Times Magazine listed him as one of the 100 Greatest Thinkers of the 20th Century. Richard Dawkins calls him “A uniquely brilliant scientist.” Science named him “One of the most influential evolutionary theorists alive today.”

Stephen Pinker, Professor of Psychology at Harvard and author of How the Mind Works, said, “I consider
Trivers one of the great thinkers in the history of Western thought. It would not be too much of an exaggeration to say that he has provided a scientific explanation for the human condition: the intricately complicated and endlessly fascinating relationships that bind us to one another.”

He is Professor Robert Trivers, the man who pulled back the curtain on key concepts of evolved preferences, and produced a major redirection in social and evolutionary psychology. He will speak at the Louisiana Psychological Association workshop on November 9, in New Orleans.

In a series of brilliant papers beginning in the 1970s, he laid out the evolutionary logic and foundational theory for major areas of human social interaction. His combining of psychology and evolutionary biology opened the door to a better understanding of the deep connections of love, cooperation, competition and the unconscious conflicts that accompany them.

In 1971, with, “The evolution of reciprocal altruism,” Dr. Trivers put the heart back into the psyche: Being moral, good, and fair, had in fact, evolved right alongside our purely selfish traits.

The model is where “friendship, dislike, moralistic aggression, gratitude, trust, suspicion, trustworthiness, aspects of guilt, and some forms of dishonesty and hypocrisy” could be explained as important adaptations to regulate the reciprocalaltruistic system, sensitive to developmental variables and selected to their specific social environment.

Trivers’ theories inspired a staggering amount of research and discussion with bestsellers like E.O. Wilson’s Sociobiology and Richard Dawkins’ The Selfish Gene, and later books like The Adapted Mind, The Red Queen, Born to Rebel, The Origin of Virtue, The Moral Animal, and Evolution of Desire.

As the explosion of research continued, Trivers wrote that some of the ideas had “…almost biblical proportions.” He said, “… you could see how a kind of social heaven and social hell could evolve right here on earth. The social hell was perpetual isolation, perpetual inability to link up with others in a positive way, never being cheated by others to be sure, but at the cost of eternal loneliness. The social heaven was not heavenly in some naïve way, dancing around the mulberry bush together without regard for selfish possibilities. Instead, cooperation required perpetual vigilance to enjoy its fruits, …’”

Together, Trivers’ work helped explain evolved tendencies in romantic relationships between females and males (“Parental Investment and Sexual Selection”) relationships between parents and children, and between siblings (“Parent-offspring conflict”), and how friends deal with friends, acquaintances and strangers (“The evolution of reciprocal altruism”).

In the 1990s, Trivers took another leap and explained an evolutionary logic of self-deception. (“The crash of Flight 90: Doomed by self-deception?” co-authored with Black Panther leader, Huey P. Newton; and “The elements of a scientific theory of self-deception”).

Dr. Trivers has stated that he “… was eager to contribute to building social theory based on natural selection, because a scientific system of social theory must, by logic be based on natural selection, and getting the foundations correct would have important implications for understanding our own psyches and social systems.”

Today, while psychology includes vast amounts of fascinating data and interesting partial theories, it still lacks a foundational, meta-theory, say evolutionary psychologists William Von Hipple and David Buss. In their survey, the two found that almost 90% of social psychologists accept Darwin’s ideas in general, but only about 50% believe that evolved characteristics apply to the human mind and social tendencies.

Trivers himself wrote that he expected his work would be welcomed––he viewed himself to be “on the side of the angels,” he said. Instead, it was labeled “regressive.”

In the past, evolutionary theory may have seemed harsh, and even to be a theory that gives permission for inequality, something psychologists work against. Von Hipple and Buss point to the mistaken idea of “genetic determinism”––the belief that genetic behavior is fixed, and also to the confusion between evolved preferences and actual behaviors in modern humans, as contributing to discomfort with embracing evolution as a metatheory.

Today, a stronger understanding that the expression of these predispositions is plastic, fluid, varying and context-dependent, has worked its way into psychologists’ thinking, along with the acknowledgement that the discipline cannot ignore important science only because it may at times be uncomfortable.

