Meeting: Tuesday, October 27, 2015 The Henry B. Gonzalez Convention Center, 200 E Market St, San Antonio, TX

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1 Assembly Meeting: Tuesday, October 27, 2015 The Henry B. Gonzalez Convention Center, 200 E Market St, San Antonio, TX MINUTES Welcome and Remarks of Assembly Chair Warren Ng, MD, Assembly Chair Dr. Ng welcomed everyone and introduced the Assembly Executive Committee Mark Borer, MD, Assembly Vice Chair; Debra Koss, MD, Assembly Secretary-Treasurer; Marian Swope, MD, Jose Vito, MD, Assembly Representatives to Council; Scott Palyo, MD, Assembly ECP Representative; and Richa Maheshwari, MD, Assembly Resident Representative. He acknowledged the current Executive Committee Paramjit Joshi, MD (President); Greg Fritz, MD (President-Elect); David Fassler, MD (Treasurer); and Bela Sood, MD (Secretary). He welcomed the 111 delegates from 45 ROCAPs. Dr. Ng stressed the importance of the Assembly and explained that it is the responsibility of the Assembly to represent our members and the Regional Organizations. He reviewed the structure of the meeting and highlighted a new feature at this year s meeting. There will be a two minute time limit for each delegate when they speak at the podium. Dr. Ng discussed the results of the Spring Assembly Survey, which were overall very positive. Dr. Ng also announced that from 2:00-4:00pm, there will be ECPs and Residents attending Assembly as part of a new Passport Program. Written Reports ACTION: THE ASSEMBLY MOTIONED, SECONDED AND AGREED TO ACCEPT THE CONSENT AGENDA: Minutes from April 25, 2015 Assembly Meeting Assembly Chair Report AACAP President-Executive Director Report JAACAP Written Report Assembly Vice Chair s Report Mark Borer, MD, Assembly Vice Chair PCPCC and PCMH Update Dr. Borer gave an update on PCPCC, which many government organizations are taking part in. He will be representing AACAP on the panel. He highlighted the following: CAP leadership is essential on PCMH teams Integrated PCMH is the core of successful ACOs PCPs will pay out for the mental health care delivery to the PCMH. Psychiatry in traditional and innovative roles 1

2 Dr. Borer explained that evolving consultative roles requires innovative funding strategies. Moving from pilot programs to insurer-funded programs remains a huge challenge. There is an opportunity for innovative involvement collaboration. Collaborating within AACAP will improve the ability to collaborate with other professionals and organizations. The Back to Project Future Roadmap priorities can be achieved through work in the PCMH. Assembly Policies Dr. Borer reviewed the Listserv Guidelines and explained that the guidelines are a compromise between unrestricted s and very restricted listservs. He encouraged all delegates to review the guidelines. Grants (advocacy & collaboration) Dr. Borer provided an update on the AACAP Advocacy and Collaboration Grants program, which is managed by AACAP's Department of Government Affairs. The application deadline is on January 15, 2016 and 10 grants are awarded at $3,000 each (total=$30,000). The following regional organizations received grants: Arkansas Council on Child and Adolescent Psychiatry Colorado Child and Adolescent Psychiatric Society Georgia Council of Child and Adolescent Psychiatry Maine Council of Child and Adolescent Psychiatry Michigan Council of Child and Adolescent Psychiatry Minnesota Society of Child and Adolescent Psychiatry North Carolina Council of Child and Adolescent Psychiatry Puerto Rico Council of Child and Adolescent Psychiatry San Diego Academy of Child and Adolescent Psychiatry Virginia Council of Child and Adolescent Psychiatry APRN Update About half of the states have adopted some form of the APRN Consensus Model. Many doctors and APRNs continue to believe working collaboratively is best for patient care AACAP News Initiative: RO Submissions Dr. Borer gave a quick update on the 2015 Assembly Submissions. ACTION: MEMBERS NEED TO CONTINUE TO REACH OUT TO PCPS AND EXPLORE INNOVATIVE MODELS. COLLABORATIVE CARE RESULTS IN BETTER OUTCOMES, BOTH CLINICAL AND FINANCIAL. WE MUST INCREASE LIAISONS WITH OUR AACAP COMMITTEES AND RESOURCES Grants for Regional Organization Directories (online) Directory grants, up to $500 through the American Professional Agency (AmPro), are given to regional organizations for paper/online directories. You must apply directly to AmPro and more information is available online. 2

