Category Archives: News Stories

KFF Finds 53% of US Adults Stressed by Coronavirus & Economic ConcernsUntitled

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The COVID-19 pandemic and the resulting many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders,” report authors at the Kaiser family foundation (KFF).

The research team was led by Nirmita Panchal, collected data in July. They found that 53% of US adults said that their mental health has been negatively impacted due to worry and stress over the coronavirus. Researchers noted that this was significantly higher than the 32% they found in March 2020.”

Many adults are also reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus.”

Authors concluded that, “As the pandemic wears on, ongoing and necessary public health measures expose many people to experiencing situations linked to poor mental health outcomes, such as isolation and job loss.”

The researcher cited other conclusions noting that research links social isolation and loneliness to poor mental health. The data from late March shows that “significantly higher shares of people who were sheltering in place (47%) reported negative mental health effects resulting from worry or stress related to coronavirus than among those not sheltering-in-place (37%).”

“In particular, isolation and loneliness during the pandemic may present specific mental health risks for households with adolescents and for older adults. The share of older adults (ages 65 and up) reporting negative mental health impacts has increased since March. Polling data shows that women with children under the age of 18 are more likely to report major negative mental health impacts than their male counterparts.”

Authors also point out that job loss is associated with increased depression, anxiety, and low self-esteem. These problems may lead to higher rates of substance use disorder and suicide. “… data shows that more than half of the people who lost income or employment reported negative mental health impacts from worry or stress over coronavirus; and lower income people report higher rates of major negative mental health impacts compared to higher income people,” noted the KFF researchers.

“Prior to the COVID-19 pandemic, nearly one in five of U.S. adults (47 million) reported having a mental illness in the past year, and over 11 million had a serious mental illness, which frequently results in functional impairment and limits life activities. In 2017-2018, more than 17 million adults and an additional three million adolescents had a major depressive episode in the past year.

“Deaths due to drug overdose have increased more than threefold over the past 19 years (from 6.1 deaths per 100,000 people in 1999 to 20.7 deaths per 100,000 people in 2018).

In 2018, over 48,000 Americans died by suicide, and in 2017-2018, nearly eleven million adults (4.3%) reported having serious thoughts of suicide in the past year.

The authors state that during this unprecedented pandemic, it is reasonable to predict that mental health issues and substance abuse are exacerbated.

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CMS Seeks Cuts to Fees of Psychologists; Supervision In place until October 9, the newest of Testing by Nurses, PAs

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Centers for Medicare and Medicaid Services (CMS) are proposing hey new rule impacting the 2021 Medicare physician fee schedule, which will likely result in a 10.6% reduction in payments to psychologists providing services to Medicare beneficiaries, according to the American Psychological Association (APA) Office of Health Care Financing.

APA said that the reductions are proposed in order to offset higher values for next year’s outpatient evaluation and management (E/M) services. E/M services, which are typically a 15 minute, face-to-face with the patient, and decision-making of low complexity.

APA reported that CMS is also proposing to increase the values for some psychotherapy
codes (90791, 90832, 90834, and 90837) but this will not be enough to offset the losses for psychologists.

These payment cuts stem from the agency’s legal requirement to maintain a neutral budget from one year to the next, said APA.

APA is also partnering with a coalition of healthcare providers asking Congress to work
with CMS on a solution that will allow the increases for E/M without cutting payments to
other providers, said officials.

CMS is also proposing that non-physician practitioners (nurse practitioners and physician assistants) be allowed to supervise diagnostic testing including psychological and neuropsychological testing, if the state law and their scope of practice allows.

“APA is adamantly opposed to this proposal and is reaching out to CMS for more information— e.g. circumstances under which such supervision could occur and what types of tests would be involved,” said APA officials.

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Legislature Calls Itself into Session

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The Louisiana legislature called themselves into a special session that began on September 28 and which will end by October 27. The September 21 Proclamation lists 70 topics to be addressed, including items for replenishing Louisiana’s Unemployment Trust Fund, addressing COVID-19 recovery efforts, supporting communities impacted by Hurricane Laura, and possible funding of certain devastated school systems.

However, at the top of the list are items about the expanded powers of government under emergency conditions.

The first topic relates to “…legislative procedures, powers, duties, and authority pursuant to the Louisiana Health Emergency Powers Act…” The second item refers to ” … the power and authority of executive branch officers and agencies.”

Gov. Edwards immediately voiced his concerns in a September 21 statement.

“At a time when our state is dealing with the COVID-19 health emergency, hurricanes,
and one severe weather event after another, I am concerned that the Legislature has
again called themselves into a month-long session with an agenda of 70 items. This
session will occur at a time when the public will again be restricted in their access to the
State Capitol and their ability to give needed public input.

“From the beginning of this emergency, I have relied on public health experts and the
White House Coronavirus Task Force to guide Louisiana’s response to this historic
emergency. Further, this response has been in line with the measures taken by our
neighboring states that have unfortunately also been enormously impacted by COVID19.

“Put simply, the measures we have taken in Louisiana are working and we are making
significant progress. However, to abandon these efforts in defiance of the unanimous
advice of the public health experts and the Trump administration would seriously
jeopardize the lives of our people and the gains we have made. Further, it is important
to remember our work in containing COVID19 is far from done, as Louisiana still has the
highest number of per capita infections in the country.

“I am hopeful that the Legislative leadership will significantly narrow the scope and the
duration of this session so that they can do the work they deem necessary, while at the
same time working in a bipartisan and cooperative manner to address our
significant challenges in an honest and transparent manner. Louisianans have come
too far to have all of our effective and lifesaving work upended.”

In a September 28 editorial, The Advocate warned, “As with some of the other
budgetary items on the expansive menu, it’s too soon to say if the body can make
intelligent decisions when so many things, really almost everything, is in flux.