“But Trivers’ ideas are, if such a thing is possible,” said Pinker in an interview with the Edge, an intellectual think tank, “even more important than the countless experiments and field studies they kicked off. They belong in the category of ideas that are obvious once they are explained, yet eluded great minds for ages; simple enough to be stated in a few words, yet with implications we are only beginning to work out,” Pinker said. This may be the case. Trivers Google Scholar citations, now over 44,500, are continuing to increase. Citations for his 10 major papers are much higher now than they were for the first 30 years after publication.

The Louisiana Psychological Association will host the evolutionary theorist at their winter workshop, to be held Friday, November 9, at the Hotel Monteleone in New Orleans.

The one-day event, “Evolutionary Psychology & Ethics,” will address the scientific foundations of self-interest, reciprocal-altruism, cooperation and deception in human relationships, and the evolutionary logic that predicts this complex psychological terrain.

Dr. Trivers will speak on “Ethics and Social Theory: The Evolution of Reciprocal Altruism,” and then on “The Logic of Deceit and Self-Deception.

“I will define natural selection, the basis social traits, then concentrate on altruism and quickly move to reciprocal,” he said, and explain gross and subtle cheating, sense of justice and other traits.

In “The Logic of Deceit and Self-Deception,” he will start with the co-evolutionary struggle between deceiver and deceived, the intrinsic bias in favor of the deceiver, and the invention of self-deception to facilitate deception.

Also presenting and participating as discussants will be Dr. Jack Palmer, from University of Louisiana Monroe, author of Evolutionary Psychology: The Ultimate Origins of Human Behavior.

Dr. Matthew Rossano, from Southeastern Louisiana University, author of Supernatural Selection: How Religion Evolved, will also present.

Dr. Michael Chafetz, known for his extensive work in malingering research, and Dr. Denise Newman, chair of the Louisiana Psychological Association Psychotherapy Interest Area and a psychoanalytic psychologist, and others.

Brilliant and controversial, Robert Trivers has attracted attention for his immensely original thinking and also for his unconventional activities. He currently lives in Jamaica, which he loves, and where he studies body symmetry in elite runners, and where he recently completed an autobiographical memoir––Wild Life: Adventures of an Evolutionary Biologist.

Registration opens August 10 at louisianapsychologicalassociation.org

In the 2018 regular session, House Bill No. 145 placed limitations on who may diagnose the disorder known as “Munchausen Syndrome by proxy,” which is known in the DSM-5 as factitious disorder imposed on another or FDIA. The bill, by Representative Kenny Cox, was signed by the Governor and became Act 193.

Formally known as Munchausen syndrome by proxy (MSP), this condition is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. In some cases, illnesses may be actually produced by the caretaker.

Act 193 directs that no physician or other health care provider shall diagnose the condition of factitious disorder imposed on another (formerly “Munchausen syndrome by proxy”) unless he or she meets certain criteria, such as being licensed, qualified by his or her license and training to diagnose, able to provide a certain level of quality in the evaluation, and other stipulations. The new law indicates that the evaluator must review relevant records, history, current clinical conditions, and obtain records from external sources searches schools, childcare providers, and family.

While these quality controls and expectations are standard for psychological evaluation, Representative Cox’s measure suggests that problems have been encountered in the past in this complex area where teasing out the accuracy of claims and symptoms could require a deeper understanding of illness-deception.

The measure was signed by the governor recently and became law as Act 193. However, the real complexities of the matter may still cause issues for those practitioners who are not highly trained to understand nuances and pitfalls regarding illnessdeception.

Dr. Michael Chafetz, a nationally recognized expert when it comes to malingering in forensic and medical
assessments, points to the complexities in understanding these issues.

“Every practitioner who makes a diagnosis has two potential positive outcomes and two potential errors,” said Chafetz. “If the diagnosis is made and is correct, it is a good thing because the patient has the pathology identified and can get appropriate treatment. If the diagnosis is correctly rejected (because no evidence for the pathology could be adduced), it is a good thing because the patient is spared the wrong treatment for pathology that does not exist.”

“The flip side of the positive outcomes involves the errors that are potentially made,” he said. “If the practitioner makes a diagnosis of a condition that the patient does not have, that is a false-positive error. Everyone involved with the case is now acting on false new information about the patient.

