Tag Archives: LSBEP

New Facts Point to Discrimination in National Exam, Selection Programs at State Boards

The debate over an additional exam for those applying for a state psychology license has shined the light on a nest of scientific problems originating at the Association of State and Provincial  Psychology Boards (ASPPB).

The debate has unearthed new facts and a jaw dropping irony––the psychology profession, a  discipline that preaches anti-discrimination to others, and that sets the bar for selection-testing, has been promoting racism at state licensing boards, and by all accounts doing it for the  money.

These problems might start with the ASPPB, but legally and morally they land at the doorstep of every state psychology board. The situation hits Louisiana particularly hard. While only 4% of  licensed psychologists nationwide are African-Americans, Louisiana has a 34% Black population, a group chronically underserved by mental health professionals. Louisiana is specifically in need of psychologists who understand the Black experience.

For this report we look at current facts, core problems and underlying causes of how organized  psychology is failing its students, the public, and its own goal of fighting systemic racism.

“Adverse Impact” found in psychology license examination program

The psychologist license exam is called the Examination for Professional Practice in Psychology  or EPPP. After finding racial differences in the New York state pass–fail rate on the EPPP scores, Dr. Brian Sharpless has now found similar problems in Connecticut.

Dr. Sharpless studied 642 applicants to the Connecticut State Board of Examiners of Psychologists. In his article, “Pass Rates on the Examination for Professional Practice in Psychology (EPPP) According to Demographic Variables: A Partial Replication,” he reported  significant differences in failure rates based on ethnicity.

Whites had a 5.75% failure rate, Blacks had a 23.33% failure rate, and Hispanics had a 18.6%  failure rate.

In a much larger study in New York, Dr. Sharpless discovered an even greater impact by race.  He reported his findings in “Are Demographic Variables Associated with Performance on the  Examination for Professional Practice in Psychology (EPPP)?”

Dr. Sharpless gathered data on 4,892 New York applicants and first-time EPPP takers. He  obtained records of all doctoral-level psychology licensure applicants from the past 25 years  and looked at their EPPP scores.

He found that Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%.  Whereas, Whites had a failure rate of 14.07%.

“Adverse impact” is the term used to describe differences in scores. An exam has adverse  impact if minority candidates fail to pass at at least 80% of the majority race candidates’ rate.  The results in New York classify as adverse impact and the Connecticut results clear the bar only by a hair.

Title VII of the Civil Rights Act of 1964 makes it illegal to discriminate against someone on the  basis of race, color, religion, national origin, or sex. When state psychology boards deny a  license based only the EPPP scores, they must prove that the test is being used in a fair and 
unbiased manner.

Selection–testing and design of selection programs is most often a subspecialty in industrial– organizational and business psychology. State boards primarily deal with healthcare  practitioners, and are composed of clinicians. So, expertise in selection testing is unlikely to be  involved in all or most states.

“If two states have found adverse impact, it is probable that all or most states will also find  adverse impact. It is typical for knowledge tests to have adverse impact anyway, and this must  be handled in the overall selection program,” said one expert.

One Black candidate told the Times, “We’ve known for a long time that the test discriminates–we learned it in graduate school. But there’s nothing we, as students, can do about it.”

According to one source at the Louisiana State Board of Examiners of Psychologists (LSBEP), the board makes no effort to study their procedures for adverse impact.

Critics of the national exam have gained momentum, fueled by the ASPPB’s effort to install yet  another, second examination, called the EPPP2.

Dr. Jennifer Callahan sounded the alarm as lead author in her article, “The enhanced  examination for professional practice in psychology: A viable approach?” published in the  flagship journal for psychologists, American Psychologist.

The EPPP2 has not been evaluated for its intended purpose, Callahan said. “For jurisdictions  implementing the EPPP Part 2, failure to gather and report the evidence required for use of a  test in a forensic context may also open the door for legal challenges.”

Dr. Sharpless had also been pointing to legal risks. “… given the ethnic performance  discrepancies and limited validity evidence, […] it will remain open to charges of being a  potentially arbitrary barrier in an already protracted path to professional independence…”.

Industrial-organizational psychologist Dr. William Costelloe, who works in the private sector,  agrees. There is no other choice these days, he told the Times, “… predictive validation studies must be conducted.”

Another business psychologist said that in the private sector the ASPPB’s approach would not  be accepted. “Business owners would not take the risk of having adverse impact. We would be  adjusting cutoffs and adding unbiased tests to the overall selection program, so that our clients  could avoid adverse impact.”

Criticisms have been mostly dismissed by officials at the ASPPB. In an answer to Callahan, also  published in the American Psychologist, Drs. Matthew Turner, John Hunsley and Emil Rodolfa  defended their decisions. “The standards emphasize that licensure/credentialing examinations  are built from a content validation framework, and this framework is used for licensure examinations across professions,” they said.

Dr. Turner is employed by ASPPB and in charge of the exam services. He was previously  employed by the Georgia school systems. Both Hunsley and Rodolfa have also worked with and  provided consulting services for the ASPPB examinations.