“Further, legislators should remind themselves that interfering with the complex
machinery of emergency declarations means that lawmakers will be taking responsibility upon themselves, individually and as a body, in a situation where there is no pleasant alternative, only a choice among bad options.”

Regarding the special session, proposed measures have been submitted and are being reviewed this month. The Louisiana State Board of Examiners of Psychologists did not submit a new copy of their legislation, which they proposed earlier this year in the
regular session. Sources indicate that the board is working on that legislation for 2021.

Very few bills have to do with psychology since the topics for the session are narrowed
to emergency events. However, House Bill 33 and Senate Bill 12, which are duplicates,
relate to emergency counseling in healthcare facilities.

Present law defines “mental health support personnel” to include psychiatrists, psychologists, social workers, and volunteer crisis counseling groups.

The proposed law provides that the Louisiana Department of Health may include the availability of no-cost or reduced-cost counseling or mental health support services offered by members of the clergy, religious organizations, or other nonprofit organizations when providing information about and referrals to mental health support personnel to address the psychological responses to the public health emergency.

The proposed law requires that, during the COVID-19 public health emergency or any
other contagious or infectious disease for which a state of public health emergency
has been declared, an inpatient healthcare facility provide patient or resident access
to members of the clergy for prayer, mental health support or religious counseling, the sacraments of Holy Communion, Anointing of the Sick, and Last Rites, and other such customary religious services that would normally be offered to patients or residents if the healthcare facility was not subject to a declaration of a state of public health
emergency.

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U21 Parishes in FEMA Disaster Area Governor Renews Emergency Status from Hurricane Laura

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Gov. Edwards renewed his State-of-Emergency proclamation on
September 18, authorizing the Governor’s office of Homeland
Security and Emergency Preparedness to continue to undertake all
activities authorized to assist in recovery from Hurricane Laura.

The proclamation prohibits price gouging and allows the Secretary
of the Department of Health to establish protocols and policies for
certain facilities to receive evacuated residents at nursing facilities.
Certain regulations are suspended and schools are allowed to
substitute online instruction.

The proclamation also provides for unemployment compensation
for some of those directly affected by flooding or due to the inability
to get to their worksite in a disaster parish.

The proclamation also authorizes all departments and agencies as
officers of the state to cooperate in actions that may be helpful in
dealing with the effects of this weather event.

On September 13, FEMA approved three additional Louisiana parishes for Individual
Assistance due to Hurricane Laura, bringing the total number of parishes where residents are eligible for aid to 21.

Federal FEMA assistance can include grants for temporary housing and home repairs, low-cost loans for uninsured property loss and other programs to help people and businesses recover from Hurricane Laura.

People who sustained losses in the designated parishes of Acadia, Allen, Beauregard,
Caddo, Calcasieu, Cameron, Grant, Jackson, Jefferson Davis, LaSalle, Lincoln, Morehouse, Natchitoches, Ouachita, Rapides, Sabine, St. Landry Vermilion, Vernon, Winn and Union.

Some additional parishes are still under review.

Individuals can apply for assistance. Register online at http://www.DisasterAssistance.gov or by calling 1-800-621-FEMA.

“People all across Louisiana were impacted when Hurricane Laura brought its strong winds ashore, knocking out power and causing massive destruction,” said the Governor.

Hurricane Laura made landfall in Cameron Parish on Thursday, August 27, with 150 mph sustained winds.

Laura was one of the strongest hurricanes to hit the United States and the worse storm for Louisiana since the 1856 “Last Island Hurricane.”

Twenty-six deaths have been attributed to Hurricane Laura. Property damages have been estimated at approximately $9 billion.

If some you know needs shelter, text LASHELTER to 898-211 for information about where to go or call 211.

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Gov Edwards Signs State Budget

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State Agency Heads Directed to Prepare for Possible Mid-Year Budget Cuts
Gov. Edwards Signs State Budget to Preserve Critical Funding During the Covid-19 Pandemic

Baton Rouge – On July 8, Gov. John Bel Edwards announced that he has signed the
state’s budget for the FY 20-21 operating year, preserving funding for critical health
care, workforce and education services that are needed during the pandemic, especially
as new COVID-19 cases rise again as school systems prepare to return to campus
in the fall, according to the press release from the Governor’s office.

Additionally, the Governor Edwards has ordered cabinet agencies to prepare for possible mid-year budget cuts by sequestering at least 10 percent of their budgets, which he also recommends for the judicial and legislative branches.

He will also issue an executive order to freeze hiring of state employees.

“Right now our budget is in a far better shape than we could have hoped just three
months ago, with funding for critical services in place as we continue to respond to the
COVID-19 pandemic and see case counts as well as hospitalizations rising,” he said.

“I have directed state agencies to prepare for possible mid-year cuts and, we will continue working with the Legislature to make any adjustments that may be necessary this fall,” Gov. Edwards said. “While there are cuts in the budget, federal CARES act funding allowed us to avoid making them even more catastrophic. In addition, we were able to invest CARES act funding into programs for local governments, aid to businesses and direct payments to essential front line workers.”

The Governor also vetoed language that cancelled meritr aises for classified state employees

Gov. Edwards vetoed a provision that impermissibly delayed pay raises for classified state employees and other provisions that sequestered funds appropriated to the executive branch, but not funds appropriated to the legislative and judicial branches.
He also vetoed more than $9 million in
new spending, as well as a provision
contrary to Centers for Medicare and
Medicaid Services guidelines that would
negatively impact the Louisiana
Department of Health and require the
expenditure of more than $10 million of
state general fund plus $32 million of
federal funds.

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Cases Rise, Governor Extends Phase Two

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Cases Rise, Governor Extends Phase Two

On July 23, Gov. Edwards signed orders and extending Phase Two and the Statewide Mask Mandate as Louisiana surpassed 100,000 known COVID-19 cases.

State officials put out a graphic highlighting the fact that Louisiana was first in the
nation based on a July 26 high of 3,840 new cases.