“On the other hand, if the practitioner rejects the diagnosis for a condition that the patient does have, that is a false-negative error,” he explained. “This error can be problematic, as no one involved with the case will get on board with the appropriate interventions.”

In decision-making, there is often a trade-off between false-positive and falsenegative errors, and the importance of not making one or the other depends on the relative merits of the outcomes, he explained. “For example, in cancer screening and bomb detection, a false negative error can be more costly than a false-positive error. TSA certainly does not want to miss a bomb, and the radiologist certainly does not want to miss a possible cancer. These false-positive errors may cause some discomfort, but they sure beat the alternatives!”

In Factitious Disorder Imposed on Another, both kinds of errors have realworld consequences. “If the practitioner makes a false-negative error, missing the parental deceptions, the parent does not get diagnosed, which increases the potential for a child to suffer abuse,” Dr. Chafetz said.

“If the practitioner makes a false-positive misdiagnosis of the parent, that parent may face drastic consequences with the possibility of termination of their parental rights.”

He noted that Factitious disorder (FD), like malingering (M), involves deceptive behaviors. In fact, both FD and M are similar in that they both involve deception of others. Malingering involves deception in a medico-legal setting, whereas FD typically occurs in a medical or psychological setting.

The “by-proxy” or “imposed on another” conditions for both disorders are meant to convey that an individual, usually a caretaker, is creating the deception by use of a person under their care.

Dr. Melissa Dufrene and Chafetz have studied these exact issues, in Chafetz, M.D., & Dufrene, M. (2014). Malingering-by-proxy: Need for child protection and guidance for reporting. Child Abuse & Neglect, 38, 17551765.

Both of the by-proxy or imposed conditions can lead to child abuse, he explained. In their guidance article, Chafetz and Dufrene developed guidelines for reporting.

Dr. Chafetz has also discussed these conditions in a physicianeducation article, Chafetz, M.D. (2018). Factitious Disorder Imposed on Another and Malingering by Proxy: Controversies, Recognition, Responsibilities, and Management. American Physician Institute, CMEtoGo, Volume 7, Issue 2.

It is important to recognize that both conditions, M and FD, involve deception of others. Typically, psychological treatments do not take into account the deception, he said.

While Act 193 may help somewhat to make sure qualified professionals are called upon for these complex issues, there could still be a lot of confusion for those that do not have the tools and methods to evaluate these serious issues.

After a total of seven special sessions since 2016, and three special sessions this year, Governor Edwards and legislators finally wrestled the budget into some type of order by the passage
of an extra .45 percent sales tax, in down to the wire negotiations that ended last week. The move sidesteps drastic cuts to public health and higher education and provides several years
of stability.

The new tax will raise an estimated $463 million to plug holes in the budget hat if left unresolved, had threatened to bring dramatic cuts in health care services and what the Governor called
“a catastrophic cut” to higher education.

The new sales tax, a partial renewal of an expiring one percent sales tax, is said to give the lawmakers some respite from the yearly battles with the budget. The .45 brings the state sales
tax to 4.45.

“The fiscal cliff is now gone and we have predictability ahead of us,” the Governor said after the agreement passed in this year’s third special session.

In the special sessions lawmakers were attempting to deal with the state’s budget crisis when more than $1 billion in taxes would expire on June 30, 2018. The two earlier special sessions
floundered after the House repeatedly rejected increased taxes. The House passed a budget that made dramatic cuts to TOPs, universities and state agencies, and then that was vetoed by
the Governor.

Allowing the new arrangements, this week Moody’s Investors Service changed Louisiana’s rating to “stable.”

Gov. John Bel Edwards said, “Today’s action by Moody’s validates what we’ve been saying about the need for budget stability,” said Gov. Edwards.

“Thanks to the bipartisan compromise achieved during the last special session, Louisiana is no longer on the negative watch list. By working together, for the first time in a long
time, Louisiana’s budget will have the kind of stability and predictability we need to bring new business opportunities to our state and grow our economy. As a result, not only are the
credit rating agencies taking notice, but we are positioned to generate greater savings for our state that will enable us to continue on our path toward prosperity.”

“Usually the day after session is a day of relaxation after a long few months of hard work and a little late night celebration,” said Keli Williams, with Ourso Consulting.

