Category Archives: News Stories

Trump Takes Swipe at Healthcare Monopoly: Orders Transparency in Hospital Costs

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On June 24, President Trump signed an Executive Order on “Improving Price and Quality Transparency in American Healthcare to Put Patients First.” The Order requires the posting of standard charge information for services, supplies, or fees billed by hospitals, and special rates negotiated behind the scenes. “Providing access to this data will facilitate the development of tools that empower patients to be better informed as they make decisions related to healthcare goods and services.” And, “Access to this data will also enable researchers and entrepreneurs to locate inefficiencies and opportunities for improvement, such as patterns of performance of medical procedures that are outside the recommended standards of care,” the President wrote.

“To make fully informed decisions about their healthcare, patients must know the price and quality of a good or service in advance,” the President said. “With the predominant role that third-party payers and Government programs play in the American healthcare system, however, patients often lack both access to useful price and quality information and the incentives to find low-cost, high-quality care. Opaque pricing structures may benefit powerful special interest groups, such as large hospital systems and insurance companies, but they generally leave patients and taxpayers worse off than would a more transparent system.”

In 2017, the Administration issued a report titled “Reforming America’s Healthcare System Through Choice and Competition,” and was referenced in the June Ex. Order.

The report recommends developing price and quality transparency initiatives to ensure that patients can make wellinformed decisions about their care. “In particular,” the President wrote, “the report describes the characteristics of the most effective price transparency efforts: they distinguish between the charges that providers bill and the rates negotiated between payers and providers; they give patients proper incentives to seek information about the price of healthcare services; and they provide useful price comparisons for ‘shoppable’ services (common services offered by multiple providers through the market, which patients can research and compare before making informed choices based on price and quality).” Of inpatient care, 73 percent of the 100 highest cost services are shoppable and of outpatient, 90 percent of the 300 highest costs are shoppable.

“Improving transparency in healthcare will also further protect patients from harmful practices such as surprise billing, …”

“Making meaningful price and quality information more broadly available to more Americans will protect patients and increase competition, innovation, and value in the healthcare system.”

The President notes the Policy as follows: “It is the policy of the Federal Government to ensure that patients are engaged with their healthcare decisions and have the information requisite for choosing the healthcare they want and need. The Federal Government aims to eliminate unnecessary barriers to price and quality transparency; to increase the availability of meaningful price and quality information for patients; to enhance patients’ control over their own healthcare resources, including through tax-preferred medical accounts; and to protect patients from surprise medical bills.”

The Order also lays out the rules for making charges, including negotiated rates and rates worked directly with insurance companies, available to the public: “Within 60 days of the date of this order, the Secretary of Health and Human Services shall propose a regulation, consistent with applicable law, to require hospitals to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format using consensus-based data standards that will meaningfully inform patients’ decision making and allow patients to compare prices across hospitals.” […]

[…] “Within 180 days of the date of this order, the Secretaries of Health and Human Services, Defense, and Veterans Affairs shall develop a Health Quality Roadmap that aims to align and improve reporting on data and quality measures across Medicare, Medicaid, the Children’s Health Insurance Program, the Health Insurance Marketplace, the Military Health System, and the Veterans Affairs Health System. The Roadmap shall include a strategy for establishing, adopting, and publishing common quality measurements; aligning inpatient and outpatient measures; and eliminating low-value or counterproductive measures.”

Comments on Medscape, a popular physician and healthcare professional website and blog, were poignant.

Commenting was a psychologist. Dana Beezley-Smith| Psychologist ––Well, I for one am tickled pink. It’s a travesty that consumers have to purchase healthcare services without understanding what their portion of the expense will be. I wrote about this topic almost two years ago. (https://nationalpsychologist.com/2017/ 09/health-care-reform-update-pricetransparency-movementgrowing/104010.html) The devil’s in the details, of course, as proposed and final rulings will take some time, but if it plays out right, the entire provider
insurer-patient relationship will be transformed. No more secrets. Hospitals won’t like this, insurers won’t like this, but perhaps private physicians can prove they offer more value per dollar than giant hospital systems do. At the very least it encourages the consumer to ask more questions.