3 Assembly Secretary-Treasurer s Report Debra Koss, MD, Assembly Secretary-Treasurer Dr. Koss highlighted the following: Awards Catchers in the Rye Three categories that recognize and promote advocacy for children are: individual, AACAP committee, and regional organization. D&O Insurance AACAP pays for the entire insurance premium of all directors and officers of all regional organizations. Regional Organizations are still required to complete a Regional Organization Profile. ACTION: ALL REGIONAL ORGANIZATIONS MUST SUBMIT A D&O INSURANCE FORM EVERY OCTOBER TO AACAP AND NOTE WHEN THEIR ELECTIONS OCCUR. Assembly Budget Dr. Koss presented the proposed 2016 Budget. Updates to RO Officers Lists (January and July) Changing RO Dues Guidelines/Dual Billing Agreement, and EFT Update Form (RO quarterly dues payments) Regional organizations that contracted with AACAP to collect regional dues and would like to increase/decrease their dues should complete the Dual Billing Agreement Form. (EFT) is available to regional organizations who would like their dues reimbursement funds to go directly to their bank accounts. Most regional organizations already utilize this benefit. She recommended that the few regional organizations who have not signed up for electronic funds transfer (EFT) should complete and send the form to the National Office. She emphasized that any changes in banking information should be reported to Genifer Goldsmith or Nicole Creek at the National Office using the EFT Form. Updated Bylaws and Articles of Incorporation of Regional Organizations Any Regional Organizations who have changed their bylaws or modified their Articles of Incorporation, should send a copy to Genifer Goldsmith at the National Office. AACAP recommends regional organizations who have not reviewed/revised their bylaws in the last 10 years consider doing so. All regional organizations should submit updated lists of their officers twice per year January and July or whenever a change occurs. AACAP-Sponsored RO Websites (online form) AACAP offers cost-free regional organization websites on its server. Currently, AACAP created at least a webpage (or linked to an existing site) for each regional organization (see map). To take advantage of this member benefit, complete the Website Agreement Form, selecting webpages desired then submitting the form to Genifer Goldsmith or AACAP s Webmaster who will contact the designated person to request information to populate the webpages. Assembly ECP Representative Report Scott Palyo, MD, Assembly ECP Rep 3

4 Dr. Palyo discussed the ECP Committee sponsored Events at the Annual Meeting. He reminded delegates that an ECP is defined as seven years out of training. He thanked the 20 ROs who responded to the questionnaire and shared the results. The questionnaire asked the following three questions: Do you have an ECP RO Council Position? Who is Your ECP Liaison? If no Rep/Liaison, would you like help with recruiting one? Assembly Resident Representative Report Richa Maheshwari, MD, Assembly Resident Rep The Assembly was updated on programs available for residents. This year s meeting had its first pre Assembly mentoring event for residents. 53 travel grants were given out to residents this year. President s Report Paramjit Joshi, MD, AACAP President Dr. Joshi gave the report on behalf of the Executive Committee. Dr. Joshi discussed the tragic death of Dr. Carolyn Ekong and expressed her support to the Delaware ROCAP. The following items were discussed: Dr. Joshi reviewed AACAP s positive health indicators; 23% of members registered for the Annual Meeting in San Antonio. The Ad Hoc Committee on Editorship and Publications is searching for a new JAACAP Editor. Applications will be available in November and the final decision will be made at the June 2016 Council Meeting. AACAP has a new Advocacy Committee chaired by Drs. Karen Pierce and Deb Koss, which will be part of the Association. Dr. Joshi thanked Dr. Fassler for his work as AACAP Treasurer. It is the first time AACAP has crossed the $10 million mark in its reserves. She also acknowledged that AACAP has 44 new distinguished fellows this year. Furthermore, this is the fifth year in a row that AACAP has increased their membership. AACAP has a new Triple Board and Post Pediatric Portal Programs Committee. There are only 5 programs in the United States, and these programs have now found a home in the Academy. Dr. Joshi then gave an extensive presentation on Study 329. She presented detailed information on what has occurred from the release of the article to today. Dr. Joshi recapped her Presidential initiative, Partnering for the World s Children, and discussed the two international awards that were established during her presidency, the Ulku Ulgur, MD International Scholar Award and the Paramjit Toor Joshi, MD International Scholar Awards. ACTION: THE SLIDES FROM DR. JOSHI S 329 STUDY PRESENTATION WILL BE SHARED ON AACAP S WEBSITE FOR MEMBERS TO REVIEW. EMBARGOED INFORMATION WILL BE REMOVED PRIOR TO BEING POSTED ONLINE. Special Topics Task Force on School Violence, Steve Berkowitz, MD and Bela Sood, MD Dr. Berkowitz said the task force has been focused on studying the charge to address the president s mandate The Task Force engages in a PRE, DURING, POST event Strategy, in which the emphasis is on the prevention of school violence. They have engaged national experts in their different focus areas. 4

