behavior and has been featured in top psychology and  psychiatry journals.

In an interview with the Times, Dr. Cohen said, “I think we are pushing the boundaries of what  clinical science can do in measuring symptoms of serious mental illness.

“Psychology has not sufficiently addressed many areas of human suffering, and innovation is  needed. I believe that Psychology can’t fulfill its potential alone, and will require cooperation between other academic disciplines, and also community partners, big tech, advocacy and political groups, business, government regulators, law enforcement and above all, people from  the communities we are serving,” he said.

“Finding ways to cooperate and overcome the inevitable ‘tower of babel’ problem between  these groups, in my opinion, is essential to solving many of the big problems that we face right  now. Who else is trained so effectively in bringing people together? I think psychology can  occupy a central role in coordinating these efforts.”

What does he think are the major and most important findings of this new study? “We were  trying to use objective vocal data to predict personality traits associated with psychosis risk,” Dr. Cohen said. “Given the nature of our data, we used supervised machine learning. Our models  were highly accurate, generally 85% or so in classifying people with versus without the traits.

“More importantly, we were exploring how this kind of model building should be done, and this  problem extends well beyond psychosis risk research. Our models didn’t actually predict  personality traits or psychosis risk, but rather, people’s report on ‘gold-standard’ self-report  scales. Predicting psychosis risk and predicting scores from a gold-standard measure are not the same, and our secondary analyses speak to this.

“Generally speaking, ‘gold standard’ measures are good enough for many purposes in  psychology. If the goal is highly accurate prediction using objective data however, our measures are often inadequate. This is an unrecognized obstacle to implementing predictive analytics into psychology,” Dr. Cohen said.

This most recent work was a collaboration with the LSU Department of Psychology, the LSU  Center for Computation and Technology, the Department of Psychiatry at University of Utah,  and Department of Psychology at University of Central Florida.

Dr. Cohen worked with Dr.  Christopher Cox on this project, an Assistant Professor of Psychology at LSU. Dr. Cox is involved in various research endeavors, including focusing on experimental machine learning tools, exploring the context sensitivity of semantic knowledge, building computational models of reading.

What was it like collaborating with Dr. Cox? “Dr. Cox is one of the most thoughtful people I have  had the pleasure to work with,” said Dr. Cohen. “He is extremely bright and methodical, and  cares deeply about students and learning. He seems to operate on a higher level of consciousness than most, and it wouldn’t surprise me if he sees the world in streams of binary  data like Neo from the Matrix movies.”

Dr. Cohen is also an adjunct professor at Pennington Biomedical Research Center and LSU  Health Sciences, where he manages a team of doctoral students and graduate assistants. His  current research projects focus on understanding and helping those with severe mental illness,  notably schizophrenia, and those at risk of developing various psychotic-spectrum disorders.

Dr. Cohen’s current research projects are multi-tiered. He is currently working on a project that  involves adapting biobehavioral technologies for use in assessing mental well-being. This  project involves a highly constructed collaboration between industry and academia and uses  “Big Data” methods to measure and predict cognitive, affective, and behavioral states in those with serious mental illness.

A few years ago, LSU helped Dr. Cohen and some of his colleagues to commercialize his  technologies for “digital phenotyping.”

“Digital phenotyping involves quantifying aspects of mental health using complex, objective  data streams,” he said. “In our case, these data are from automated language, facial, vocal,  location and movement analysis from a smart phone. Since then, we have created an app using  these technologies to support clinical trials. We are starting to explore digital phenotyping to  support clinical management of patients with serious mental illness, and I am proud to have community partners in Baton Rouge for this. The methods used in our clinical psychological science paper were central in advancing these technologies.”

Dr. Cohen is in collaboration with an international consortium involved in researching the links  between disturbances in natural speech and symptoms of mental illness and genomics. Pattern recognition and advanced machine learning are being utilized in this research. In addition to  these projects, he facilitates research investigating how emotion, cognition, motivation, and  social functions in those predisposed for developing serious mental illness and those already combating serious mental illness. This project uses “small data” and basic psychological science  methods are used, including self-report, behavioral and electrophysiological measures, and performance measures.

Dr. Cohen has been working for nearly 20 years on these innovations, and explains that with  the help of many colleagues, “… we are getting closer – though this process has been anything  but time efficient.”

“What I have found is that digital data and symptoms ratings rarely agree,” he said. “Using  machine learning, one can engineer solutions that show impressive agreement in one setting,  but they don’t generalize. What is considered flat and unresponsive speech in one setting by  one group of people is considered unremarkable in another setting for other people. That is one major thing we found in the CPS paper, and have replicated in a number of other studies.”

“Why don’t they agree? Are clinicians wrong? Are digital technologies missing a critical human  element? The answer is, of course, both. So we are trying to develop methods for optimizing and evaluating these digital technologies. This field is huge right now, but I am afraid many of  the solutions being proposed are superficial and will fade quickly. I think my colleagues and I  are in a unique position to advance this field.”

Some of Dr. Cohen’s recent work helps to explain these complexities. • Cohen, A. S., Rodriguez,  Zachary Warren, K. K., Cowan, T. M., Masucci, M. M., Granrud, Ole Edvard Holmlund, Terje B  Chandler, C., Foltz, P. W., & Strauss, Gregory, P. (2022). Natural Language Processing and  Psychosis: On The Need for Comprehensive Psychometric Evaluation. Schizophrenia Bulletin, In Press.

“Evaluation of digital measures falls far short of what is expected of most psychological tests,” Dr. Cohen said. “This is part of a themed issue Brita Elvevåg and I are finalizing for the journal  Schizophrenia Bulletin.”