Popular comments included:

Dr. Chris Burritt| Psychiatry/Mental Health ––The Hospitals practically operate as cartels…pushback from them should be viewed as a sign of going in the right direction. I hope Trump stays the course – this should be a bipartisan effort!!

Dr. Yehuda Mond| Internal Medicine ––Politics aside, President Trump is the only president who has the guts to face on the pharma companies, call their bluff, and end the status quo. He’s the first to explain to the American people where the problem is and how it can be solved. We’re paying through the nose with unfettered billions of our tax and insurance dollars going straight to pharmaceutical companies. While this will not solve all our problems, if he is successful (ahem, so-called democrats), then it will reduce healthcare costs across the board. Please folks, put your unjustified hatred towards our president aside and show him your support.

Dr. Kathryn Duplantis| Plastic Surgery and Aesthetic Medicine –– president trump 2020! I wrote him a letter recently addressing the challenges that we doctors are facing including rising overhead, constant fighting with insurance companies to be paid and increasing liability! We are tired of all the big bosses running healthcare! I want doctors to be able to run their own practices and not deal with all the bosses that have driven up the cost of healthcare! My practice is all cash and will retire with a cash practice!

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PTSD to Be Covered for Firemen, Police

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After being amended on both the House and Senate Floors, Senator Gatti’s SB 107, which adds PTSD to injuries covered by workers’ compensation for certain public employees, passed. The House vote was 99 to 0 and Senate was 34 to 0.

Amendments included: Specify that the posttraumatic stress injury shall be caused by an event occurring in the course and scope of employment and which the preponderance of evidence indicates that the event was a substantial contributing factor; Remove the determination and factors of whether the evidence presented to determine if an employee has a posttraumatic stress injury has successfully rebutted the presumptions provided for posttraumatic stress injury; and Add that a posttraumatic stress injury that arises solely from a legitimate personnel action such as a transfer, promotion, demotion, or termination, is not a compensable injury under present law.

The newest digest indicates that while present law requires the state fire marshal to obtain workers’ compensation coverage for volunteer members who participate in the normal functions of the fire company, the new law will also now require upon the purchase of a new policy or renewal of an existing policy, that any workers’ compensation policy which provides coverage for a volunteer member of a fire company, pursuant to present law, will include coverage for posttraumatic stress injury.

The new law provides that any volunteer member of a fire company who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during his period of voluntary service or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his volunteer service.

Once diagnosed with posttraumatic stress injury the volunteer member affected or his survivors shall be entitled to all rights and benefits as granted by present law to one suffering from an occupational disease.

The new law also provides that, except as provided in proposed law, any local emergency medical services personnel, any employee of a local police department, or any local fire employee who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during employment or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his employment.

An employee of the division of state police who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during employment or thereafter,
shall be presumed, prima facie, to have a disease or infirmity connected with his employment for purposes of workers’ compensation benefits.

Once diagnosed with posttraumatic stress injury the employee of the division of state police affected or his survivors shall be entitled to all rights and benefits as granted by state workers’ compensation law, as service connected in the line of duty, regardless of whether the employee is employed at the time of diagnosis.

The new law provides that a posttraumatic stress injury that arises solely from a legitimate personnel action such as a transfer, promotion, demotion, or termination, is not a compensable injury pursuant to present law. The law is set to become effective August 1, 2019.

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Gov Edwards Comments: US News &World Report Ranks Louisiana 50th

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For the second year in a row, U.S. News & World Report has placed Louisiana at the bottom in their rankings of states. In the report, Louisiana’s total rank of 50th was a result of ranking 45th in health care, 48th in education, 49th in the economy, 48th in infrastructure, 50th in opportunity, 43rd in fiscal stability, 50th in crime and corrections, and in 50th in natural environment.