“Last night was a late night, but there was no celebration. With the last 30 minutes of the special session, which had to end at midnight, the House began taking up the budget bill, HB 1, and the revenue bills, HB 12 and HB 27.”

This special session was the second session and the sixth financial session in the last two years, attempting to deal with the state’s budget crisis when more than $1 billion in taxes are scheduled to expire on June 30. The earlier special session floundered after the house repeatedly rejected increased taxes. At the same time, dramatic cuts in health care services and what the Governor called “could face a catastrophic cut” to higher education had been threatening.

This week the House approved HB 1 but it makes dramatic cuts to TOPS, universities and state agencies, and is similar to the budget that the Governor previously vetoed, explained Williams to the Times.

But the deal collapsed when lawmakers failed to take up the two revenue bills that would have filled the gaps, something the Governor put forth in his hoped for compromise plan.

“HB 12 and HB 27 were both sales tax measures that would have increased the sales tax by 1/2 to 1/3 penny, respectfully, and cleaned some exemptions from the remaining pennies,” said Williams.

“Neither bill was able to gain enough support to pass before midnight,” she said. “With two minutes left, HB 12 was brought up for reconsideration. Rep. Seabaugh went to the microphone to oppose the bill for the purposes of running out the clock, per his own statement at the microphone. A second vote on HB 12 was not taken as time expired.”

As of publication there is no news yet about another special session.

This past weekend the Senate Finance Committee put forth a measure that would begin in July and would cover over $500 million of the state’s $600 million problem.

This is more than the house wanted to cover but not the entire amount that was asked for by Gov. Edwards.

In a May 25 statement Gov. Edward said, “We have a very short window left to fix the fiscal cliff and fund our critical priorities. Right now, the Senate is waiting on bills to come from the House and, with the clock ticking, any day not spent solving this crisis is simply unacceptable to the people of Louisiana. I am here and ready to work, and I’d hoped that the House would do the same. While I’m disappointed that we haven’t made more progress to close the budget gap, the fact that a majority of both the Republican and Democratic caucus members supported renewing a portion of the expiring revenue gives me hope that we can come to an agreement very soon.”

The Republican delegation responded On May 29, “Yesterday, the House of Representatives passed the Republican Spending Reduction Plan that makes sure our critical services like nursing homes and hospitals are funded by renewing one-third of the one-cent sales tax and requires government to reduce it’s spending by 1.3%.”

“The basis for our compromise is that government reduce its spending. Asking state government to cut its spending by 1.3% is not unreasonable. We simply cannot continue to grow the size of government while Louisiana’s GDP is shrinking, businesses are leaving and our population is falling. Again, asking government to reduce its spending by 1.3% is not unreasonable, it’s the most responsible thing we can do.”

In Gov. Edwards’ 2018 Second Special Session opening remarks he said, “The House of Representatives and the Senate passed wildly differing budgets. One completely decimated health care in Louisiana, the other funded health care but decimated higher education and other critical state services like education and public safety, while ignoring that a nearly 25 percent cut to our state agencies would leave thousands of our fellow Louisianans out of work and our agencies unable to do their work.” He asked them to do better.

On April 11 the State of Louisiana First Circuit Court of Appeal, reversed Judge Michael Caldwell’s decision that the state psychology board violated Dr. Eric Cerwonka’s rights when the board used attorneys from the same law firm, and when the board’s prosecuting attorney had been previously involved with Cerwonka in a child custody case and fee dispute.

The Appeals Court reversed Caldwell, and sent the matter back to the district court for further proceedings. Costs of the appeal are to be paid by Cerwonka.

Following a January 2017 hearing the Louisiana State Board of Examiners of Psychologists revoked Dr. Cerwonka’s license. He then sought a review in the 19th Judicial District Court. Presiding Judge Mike Caldwell stopped the review and vacated the board’s decision saying that the process “reeked” with due process violations.

Judge Caldwell said that allowing Lloyd Lunceford, a member of the same law firm as the Board’s general counsel, to serve as presiding officer for the administrative proceeding; and allowing James ‘Jim’ Raines, who represented Dr. Cerwonka in a prior child custody matter, which also resulted in a fee dispute, to serve as the Board’s prosecuting attorney, violated Cerwonka’s rights to a fair hearing.