Callahan and coauthors replied, “…Turner et al. remain narrowly focused on defense of content  validity and a reliance on outdated standards that fail to meet contemporary expectations for  assessment of health care professionals. […] ASPPB’s methods demonstrably foster linguistic biases and systemic racism that constricts licensure of diverse individuals as psychologists.”

Callahan urged ASPPB to take “drastic corrective action.”

Experts point to serious issues with how states use cutoff scores on the national test, especially  since there is no criterion related research to help set the cutoff.

“A 50th percentile cutoff score, that automatically fails the bottom half of a sample, all who are  highly qualified already, does not make sense,” said one business psychologist. “This is exactly  the way you drive up adverse impact. You’re basically having a bunch of PhDs compete against  each other and then flunking half of them. Is your hypothesis really that half are incompetent?”

Sharpless had earlier noted problems with the cut off scores, typically set at the 50th percentile  by state boards. “Additional empirical attention should be devoted to the cut score…” he said.  “…the determination of the ‘passing’ score is one of the most important, yet difficult, psychometric tasks in testing …”

ASPPB acknowledges the exam limitations. On their webpage officials state, “There is no  suggestion that people who do better on the EPPP will be better practitioners.”

The connection between test score and job performance would require predictive validity  research, which ASPPB does not conduct.

Dr. Costelloe, explained “… predictive validation studies must be conducted.” For instance, “…  you infer that a candidate with a high Extroversion score will make more sales than a candidate  who has a high Introversion score,” Costelloe said. With a predictive study, “… you realize that  your inference was not only completely wrong but backwards. Why? The sales personnel are  interacting with mechanical engineers who must make the decision to switch over these new  valves. They don’t want to relate. They want specific engineering facts and data and they are  introverts.”

Michael Cunningham, PhD, Professor of Psychology, Africana Studies and Associate Provost at  Tulane, points to potential problems with item development.

“Like all standardized exams, people with the highest pass rates tend to very similar in racial  and ethnic backgrounds as the test developers,” he said. “For many standardized tests, experts  examine items for bias when there is an adverse impact of a question for males or females. In  these cases, when bias still exists after an item analysis, the question is excluded. I don’t think  similar considerations are done for racial/ethnic or SES backgrounds.”

ASPPB seems unconcerned with the scientific criticisms and standards. In April 2018, then SPPB CEO, Dr. Stephen DeMers, met with members of the Louisiana State Board of Examiners of  Psychologists and representatives of Louisiana Psychological Association (LPA).

About the meeting, Dr. Kim VanGeffen, Chair of LPA Professional Affairs, said, “Dr. DeMers  acknowledged that, currently, there is not really any research on the validity of the EPPP-2.  There do not seem to be any plans to obtain predictive validity nor does the EPPP2 committee  believe that establishing this type of validity is necessary,” she said.

Dr. Marc Zimmermann, past LSBEP board member, also attended. “He [Dr. DeMers] stated that  there is no predictive validity,” said Zimmermann. “He also threw in that none of the national  tests had predictive validity. He reported that content validity was the accepted standard  because a test with predictive validity could not be constructed,” said Dr. Zimmermann. “…  DeMers had the temerity to try to sell us something that does not meet the standard that  psychological tests being published are expected to have.”

Is more regulation needed? Safety estimates for psychologists are very good

One of the arguments that critics mention is the consistently high safety ratings for  psychologists, based on the low number of disciplinary actions nationwide.

“There is no evidence that the public is facing some sort of previously unheard of crisis in terms  of safety from currently practicing psychologists,” said Dr. Amy Henke, who spearheaded a  Resolution opposing the EPPP2 while serving as a director for the LPA.

“Trainees are already held to high standards through a variety of benchmarks,” Dr. Henke wrote in the Resolution, “… including but not limited to: APA approval of doctoral programs, multiple  practicums where competency is repeatedly assessed, completion of formal internship training  (also approved and regulated by APA and APPIC), and supervised post-doctoral hours obtained  prior to licensure.”

However, Dr. Emil Rodolfa, then a program developer at ASPPB, questioned if these standards  are enough, saying that supervisors have “… difficulty providing accurate evaluations of their  supervisees to others who may have to evaluate the supervisee’s competency.”

The facts are on Dr. Henke’s side. Data from their own ASPPB Disciplinary Data System:  Historical Discipline Report show rates of disciplinary actions for psychologists to be  consistently low. For an estimated 125,000 psychologists in the US and Canada, the disciplinary  rates remain around 1–2 per 1,000.

For 2016–2020, the total reported disciplinary actions across the U.S. and Canada ranged from  139 to 186.

Using a conservative estimate of 10 clients per psychologist per year, this translates to a safety  problem of one or two per 10,000 service events.

Louisiana’s rate is similar to the national average. For the year 2019–2020 there was one  disciplinary action, for 2018–2019 there were two, for 2017–2018 there were also two, for 2016– 2017 there were three, in 2015–2016 there was one, and in 2014–2015 there was also one.