Washington state ranked first followed by New Hampshire, Minnesota, Utah, and then Vermont.
At the bottom of the list rankings slightly higher than Louisiana, was Alabama at 49th, Mississippi at 48th, West Virginia at 47th, and New Mexico at 46th.

In a press release on May 14 governor Edwards said, “Unfortunately, this ranking doesn’t accurately reflect the progress Louisiana has made in recent years and how much better we are doing today, given the gains that we have made in many critical areas that directly impact people’s lives.

“Louisianans know how much better we’re doing now than when we were facing down a $2 billion dollar deficit just a few years back. By working together across party lines, we’ve stabilized our budget, turned deficits into a surplus, are investing more in education at all levels and focusing on our infrastructure for the first time in years. We have improved our health care by extending coverage to thousands of working adults, we no longer have the highest prison population in the country, and higher education funding is fully stable.

“It takes time for improvement to show up in data, and some of the U.S. News and World Report’s data sources are several years old, which is frustrating. But we know we’re doing far better than we were years ago and we fully expect that will show up in future rankings.”

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Bill to Create Services for Trafficking Victims Passes Senate and Goes to House Health & Welfare Committee

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SB 145 by Sen. Ronnie Johns was heard in committee, amended and passed to the Senate Floor where it was supported by favorable vote of 38 yeas and no nays. In the House it was referred to the Committee on Health & Welfare. It passed the Senate on April 29.

If it were to become law, the measure provides that, subject to appropriation by the legislature, the Dept. of Children and Family Services, working in collaboration with the Dept. of Health, and the Family in Need of Services Assistance Program, with the assistance of the La. Alliance of Children’s Advocacy Centers, to create a coalition to develop a human trafficking victim services
delivery model.

The proposed law further provides that the model is to be developed with consideration of the recommendations of and collaborating with the La. Human Trafficking Prevention Commission and Advisory Board, and provide a multidisciplinary and agency approach that coordinates resources and improves the statewide response and delivery of services to victims.

The new would designate that the human trafficking victim services delivery model is to provide a plan to address and promote the following goals including but not limited to:

(1) Safe and sufficient placements. (2) Available and adequate funding sources. (3) Stakeholder partnerships. (4) Coordinated response. (5) Appropriate and responsive services.

The Dept. of Children and Family Services is to promulgate any rules necessary to implement the provisions of proposed law, and that the Dept. of Children and Family Services is to provide a report on the development of the coalition’s services delivery model to the Senate and House
Committees on Health and Welfare by June 30, 2020, and annually thereafter until completion of the model.

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Measure to Prohibit Cherry Picking by Insurance Venders Involuntarily Deferred

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

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

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

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

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

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Natural Chemical Helps Brain Adapt to Stress

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

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

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

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

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

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

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Governor Edwards Promotes Bi-Partisan Efforts and Announces Priorities

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

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

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

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

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

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

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

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Judge Caldwell Reverses His 2017 “Reeks” Decision

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

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

However, in February Judge Caldwell reversed his 2017 decision.

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

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

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

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

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

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

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

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

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

According to public records the Board’s escalating legal fees stemmed primarily from fees from the Board Prosecutor, held at that time by Mr. James Raines. Over 2015 to 2016, and into January 2017, Mr. Raines prosecuted 16 cases. Three of these 16 cases amounted to $146,987 of fees from Mr. Raines.

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

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Dr. Moore Top Vote Getter for State Psychology Board

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

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

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

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

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

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

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

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

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

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Gov. Announces Work Training Program For Medicaid Recipients

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

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

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

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

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

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

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

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

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

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

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

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

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New Rule Allows More Private-Sector Care for Veterans

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

The proposed regulations are open for public comments.

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

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

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

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

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

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

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

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

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

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

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

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

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

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New APA Guidelines Spark Debate, Criticism

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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