The Gov. Edwards signed a renewal of the current proclamation extending Phase Two
in the state, which includes the statewide mask mandate and additional restrictions,
until August 7.

“Today, we are reporting 2,408 new cases, which means that the state has now
surpassed 100,00 total cases. And of course, these are only the cases we know about. There are undoubtedly more,” Gov. Edwards said. “When you hit a milestone like
this one and when you see death totals that are higher than they’ve been in months, as we did yesterday, it’s a reality check.”

“For anyone out there minimizing the seriousness of this situation, you are doing
yourself and this state a terrible disservice. The same is true for anyone questioning the validity of the data that we’re using and releasing every day,” Gov. Edwards said. “COVID-19 is very prevalent throughout our state, and it is more widespread than ever before. We are certainly not where we want to be in Louisiana. I’ve extended Phase 2 with the mask mandate and other restrictions, but we are perilously close to having to make tough decisions that no one wants. This is why we have to follow the mitigation measures that are in place. We have to wear our masks, keep social distance, wash
our hands frequently and stay home when we are feeling sick.”

The statewide mask mandate applies to all 64 parishes in Louisiana. However, parishes with a COVID-19 incidence of fewer than 100 cases per 100,000 people for the most recent two week period for which data is available can choose to opt out of the mandate. Under the state’s policy, parish presidents in parishes with lower incidence rates do not have to opt out and may choose to keep a mask mandate in place.

The Louisiana Department of Health updates its incidence data every other week and at the time of the announcement, no Louisiana parish meets the standard to opt out of the current mask mandate.

The order requires face coverings for everyone ages 8 and older except for the following

Anyone who has a medical condition that prevents the wearing of a face covering
Anyone who is consuming a drink or food
Anyone who is trying to communicate with a person who is hearing impaired
Anyone who is giving a speech for broadcast or to an audience
Anyone temporarily removing his or her face covering for identification purposes
Anyone who is a resident of a parish without a high COVID incidence that has opted out of the masking mandate
Masks are strongly recommended for children
ages 2 to 7.

All bars, including those with food permits from the Louisiana Department of Health, will be closed to on-premises consumption. They can operate for curbside takeout or delivery service only.

The order also limits the size of social gatherings to 50 people indoors. Outdoor
social gatherings are also limited to 50 people if individuals cannot avoid being within six feet of one another.

Experts warn of a mental health crisis due to the impact of Covid-19.

According to a report by ABC News, authored by Alexis Carrington, the impact of Covid-19 could include 20 additional firearm-related suicides per day.

In the July 7 report, the author wrote that a new study has found that there may be a 20 to 30% increase in firearms suicides due to the mental health impact of Covid.

“The uncertainty brought on by the pandemic has been impacting people’s mental health and increasing feelings of anxiety and depression. The pandemic has also led to
increases in gun purchases with an estimated 1.9 million additional guns sold during March and April 2020 compared to the same time period last year. Having access to a firearm in the home triples the risk of death by suicide.”

“The study comes from the research arm of Everytown for Gun Safety, a non profit
organization which advocates for gun control. Rearchers at Everytown looked back at prior crises that led to massive unemployment, including the Great Depression of the 1930s and the Great Recession that ended in 2010.”

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Ex. Order Aims to Boost Valid Assessments for Federal Hiring/Selection

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On June 26, the President issued an Order to modernize and reform the hiring
process for federal work candidates.

In the introduction, President Trump wrote, “America’s private employers have
modernized their recruitment practices to better identify and secure talent through
skills- and competency-based hiring. As the modern workforce evolves, the Federal
Government requires a more efficient approach to hiring.

“Employers adopting skills- and competency-based hiring recognize that an overreliance on college degrees excludes capable candidates and undermines labor-market efficiencies. Degree-based hiring is especially likely to exclude qualified candidates for jobs related to emerging technologies and those with weak connections between educational attainment and the skills or competencies required to perform them.

“Moreover, unnecessary obstacles to opportunity disproportionately burden low-income Americans and decrease economic mobility.

“My Administration is committed to modernizing and reforming civil service hiring through improved identification of skills requirements and effective assessments of the skills job seekers possess. We encourage these same practices in the private sector. Modernizing our country’s processes for identifying and hiring talent will provide America a more inclusive and demand- driven labor force.

According to the President, this effort “…directs important, merit-based reforms that will replace degree-based hiring with skills- and competency-based hiring and will hold the civil service to a higher standard — ensuring that the individuals most capable of performing the roles and responsibilities required of a specific position are those hired for that position — that is more in line with the principles on which the merit system rests.

The President is directing the heads of the Office of Personnel Management and
Office of Management and Budget, the Assistant to the President for Domestic
Policy, and the heads of agencies, to review and revise all job classification and
qualification standards for positions within the competitive service, nd that changes
to job classification and qualification standards shall be made available to the
public within 120 days. Reforms include the following:

An agency may prescribe a minimum educational requirement for employment in the Federal competitive service only when a minimum educational qualification is legally required to perform the duties of the position in the State or locality where those
duties are to be performed.

Position descriptions and job postings published by agencies for positions within the competitive service should be based on the specific skills and competencies required to perform those jobs.

Section 3 of the Order addresses “Improving the Use of Assessments in the Federal Hiring Process.”

“(a) In addition to the other requirements of this order, the Director of OPM [Office
of Personnel Management] shall work with the heads of all agencies to ensure that, within 180 days of the date of this order, for positions within the competitive service, agencies assess candidates in a manner that does not rely solely on educational attainment to determine the extent to which candidates possess relevant knowledge, skills, competencies, and abilities. The heads of all agencies shall develop or identify
such assessment practices. (b) In assessing candidates, agencies shall not rely solely on candidates’ self-evaluations of their stated abilities. Applicants must clear other assessment hurdles in order to be certified for consideration. (c) Agencies shall continually evaluate the effectiveness of different assessment strategies to promote and protect the quality and integrity of their hiring processes.