ASPPB’s plans for doubling the size and cost of licensing exam

Several sources suggest that profit motives may be the main reason for the cutoff and the extra test. The current EPPP costs candidates $600 plus administration fees. The test contains 225  items, with a four-hour time limit. To compare, physicians pay $605 for an eight-hour exam and  social worker candidates pay about $250 for a 170-item exam. The EPPP2 would increase cost  from $600 to $1200.

Some years ago, ASPPB appears to have embraced a more aggressive corporate strategy. An  insider told the Times, “In 2010 or somewhere around that time they [ASPPB] were in New  Orleans and they implied that they would be making a lot of money on the new test.”

In 2012, ASPPB acquired the rights to the exam, taking over from Professional Examination  Service (PES). In 2013 ASPPB wrote the boards that their contracts with PES were being “… 
replaced with a contract between your jurisdiction and the Association of State and Provincial  Psychology Boards.”

In that letter, ASPPB officials said, “ASPPB and PES have agreed that it would be simpler and  more appropriate for ASPPB to contract directly with the 64 psychology regulatory agencies that are members of ASPPB.”

ASPPB said the change would be “…mutually beneficial because ASPPB can now provide a  simplified agreement that is more specific to the needs of psychology licensure boards. In  addition, the renewal of contracts is expected to be more efficient…” At the same time, ASPPB  increased candidates’ exam fees from $450 to $600.

One insider thinks the corporate objective for ASPPB is to be a central source for regulation of  psychologists. “They want to ultimately do all the licensing and regulating for psychology,” said  the insider. “They want to regulate all the telepsychology.” And, “They want to be the Walmart.”

In 2013 ASPPB officials were instrumental in conducting and designing the 5th International  Congress on Licensure, Certification, and Credentialing of Psychologists, held in Stockhom. The  invitation-only conference was primarily funded by ASPPB. Dr. Emil Rodolfa, Chair of the Implementation Task Force for the EPPP 2, facilitated at the Congress.

ASPPB officials have gone through several roll-out efforts for the EPPP2, first to persuade  member jurisdictions to accept the new test, and then to force the new exam on states.

In 2016 the firm announced the EPPP2 and told its members, licensing boards across the United States and Canada, that the use of the new test would be “optional.”

However, after criticisms mounted, ASPPB did an about face in late 2017 and announced in a  surprise move that the new exam would be mandatory after all, and combined with the tests.  And, the price would increase from $600 to $1200.

In July 2018, Dr. Amy Henke, then serving on the Louisiana State Board of Examiners of Psychologists (LSBEP), and LSBEP members sent a blistering letter to the ASPPB Board of  Directors, to the ASPPB members, and to the administrators of state psychology boards across the US and Canada.

Following this, in August 2018, ASPPB President Sharon Lightfoot, PhD, announced that the  ASPPB Board of Directors voted to rescind the mandate.

However, shortly after that, ASPPB decided to use a carrot and stick approach. According to an  October 24, 2018 letter from Lightfoot, if Louisiana, or other jurisdictions, chose to decline the use of the new additional test, then student candidates in those jurisdictions would be  prohibited from taking the test. Sources at the Louisiana state board considered this to be punitive, because many students  wished to prepare for licenses in other states, which might require the second test.

Dr. Henke said that at a recent meeting of the member jurisdictions, representatives voted  100% to allow qualified candidates from any jurisdiction to take the EPPP2.

“Unfortunately,” Henke told the Times, “the ASPPB Board and staff have pushed back on both the vote and the formal request. For instance, despite this unanimous vote, ASPPB’s Board has  not acted on the clear wishes of the member jurisdictions. Instead, they have decided to  individually poll each jurisdiction with a survey that I felt was misleading and biased.”

ASPPB’s non-profit & financial status

The ASPPB is a private, non-profit, 501(c) 6, tax-exempt  corporation located in Tyrone, Georgia.

The IRS notes that the 501(c) 6 “… may not be organized for profit to engage in an activity ordinarily carried on for profit (even if the business is operated on a cooperative basis or  produces only enough income to be self-sustaining).”

The corporate mission is to “Facilitate communication among member jurisdictions about  licensure, certification, and mobility of professional psychologists.” The “members” are the 64 or so regulatory boards from across the United States and Canada.

These boards pay dues to ASPPB. LSBEP records note they paid $2,660 in 2020 for annual ASPPB dues.

ASPPB’s net assets for 2018 (the most recent year available due to delays from Covid) totaled $9,137,930. GuideStar estimates their assets at $11,013,348.

Total revenue for 2018 was $6,505,651. Revenue for 2017 was $6,645,731 and $5,933,473 for  2016.

ASPPB’s main income producing product is the national exam. The exam and related services  generated $6,137,348 in 2018. This accounted for 94% of the Association’s 2018 income. Exam  income was $5,378,524 in 2017, and $4,916,406 in 2016.

While they paid $1,302,603 to Pierson Vue Minneapolis for exam administration in 2018, most  other expenses claimed on their tax reports are for employees and employee related expenses.

They report a total of $2,278,482 for compensation of key employees, other salaries and wages, contributions to pension plans, employee benefits and payroll taxes.