• Cohen, A. S., Cox, C. R., Tucker, R. P., Mitchell, K. R., Schwartz, E. K., Le, T. P., Foltz, P. W., Holmlund, T. B., & Elvevåg, B. (2021). Validating Biobehavioral Technologies for Use in Clinical Psychiatry. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.503323

“In this paper,” he said, “we compare evaluation of objective measures in other areas of science (e.g., physics, computer sciences, engineering) to that of psychology. There are some critical differences, particularly surrounding how ‘resolution’ is handled. The upshot is that psychology  should do a better job of defining exactly when, where and how a phenomenon is occurring. . . at least with respect to validating objective measures.”

• Cohen, A. S., Schwartz, E., Le, T. P., Cowan, T., Kirkpatrick, B., Raugh, I. M., & Strauss, G. P.  (2021). Digital phenotyping of negative symptoms: the relationship to clinician ratings. Schizophrenia Bulletin, 47(1), 44-53. https://doi.org/10.1093/schbul/sbaa065

“In this paper, we demonstrate how objective technologies often disagree with what a clinician  says. We attempt to unpack why that is – with the idea that neither is inherently wrong. Rather,  they are looking a different phenomenon,” he said.

• Cohen, A. S., Cowan, T., Le, T. P., Schwartz, E. K., Kirkpatrick, B., Raugh, I. M., Chapman, H. C., &  Strauss, G. P. (2020). Ambulatory digital phenotyping of blunted affect and alogia using objective facial and vocal analysis: Proof of concept. Schizophrenia Research, 220, 141–146.  https://doi.org/10.1016/j.schres.2020.03.043

“In this paper, we evaluate a method of evaluating aspects of psychosis using smart phone  technologies. We are currently trying to implement these technologies with Capitol Area Human Services District ––though, in early stages.”

Besides pushing the boundaries of what clinical science can do in measuring symptoms of serious mental illness, what was the most enjoyable thing for about the work for Dr. Cohen?

“This is a necessarily multidisciplinary endeavor, and I really enjoy being challenged by my students and colleagues. When trying to objectify aspects of mental illness, we need to be very  mindful of the role that demographics, culture and other individual differences play. I am blessed to have a network of colleagues from a variety of walks of life that can help challenge us to create culturally appropriate, and ultimately better, measures.”

 

 

 

 

 

 

 

“Psychiatric Collaborative Care Model” Passes House 98 to 0

HB 278 by Rep. Echols passed the House on April 27 with a vote of the 98 to 0. It was received in the Senate and placed on the calendar.

The measure provides requirements for the Psychiatric Collaborative Care Model and requires mental health or substance abuse benefits for services delivered through the model. The bill is pending in the Insurance Committee.

The proposed law requires a health coverage plan delivered or issued for delivery in this state  that provides mental health and substance abuse benefits to reimburse for such benefits that  are delivered through the psychiatric Collaborative Care Model. The model includes the current  procedural terminology (CPT) billing codes 99492, 99493, and 99494.

The new proposed law requires the commissioner of insurance to update the CPT codes if there are any alterations or additions to the billing codes for the Collaborative Care Model.

Proposed law authorizes a health coverage plan to deny reimbursement of any CPT code  provided in proposed law on the grounds of medical necessity, provided that such medical  necessity determinations are in compliance with certain federal and state law.

Defined are: (2) “Mental health or substance abuse benefits” means benefits for the treatment  of any condition or disorder that involves a mental health condition or substance use disorder  that falls under any of the diagnostic categories listed in the mental disorders section of the  current edition of the International Classification of Diseases or that is listed in the mental  disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental  Disorders. (3) “Psychiatric Collaborative Care Model” means the evidence-based, integrated  behavioral health service delivery method described in 81 FR 80230. 

 

 

 

 

Gov. Edwards Signals Veto of Mizell’s SB 44

Senator Beth Mizell’s “Fairness in Women’s Sports Act,” was reported out of committee with amendments and voted on by the full Senate on April 19. The measure passed by a vote of 29  to 6. The proposed law, SB 44, will have the effect of prohibiting transgender females, those  assigned as male at birth, from competing in traditional women’s sports.

Gov. Edwards vetoed the same measure last year and foiled the Legislature’s attempt at an  override in a special session. Regarding this new effort, the Governor said, “I don’t think you all  have ever heard me announce from this podium before a bill gets to my desk that I’m going to  veto it because I always think that there’s an opportunity and a path forward to working things  out,” he said. “So that may not be necessary, but I will tell you that my views haven’t changed.”

According to the SB 44 digest, the “Fairness in Women’s Sports Act” requires an athletic team or sporting event sponsored by an elementary, secondary, or postsecondary educational institution to be designated, based upon the biological sex of team members, as only one of the following: (1) A males’, boys’, or men’s team or event only for students who are biological males.
(2) A females’, girls’, or women’s team or event only for students who are biological females. (3)  A coeducational or mixed team or event for students who are biological males or biological females.

Among other provisions, the proposed law provides that certain persons are entitled  to legal causes of action and legal remedies under proposed law. A biological female student  who is deprived of an athletic opportunity or suffers or is likely to suffer from any direct or  indirect harm as a result of a violation of proposed law.

The proposed law provides that requiring a biological female to compete against a biological male on a team that is designated as a “female”, “girls'”, or “women’s” team is inherently discriminatory to biological females and is a cognizable harm under proposed law.

In the 2021 Session, Senator Mizell’s SB 156, easily passed both the Senate (29–6–4) and the House (78–19–8).

But on June 22, 2021, Gov. Edwards announced he had vetoed the bill, stating “… discrimination  is not a Louisiana value, and this bill was a solution in search of a problem that simply does not  exist in Louisiana.” And, “Further, it would make life more difficult for transgender children, who are some of the most vulnerable Louisianans when it comes to issues of mental health.”

On July 20 the Legislature convened a veto override session for the first time since the 1974 constitution. Sources report a primarily reason for the session was to override the veto on  Mizell’s SB 156.