5 Dr. Sood discussed how they have worked on developing a common lens to look at school violence. They have encountered several challenges, including philosophical differences among members. The Task Force landed on a public health approach a before, during and after approach. A document called, What Every CAP needs to know about HIPAA/FERPA is an essential tool for crisis situations. The Task Force has compiled a working Resource Library consisting of over 40 plus docs, tools, and other website links. ACTION: AN INTRODUCTORY AND OVERVIEW DOCUMENT WILL BE CLEANED UP BY NEXT YEAR. Dr. Jeanne Holzgrefe proposed a motion for a public health campaign to promote gun safety. This motion will be on the Tip sheet. ACTION: THE ASSEMBLY EXECUTIVE COMMITTEE WILL BRING THE MOTION TO COUNCIL FOR DISCUSSION. AACAP Youth Connection (AYC), Justine Larson, MD and Otema Adade, MD Drs. Larson and Adade gave a brief history of the AYC. They have recruited members from Youth Move National, LETS and Active Minds The AYC currently consists of 5 members between the ages of 17-26, who have had experience with mental health issues. They are currently taking applications for members and want to especially encourage men to apply for diversity and representation. Their goals are to give youth a voice in advocacy and to bridge the gap between CAPs and youth. It is crucial to provide guidance to CAPs on how to engage youth. There is a strong need for products based on the youth perspective. Drs. Larson and Adade want AYC to benefit AACAP members. They hope to receive feedback from AACAP members on what would be useful. Oregon ROCAP, Kirk Wolfe, MD Dr. Wolfe noted the recent tragedy with the Umpqua CC shootings resonates with other school shootings each delegate has had to deal with. The Task Force on School Violence is one important resource for all of us. While mental health resources in rural Oregon are scarce, communities find a way to rally in the face of tragedy. Spiritual support can make a big difference. Both the Oregon Council and the OPPA have been stepping up efforts to deal with school violence, and will look to work more closely with others in dealing with the media and local resources with future tragedies, as well as with proactive partnering trying to prevent these tragedies. Issues related to gun control are part of the solution. An even bigger issue in Oregon is violence to self, with youth suicide being the #2 cause of death in Oregon youth. The Oregon Council has been helping to address this issue for two decades, including work in developing Oregon's first youth suicide prevention plan in 2000; developing a series of youth suicide prevention brochures for parents and teachers, and a 5