“For purposes of this order: (a) the term “assessment” refers to any valid and reliable method of collecting information on an individual for the purposes of making a decision about qualification, hiring, placement, promotion, referral, or entry into programs leading to advancement;…”

The Order is available at https://www.whitehouse.gov/presidentialactions/executive-order-modernizingreforming-assessment-hiring-federal-jobcandidates/

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Dr. Erin Reuther Honored for Service

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The Louisiana Psychological Association (LPA) has named Dr. Erin Reuther, PhD, ABPP,
recipient of the 2020 Distinguished Service Award, announced at a recent meeting.

This award is given to an individual who has made significant contributions to the
professional field of psychology in Louisiana and beyond, by their professional service, noted to the officials.

The Awards Committee recognized Dr. Reuther for her dedication and leadership in
legislative issues and as special task team leader for matters related to Covid-19, as well as for her accomplishments in the role of President-Elect.

“In her leadership of the Legislative Affairs Committee, Dr. Reuther has created an active work group of psychologists who have been monitoring legislation which affects mental health issues in Louisiana. She is also leading LPA’s efforts to gather and disseminate information on COVID-19 during a time of crisis for psychologists in the state.

“Through her work on these committees, Dr. Reuther has demonstrated the abilities of a true leader who is able to bring together psychologists of different backgrounds and to shape them into an effective work group,” said the Committee. “In her role as President-Elect of LPA, Dr. Reuther has also provided outstanding leadership to the
Executive Council.”

Dr. Reuther is a licensed and board-certified clinical psychologist. She works at Children’s Hospital New Orleans, providing patient care to children and adolescents with pediatric illness in both inpatient and outpatient health/pediatric psychology.

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Legislature Calls Special 30-Day Session for Budget, Virus Fallout

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The regular legislative session ended on June 1 at 6 p.m. and the special 30-day session began one minute later at 6:01. The regular session was fragmented say observers, adjourning one week after it began due to the coronavirus and picking up only again on May 4. Some estimate that up to two-thirds of the bills introduced were dropped.  

The special session will address the states budget, not dealt with in the first session. According to the Proclamation to convene, only 41 items will be addressed. These include operating expenses of the state government and measures to appropriate funds. Other items include the Coronavirus Aide and Economic Security Act, the emergency unemployment compensation filed by persons impacted Covid19, and licensure of medical professionals during a declared public health emergency. Insurance dispute resolution for healthcare services, coverage for home health services, extension of filing for state and local tax returns, and expansion of broadband coverage, are also among the 41 topics.  

Senate Bill 458, initiated by the Louisiana State Board of Examiners of Psychologists (LSBEP) and authored by Senator Luneau from Alexandria, was not heard in committee. The measure set out ambitious changes to the Psychology Practice Act, but was put on hold after officers from the Louisiana Psychological Association (LPA) raised objections. Dr. Greg Gormanous, Chair of Legislative Affairs for LSBEP, established an Ad Hoc Legislative Collaborative Committee composed of community members who have been studying the issues. 

Some bills did make it through the chaotic session. These include the following (excerpts are from the digests): 

HB 317 by Thompson establishes an autism spectrum disorder designation for a person’s driver’s license. The new law authorizes an applicant for a driver’s license who has autism spectrum disorder to request a designation and requires the designation to be placed on his driver’s license. The new law requires the applicant to provide a sworn statement from a qualified medical or mental health professional licensed in La. or any U.S. state or territory verifying his disability and prohibits any additional fee for the designation. The new law requires a driver who has autism spectrum disorder to provide a statement from a qualified medical or mental health professional […] authorized to diagnose autism spectrum disorder.  

The new law requires the Dept. of Public Safety and Corrections, public safety services, to establish and implement a law enforcement training course relative to law enforcement officers’ interactions with persons who have autism spectrum disorder, in addition to the requirements of present law. And it requires the course to instruct law enforcement officers on sensitivity and awareness to ensure equitable treatment and how to effectively communicate and interact with persons who have autism spectrum disorder.  

HB 449 by Echols also passed. In present law, the Louisiana Telehealth Access Act (R.S. 40:1223.1 et seq.), defines “telehealth”, in pertinent part, as a mode of delivering healthcare services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education, care management, and self-management of patients at a distance from healthcare providers. The new law amends this definition to provide that healthcare services delivered via telehealth include behavioral health services. Stipulates that, for purposes of proposed law, “behavioral health services” means those services as defined in present law that are appropriate for the patient and delivered by a licensed mental health professional, acting within the scope of applicable state laws and his professional license for services identified by the Louisiana Department of Health (LDH), to treat mental illness or substance use.  

Present law, the Behavioral Health Services Provider Licensing Law (R.S. 40:2151 et seq.), authorizes the provision of behavioral health services in residential settings, clinic settings on an outpatient basis, and in home or community settings. The new law amends present law to authorize the provision of behavioral health services through telehealth, and stipulates that the provision of behavioral health services in any authorized setting shall be subject to rules and regulations of LDH. 

The present law known as the Behavioral Health Law (R.S. 28:1 et seq.) authorizes psychiatrists to conduct via telemedicine a required examination of a person with a behavioral health condition who is subject to admission by emergency certificate to a treatment facility. […] The new law retains present law and authorizes psychiatric mental health nurse practitioners to perform these examinations, and to do so via telemedicine as present law authorizes for psychiatrists. 

HB 819 by Bagley authorizes the recommendation of medical marijuana by physicians for treating additional conditions and authorizes any state-licensed physician to recommend medical marijuana. New law retains present law and adds all of the following to the list of debilitating medical conditions which qualify a patient for treatment with medical marijuana: (1) Alzheimer’s disease. (2) Amyotrophic lateral sclerosis. (3) Huntington’s disease. (4) Lewy body dementia. (5) Motor neuron disease. (6) Spinal muscular atrophy. (7) Chronic pain associated with fibromyalgia. (8) Chronic pain associated with sickle cell disease. (9) Any condition for which a patient is receiving hospice care or palliative care. (10) Any condition not otherwise specified in present law or proposed law that a physician, in his medical opinion, considers debilitating to an individual patient and is qualified through his medical education and training to treat. 