The Senate narrowly overcame the veto with a 26–12–1 vote. However, the House vote, 68–30- 6, fell two votes short of the super majority needed to override the Governor’s veto.

The text of the currently proposed law states: “A recent study of female and male Olympic performances found that, although athletes from both sexes improved over the time span, the athletic gender performance gap between female and male performances remained stable.  These studies suggest that women’s performances at a high level will never match those of  men.”

Mizell’s bill highlights the crossroads of transgender individuals’ rights and the rights of biological female athletes. The issue has galvanized both the political left and right across the  country.

The American Psychological Association opposes these measures, stating, “Transgender  children vary in athletic ability, just as other youth do. There is no evidence to support claims  that allowing transgender student athletes to play on the team that fits their gender identity  would affect the nature of the sport or competition.”

The Louisiana Psychological Association opposed the 2021 SB 156 and the Louisiana School 
Psychological Association labeled the bill as discriminatory.

 

 

 

 

 

 

 

Dr. Slaton Named 2022 Distinguished Psychologist by LPA

Dr. Karen Slaton, who has been at the forefront of psychology’s transition to integrated health care for most if not all of her career, and engaged in practice, research, and teaching, has been named the 2022 Distinguished Psychologist by the Louisiana Psychological Association.

Dr. Slaton is the Program Manager of Behavioral Medicine/Health Psychology/Primary Care  Mental Health Integration at the Southeast Louisiana Veterans Health Care System. She developed and manages the Primary Care Mental Health Integration Program at the Care  System. She implements the Veterans Administration mandated effort to fully integrate  behavioral health as part of the extended Patient Aligned Care Team. This team consists of  psychiatry, social work, nursing and psychology, and is essential in assuring veteran access to same-day care.

Dr. Slaton also coordinates behavioral medicine services, such as services for pain, palliative  care, cardiology, physical medicine & rehabilitation, and integrated health services (including  yoga and hypnosis).

Dr. Slaton also serves in additional roles including Health Behavior Coordinator, Pain Psychologist, Complimentary Integrated Health VISN lead and Lead Tobacco Cessation Clinician.  She provides health promotion and disease prevention services to veterans such as tobacco cessation and weight loss coaching.

She trains other clinicians in the Interdisciplinary Pain Program, Bariatric Treatment Team, and  Controlled Substances Oversite Board. She collaborates in other teams and committees  including Health Promotion and Disease Prevention Committee, Women’s Health Committee,  Employee Wellness Committee, and the Opioid Safety Initiative.

Dr. Slaton is Clinical Assistant Professor of Behavioral Sciences at Tulane University School of  Medicine and Clinical Assistant Professor of Medicine at Louisiana State University Health  Sciences Center School of Medicine. She provides invited lectures to trainees in the Tulane  School of Medicine Clinical Psychology Internship Training Program and the LSU School of  Medicine Physical Medicine and Rehabilitation Residency Program.

Dr. Slaton is an APA accredited clinical psychology internship and postdoctoral fellowship  Training Committee Member, providing didactic training and supervision to interns and post- doctoral fellows in the areas of primary care mental health and behavioral medicine.

Dr. Slaton is a nationally Approved Consultant in Clinical Hypnosis and a Registered Yoga  teacher.

Dr. Slaton has also owned and operated her own private practice through Northshore  Psychological Services, LLC, Covington, and the Center for Wellness and Peak Performance, LLC,  Covington. She provides a wide range of psychological services including psychotherapy, assessment and evaluation, consultation, and professional training. Her areas include posttraumatic stress disorder, marriage, couples and relationship counseling, food, weight and  body image issues including eating disorders and bariatric psychology, depression, anxiety,  sport and performance psychology, clinical and sports hypnosis, personal growth and  development and counseling patients with medical illness.

Dr. Amanda Raines announced the award in April, at the annual meeting of the Louisiana  Psychological Association. “This award is given to an individual who has made significant  contributions to psychology research, practice, or both, during the course of their career,” said Raines. “This year we are recognizing Dr. Karen Slaton. Dr. Slaton currently serves as the  Program Manager for Primary-Care Mental Health Integration and the Health Behavior  coordinator at the New Orleans VA. She is actively involved in more local and regional committees within the VA than I can count,” Raines said.

“She maintains academic appointments at Tulane and LSU and actively stays involved in both  training and research related endeavors. Dr. Slaton is certified by the American College of  Sports Medicine as an Exercise Physiologist and by the American Society of Clinical Hypnosis. She is also a certified & registered yoga teacher and somehow manages to incorporate all of  these skills into her integrative practice at the New Orleans VA.”

Dr. Slaton’s research includes:

Slaton, K. (2000). An investigation of the relationship between  parental bonding and body image disturbance among male and female college students. Dissertation.

Slaton, K. & Lyddon, W. (2000). Cognitive-experiential reprocessing and rape: A case study.  Journal of Cognitive Psychotherapy, 14, 189-200.

Slaton, K. & Westphal, J. (1999). The Slaton-Westphal functional assessment inventory for adults  with serious mental illness: Development of an instrument to measure functional status and psychiatric rehabilitation outcome. Psychiatric Rehabilitation Journal, 23, 119-126

Raines, A. M.,  Primeaux, S. J., Ennis, C. R., Walton, J. L., Slaton, K. D., Vigil, J. O., Allan, N. P., Zvolensky, M. J.,  Schmidt, N. B., & Franklin, C. L. (2021). Posttraumatic stress disorder and pain
in veterans: Indirect association through anxiety sensitivity. Manuscript submitted for publication.

Vigil, J.O., Slaton, K.D., Raines, A.M., & Franklin, C.L. (2018, September). Examining the Effects of a Comprehensive Pain Rehabilitation Program among Veterans. Poster presented at the annual meeting of the Southern Pain Society, Atlanta, GA.