The Appeals Court disagreed. They reviewed the record of the January 2017 hearing and said that despite Ms. Amy Lowe and Mr. Lunceford being from the same law firm, this alone does not constitute a violation.

They cited a U.S. Supreme Court ruling (Withrow v. Larkin, 1975) noting the constitutional framework for analyzing issues involving the combination of investigative and adjudicative functions in state and federal administrative proceedings.

In a case involving a physician’s disciplinary hearing in Wisconsin, the Appeal judges wrote, “Supreme Court recognized that a fair trial in a fair tribunal is a basic requirement of due process and that this requirement applies to administrative agencies which adjudicate, as well as to courts.”

“The Supreme Court went on to state that “[n]ot only is a biased decisionmaker constitutionally unacceptable but ‘our system of law has always endeavored to prevent even the probability of unfairness.”‘

However, the Supreme Court implicitly rejected that structural argument and held that the “combination of investigative and adjudicative functions does not, without more, constitute a due process violation.”

The Appeal judges wrote that the prevailing view is that a party basing a procedural due process claim on an impermissible combination of functions argument must demonstrate that the risk of actual bias is intolerably high, not merely that a combination of functions exists.

After reviewing the record of the hearing, the Appeals court found no evidence that Ms. Lowe had interjected herself unfairly in the proceedings. She did not prosecute or defend, or crossexamine any witnesses. The presiding officer Mr. Lunceford did not decide the merits of the allegations, and while he did rule on the admissibility of evidence, the Court did not see in its review of the record any evidence of unfairness to raise issues of due process.

Regarding Mr. Raines, Judge Caldwell agreed with Dr. Cerwonka’s view that Mr. Raines’ not recusing himself constitutes a due process violation. The Appeals Court disagreed.

The Board’s pleadings note that the issue was first raised during the course of the administrative proceeding, when Dr. Cerwonka argued that Mr. Raines should be recused because he was not impartial as required by LSAC.Cr.P. art. 680. The Appeals Court wrote that the article 680 “provides that a district attorney must be recused when he has a personal interest in the case, is related to the party accused or the party injured, or has been employed or consulted in the case as an attorney for the defendant before his election as district attorney.”

“However, we note that LSAC.Cr.P. art. 680 applies to district attorneys in criminal cases. By contrast, the Administrative Procedure Act applies to the underlying administrative proceeding. It requires only that the adjudicator be impartial and neutral.”

The Appeals Court wrote that Mr. Raines is not required to be a neutral party but an advocate, who has developed the “will to win.”

They wrote, “Dr. Cerwonka contended that Mr. Raines should have been recused because he represented Dr. Cerwonka in a prior custody case in 2006 in which a subsequent fee dispute arose between Raines’ firm and Dr. Cerwonka. Mr. Raines admitted that as a second year associate, he worked under the partner of his law firm and was one of two attorneys who represented Dr. Cerwonka over ten years prior to the initiation of the underlying administrative proceeding. That representation pertained to a custody judgment rendered against Dr. Cerwonka, which was wholly unrelated to the licensing dispute before the Board.”

“Rule 1.9 of the Louisiana Rules of Professional Conduct prohibits an attorney from representing a person or entity that is adverse to a former client in the same or substantially related matter.”

However, the Court said, “Here, there is no possibility that the issues involved in a child custody matter or a collections matter could be considered substantially related to the licensing issue before the Board.

However, Dr. Cerwonka asserts that Mr. Raines used information he possessed from his prior representation against Dr. Cerwonka in the underlying proceeding and that documents from the domestic litigation were used at the examiner’s hearing. Dr. Cerwonka has cited nothing in the record to support these assertions.”

by JNelson

In 2016 a respected member of the Louisiana psychology community and past member of the state psychology board, Dr. Beverly Stubblefield, entered a plea agreement of guilty in a Medicare fraud case. Dr. John Teal, a Louisiana medical psychologist, was also charged. Both Stubblefield and Teal pleaded guilty to one count of Conspiracy to Commit Health Care Fraud, surrounding the high profile case against Mississippi psychologist Dr. Rodney Hesson and his business partner, Gertrude Parker, an occupational therapist and Hesson’s mother.