HB 871 by Marino redefines “dyslexia” for the purposes of testing and providing remediation to students. Present law provides different definitions of “dyslexia” for different purposes. New law retains present law purposes but provides a uniform definition of the term as follows: (1) Present law requires the State Bd. of Elementary and Secondary Education to adopt a program for testing students for dyslexia and related disorders and requires school boards to provide remediation for dyslexic students in accordance with the program; defines “dyslexia” for this purpose as a language processing disorder which may be manifested by difficulty processing expressive or receptive, oral or written language despite adequate intelligence, educational exposure, and cultural opportunity. (2) Present law requires every child in public school in grades K-3 to be screened at least once for the existence of certain impediments, including dyslexia; defines “dyslexia” for this purpose as in (1) above. (3) Present law requires, upon the request of a parent, student, or school personnel who has reason to believe that a student has a need to be tested for dyslexia, that a student be referred for testing; defines “dyslexia” for this purpose as difficulty with the alphabet, reading, reading comprehension, writing, and spelling in spite of adequate intelligence, exposure, and cultural opportunity. 

The new law redefines “dyslexia” for all present law purposes as an unexpected difficulty in reading for an individual who has the intelligence to be a much better reader, most commonly caused by a difficulty in phonological processing, which affects the ability of an individual to speak, read, and spell; provides that “phonological processing” means the appreciation of the individual sou unds of spoken and written language. SCR 62 by Milligan requests the State Board of Elementary and Secondary Education, through the state Department of Education, to develop and implement a traumatic injury response program to ensure that each city, parish, or other local public school in the state is prepared to respond in a traumatic injury emergency. 

The Times asked Dr. Erin Reuther, Chair of the Legislative & Governmental Affairs Committee, and President-Elect for the Louisiana Psychological Association (LPA) about the session. 

“When the legislative session reconvened, LPA remained active in engaging with legislators on several bills of interest,” Dr. Reuther said. “Namely, we monitored language in HB 449 and HB 530 to ensure that psychologists are included in definition of telehealth providers and our services are covered. We worked with stakeholders and legislators on HB 871 (formerly HB 391) and HB 542 regarding dyslexia with the goal of ensuring that legal definitions and practices in the state are consistent with evidence and best practices. This included a call to action of our members, which was helping in advocating for psychology and bringing us into meaningful discussions,” she said. 

“LPA also worked to support and amend HB 317, which creates an optional designation of autism spectrum disorder on drivers licenses for individuals who decide to opt in. It also calls for training of officers in working with individuals with ASD,” Dr. Reuther said. 

“LPA plans to continue monitoring legislation in the special session to continue our goals of bringing psychological science to policy and advancing the field of psychology in Louisiana,” she explained. 

Dr. Reuther is a licensed and board-certified clinical psychologist and works at Children’s Hospital New Orleans, providing patient care to children and adolescents with pediatric illness in both inpatient and outpatient health/pediatric psychology. 

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Malpractice Lawsuit in Terrebonne Parish Goes Against Lafayette Psychologist

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In a lawsuit filed in 2017 against psychologist Dr. Eric Cerwonka, a Terrebonne Parish jury awarded $1,150,000 to a 35-year-old Houma man. The plaintiff said he suffered emotional abuse from Cerwonka, according to the news article in a March issue of The Houma Courier.

The plaintiff’s case was tried by Jerri and Maxwell Smitko of the Smitko Law firm, in Houma, Louisiana.

According to the Courier, Jerri Smitko said that some of Dr. Cerwonka’s mental abuse included forms of brainwashing.

“He wrongfully attempted to convince my client that he had been abused by family members,” Smitko told the Courier reporter, Dan Copp.

Copp reported that the legal complaint alleged that the plaintiff had been in therapy with Dr. Cerwonka in early 2017, during the time that the defendant’s license to practice had been suspended.

However, other sources indicate that while Dr. Cerwonka‘s license had been suspended following a January 2017 hearing held by the Louisiana State Board of Examiners of Psychologists, he retained his license because he immediately appealed the decision. According to state records, Cerwonka‘s license is currently in effect in both Louisiana and New York.

The Courier report notes that the Houma man’s legal complaint included the following:

• “Dr. Cerwonka‘s advice during this time reflected the obvious tumult in his practice, as he advised plaintiff to live in his car and fight his father.”

• “When plaintiff learned of Dr. Cerwonka‘s suspension he reached out to him for clarification. In retaliation, Dr. Cerwonka threatened to have the plaintiffs subject to a civil commitment.“

Dr. Cerwonka has been involved in legal matters since 2017, when the psychology board decided to remove his license. He immediately filed an appeal and alleged several due process violations.

In August 2017, he also filed a lawsuit in the United States District Court Western District of Louisiana Lafayette division. In his complaint, Cerwonka and his attorneys allege that the board acted on an interim basis before any hearing had taken place, that Cerwonka was denied a proper opportunity to defend himself against specific charges, that an emergency action was taken because he exercised his right to free speech, and that evidence was manipulated and obtained illegally.

Among these and other violations of his rights, he and his attorneys also allege that because the prosecuting attorney for the board had previously represented Cerwonka in a hotly contested custody battle, and that the attorney had information that was, allegedly, used in the prosecution, the attorney should have been removed.

The due process lawsuit is scheduled for next month and based on an unopposed motion by Ms. Jaime Monic and her attorneys, was changed from a bench trial to a jury trial.