Lyddon, W., & Slaton, K. (2001). Promoting healthy body image and the prevention of eating disorders among adolescent women. In C. Juntunen & D. Atkinson (Eds.), Counseling strategies  for developmental concerns. Thousand Oaks, CA: Sage Publications.

Her training lectures are  numerous, and include: Use of Hypnotic Language in Non-hypnosis Clinical Encounters.  Presented at 6th Dabney Ewin, MD FACS Hypnosis Lecture. 2022 Tulane Brain and Behavior Conference.

Primary Care Psychology. Presented to Psychology Interns at Tulane University School of Medicine and Southeast Louisiana Veteran Health Care System.

Motivational Interviewing: Effective Communication with Veterans. Presented at the Southeast  Louisiana Veterans Health Care System 2020 Fall Women’s Health Summit.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

Behavioral Intervention for Chronic Pain. Presented at LSUMC Physical Medicine and Rehabilitation Resident Didactic Lecture.

Motivational Interviewing. Presented to the LEND program staff at Louisiana State University  School of Medicine.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

“My career as occurred in phases,” Dr. Slaton said, “I started in academic medicine at Tulane School of Medicine and like many of my Tulane colleagues, left after hurricane Katrina for  private practice. I enjoyed a thriving practice in Covington for almost a decade before joining  the New Orleans VA 10 years ago. I always say I have the best job ever! I work as a clinical health psychologist in various medicine services and have the privilege of serving Veterans in honor of my grandfather who was awarded the Medal of Honor for his service in WWII,” she said.

“I’m lucky to be able to provide clinical hypnosis to Veterans and to teach hypnosis at the National level for the VA, teach a weekly yoga class to Veterans, lead the Primary Care Mental  Health Integration team, and serve the facility as a consultant for patient education. However,  my favorite part of all is training the next generations of psychologists in our APA accredited  internship and fellowship programs,” Dr. Slaton said

 

 

Discrimination Complaint Rejected by LSBEP

A Request for Investigation, stating that members of the Louisiana State Board of Examiners of Psychologists are operating outside of their area of competence in regard to selection-testing  and racial discrimination, was rejected by the Board. In a letter dated March 7, Ms. Jaime Monic, the Executive Director, said that the members do not have jurisdiction over themselves. Also,  she said, they are not engaged in the practice of psychology as board members. However, they  are open to reviewing this issue, Ms. Monic wrote.

The psychologists who submitted the request, Drs. William Costelloe, Julie Nelson, and Marc Zimmermann, are all business psychologists who have extensive experience with high stakes  selection testing in the private sector. In their request for an investigation submitted in January,  the three said, “There is evidence that confirms that the EPPP has adverse impact against  African-Americans and Hispanics. […]

“Once adverse impact has been shown for a test it is improper to ignore the selection problems.
Furthermore, the way in which the test is used by the Board members drives up adverse  impact. As just one example, the use of a hard cut off, and one that sets a higher bar  considering the restricted sample, on a test with proven adverse impact, is an error in  professional selection testing design.”

The March 7 letter noted:

“Dear Dr. Nelson, Dr. Costello and Dr. Zimmermann, On January 11, 2022, the office of the  Louisiana State Board of Examiners of Psychologists (LSBEP) received your Request for  Investigation form and a statement of complaint against current LSBEP Board Members. Please  be advised that individual members of the LSBEP in their capacity as board members do not  have jurisdiction to initiate a formal investigation or action against themselves under the  authority of La. R. S. 37:2351 et al. All current Board Members meet the requisite requirements  established by the Louisiana Legislature under Chapter 28 of Title 37 of the La. Revised Statutes  to serve the LSBEP and are uniquely qualified to carry out this authority by way of their service,  teaching, training, or research in psychology, degree and licensure as outlined under the  provisions of La. R. S. 37:2353 et al. However, Board Members are not engaged in that which is defined as the ‘practice of psychology’ in their work as a Board Member.

“In consideration of the above, your Request for Investigation of the Board Members is rejected. However, the LSBEP will consider your concerns, “…that the EPPP has adverse impact against African-American and Hispanic populations“, including your concerns regarding LSBEP‘s continued use of the EPPP (Part I – Knowledge) as a tool to assess professional knowledge as  required under R. S. 37:2356. (A)(7). This review is consistent with LSBEP’s statutory authority  and its ongoing endeavors to increase multicultural awareness through assessment of  candidates for licensure and continuing education offerings provided to all licensees who are  involved in direct client services to ensure public protection.

“You will be notified in writing of the final disposition of this matter on completion of the review. If you have any documentation, including peer reviewed articles, valid documentation or studies to support your claims, and/or alternate valid assessments that measure entry level  professional knowledge that should otherwise be considered, please forward that information  directly to the office of the Louisiana State Board of Examiners of Psychologists at 4334 S. Sherwood Forest Blvd., Suite C – 150, Baton Rouge, LA 70816. Due to security and resources,  emails or email attachments will not be accepted or downloaded for consideration in this  matter.

“Thank you for calling our attention to any practices that raise concern regarding the practice of the profession. Sincerely, Jaime T. Monic, Executive Director”

According to Dr. Zimmerman,  copies of Dr. Sharpless’ two articles on the adverse impact of the EPPP have been sent by US  mail to the Board and more information will be sent to them for their study of the issue.

 

 

 

 

 

 

 

Rep. Firment Seeks to Prohibit Gender Change Procedures on Those Under 18 Years of Age

HB 570 by Rep. Firment prohibits certain procedures to alter the sex of a minor child and to  designate this act as the Save Adolescents from Experimentation (SAFE) Act. The bill is pending  in Committee on Health and Welfare.

Proposed law states that the risks associated with the allowance of irreversible, permanently  sterilizing genital gender reassignment surgery outweigh the scientific benefits.