In 2018, the CEO, M. Burnetti-Atwell, received pay and benefits of $255,936. In 2017, Dr. Steven  DeMers, then CEO, received $270,784.

Assn Executive Officer Dr. Matthew Turner received pay and benefits of $$171,174 in 2018. He  has four employees reporting to him for exam services.

Assn Executive Officer Janet Orwig received pay and benefits of $158,142 in 2018. Ms. Orwig has 12 employees reporting to her for member services.

The ASPPB website lists other staff, including a business manager, financial officer, two  directors of professional affairs, and an administrative associate.

“With a lot of cash sitting on the balance sheet, the strategy is to maximize expenses,” said an  MBA in reviewing the information for the Times. “The extra profits are likely to go into perks  rather than price cuts,” he said.

Examples of this appear to include items like travel, which includes travel for spouses or  companions. The organization spent $949,483 on travel in 2018 and $1,169,743 on travel in 
2017.

Other examples are $336,175 on “technology,” $188,256 on conventions, $123,053 for “item  writers and exam consultants,” $144,000 on bank fees, $60,610 on advertising, and $55,946 on dues and subscriptions.

It is not clear how oversight is established at ASPPB. The Times asked one CPA to look over the  information and he said, “Of course there is influence and COI (Conflict of Interest).”

Conclusions

ASPPB appears unable to constructively answer the criticisms and mounting evidence that their  exam program, marketed to the captive customers through state boards, is scientifically  deficient and discriminatory.

The state boards have bought into a mess, but do not appear able to deal with the bureaucracy  at ASPPB. Since state boards are typically composed of clinicians, and rarely have the hands-on experience needed for high-stakes selection testing, they may lack the knowledge to fight the  problem.

Ignorance does not fly as an excuse for discriminatory practices in the private sector, so it’s  ironic that it is found in the public and quasi–governmental agencies of psychology.

ASPPB appears too busy feeding off of the exam revenues, and building their bureaucracy on  the backs of psychology license candidates, perhaps especially racial minorities, to wake up. State psychology boards must not ignore the problem any longer. Callahan’s call for “drastic corrective action” is on point. But it is the members of ASPPB who need to take action, with or  without ASPPB bureaucrats.

In September 2020, the American Psychological Association (APA) called for “… true systematic  change in US culture.” Zara Abrams reported in a Monitor article, APA “… is working to dismantle institutional racism over the long term, including within APA and psychology.”

Before preaching anti-discrimination to others, APA needs to start in their own backyard.

LSBEP Legislation Passes H&W Committee with Reservations

House Bill 477, the legislative effort put forth by the Louisiana State Board of examiners of
psychologists (LSBEP), advanced out of the House Health and Welfare Committee with a favorable vote on May 4, but with the author agreeing to make changes later as matters could continue to unfold.

Testimony was provided by LSBEP members, members of the Executive Council of the Louisiana Psychological Association (LPA), and a community member representing those in opposition to the measure.

Board Executive Director, Ms. Jaime Monic, testified to the various financial difficulties the board was experiencing and offered comparisons to other agencies.

Current board chair Dr. Amy Henke testified to the beneficial reasons for registration of assistants and commented about best practices across other states as well as other common practices contained in the measure.

LPA President Dr. Erin Reuther and Dr. Matt Holcomb also testified in favor of the
legislation. Dr. Reuther said that she and others have worked for months on collaborative solutions with the board members.

 Dr. Alan Taylor testified in opposition to the measure, commenting that there was no disagreement about the financial need, only about the best solutions. He said more communication was needed in the community.

Representative Stagni, the author of the bill, said, “Mr. Chairman you’ve heard the urgency and the need, the board is vital to the profession.

They’ve come to us and asked us for help. I would ask that you move this along. I think two days from now you’ll have an official vote by the association.

“If there is a change as to where the finances are coming from, I will do that and I commit to do  that.

“But I think this is vital. You’ve heard testimony that for 18 months that there have been members of the association and members of the board working collaboratively that would be beneficial to the profession and to the citizens so I would ask that you move this favorably and I’ll work on it as need be going to the floor.”

Sources indicate that members of the Louisiana Psychological Association petitioned their Executive Council so as to call a special meeting of the membership about the legislation.

HB 477 began as HB 458. In February 2020, a memo circulated from the Board of Examiners of Psychologists on “Possible Housekeeping Legislation.” The memo, obtained from an undisclosed source, included substantialchanges to areas of the psychology law, said the source.

A 23–page document, Senate Bill 458, outlining an ambitious set of changes to the psychology practice law was introduced on March 31, 2020.

SB 458 set out sweeping changes to the psychology law including a new set of regulations for assistants, additions to the charter of the board, changing qualifications for serving, authorizing the board to conduct continuing education, exempting the board from Open Meetings Law for investigatory meetings, and formally establishing the position and duties of the Executive Director.

However, the 2020 legislative agenda was swallowed up by the pandemic.

In the meantime, due to opposition to the original SB 458, Dr. Greg Gormanous, Chair of Legislative Affairs for LSBEP, put forth a motion in April 2020 to establish an Ad Hoc Legislative Collaborative Committee. This would include community members and have the objective seek to reach consensus about the board’s legislative goals.