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Trump Administration and CMS Expand Telehealth During COVID-19 Pandemic

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In an April 30 press release, the Centers for Medicare & Medicaid Services (CMS) announced that at President Trump’s direction, and building on its recent efforts to help the U.S. healthcare system manage the COVID-19 pandemic, CMS has issued another round of regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system. These changes include continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services.

CMS is taking action to ensure states and localities have the flexibilities they need to ramp up diagnostic testing and access to medical care, key precursors to ensuring a phased, safe, and gradual reopening of America, said the authors.

CMS’s goals during the pandemic are to 1) expand the healthcare workforce by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community or other states; 2) ensure that local hospitals and health systems have the capacity to handle COVID-19 patients through temporary expansion sites (also known as the CMS Hospital Without Walls initiative); 3) increase access to telehealth for Medicare patients so they can get care from their physicians and other clinicians while staying safely at home; 4) expand at-home and community-based testing to minimize transmission of COVID-19 among Medicare and Medicaid beneficiaries; and 5) put patients over paperwork by giving providers, healthcare facilities, Medicare Advantage and Part D plans, and states temporary relief from many reporting and audit requirements so they can focus on patient care.

According to the announcement, for the duration of the COVID-19 emergency, CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others could deliver telehealth services. Now, other practitioners are able to provide telehealth services, including physical therapists, occupational therapists, and speech language pathologists.

Also, CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14- $41 to about $46-$110. The payments are retroactive to March 1, 2020.

In a May 1 press release, the American Psychological Association applauded the Administration and CMS for expanding Medicare coverage for audio-only phone services during the coronavirus pandemic, including psychotherapy, health behavior assessment and intervention services, and other behavioral health services.

Previously, Medicare recipients who wanted to take advantage of psychotherapy through telehealth could do so only via videoconferencing. This was a significant limitation for people without access or capability to use those technologies

“To curb the spread of the coronavirus and help our communities heal, we cannot leave any of our neighbors behind,” said Arthur C. Evans Jr., PhD, CEO of the American Psychological Association. “The American Psychological Association is grateful to our members and congressional leaders on both sides of the aisle for tirelessly advocating for these needed phone services.”

“Psychologists can now use their specialty skills to improve the health of ALL the communities we serve, including older adults, people with lower income or education, individuals with disabilities and people in rural areas,” he added. “Yesterday, some of the most vulnerable people in our country did not have access to psychological care. Today, they do.”

For additional background information on the waivers and rule changes, go to: https://www.cms.gov/newsroom/factsheets/additional-backgroundsweepingregulatory-changes-help-us-healthcare-systemaddress-covid-19-patient

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Gov. Edwards Establishes COVID-19 Help Desk for Louisiana Businesses

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Gov. John Bel Edwards and Secretary Don Pierson of Louisiana Economic Development announced the opening of an LED help desk that provides email and hotline support for Louisiana businesses impacted by COVID-19.

For COVID-19 business questions, LED may be reached at LEDbiz@la.gov or via the toll-free hotline, (833) 457-0531. The COVID-19 hotline is staffed from 8 a.m. to 8 p.m. Monday through Friday.

“Louisiana has experienced the fastest rate of increase for confirmed COVID-19 cases in the world, and it is imperative that everyone in our state take part in the efforts to slow the spread of this disease,” Gov. Edwards said.

“Businesses are making tremendous sacrifices to slow the spread, and resources are available to help businesses navigate this crisis. If your business has questions, please make use of the resources that Louisiana Economic Development has made available to you.”

“This LED help desk is the latest of our efforts to serve Louisiana businesses and to help them sustain operations through the challenges presented by COVID-19,” Secretary Pierson said.

LED is working with all levels of government and the private sector to support Louisiana businesses and their employees during the COVID-19 pandemic. At the LED website — OpportunityLouisiana.com/covid19 — businesses may find workplace guidance from the Governor’s Stay At Home Order and other proclamations; COVID-19 public health recommendations; sources of COVID-19 financial aid; regional resources across the state.

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Dr. Buckner Named for Research Excellence

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Louisiana State University Professor Dr. Julie Buckner has been named the G. Alan Marlatt Mid-Career Research Award winner for 2020, announced at this year’s annual meeting of the Association for Behavioral and Cognitive Therapies (ABCT) Addictive Behaviors & Anxiety Disorders Special Interest Group.

Julia Buckner is a Professor and Director of Clinical Training in the Department of Psychology at Louisiana State University and the Director of LSU’s Anxiety and Addictive Behaviors Laboratory & Clinic. She is also a Clinical Associate Professor in the Department of Psychiatry at LSUHealth Sciences Center and a Visiting Professor at the London South Bank University School of Applied Sciences. She is also a licensed clinical psychologist.

The awards committee said, “Among the multiple renown and highly-productive researchers who were nominated this year, you were the unanimous choice of the award selection committee. The praised her “pioneering work on the role of anxiety in substance use and related problems as well as her commitment to the development of innovative treatments for addictive behaviors, her research with historically underrepresented groups, her work to disseminate evidence-based practice to Baton Rouge (a high need area), and her outstanding mentorship and commitment to teaching…”

Dr. Buckner said, “I am honored to have received this award. Alan Marlatt was committed to both research aimed at understanding substance misuse as well as the translation of evidence-based findings to help improve treatment outcomes. Receiving this award highlights my research on the impact of psychosocial vulnerability factors such as anxiety on the etiology and maintenance of substance use disorders and research on ways to best treat dually diagnosed patients.” She explained that these patients, such as those with comorbid anxiety and substance use disorders tend to have poorer treatment outcomes.

Dr. Buckner’s program of research primarily focuses on: (1) delineation of causal and maintaining factors implicated in substance use disorders, especially the role of affect-related vulnerability factors; and (2) development and evaluation of empirically-informed treatment and prevention protocols for substance use disorders, including treatment for cooccurring anxiety-substance use disorders.