The author notes “It is a grave concern to the Legislature of Louisiana that the medical  community is allowing individuals who experience distress at identifying with their biological  sex to be subjects of irreversible, and drastic non-genital gender reassignment surgery and  irreversible, permanently sterilizing genital gender reassignment surgery, despite the lack of studies showing that the benefits of such extreme interventions outweigh the risks.

“Studies consistently demonstrate that the vast majority of children who are gender non-conforming or experience distress at identifying with their biological sex come to identify with  their biological sex in adolescence or adulthood, thereby rendering most medical healthcare  interventions unnecessary.

“Scientific studies show that individuals struggling with distress at identifying with their  biological sex often have already experienced psychopathology, which indicates these individuals should be encouraged to seek mental healthcare services before undertaking any  hormonal or surgical intervention.”

Rep. Firment’s proposed law prohibits any physician or other medical healthcare professional  from performing any gender transition procedures on any person under 18 years of age or referring any person under 18 years of age to any medical doctor for gender transition  procedures.

The proposed law prohibits school personnel from encouraging or coercing a minor to withhold from the minor’s parent or legal guardian the fact that the minor’s perception of his gender is  inconsistent with his sex.

“Only a tiny percent of the American population experiences distress at identifying with their  biological sex. According to the American Psychiatric Association, prevalence ranges from five  thousandths of a percent to fourteen thousandths of a percent for natal adult males and from  two thousandths of a percent to four thousandths of a percent for natal females.”

 

 

 

 

 

 

 

Cybersecurity Expert Offers Essential Ideas for Defending Yourself and Your Clients

by Leslie Todd, LCSW, ACSW
AFCC Correspondent

Those of us who work with victims of intimate partner violence or vengeful ex-partners have  seen how badly technology can be misused to harm our clients. And we also know that just as  private citizens, we have to be on guard against cyber shenanigans. Then there’s our offices, our
electronics files, our phones….it’s pretty daunting, right?

Fortunately, there are folks who specialize in educating us so we can keep our clients and ourselves safe. 

Steven Bradley began his career with the FBI, starting a task force which investigated  technology and cyber-related crimes. Later, he worked with state coalitions and local domestic  violence/sexual assault center as a liaison between law enforcement and community partners  to better support survivors and victims. Today, he works with Our Family Wizard to promote  healthy communication between co- parents via technology. He has been an international  trainer for over 25 years, and recently presented at the AFCC-LA State Conference on March  18th on this subject. He agreed to share further information with The Psychology Times regarding handling the very difficult cyber abuse issues our clients may bring in—and tips for  protecting ourselves as well.

First, let’s start with Bradley’s pet peeve: people who don’t use passwords, or use them poorly.  Your first defense against hacking is to have a complex password, and to keep it private. Too  many of us still use lazy and highly guessable ones like “12345” or “password”– and many  people don’t even put a password on their smartphones. If you worry about not being able to  keep up with all your passwords (and no, you should not use one password for everything),  then allow your device to generate a complex password which will then be stored for you. And  do NOT tape it to your laptop or otherwise leave it handy for others to discover.

So—sloppy security starts with sloppy passcode management. If you have a client who is  endangered or may be at risk of being stalked, have them list ALL their social media and other  sensitive sites and discuss changing their passwords and security questions to things the stalker could not possibly know. That means no birthdays, pet or child names, or any other easily-guessed information. Remember to have them check medical portals as well.

Thanks to “the internet of things,” it is possible that your client is being monitored via a car’s nav system or some other device. Make sure you discuss with your clients what technologies are being used such as Bluetooth, GPS, On-Star, etc.

Bradley stresses that we should all keep our Bluetooth OFF unless we are actively using it,  because it is easily hacked. Also public access internet, such as in hotels or cafes, is highly  vulnerable to hacking. Malicious software can be installed, including tracking devices. And  remember to check the location services in a phone’s settings to be sure you or your client is  not giving away your location. Bradley noted that when he was to meet an abused client at  court, he would first meet with them near the courthouse in a fast-food place, where they  would both then turn off their location and Bluetooth settings. After court, they would return to  the same fast-food place or gas station and turn them back on. That way, anyone monitoring  would only track them to the innocuous site and not know about Court or other more sensitive destination.

Also, check with your vulnerable client to see if they have devices that were provided by the  suspected person. If a cellphone has been provided by the abusive party, ask your client to  consider using a donated or new cell phone. Same for a computer. If the client is looking for a  new place to live or making travel plans, ask them to use a computer at a public library.

The client should also update all privacy settings on any dating sites and social media sites  (Twitter, Facebook, LinkedIn, Pinterest, TikTok, etc.) and be very wary of what they post. Remember that pictures and images can be searched as well as names and words.

Another way to safeguard a phone is to choose an optional service, like Google Voice, to keep a  personal number safe. Some of these services will let you forward calls and messages to up to five different phones while you simple have one phone number. That way, if the client’s number is compromised, they can log in and change one phone number instead of having to contact the phone company to change many.

Other than tracking people, cyber-hacking can allow the bad guys to “spoof” your phone. This  means that you may answer a call which looks like it’s coming from your mom, but it is really  the hacker. Spoofing allows threatening texts to show up from anonymous numbers (or  highjacked ones, like Mom’s.) In one of my high-conflict divorce cases, each of the spouses was  spoofing their OWN phones with threats ostensibly from their ex.

As a mental health professional, you may have tried to secure your office space and your files— but your cellphone and your car may betray you. Bradley points out that a judge may feel safe  in her courtroom, but once she gets in her car, she is as vulnerable as the next person unless  she takes cyber precautions to safeguard her devices (including her car). In a world where our  clients can Google images of our home and family, we need to keep this in mind.