6 suicide prevention checklist to encourage communication among providers; as well as helping to develop the state's youth suicide prevention and intervention plan currently being finalized. Members have also been involved with the state's efforts with developing traumainformed care. In stepping up efforts, child psychiatrists become a part of the larger community. The Oregon Council gave an award to former US Senator Gordon Smith in 2004 for his efforts in passing the Garrett Lee Smith Memorial Act, which has helped to prevent youth suicide throughout the US. Last year the Oregon Council gave an award to Oregon Senator Sara Gelser who developed a bill for youth suicide prevention and early intervention in Oregon. We continue to deal with the ramifications of an Oregon law mandating equal pay in psychiatry and primary care for physicians, nurse practitioners and NP's for a billing code. Part IV MOC, Warren Ng, MD The recertification problem was discussed. More psychiatrists are retiring early, so that they don t have to go through the recertification process. Dr. Ng asked the Assembly if Part IV should be removed from the MOC. Almost all delegates agreed that part IV should be removed. Dr. Sandra Sexson disagreed, and said she thinks part IV is the most important part. Some members felt that even if they were not in support of part IV of MOC, it is important to set standards for CAPs. Illinois Council, Osama Elshafie, MD and Peter Nierman, MD Illinois made a $5,000 donation to the American Association of Child and Adolescent Psychiatry and requested it be earmarked to fund families to come to DC in April to advocate for child mental health (Legislative Conference). Members will nominate families to come to DC. IT Follow-up from Last Assembly Peter Plourd, Director of Information Systems and Web Services Mr. Plourd encouraged members to download the App. He gave a quick demo of the App. and explained that the App will now be available all year long as opposed to only being available during the Annual Meeting. Open Forum #1 Open dialogue occurred and the following items were discussed: 6

7 Advocacy training Dr. Joshi s Paxil article PhRMA discrimination Mental health parity rules and legislation. Mental health parity needs to be operationalized and monitored. Mental health parity regarding Medicaid. How can we better partner with colleagues (eg. integrated care) If someone is suicidal, the inability to restrict access to guns is a huge problem. There is a lot of difficulty in getting CME approval. Small organizations and smaller meetings have more challenges in getting CME approval. There should be a way to give trainees an opportunity to be voting delegates at the Assembly. Assembly Election Warren Ng, MD Dr. Ng administered the election of the Assembly Chair, Assembly Vice Chair and Assembly Secretary/Treasurer. He introduced each candidate for the Assembly Executive Committee member election. Assembly delegates received bios and disclosures for each candidate prior to the meeting. The candidates included the following delegates: Assembly Chair Sherry Barron-Seabrook Mark Borer Vice Assembly Chair Randy Gurak Debra Koss Secretary/Treasurer Kathleen Kelley Melvin Oatis Due to a personal conflict, Dr. Gurak could not attend the meeting. ACTION: ASSEMBLY DELEGATES VOTED VIA CLOSED BALLOTS AND ELECTED MARK BORER, MD AS ASSEMBLY CHAIR, DEBRA KOSS, MD AS ASSEMBLY VICE CHAIR AND MELVIN OATIS, MD AS ASSEMBLY SECRETARY/TREASURER TO SERVE ON THE ASSEMBLY EXECUTIVE COMMITTEE FROM Journal Editor Report Andrés Martin, MD Dr. Martin briefly discussed Study 329 and thanked Dr. Joshi for her presentation to the Assembly. Oliver Stroeh, MD is the newly elected McDermott Resident Editor. The Ad Hoc Committee is searching for a new JAACAP editor in chief. A new editor will be chosen in June 2016 to allow 1.5 years of overlap between editors. The impact factor is at an all-time high of

8 It is the number 1 ranked journal of all pediatrics and has been ranked number 1, six out of the seven years Dr. Martin has been editor. Dr. Martin discussed Break the Cycle, which is an event whose goal is to raise awareness of mental illnesses in children and raise funds to support research, training and education initiatives. Break the Cycle will be a 5,000 mile bike ride across the country during the summer of 2017, culminating in DC during the 2017 Annual Meeting in DC. Dr. Martin hopes that this will become an Academy wide event. Regional Organization Manual (ROM) Task Force Scott Palyo, MD and Jenna Saul, MD Drs. Palyo and Saul provided an update on the process for developing the ROM. They invited delegates to complete a survey regarding their ROCAP. Dr. Saul announced that the ROM Task Force will be having a meeting directly after the Assembly Meeting. She invited any delegates interested in the ROM to attend the meeting. ACTION: THE ROM TASK FORCE WILL HAVE A COMPLETED MANUAL BY NEXT YEAR S ANNUAL MEETING IN NEW YORK. AACAP Membership Report David Kaye, MD and Rao Gogenini, MD David Kaye, MD and Rob Grant provided a membership report to the Assembly. AACAP currently has over 9,000 members. There has been consistent growth over the past five years. The number of trainees joining AACAP has risen greatly. Department of Government Affairs Report Ron Szabat, Esq., Bryan Shuy Mr. Szabat provided a political update, including current events in the federal government and the upcoming presidential election. He provided an update on two Workforce Bills. HR 1859 and HR The HR 2646 Bill, introduced by Senators Murphy and Johnson, targets psychiatric and other mental health services to those most in need. It also targets new funding for early intervention and the treatment of children. The AACAP Legislative Conference will be held April 14-15, 2016 in Washington, DC. As part of the new Association, there will be an Advocacy Committee, co-chaired by Drs. Deb Koss and Karen Pierce. Mr. Szabat urged more members to join the Association. Mr. Shuy gave a brief state update. He discussed the new grassroots software, which is mobile friendly. A few of its features include legislation lookup and voter voice, which allows individuals to compose notes directly to legislators. Political Action Committee Update Dr. Robert Hendren explained that the mission of the PAC is to educate, support, and elect 8