Dr. Buckner has had over 150 publications and has been involved in several NIH grants. She is currently Primary Investigator on a graduate education training grant from the US Department of Health & Human Services’ HRSA to integrate clinical graduate students into Our Lady of the Lake Hospital in Baton Rouge to bring evidence-based psychotherapy for substance use disorders, with a particular focus on treatment for opioid misuse. She has also received awards from organizations such as the American Psychological Association, College on Problems of Drug Dependence, Anxiety Disorders Association of America.

The award is in honor of Dr. G. Alan Marlatt for his distinguished career as a pioneer and innovator in cognitivebehavioral therapy and research on addictive behaviors.

Dr. Buckner said, “This award is unique in that it also highlights our work that more directly impacts the lives of individuals in Baton Rouge who are suffering from these conditions, including our efforts to bring MET-CBT for substance use disorders (including those with dual diagnoses) to several locations throughout Baton Rouge, including the 19th JDC Adult Drug Treatment Court Program, Our Lady of the Lake’s outpatient clinic Center for Psychiatric Services, and thanks to a recent HRSA grant we received from the US Dept of Health & Human Services, to several units in OLOL Hospital.”

Also at this year’s conference Kayce Hopper was awarded the Outstanding Student Poster award for her poster, “Dual electronic and combustible smokers use of cannabis in relation to pain and hazardous drinking.”

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DOJ Asks Judge for More Time to Answer Dr. Hesson’s 2255 Petition

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On February 12, prosecutors at the Department of Justice asked for a second extension to respond to a 2255 Petition by Dr. Rodney Hesson, who was at the center of the 2015 high profile Medicare fraud case that resulted in convictions of two other well-respected psychologists in the community, Dr. Beverly Stubblefield and Dr. John Teal.

Dr. Hesson filed 829-pages of documents and exhibits with the United States District Court, Eastern District of Louisiana on November 1, 2019, alleging violation of his Constitutional rights to a fair trial due to inadequate representation.

A 2255 petition is a motion under 28 United States Constitution §2255 to vacate, set-aside, or correct sentences for a person in federal custody.

Among other assertions, Hesson alleges that his rights were violated when his defense attorney failed to “move the court” to issue a jury instruction which would have identified the governing Medicare rules and regulations that Hesson relied upon in his clinical and billing practices. In contrast, prosecutors focused on CPT codes. The failure to explain Medicare regulations caused numerous “prejudicial consequences which were overwhelming…” Hesson writes.

Representing himself in the Petition, Hesson argues that the jury was not given instructions as to how to understand critical Medicare regulations and rules, and if they had, their understanding would have been the basis of a “complete defense.”

“In the end, not even one governing Medicare regulation was presented in the court’s instructions to jurors,” he writes, “leaving jurors unable to determine that the billing procedures were based on Medicare regulations, CPT codes being only a part of the more complex Medicare guidelines, and that Hesson relied on these regulations in good faith.”

If jurors had been made to fully understand, he explains, that Hesson’s company, Nursing Home Psychology Services (NHPS) passed a 2011 Medicare audit and review of its procedures for billing, and also that in 2012 he voluntarily asked Civil-DOJ to review NHPS billing procedures, then jurors would have concluded that he did not have any intent to do fraud or make false statements, he writes.

In the fact-filled 2255 Petition, Hesson argues that the jury was not instructed nor allowed to understand the official regulations, which would have successfully countered the prosecutors’ theory of fraud, and more importantly, their “theory of conspiracy.”

In response to the November 8 Petition, Judge Carl Barbier ordered that the US attorneys file a response to Hesson’s arguments by January 7. In December the prosecutors filed a motion for additional time and then again in February prosecutors asked for more time. Judge Barbier granted both extensions. The US response is now due on April 6, 2020.

Hesson’s company, Nursing Home Psychological Services (NHPS) consulted with and served up to 72 nursing facilities and employed between 23 and 26 psychologists and between 18 and 20 clinical coordinators. Hesson designed a service that paired each psychologist with a clinical assistant, and the total units/hours billed was a sum of both the psychologist’s and the supervised assistant’s procedures. Consulting with the staff at the nursing home and working from physician referrals were part of the program for diagnostic testing of patients.

Three main NHPS practices formed the basis of the charges against Hesson: use of clinical assistants, medical necessity, and “locum tenens” billing, of one psychologist under the agency Medicare number of another.

In the Petition, Hesson argues that each of these business practices would have been shown to be legal and valid, or a good faith reliance upon them at the least, if the jury would have been caused to fully understand the Medicare regulations and rules. And, his company’s willingness to undergo voluntary reviews by Civil-DOJ would have countered any conclusion of “conspiracy.”

The 2015-2016 charges against all defendants were elevated to “conspiracy,” which carries some of the harshest legal treatment that Government prosecutors can bring to bear on defendants, through laws that allow pre-trial and pre-conviction seizing of assets and property.

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

Even the Judge, notes Hesson, commented on the unusual circumstances of the case. Before the trial began, Judge Barbier said, “You know, in many criminal cases, the defense is: I didn’t do it. I didn’t commit the act you said I committed. I didn’t have a gun, I did not do whatever it is. But in this case, as I understand it, the defendants are saying: we did what we did, but we didn’t believe it was illegal to do what we did.”

And, the transcript confirms that confusion. The Judge acknowledged that he had not reviewed the regulations and stated, “I have seen references to them in all the pleadings, all the memoranda that have been filed. They said these are very complex regulations, does it pretty much say in black and white under 101 and 102 what you can do and not do?“

Prosecutor’s Kanellis response was misleading at best, writes Hesson: “The CPT codes are very short. What [the defense] want[s] to do is they want to muddle the picture by saying here’s a way you interpret these codes, why don’t we consider this ….”

Hesson writes that when prosecutor Kanellis reinforced his point that any interpretations about the governing law is “the Judge’s function,“ the following conversation occurred:

The Court: You’re going to propose or suggests legal instructions on that, right?

