Membership issues took center stage at the Executive Council meeting in San Francisco. A proposed bylaw amendment was approved unanimously placing responsibility for membership in the hands of Council. As is presently the case, any proposed changes in membership criteria would still need to be ratified by two-thirds of the full voting membership. (For detailed coverage, see bylaw article on page 20.)
Jon Meyer responded to questions from the floor of Council as to the extent to which the Task Force on Reorganization must adhere to the guidelines the Executive Committee developed to steer its work. He clarified that the guidelines, which were ratified by the membership, are not intended to restrict or confine the task force. Rather, the guidelines' purpose was to inform and shape the agenda of the task force.
Robert Pyles and Jim Pyles, APsaA's legislative consultant, updated the Council on several important cases involving infringements on patient privacy and confidentiality with which APsaA has been involved. Among those was the RICO class action suit against the managed care industry. The suit, which represents over 900,000 physicians, seeks to recoup financial losses and to change the way managed care companies are allowed to conduct business. Robert Pyles reported that APsaA, along with state medical societies and other professional organizations, has been working closely with RICO attorneys representing the interests of psychiatry. Two of the ten managed care companies named in the suit have settled instead of facing court action.
Also reported on was the suit against HHS regarding HIPAA amendments, seen as significantly eroding doctor-patient confidentiality. They said the recent ruling was against the case presented by APsaA, which was one of a number of plaintiffs filing suit against HHS on both constitutional and legal grounds.
One other activity on behalf of patient privacy and confidentiality was APsaA's engagement early this year with Oxford Health Plan of New York. APsaA's involvement was prompted by Oxford's demand that hundreds of therapists turn over treatment records to substantiate payments rendered for psychotherapy and psychoanalysis, without patient consent. Records reviews were used to justify the demand to impaneled therapists to return fees. APsaA successfully negotiated with Oxford eight allowable categories of information, limited to clinician activities (such as mental status examination) that do not infringe on patient activity, and only with patient consent. Oxford agreed that information in these categories would be the maximum sought for payment and routine health care communications. Pyles reported that several other initiatives in other states and on Capitol Hill are underway to support protective legislation.
The importance of APsaA members' contributions to fund efforts to safeguard the therapist-patient relationship against intrusions by government and third party payers was underscored. Pyles emphasized that 100 percent of all contributions go toward lobbying and litigation. Councilors discussed the nature and extent of APsaA's financial and political involvement with these initiatives.
Steven Levy, the new editor of the Journal of the American Psychoanalytic Association, reported that new sections on education, research, and child psychoanalysis are being developed.
He also asked Council to consider changing the process of choosing JAPA editorial board members. He requested that the Council permit him and the JAPA Editorial Board to choose new members, a practice, he said, of other major scholarly journals. He said this would allow more in-depth review of prospective members' qualifications and would allow for balancing the expertise required by a wideranging journal. These selections would be presented to Council for their approval. Some councilors objected to the proposal on the grounds that it would circumvent local society input, while others offered at least partial support of Levy's proposal or suggested striking a compromise. The proposal will be taken up at the Council meeting next January.
Nadine Levinson, treasurer of the International Psychoanalytical Association, spoke on behalf of President Daniel Widlocher about several IPA practice-related initiatives. The Developing Psychoanalytic Practice and Training (DPPT) project is funding projects designed to enhance members' practices and candidate recruitment at the local and regional levels. She reported that $50,000 was granted for APsaA's Web site redevelopment. Levinson also noted that the IPA awarded a $6,000 grant to the Columbia Psychoanalytic Institute for a longitudinal study on career development.
Levinson explained that the IPA is developing a response to a Latin American request for greater flexibility in training standards. She reported that an educational document was prepared, but the issue of session frequency has delayed consensus. Provisions for regional and societal protection and oversight have been built into the document as it stands.
Dean K. Stein addressed the Council as the first executive director of APsaA. Central to Stein's report was his observation that APsaA had the most active membership of any of the many non-profit organizations that he has advised or observed.
He suggested that the benefits of membership in the organization must be emphasized if APsaA is to experience future growth.
Brenda Bauer, M.S., is a predoctoral clinical psychology intern at the Karen Horney Clinic in New York City. She is co-chair of both APsaA's Committee on Student Associates and the Committee on Community Clinics.
He recommended the creation of a new benefit: seminars at national meetings on practical, but much-overlooked, topics such as developing effective boards of directors, budgeting, hiring, and public relations for local institutes and societies, and training on how to conduct successful meetings.
Richard Lightbody was elected to fill the four-year councilor-at-large term of Prudence L. Gourguechon, who resigned when her term as APsaA secretary became effective.
Michael Slevin was ratified as the new editor of The American Psychoanalyst (TAP). He succeeds Prudence L. Gourguechon, who resigned when her election as new APsaA secretary became effective.