The AdHoc Legislative Collaborative Committee met dozens of times, worked on numerous changes, and agreed on much of what was in the legislation, but not all, according to
sources.

The Board voted unanimously on January 28, to begin the search for a legislator to sponsor their changes to the psychology law for the 2021 legislative session.

In February LPA voiced opposition to moving the legislation ahead in 2021.

At their regular monthly meeting, March 26, the LSBEP passed a motion to proceed to file a reduced version of their legislation. Members of the LPA Council supported this step but opposition was still present elsewhere.

 

 

 

 

 

 

LSBEP Pushes Their Legislation Despite Opposition from La Psychological Assn

The Louisiana State Board of Examiners of Psychologists (LSBEP) continues their
planning to introduce comprehensive legislation in the upcoming April session,
according to sources. This despite a recent vote by the Executive Council of the
Louisiana Psychological Association to oppose the bill.

According to sources, LPA President Dr. Erin Reuther made an announcement to
members last month that the LPA Executive Council had decided not to support the
LSBEP introducing the measure.

In January the LSBEP voted unanimously to begin the search for a legislator to sponsor their changes to the Psychology Practice Act for the 2021 legislative session.

LSBEP’s legislation will make sweeping changes to the psychology law. These changes
include the registering assistants, expanding the board’s charter, expanding legal
authority of employees, adding fees, changing the scope of practice, modifying board
composition, and exempting hearings from Open Meetings Laws. The new law also gives the board the authority to conduct and sell continuing education.

According to a draft copy of the new proposed law psychologists would be required to seek the board’s approval for any assistant who is helping the psychologist provide services to patients or clients. This would include any clinical, family, or organizational setting, including government. The yearly fee is up to $75 per assistant.

Included is the requirement that the assistant initiate a criminal background report from the Louisiana Bureau of Criminal Identification and Information.

The board would approve the assistant’s training, qualifications, and services to be provided. The board can deny or revoke the registration of the assistant at any time that it receives reliable information that the assistant is causing harm to clients or patients, or likely to, or is unethical or unprofessional.

The new law also gives the board authority to collect an array of new fees. These include up to $250 for preapproval of continuing education courses. Also they can charge up to $200 for authorization to conduct tele-supervision, to authorize an inactive status or renewal, or to authorize emeritus status and renewal. The board appears to be intending to provide continuing professional development with a charge of up to $200 per continuing unit.

According to the draft of proposed legislation, the board will be creating new committees that may operate with full authority of the board for complaints procedures and disciplinary actions, to perform tasks such as creating subpoenas and summary suspension authority.

The board will add the ability to restrict a license along with the current law for suspension are revoking. Also added in new language, the board is to communicate violations to the District Attorney.

Under scope of practice the board is adding language for:
• psychological test development;
• provision of direct services to individuals or groups for the purpose of enhancing individual and organizational effectiveness;
• using psychological principles, methods and procedures to assess and evaluate
individuals for the purpose of rendering an expert opinion or diagnosis in a legal
setting; and
• supervision and consultation related to any of the services described in the current
law.

The new language affirms that psychological services may be rendered to persons throughout their life time including families, groups, institutions, organizations, and the public. The board is also creating new language that removes transparency having to do with investigations. “All proceedings in connection with any investigation by the board shall be conducted in closed session, and are exempt from the provisions of the Public
Meetings Law [….]

LSBEP Determined to Push Their New Laws

The Louisiana State Board of Examiners of Psychologists (LSBEP) appears determined to go forward with it’s ambitious and comprehensive legislation, voting unanimously on Thursday, January 28, to begin the search for a legislator to sponsor their changes to the psychology practice law for the 2021 legislative session.

If passed, the LSBEP’S legislation will make sweeping changes, including registering
assistants, expanding the board’s charter, expanding legal authority of employees, adding more fees, changing the scope of practice, modifying board composition, and exempting investigations from Open Meetings Laws. The new law also gives the board the authority to conduct and sell continuing education.

In the new law, psychologists would be required to seek the board’s approval for any assistant who is helping the psychologist provide services to patients or clients. This
would include any clinical, family, or organizational setting, including government. The yearly fee is up to $75 per assistant.

Included is the requirement that the assistant initiate a criminal background report from the Louisiana Bureau of Criminal Identification and Information

The board would approve the assistant’s training, qualifications, and services to be provided. The board can deny or revoke the registration of the assistant at any time that it receives reliable information that the assistant is causing harm to clients or patients, or likely to, or is unethical or unprofessional.

The new law also gives the board authority to collect an array of new fees. These
include up to $250 for preapproval of continuing education courses. Also they can charge up to $200 for authorization to conduct tele-supervision, to authorize an inactive status or renewal, or to authorize emeritus status and renewal. The board appears
to be intending to provide continuing professional development with a charge of up to $200 per continuing unit.

According to the draft of proposed legislation, the board will be creating new committees that may operate with full authority of the board for complaints
procedures and disciplinary actions, to perform tasks such as creating subpoenas
and summary suspension authority.