If you do work with court systems or government agencies, you should know that they often  publish records online. Ask them how they protect or publish your records and request that access to your files is sealed or restrict to protect you and your client’s safety.

Bradley lives in this cyberworld everyday, but understands that we are far less aware than he is. He notes that he most common mistake he sees professionals make is to brush off a client’s suspicion that someone may be monitoring them. Since abusers love to make their clients feel  or look crazy, we should be wary not to add to the gaslighting. Abusers can use highly subtle  methods that will make your client sound paranoid. For instance, I had a client who would frequently find she had a flat tire in the morning. She assumed she was hitting nails around a  construction site—until her mechanic pointed out the frequency and types of punctures and boldly asked her if she was going through a divorce. Bingo. She ended up seeking counseling,  and we discovered many more dangerous indications of stalking.

Bradley’s talk was such a hit at our AFCC-LA State Conference that we are going to have him  return to do a half-day training later in the year, specifically for mental health and legal  professionals. We’ll be sure to publicize that event. Meanwhile, if you’d like a handout from  Bradley on this basic information, email me at Leslie.todd@leslietodd.com and I’ll pass it along to you.

[Editor’s Note: Leslie Todd served as the founding President of the Louisiana Chapter of the  Association of Family and Conciliation Courts (AFCC). Her contributions were acknowledged by AFCC  when they named her an “AFCC Ambassador,” a designation exemplifying the collegial and  collaborative spirit of AFCC membership.]

 

 

 

 

Gov. Edwards Budgets More for Higher Education

The Louisiana Legislature convened March 14 for the 2022 Regular Session, and hundred bills have been filed and are under review by Legislators. See our report starting on page 8.

The Governor’s proposed budget includes: $31.7 million for faculty pay raises in higher education; $10.5 million for the MJ Foster Promise Program Fund; $97.2 million for higher education, which includes $5 million for Title IX offices across the state, $15 million increase
in GO Grants, and $25 million into the Higher Education Initiatives fund.

In his opening remarks Gov. Edwards said the state is in a much better place then when he took office six years ago. “At my first state of the state, I had just inherited a billion dollar budget deficit to close out that fiscal year, and a two-billion-dollar deficit for the year that started July 1,  2016. Today, as I stand here before you, we have hundreds of millions in surplus, even more in current year excess, and billions in federal funding through the American Rescue Plan and the Infrastructure Investment and Jobs Act.”

The proposed budget also includes $43.4 million for early childhood education, with more than  $17 million for the LA-4 Early Childhood program; $148.4 million for teacher and support staff  pay raises, which is at least a $1,500 raise for teachers and $750 for support staff; a $12 per  diem increase for intermediate care facilities for people living with intellectual disabilities; and more than $1.1 billion in funding for critical infrastructure, such as $500 million for a new Mississippi River Bridge in Baton Rouge, an additional $100 million for the bridge in Lake Charles, and $500 million for water and sewer improvements statewide.

“This is a balanced budget that is responsible, transformational, and continues my administration’s practice of only using one-time dollars for one-time expenses. It’s a promise I  made six years ago and one that I have not deviated from. We are not going back to the days of  deficits, fiscal cliffs and one-time dollars for recurring expenditures. And we will continue to be  focused on empowering families and communities for the future,” Gov. Edwards said.

“My legislative package includes a number of bills focused on hurricane deductibles, claim  transparency, enforcing insurance fraud laws against bad actors, revamping the adjuster  registry so that policyholders can verify their adjusters, and stopping mortgage companies from withholding insurance money from homeowners without good reason.

He noted his Climate Initiatives Task Force had set a goal of reaching net zero by 2050. “This  taskforce, which includes scientists, academics, industry leaders and environmentalists, has  adopted a Statewide Climate Action Plan,” the Gov. said. “What makes Louisiana’s plan special,  and the most attainable in my opinion, is that instead of working against oil and gas companies,
we are working with them.”

He made an appeal to raise the minimum wage and reduce the gender pay gap. Gov. Edwards  began his address by saying, “All too often, our world is filled with unrest, and right now our  prayers are especially with the people of Ukraine as they defend their homes, their families, and their freedom. We are joined today by Eddy Hayes who is the Honorary Consul of Ukraine. He  represents the economic and cultural interests of the country here in Louisiana. I asked him to  be here today in hopes that he will relay our unified support to his colleagues in Ukraine.” 

 

 

 

 

 

 

 

Experts Point to Alarming Trend of Increased Opioid Related Overdose Fatalities

A new report warns of soaring overdose deaths from the opioid crisis. Authors from the  Lancet’s, “Responding to the Opioid Crisis in North America and Beyond: Recommendations of  the Stanford-Lancet Commission,” published in February, said that in the USA and Canada, 2020 was the worst year on record for fatal opioid overdoses. The US overdoses rose 37%.

The Centers for Disease Control and Prevention (CDC) said that provisional data analysis  estimates for the 12 months ending in May 2021, there were 75,387 deaths from opioid toxicity.

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of  drug overdose deaths, said the CDC, with 72.9% of opioid-involved overdose deaths involving  synthetic opioids. And, overdose deaths involving psychostimulants such as methamphetamine  are increasing with and without synthetic opioid involvement.

Also in February, Medscape reported a surge in the rate of Black Americans dying from a  combination of opioids and cocaine, an increase of 575%. The rate for White Americans  increased by 184%.

A recent analysis in the American Journal of Epidemiology, found that in the South, deaths from  cocaine and opioids increased 26% per year among Black people, 27% per year among Latinx  people, and 12% per year among non-Hispanic Whites.

Dr. Marc Zimmermann is a neuropsychologist and medical psychologist in Baton Rouge, with over 30 years experience. He  is noted for his work in forensic psychology having testified in multiple states and jurisdictions, and he has been a consultant to many chemical dependency programs such as the Serenity Center and Lane Recovery Solutions. He is also a staff member at PTI in Baton Rouge.