Hesson and 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, and built on requirements in federal regulations, 42 CFR 483.20, a law requiring nursing home residents be evaluated every three months in a “…comprehensive, accurate, standardized, reproducible,” manner.

At the trial, Hesson said that his company served up to 72 nursing homes and that the 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 needed them. According to the regulation, evaluations were to include information about “cognitive patterns,” “mood and behavior patterns,” “communication,” and “psychosocial well-being.”

Hesson designed a service that paired each contract psychologist with an assistant, called a “clinical coordinator.” The total units/hours billed was a sum of both the psychologist’s and the assistant’s procedures. The companies billed Medicare between three and eight hours of CPT code 96101, psychological testing, for which Medicare reimbursed an average of $80 per unit/hour.

Hesson testified he typically employed between 23 and 26 psychologists and between 18 and 20 clinical coordinators. One of the prosecutors stated that the firm has assessed 9,000 individuals and was one of the top billers for psychological testing in the country.

Contract psychologists were paid a flat fee of between $90 and $100 per case. Psychologists would go to a nursing home and see as many as 10 residents in a day, or more, along with the assistant.

In an interview with Dr. Stubblefield, she explained that the evaluation process was standard and set by the company. The evaluation included six components with tests, behavioral observations, review of chart information, and meeting with staff. She explained that the goals were often to “… get them off meds or increase functioning.”

In his testimony, Dr. Teal said the coordinator would complete information for the psychologist’s review and then prepare the “formalized report”
which the psychologist would review and edit.

The prosecution argued that the service was fraudulent because it was a screening, because it was not medically necessary, and because the time the psychologist provided in face-toface client contact was exaggerated and inflated.

At trial Hesson testified that Medicare had audited the design of the service in 2011 and the approach passed. He said, “When I was audited, we were billing 96101 and — 36 claims is a lot of claims, to my knowledge, to get in an audit,” he said. “Within those claims, we were billing 96101. Within those specific records, it was evident that there was an assistant…,” he said. “Under the diagnostic tests provision, all diagnostic tests are assigned a certain level of supervision,” he said, reading from the Medicare rules.

The defense attorney asked, “Did you rely on that in making your decision whether you could bill 96101?”

“Yes,” Hesson said, referring to Federal Code 42 CFR 410.32 for diagnostic tests. Under this regulation psychological testing is payable if “… personally furnished by a clinical psychologist, or “Furnished under the general supervision of a physician or a clinical psychologist.” And under Louisiana law, a psychologist may utilize assistants but billing must “… not be in the name of an assistant.”

Despite the fact that the evaluations were ordered by medical doctors, the Government prosecutors said that the defendants’ actions were fraudulent, “… by scheduling repeat tests for the same nursing home residents at three- to fourmonth intervals, notwithstanding Medicare’s stipulation that re-testing is not medically necessary unless it is required for a diagnosis or continued treatment.”

“The prosecution insisted that we were doing screening instead of testing,” Dr. Stubblefield explained to the Times, “and therefore we committed fraud and everyone who was compliant with the procedure was a conspirator. That is the gist of things.”

The Government presented other issues at trial, producing several individual cases where it was clear that cognitive testing had to be discontinued because the resident was too disabled to participate.

One attorney asked Dr. Teal, “Looking back on it, sir, was there a benefit to these patients for the tests you were performing on them?”

Teal said, “In general, that kind of testing could be helpful once perhaps, but the benefit of continuing to do that repeatedly over time the way we did it is limited and certainly questionable as far as how clinically useful it could be.”

The prosecution also presented charts where, based on Medicare data, large numbers of hours had been billed for a single psychologist. According to Hesson’s testimony this was due to locum tenens, where one doctor bills under another.

Also presented by the prosecution at trial was the Medicaid fraud case against Hesson from Mississippi that occurred in 2012. He had pleaded guilty to billing patients on one day when the services had been delivered on another day.

Dr. Stubblefield said that Hesson had described this as a bookkeeping error, but “Now, I’m not so sure,” she said.

Charges against all four 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.”

Based on documents, prosecutors seized all assets from Hesson’s company, personal bank accounts, cash and real estate, including the family home, immediately once charges were formal.

According to Stubblefield, her home and accounts, including her retirement accounts, were seized. She said her elderly father placed a second mortgage on his home and that money allowed her to hire an attorney.