The board will add the ability to restrict a license along with the current law for suspension are revoking. Also added in new language, the board is to communicate violations to the District Attorney.

Under scope of practice the board is adding language for: • psychological test development; • provision of direct services to individuals or groups for the purpose of
enhancing individual and organizational effectiveness; • using psychological principles,
methods and procedures to assess and evaluate individuals for the purpose of rendering an expert opinion or diagnosis in a legal setting; and • supervision and consultation related to any of the services described in the current law. How much authority they have over individuals doing psychological research appears to be in question at this point based on discussions on Thursday.

The new language affirms that psychological services may be rendered to persons
throughout their life time including families, groups, institutions, organizations, and the public.

The board creates language that removes transparency having to do with
investigations. “All proceedings in connection with any investigation by the
board shall be conducted in closed session, and are exempt from the provisions
of the Public Meetings Law [….] All records in connection with any investigation by the board are confidential.”

The Times asked Dr. Kim VanGeffen, chair of Professional Affairs for the Louisiana Psychological Association, if the legislation put forth by the psychology board, and explained as “housekeeping” legislation, was actually housekeeping?

“This legislation opens up the Psychology Practice Act in order to make changes.
The proposed changes include some items which could be considered ‘housekeeping,” Dr. VanGeffen said. Housekeeping items consist of changes in language to fit with current practices or statutes. Correcting errors, clarifying or updating information, changing numbers or letters of items in the Act would also be considered housekeeping
items.”

“[the legislation] includes other changes which go beyond housekeeping changes and are more fundamental modifications to the practice of psychology in Louisiana,” she said.

“Drs. Matthew Holcomb and Erin Reuther and I represented LPA on this Committee. During these meetings, LPA’s representatives have been encouraged to and have
offered a great deal of input about the legislation. Some of the concerns raised by the
LPA members resulted in changes to the legislation. There are some areas in which the LPA representatives continue to have concerns or disagreements with what is in the legislation.”

“LSBEP put for this legislation last year. LPA was not involved in the development of that bill. Because of the corona virus, the Louisiana legislature only addressed a very limited number of bills during last year’s legislative session. LSBEP’s bill was not addressed last year.

Members of the psychological community may have had access to that bill although I
would doubt that most psychologists were aware of this legislation,” Dr. VanGeffen said. “When the Ad Hoc Collaborative Committee was formed, it was agreed that the Committee members would not distribute the bill we were discussing until it was in its
final form.”

Dr. Greg Gormanous, Chair of Legislative Affairs for LSBEP, said to attendees at the Thursday online meeting, that he was comfortable that “…we have honored the agreement,” to reach consensus with representatives of the community.

Are Money Problems Behind the Psychology Board’s Latest Legislation?

by Julie Nelson

In the last week of February, the state psychology board surprised the community when they circulated a memo that the board would be putting forth legislation in the 2020 session. The memo cast the legislation as “housekeeping,” but the sweeping changes they wanted were anything but.

By March, Senate Bill 458 had been filed, 23-pages that detailed an ambitious set of changes to the Psychology Practice Act. The changes included expanding the board’s
own charter, creating new qualifications for serving, authorizing the board to conduct continuing education, exempting the board from Open Meetings Law in certain
situations, and redesigning the position of the Executive Director.

But the most financially significant change was the board’s goal to register psychological assistants, creating new regulations and fees that could double or even triple costs for some psychologists, especially those in small businesses.

Similar to other past legislative goals by the board, the plan was essentially kept from the public. Why the secrecy? Why bypass rulemaking? Why more legislation?

In this article, we examine the possible issues behind the odd behaviors of the Louisiana State Board of Examiners of Psychologists (LSBEP).

LSBEP’s Ongoing Financial Problems

Posted under “Performance” for 2019, LSBEP data from the Boards and Commissions website gives strong hints to the underlying reason that the board might be looking for more money from the registration of psychologists’ assistants. They noted:

“The Board is planning to engage in rule-making this FY that will impact revenue in FY2020-21 and include requiring the registration of assistants to psychologists providing
psychological services to clients under the supervision of a licensed psychologist and begin pre-approval of continuing professional development activities. A financial analysis for
the impact of these initiatives is being conducted and an amendment to the projected 2020-21 Budget is anticipated.”

The board’s financial problems are long standing, they have been running deficits since 2014.

Based on the financial tracking data, the LSBEP stayed within budget for most years and carried a “fund balance” of around $100,000. A source at the Legislative Auditor’s office said the fund was a surplus or reserve.

For 2014, the board took in $262,582 and spent $249,517. Legal services were $37,882. The fund balance had a surplus of $144,709.

In 2015, the board received $263,691 in fees and spent $275,147. Legal services increased to $56,002. The fund balance was listed at $120,188.

However, in 2016 budget tracking indicates a fund deficit of $214,818.

In a June 2016 Report, the Louisiana Legislative Auditor found the LSBEP to have inadequate controls over financial matters during the 2014–2015 period. The Auditor found a lack of business and accounting functions, and reported there were inadequate segregation of duties and lack of supporting documentation, inadequate controls over employee payroll and leave, inadequate controls over debit and credit cards, and inadequate controls over travel and meals expenses.