Prosecutor Kanellis: Yeah. If there’s a reason —

The Court: is there case law on this that’s relevant, on how to instruct the jury on these types of regulations?

Prosecutor Kanellis: There are cases that discuss the issue in general. I have not seen a case where they discuss the specific instructions in that regard. That’s certainly something, your honor – – I mean, the easiest thing to do is for the court to say, this is what CPT code 96101 says,” and it’s a sentence, or a few sentences. Here is what CPT code 96102 says.”

Jurors never received these instructions, Hesson writes, and so could not determine whether he and his employees reasonably complied in good faith with civil law.

Hesson and his mother, Gertrude Parker, owned and operated regional companies, Nursing Home Psychological Service and Psychological Care Services. They marketed to nursing homes in Louisiana, Mississippi, Alabama and Florida. At the trial, Hesson said that his company was “…inundated with referrals.” He said that at times the company had to cap how many people could be seen.

Physicians ordered the assessments and nursing homes appeared to need them, based in part in changing attitudes around the country and the increasing awareness about overmedication of senior citizens in nursing home care. Many sources note the under utilization of psychological services in senior care facilities. Hessen and his company, classified as a small-business based on yearly revenues, became a top biller of Medicare services.

Dr. Hesson was found guilty and sentenced to 120 months, and restitution of $13,800,553 with at least $200 per month after release, paid to Medicare.

Gertrude Parker was sentenced to 84 months, restitution of $7,313,379, and $200 per month.

Dr. John Teal was sentenced to serve 24 months, restitution of $3,505,137, and $200 per month. He has completed his sentence.

Dr. Beverly Stubblefield was sentenced to serve 30 months, restitution of $2,181,378, and $200 per month. She is home in Ecru, Mississippi. Stubblefield worked contract for the Hesson companies, part-time for about five years. She was paid roughly $89,000 per year.

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President Trump Issues Executive Order to Combat Human Trafficking and Child Exploitation

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President Trump signed an executive Order on January 31 to establish goals and priorities to end human trafficking in the U.S.

“Human trafficking is a form of modern slavery,” he said. “Throughout the United States and around the world, human trafficking tears apart communities, fuels criminal activity, and threatens the national security of the United States. It is estimated that millions of individuals are trafficked around the world each year — including into and within the United States. As the United States continues to lead the global fight against human trafficking, we must remain relentless in resolving to eradicate it in our cities, suburbs, rural communities, tribal lands, and on our transportation networks. Human trafficking in the United States takes many forms and can involve exploitation of both adults and children for labor and sex.

“Twenty-first century technology and the proliferation of the internet and mobile devices have helped facilitate the crime of child sex trafficking and other forms of child exploitation. Consequently, the number of reports to the National Center for Missing and Exploited Children of online photos and videos of children being sexually abused is at record levels.

The President wrote, “Effectively combating these crimes requires a comprehensive and coordinated response to prosecute human traffickers and individuals who sexually exploit children online, to protect and support victims of human trafficking and child exploitation, and to provide prevention education to raise awareness and help lower the incidence of human trafficking and child exploitation into, from, and within the United States,” he said.

“To this end, it shall be the policy of the executive branch to prioritize its resources to vigorously prosecute offenders, to assist victims, and to provide prevention education to combat human trafficking and online sexual exploitation of children.”

The Order aims to strengthen federal responsiveness to human trafficking, and make available, online, a list of the Federal Government’s resources to combat human trafficking, ways to identify and report instances of human trafficking, to protect and support the victims of trafficking, and to provide public outreach and training.

Improving interagency coordination for targeting traffickers, assessing threats, and sharing law enforcement intelligence is an objective, and also to enhance capabilities to locate children who are missing. The Secretary of Health and Human Services is to establish an internal working group to develop and incorporate practical strategies for state, local, and tribal governments, child welfare agencies, and faith-based and other community organizations to expand housing options for victims of human trafficking. The Attorney General and the Secretary of Homeland Security, in coordination with the Secretary of Education, shall partner with state, local, and tribal law enforcement entities to fund prevention programs.

In 2017 Gov. Edwards and the Governor’s Office Human Trafficking Prevention Commission announced a series of regional summits on human trafficking. In collaboration with various agencies the summits aimed to highlight pertinent information from key stakeholders regarding the existing services, protocols and community response to trafficking victims.

Psychologist Dr. Rafael Salcedo attended the Louisiana Human Trafficking Prevention Advisory Board meeting, held 2018. First Lady Donna Edwards and Senator Beth Mizell, gave opening remarks.

Dr. Salcedo represents psychology on the advisory group and he is also the cocreator with his wife Beth, of a the Free Indeed Home, the only licensed, therapeutic group home in the state for helping teen girls escape the physical and psychological bonds of sex-trafficking. The First Lady Ms. Edwards has toured the Home, Dr. Salcedo explained to the Times.

Dr. Rafael Salcedo is known for his advocacy and comprehensive treatment program for the young victims of human sex trafficking, and for this and other efforts, was named the 2017 Distinguished Psychologist by the Louisiana Psychological Association.

Salcedo is a licensed Clinical Psychologist with subspecialties in the area of forensic and neuropsychology, providing services for issues such as competency to stand trial, sanity at the time of crime, and other legal issues.

He consults to the court system in Orleans, Jefferson, Lafourche and Terrebonne Parishes, to the Office of Community Services, and has worked with the Department of Children and Family Services for the last 25 years, conducting evaluations of children who are in need of supervision or care.

Dr. Salcedo also chairs the Louisiana Psychological Association Committee for Community Psychology & Psychology in the Public Interest.

In 2012, after becoming aware of the depth and tragedy surrounding child sex trafficking, Rafael and Beth, a licensed speech- language pathologist, founded the nonprofit, advocacy group, the Louisiana Coalition Against Human Trafficking.

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