Dr.  Zimmermann said that according to the Louisiana Department of Health, the bulk of all  recorded opioid overdose deaths occurred in the parishes of Southeast Louisiana. St. Tammany Parish experienced an average of over 47 opioid overdoses a year and Jefferson Parish  averaged over 71 opioid overdoses a year.

While their age-adjusted rates are not as high as St. Tammany and Jefferson Parishes, Orleans  and East Baton Rouge Parish experienced high average numbers of deaths from opioid  overdoses during the same time period.

Dr. Tiffany Jennings is a Louisiana native who is the Rural Health Coordinator for the Louisiana  Psychological Association and in full time private practice. Dr. Jennings has worked in a variety  of settings, including outpatient, inpatient, state and Federal agencies. She was previously an  Assistant Professor, Department of Neurology, at Ochsner LSU Health Shreveport and a Neuropsychologist at Overton Brooks VAMC in Shreveport, and for the US Army’s Traumatic  Brain Injury Clinic at Fort Polk in Leesville.

How serious does she feel the opioid crisis is in rural settings for Louisiana? “The opioid crisis  continues to be a serious crisis that has not shown any signs of abating,” Dr. Jennings said.

“The COIVD-19 may have exacerbated the crisis. The Louisiana Dept of Health’s website notes  an increase in fatal and nonfatal opioid overdoses as people are ‘cut off from services and  disconnected from support systems, have made it difficult for individuals to seek help.’

“The Louisiana Opioid Surveillance Program has noted an increase in deaths from overdose,”  she said. “This was noted to be in part due to availability of synthetic opioid drugs, which are  much more powerful than morphine. This results in a higher chance of death from use –– such  as fentanyl.”

Has she seen any changes over the last couple of years? “There’s been several high-profile  lawsuits against drug manufacturers for their alleged role in the opioid crisis,” Dr. Jennings said. “I believe there currently four US companies in the process of settling, to the tune of  approximately $26 billion. This has certainly brought attention to the extent of the current  opioid epidemic.

“Many insurance agencies, including Medicaid, expanded telehealth access due to the ongoing  COVID-19 pandemic. Unfortunately, I have not seen much change with regard to access to service for rural health settings in Louisiana. There continues to be a wait list to see Medicaid providers. Reimbursement remains an issue. Also, those in rural areas may not have the  technology to fully utilize telehealth services,” Dr. Jennings said.

The Lancet Commission Report pointed to the lack of accessible, high-quality, non-stigmatising, integrated health and social care services for people with opioid use disorder in the USA. The  authors recommended reforming public and private health insurance systems to address this issue, including cutting off funding for care that is likely to be harmful.

Dr. Geralyn Datz is a licensed Clinical Health and Medical Psychologist and a national educator  of healthcare providers, attorneys and the public. Dr. Datz is licensed in Louisiana, Alabama, and Mississippi, and specializes in pain psychology, forensic assessments, and public speaking. She is President and Clinical Director of Southern Behavioral Medicine Associates PLLC, in Hattiesburg, Mississippi, a group specialty practice devoted to treating patients with chronic  pain, She is a past president of the Southern Pain Society, and previously with New Orleans Veteran Affairs Medical Center and Pennington Biomedical Research Center

We asked Dr. Datz if there is adequate treatment available? “No there is not,” she said. “The  treatment of opioid use disorder is a very large, systems based issue that right now is in dire  straits and vastly underfunded. The short answer is that we need more insurance reimbursed  programs, and the treatment needs to extend well beyond ‘rehab’ as it is traditionally defined. Private treatment centers are one component of treatment, but cannot meet the needs of this  diverse population, which often has serious mental health issues and/or comorbid pain  conditions. There are effective treatment models like Pain Rehabiliation Programs, that help
people with medical conditions come off of opioids, but sadly these are no longer reimbursed  by insurance.

In addition, the treatment of opioid misuse is ideally multidisciplinary and  requires medical and mental health follow up, which frequently does not occur. The Commissions comment on using the Chronic Disease Model for treatment, and in healthcare, is exactly on point.”

Is treatment covered by funding such as insurance for those who need help? “.Again…no. There  are wide ranges in what insurance will and will not cover in treating opioid overuse and addiction. Often, comorbidities, such as pain or severe or even mild mental illness, are left  untreated. In addition, there are variations between what private addiction centers will accept which insurances if any at all. As a result, care ends up being parsed out for opioid-dependent  individuals and not as effective. Furthermore, many individuals do not have insurance coverage at all, further complicating the problem,” Dr. Datz said.

“The 2008 Mental Health Parity and Addiction Equity Act was designed to make treatment of  mental health and substance abuse conditions as easily and fairly reimbursed as medical conditions. This Act was a step in the right direction but is still not fully realized. A recent report  showed that many insurances are non compliant, and showed wide disparities between  behavioral health care and medical/ surgical healthcare. Mental health parity needs increased  attention, and enforcement, in order to address the public health needs that we are now facing.”

Dr. Jennings agrees. “Given the number of deaths from opioid overdose, I would say there is not nearly enough treatment, recovery and support systems in place for this population. This is especially true of those in rural settings,” she said.

“The state has enacted laws in an attempt to better regulate prescriptions and to reduce the chance of ‘doctor shopping’ for those addicted or who have developed a tolerance to their pain medication. Government agencies on federal and state levels are holding providers accountable for illegal prescriptions for opioids,” said Dr. Jennings.

“Louisiana is expecting to receive approximately $325 million from a national settlement of  opioid lawsuits. The intention is to divide monies into addiction treatment, response and recovery services. The goal is to send the monies–divided up over a 20-year period–to local  agencies that directly work with those suffering from opioid addiction,” she said.