It is not clear from the Auditors report how the board went from a surplus to a deficit between 2015 in 2016. However, also in 2016, the board spent $336,677, while proceeds remained steady at $265,945. Legal services rose to $104,894.

In 2017, legal services shot to $149,774, and the fund balance became a deficit of $352,395. In total, the board took in $272,833 and spent $408,388.

For 2018, the board collected $299,599 and spent $307,003. Legal services dropped to $40,826. The fund balance was a deficit of $359,799.

Last year, in 2019, the board took in $310,023 and spent $212,640, with legal services at $61,182. The fund balance dropped to a deficit of $262,415.

But projections for 2020 point to new problems. Salaries are projected to go from $85,727 in 2019 to $168,787 in 2020. The board is estimated to take in $329,831 and spend $366,236. Legal services are estimated at only $57,509, but the fund balance is still a deficit at $298,820.

And, for professional services there is a category for “Others” that increases from $8,620 in 2019 to $43,499 in 2020. Salaried employees in 2019 is listed at $61,569, but increased to $93,200 for 2020.

In summary, between 2019 and 2020, expenditures are set to increase by 72%. (See figure.)

The Expensive “Complaints Committee”

The LSBEP conducts two main duties as a board––approving new licensees and administering discipline. New licenses are handled by the volunteer board members and the salaried Executive Director.

However, the complaints subcommittee is designed to conduct its affairs without board members’ oversight. This arrangement leaves volunteer board members free of any bias if they are then required to participate in a disciplinary hearing.

The Rules and the internal Policies and Procedures confirm this: “The LSBEP in accordance with the La. Admin. Code, 46:LXIII.1501.C. hereby delegates authority to a Complaints Committee which may consist of the Compliance Officer, a complaints coordinator, an investigator, legal counsel, and one or more Board members […]”.

The LSBEP has both employees and contractors. For 2020, two employees are listed: The Executive Director at $62,400.00, and the Compliance Investigator at $46,200.00. With related benefits for 2020 coming to $62,537, this brings the salaried employees to
a total $168,787 for 2020. Aside from student workers there are no clerical employees or others listed.

Contract employees include contracts for a Complaints Coordinator (approved for up to $36,000); Prosecuting Attorney ($50,056); Investigator ($12,000); and General Counsel
($45,000).

According to the Policies for the complaints subcommittee, “The Executive Director oversees the functioning of this committee and may serve on the Complaints Committee if necessary.” And, “The Executive Director or Compliance Officer is authorized and empowered to assign per case, individuals who are contracted, employed or appointed by the Governor to the LSBEP, …”

A new position, a “Compliance Officer (Investigating Officer)” appears to have been added sometime in the last two years. According to the policy manual, this person may be a full-time or part-time, may conduct investigations and/or inspections outside of the main office, conduct investigations into alleged or suspected misconduct by licensed members, applicants for licensure and/or others who may be suspected of violating state and federal ethical and agency laws, rules, and policies, may conduct surveillance and unannounced on-site monitoring/compliance visits, among other duties.

The complaints subcommittee operates without the direct supervision of any board members and is the most expensive and least transparent element of the LSBEP. But what exactly is the extent of the problem that this expensive subcommittee is solving?

Is the Extra Expense Really Necessary for Public Safety?

Considering the depth and breadth of law enforcement personnel assigned to the complaints subcommittee, an observer might think that there is a serious problem with psychologists’ products/services.

However, based on LSBEP’s statistics the number of annual disciplinary actions averages between two and three per 1000 psychologists. Since a psychologist serves an average of 30 individuals per year, this translates to around 2.5 problems in
30,000 customer experiences.

This rate is consistent across states and consistent with the national averages. Statistics published by the Association of State and Provincial Psychology Boards calculates the national number of disciplinary actions for the last five years to range from 181 to 229, an average of 189.4. (See figure.) For 106,000 psychologists across the nation, this is 1.8 mistakes per 1,000.

These rates are also consistent with the other psychotherapy and counseling professions. The Times compared a random sample of disciplinary outcomes for the psychology, counseling, and social work boards. We found that all of three boards have
similarly low rates of disciplinary actions, between one and three discipline events per 1,000 licensees.

In research over a sample of a five-years, we found that 75 percent of discipline actions were related in some way to forensic child custody evaluations. The remainder was split
between sexual/dual relationships and impaired psychologist issues.

Using data of the US Consumer Product Safety Commission, which estimates the product-related injuries for various industries, psychologists compare very favorably regarding public safety. Furthermore, to compare to hospital care, where 98,000 patients die annually due to medical errors, psychologist services presents a very safe alternative to inpatient care.

Waste and Ineffectiveness in the Complaints Committee?

Do the lack of checks and balances in the complaints committee, and the heavily staffed law enforcement approach, create more problems than it solves? Have licensees, the taxpayers, been saddled with paying for unnecessary attorneys, including their mistakes?