“I didn’t have the money to fight it,” she told the Times. “I never had the chance to defend myself against the conspiracy charge. Federal courts cost two or three times as much as other courts. It takes $100,000 just as a start. I only had $75,000.”

The “conspiracy” charge may also relate to areas of harsh treatment. “I never had my Miranda rights read to me,” she said. “I didn’t even know I’d been indicted until a client saw it on the news and contacted me.”

The FBI came to her office and she didn’t know why. In an email to this reporter, she wrote, “The FBI interviewed me without stating why they were there and I was under the assumption that they were there regarding a high profile rape case who was a former patient because my office administrator said that someone was coming in regard to that case.”

It appears that Stubblefield and Teal may have been included in the indictment because of their friendships with Hesson and Parker, and because both accepted company titles for a time.

Teal accepted the title of “clinical education coordinator.” Stubblefield accepted the title of “Clinical Director,” when Hesson asked her to in 2012. This was after Hesson pleaded guilty to Medicaid fraud in Mississippi and was not allowed to work with Medicaid/Medicare. She resigned from that role after five months but she said, “It was too late.”

“I was flattered,” she wrote, “but the position was just a ‘figurehead’ title. I really didn’t get to direct anything but was set up to be the ‘bad guy’ and ‘fall guy’ if things didn’t bode well. Emails to that effect were interpreted by the prosecution as conspiring to commit fraud by encouraging a psychologist to bill as they have done for NHPS…”

Overall, Stubblefield worked contract for the Hesson companies, part-time for about five years. She was paid $448,000 total or $89,000 per year. Her restitution is over $2M.

Teal worked full-time, for four and ½ years. He testified that he made approximately “… $200,000 a year, some of the years–– one year as much as $300,000.” His restitution is over $3M.

According to testimony neither had information regarding the billing procedures. Both testified that they relied on Hesson and Parker to understand the laws regarding the CPT codes. Stubblefield told the Times, “I never saw the billing. I didn’t want anything to do with that part of the service. I was preparing to retire. I wanted everything simple.” “When I went to work for in NHPS I was an employee because I didn’t want to file any claims or do any ‘business’ paperwork. I just wanted to be a psychologist.”

In their plea agreements, Stubblefield and Teal agreed that they: 1) documented services that had been “… in fact, provided by unqualified persons working with them; 2) administered tests to residents who were non-responsive; 3) billed for time when they were not present.

Dr. Stubblefield was sentenced to serve 30 months for 1 count. Two counts were dismissed. Her sentence began April 25, 2017. She must pay restitution of $2,181,378 and upon release at least $200 per month. Payee is Medicare.

Dr. Teal was sentenced to serve 24 months for 1 count. Two counts were dismissed. His sentence also began April 25, 2017. He must pay restitution of $3,505,137 and upon release at least $200 per month. Payee is Medicare.

Gertrude Parker was found guilty of three counts and sentenced to 84 months for Count 1 and 60 months for Count 2, to be served concurrently. She began serving September 2017. Ms. Parker is to make restitution of $7,313,379 and $200 per month. Payee is Medicare.

Dr. Hesson was found guilty of three counts and sentenced to 120 months for Count 1 and 60 months as to Count 2, to be served concurrently. He began serving September 2017. He is to make restitution of $13,800,553 and $200 per month. Payee is Medicare.

Beverly was sentenced to 30 months incarceration at the Federal Prison Camp in Aliceville, Alabama. This, she explained to the Times, was not the hardest part of what has happened to her.

“The worse part is losing my psychology license,” she said. “This…the time, this is just something to be dealt with, something I had to do.”

In February Dr. Stubblefield wrote a letter to past-president of the American Psychological Association (APA), asking that APA take a stand for sentencing reform in regard to white collar, first offenders.

“In regard to white collar crime,” she wrote, “there are many innocent professional women her who have been charged with the ill-defined ‘castnet’ of conspiracy, when the only thing they’ve done was to comply with company procedures or file data given to them. If they went to trial, the sentence was automatically doubled,” she wrote. “Losing one’s license and livelihood is punishment enough, but the Department of Justice seizes or places a lien on everything owned including your home and retirement accounts because judges set unrealistically high restitution of millions of dollars never received by the people charged. The people charged are primarily MDs, PhDs, CPAs and NPs who have licenses, Medicare/Medicaid numbers, and ethical standards or responsibilities, not office managers or company owners who may be the ones submitting faulty claims.”