“For some patients, education into the nature of chronic pain and their ability to manage pain  can be helpful. There are evidence based psychotherapy treatments (such as Cognitive  Behavioral Therapy for Chronic Pain) that can be used to help a patient manage pain. For  patients in need of an increase in structure or level of care, there is certainly a need for  agencies that provide this care. Again, insurance and location can often be a barrier to treatment.”

Pain costs society up to $635 billion annually, according to the CDC, and is the number one  reason for disability. Pain is becoming better understood as a multifaceted phenomenon with  psychological factors.

In 2016, CDC authors published Guidelines and said that there was no evidence for a long-term  benefit of opioid pain medications. The authors found strong evidence for serious risks, including overdose, opioid use disorder, and motor vehicle injuries. The CDC said that other  treatments, including psychological approaches, had long-term benefits, without the high risks of opioids.

“It is now widely accepted that pain is a biopsychosocial phenomenon,” Dr. Datz, told the Times  in a previous interview. “The Guidelines are really exciting because they explicitly state that  physicians should be using nonpharmacological strategies including cognitive behavioral  therapy as well as exercise for patients with pain,” Datz said.

“This is a departure from the traditional belief that pain was primarily physical, and to be only  treated by medical means, which was the biomedical model,” Datz said.

“The benefits of pain psychology are that the person experiencing chronic pain ultimately has more control over their pain process, their reaction to it, and their life,” Datz said. “This is  accomplished by teaching patients about how their expectations, their attention, and their  stress levels interact with chronic pain and can greatly exacerbated.”

“A large body of research,” said Datz, “has shown that use of structured cognitive behavioral  therapy, and in particular cognitive behavioral therapy combined with physical therapy, as happens in functional restoration programs, are extremely effective ways of dramatically  improving physical function, mental health, and overall well-being in patients with chronic pain,” she said.

“Unfortunately, these methods have been sorely underused, partly due to insurance coverage  issues. With the advent of the ACA however, this is getting a lot better. Also, I think providers and patients are more open to these ideas now that the opioid epidemic has become such a  hot topic nationally,” she said. Among the key messages of the Lancet Commission report, the authors noted that “The profit motives of actors inside and outside the health-care system will  continue to generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.”

Dr. Datz will be presenting “Forced Opioid Tapers and the Culture of the Opioid Crisis: Time to revisit pain psychology” at the American Academy of Pain Medicine in Scottsdale Arizona on  March 19. She will speak about how the approach of using pain psychology during opioid  therapy is not new, but is enjoying a renewed urgency in the context of rising rates of opioid  tapers and the safety issues surrounding preventable side effect from forced opioid tapers.

Lancet Commission authors warned that pharmaceutical companies based in the USA are  actively expanding opioid prescribing worldwide, and are using fraudulent and corrupting tactics that have now been banned domestically.

Discrimination Complaint about LSBEP Discussed in Private

A Request for Investigation, stating that board members at Louisiana State Board of Examiners  of Psychologists are operating outside of their area of competence in regard to selection testing and racial discrimination, was reviewed in an executive session of the Board last month

The psychologists, Drs. William Costelloe, Julie Nelson, and Marc Zimmermann, are all business psychologists who have extensive experience with high stakes selection testing in the private  sector.

On February 15, Dr. Zimmerman emailed Executive Director Ms. Jamie Monic asking her, “It has  been in excess of 30 days since this was sent. We have not received any response. I am writing  to be sure the Request was received and if there has been any action on this matter.”

Ms. Monic replied, “Your Request for Investigation was received on January 11, 2022. I will send you a formal acknowledgment of receipt and response following the Board Meeting on  February 18, 2022.

“The agenda for the February meeting of the board included the Executive  Session item “Legal Issues and Strategy [LSA-R.S.42.17.A(4), 44:4.1] – AttorneyClient Privilege”  and numbered “P21-22-09P Received 1/11/2022.”

No additional information has been received as of publication.

In their Request for Investigation, Costelloe, Nelson, and Zimmermann wrote: “We submit this  request for investigation because we believe that the psychologists serving on the board (Drs.  Gibson, Gormanus, Moore, Harness, and Sam) are currently in violation of ethical principle  §1305, A.1., 2., 5., & 6. This is because the board members do not have the specific competences to develop an  anti-discriminatory selection program, then members are in violation of the ethics code.

“There is evidence that confirms that the EPPP has adverse impact against African-Americans  and Hispanics. Dr. Brian Sharpless proved adverse impact for the EPPP in New York. He studied  4,892 New York applicants and first-time EPPP takers over 25 years. He found that Blacks had a  failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07%. Dr. Sharpless also studied 642 applicants to the Connecticut State Board of Examiners of Psychologists with similar results. Whites had a 5.75% failure rate, Blacks had a 23.33% failure rate, and Hispanics had a 18.6% failure rate.

“Once adverse impact has been shown for a test it is improper to ignore the selection problems.
Furthermore, the way in which the test is used by the Board members drives up adverse  impact. As just one example, the use of a hard cut off, and one that sets a higher bar  considering the restricted sample, on a test with proven adverse impact, is an error in  professional selection testing design.

[…] “Finally, we are sympathetic to the situation that very few psychologists have developed  expertise in this subspecialty of selection testing, and in particular, ways to reduce or totally  avoid discriminatory practices. To that point, we are open to a resolution in concert with the  aspirational goal of working closely with colleagues when we perceive an ethics code violation  regarding area of competence.

“Summary We submit our complaint that the psychologists who are serving on the Board are unwittingly authorizing an inadequately designed selection program and therefore participated in unfairly denying African-American and Hispanic individuals licenses. This process may also be
harming the public by restricting the number of minority psychologists who serve the diverse  citizens of our state.

“We request an investigation and make ourselves available for additional questions and a collaborative review of the matter.”