In an interview with an MBA, he said, “Alignments and incentives are all wrong in the subcommittee. High costs and inefficiencies would be expected,” he explained.

According to several sources, beginning around 2012, the LSBEP embraced an aggressive, adversarial style for dealing with complaints. For the first time, a Prosecuting Attorney was hired in 2014. Also, a private investigator was hired. Sources
have wondered if this may have been related to the then new executive director’s background as a Fraud Analyst/Investigator in the Criminal Division of the Maryland Attorney General.

Finances and other problems began to mount. Hired in 2014 at a $15,000 contract, the first Prosecuting Attorney, Mr. Jim Raines, submitted invoices for $52,000, according to discussion between officials in December 2016. The board was still digging out of money troubles in part because Mr. Raines submitted invoices totaling $66,597 earlier that year, according to the minutes for the LSBEP.

At the same time, Mr. Raines may have contributed to an expensive escalation of legal matters when he failed to recuse himself from a complaints case against Dr. Eric Cerwonka. Mr. Raines had been previously retained by Cerwonka in Cerwonka’s own child custody dispute. Additionally, the two engaged in a fee dispute following the close of the case. Cerwonka filed a constitutional violations lawsuit alleging that the Raines had privileged information about Cerwonka that he used in the investigation.

In another example, the LSBEP contract attorneys appeared to have been confused
about time limits for investigating complaints, ignoring language in the Psychology Practice Act that limited investigations to one year.

At a 2015 hearing, demanded by the defendant psychologist to be open to the public in order to have the press attend, the time limit was to be addressed. However, General Counsel, Mr. Lloyd Lunceford, prompted the chair to have a private discussion in and executive session. When the board members emerged from the executive session, they dismissed the case. This made any discussion on time limits irrelevant. The then Complaints Coordinator, Dr. Gary Pettigrew, appeared frustrated having to dismiss the case stating that he did so, “…purely on the advice of the prosecuting attorney.”

In a side comment to the chair, overheard by the Times reporter, Mr. Lunceford appeared to confirm that the attorneys in the committee had misinterpreted the law and made an error. Two years later the board put forth legislation to change the time limit in law.

Another time limits case is still on a judge’s desk in District Court. If reversed the board
could be required to reimburse the legal fees to the defendant.

New Statutory Laws: Circumventing the Public and Solving the Wrong Problems?

Is the LSBEP solving the wrong problem when it sets out to create new law, instead of
redesigning its complaint committee? Do their legislative solutions just cost more in attorney fees? Do they circumvent the public’s involvement when they go straight to the legislature?

It appears that the board’s first foray into creating news statutes was in 2012 when they decided to craft legislation to bring behavior analysts under it’s jurisdiction. A backlash occurred, with strong animosity directed at psychology from other groups in the mental health community.

Their legislation in 2014 was less controversial, but in 2015 the LSBEP sprung Senate Bill 113 on an unsuspecting community. The bill fueled a tug-of-war between state associations over language in the Practice Act.

In both 2017 and 2020, the board first indicated they would proceed with rulemaking, which is the process for creating administrative law. However, both times they surprised the community and chose to contact a legislator.

The Times spoke to an administrative law expert who preferred to remain anonymous. The expert explained that the board is circumventing the public by putting their goals into statutes instead of using administrative law and rulemaking, which includes a process for public involvement.

“They are circumventing the public,” when they go straight to the law and ignore rulemaking, said the expert. “They are eliminating the input from the public. Administrative law is separate from the statutes, and that area of law is to be
separate. They want to put their administrative law into statutes, and that is a serious concern.”

State agencies are prohibited from taking a position or lobbying on any legislation. Emails show that the executive director took an active role in SB 113. And, the LSBEP had hired its own lobbyist, Deborah Harkins. This later prompted Sen. Fred Mills to put forth legislation to prohibit agencies from paying lobbyists.

The Times asked Senator Mills about the origins of his Act 480. “It became readily apparent to me that some of the health professional licensing boards were intentionally trying to circumvent this law by hiring a lobbyist to lobby on their behalf, either for or against legislation that the board did or did not like,” he said. “It was indisputable evidence of, for instance the board of psychology, hiring a lobbyist when the board is listed on the website as one of her clients. This was really my motivation in filing Act 480,” said the Senator.

Conclusion

Years ago the policy at the LSBEP was, “Complaints received shall be rotated between former LSBEP members appointed as investigators.” The subcommittee then appeared to have had one psychologist, Dr. Gary Pettigrew, as the Coordinator, whose contract was for 40 hours per year. Legal consultation came from the General Counsel, only as needed.

Between then and today, major changes occurred, some very expensive. The expense impacts both the licensee, who funds the board, and psychologists who have to defend themselves against a fully staffed, motivated law-enforcement unit. At the same time, the measures of public safety have remained consistently good.

One attorney said that the Baton Rouge area has become a “cottage industry” for
the legal profession due to the boards. It seems unlikely that the LSBEP can legislate it’s way out of its managerial and financial problems. Unfortunately, in trying to do so they are removing the public from it’s legitimate role––being a correcting, and perhaps helpful, influence.