Dr. Teal said at trial, “I had concerns. I look back on all that time with tremendous regret because of exactly what you just said. I should have. I should have done due diligence and called the Medicare hotline or hired a lawyer and asked him. I should have done those things. Lord knows, I wish I had.”

At trial Dr. Stubblefield, after she was surprised to hear the number of hours billed under her name, was asked how she felt to testify against Ms. Parker.

“Dismayed, disgusted, betrayed, still in shock about everything, remorseful about the whole situation, regretful that I ever went to work for another agency.”

How does she cope? “I use my cognitivebehavioral skills,” she said, “and prayer. I couldn’t get through this without my faith.”

Were you naïve? “Absolutely,” she said.

Senator Fred Mills has paired down last year’s effort to restructure the health care boards, and is proposing SB40 which contains several of the components of last year’s SB75, including adding a consumer member to each board and removing the professional associations from the board’s nomination process.

SB40 would transfer the extensive list of boards, commissions and agencies to the Louisiana Department of Health (LDH). Included will be the boards for psychology, counselors, social workers, and the other 22 healthcare boards. These are the boards for dentistry, nursing, optometry, pharmacy, medicine, physical therapy, speech-language, addictive disorders, vocational rehab, behavior analyst and others.

SB75 would also remove repealed and obsolete cites and references and categorizes those entities statutorily created within the department.

The proposed law adds at least one consumer member to any board that did not previously have one and provides standardized eligibility criteria of consumers to serve on any board.
Present law provides for professional trade associations and other entities to select and submit nominees to the governor for board appointment.

The proposed law opens board nomination eligibility to any member licensed by the board who is interested and eligible. Proposed law requires the board to send notice to its licensees to fill board positions and submit the names of those interested and eligible to serve to the governor for board appointment.

Last year, SB75 included sweeping changes in the disciplinary processes of the boards, his measures fueled in part by the 2015 anti-trust decision of the Supreme Court, and Mills’ own views that boards have “virtually no detectable oversight.”

Mills’ previously explained to the Times, “… there has to be
a place for consumers and practitioners to go when they feel they haven’t gotten a fair shake from their boards.”

Perhaps the most dramatic change Mills proposed in 2017, missing from this year’s SB40, is in disciplinary hearings. Last year the Senator wanted to remove final adjudicatory hearing authority from the boards and transfer that to the division of administrative law. The Division of Administrative Law will preside over hearings in which a final action of the licensee is being pursued by the board.

For the 2017 failed proposal by Mills, “… final adjudicatory proceedings shall be transferred to the division of administrative law, that administrative hearings shall be held in the administrative law location closest in proximity to the licensee, and that venue for appeal of the administrative law judge’s ruling shall be the district court for the parish in which the licensee is domiciled.”

Another of Mill’s efforts in 2017 aimed to restrict board investigations to a one-year time limit. “If a board does not issue notice of an adverse or disciplinary action within one year from the date upon which a sworn complaint is received or, if no sworn complaint is received, within one year from the date the board voted to commence an investigation, the matter shall be dismissed. The one-year period shall be prescriptive.”

Senator Mills’ 2017 effort was stopped in the House Health & Welfare Committee after passing the Senate. At the committee meeting Mills said that there had been some misinformation and he clarified that the measure did not affect the duties or powers of the boards, or the scope of practice that some members of the boards had believed. He said that the changes are not new ideas. “Forty-four states have Administrative Law Judges for disciplinary hearings,” he said. “We don’t want you to be the sheriff, the DA, and the judge.”

“We revised the Ethics laws in 2008 and said that, as a body, we don’t want the sheriff and
the DA to be the judge and the executioner,” said Mills. “This bill is for the little man and the little woman. If you have to go in front of a full hearing, you should not go in front of a hearing that are those who’ve been investigating you.”

One source told the Times that psychology board members helped derail Mill’s 2017 effort. And sources said other boards also helped derail SB75. Ironically, in about that same time, a District Judge found that the psychology board’s investigation methods to be violations of due process.