9 candidates for Congress who advocate for child and adolescent psychiatry and child mental health. The vision is for child and adolescent psychiatry to have strong relationships with legislators. The PAC has disbursed a total of $11,500 towards electing pro child and adolescent psychiatry candidates to Congress. Integrated Care Model Discussion Moderator: Greg Fritz, MD, AACAP President-Elect Alan Axelson, MD, Barry Sarvet, MD, Benjamin Shain, MD, Kathleen Myers, MD, David Roth, MD Dr. Fritz gave a brief overview of his integrated care initiative. He explained that descriptions of local integrative care projects, which have been successful or unsuccessful, are the most effective types of education for members. These descriptions can then be put in AACAP News and other publications. He hopes to hear from some ROCAPs in the next few months. He announced he will be hosting a Town Hall Meeting focused on integrative care and invited attendees to join. The Milliman Report is in its final stages of analysis. The data will be useful in developing advocacy strategies. AACAP has paired with the American Academy of Pediatrics and the American Psychological Association to produce this report. AACAP s Committee on Collaboration with Medical Professions (COCMP) is currently working on a new practice parameter on integrated care. Dr. Fritz introduced Alan Axelson, MD who then gave a report on AACAP s Healthcare Access and Economics Committee. Its charge is to provide leadership to AACAP, its ROs, and its members, in efforts to ensure employers and managed care organizations support and provide quality psychiatric services for children and adolescents. Dr. Axelson discussed The Triple Aim: Care, Health and Cost. He said improving the U.S. Health Care system requires the pursuit of these aims. It will reduce the per capita cost of health care. The Innovator s Prescription (2008) describes business models that improve quality, access and affordability by changing the way hospitals work with mid-level practitioners. Collaborative Care is a patient centered primary care collaborative. American Psychiatric Association and AACAP are recent members. There is a strong need to develop relationships that improve patient access and promote the value of CAP services. AACAP is also working with the Association for Behavioral Health and Wellness and wants to connect the Academy with each of the health plans. Dr. Fritz introduced Kathleen Myers, MD, who gave a report on the Telepsychiatry Committee. Dr. Myers discussed how fewer medical school graduates are choosing psychiatry as a specialty. There is an increasing demand but a decreasing supply. There is an overall shortage and maldistribution of CAPs. There is a high demand for Telepsychiatry services. Telemedicine efficiently uses technology to mobilize all types of mental health providers in the community. 9

10 Telepsychiatry can be utilized in a collaborative care model and support triple aim goals. A Collaborative Care Model means having a primary care doctor, a psychiatrist and a liaison between the two. Integrated Care will require integration across a system not within a system. The Practice Parameter for Telepsychiatry has just been revised. The committee is currently developing a roadmap for establishing a Telepsychiatry Practice. Dr. Fritz introduced David Roth, MD, who gave an additional report on Telepsychiatry. Dr. Roth presented a Telepsychiatry model he developed in Hawaii. He stressed the importance of having all professional activities reimbursed by medical insurance. He discussed Urgent Referral Speed, which is when the network s concierge receives the request and sends it to the appropriate network of medical and nonmedical mental health providers. Non-MD consultants need to be supervised monthly. Catchers in the Rye Awards Warren Ng, MD Dr. Ng provided a brief overview of the Catchers in the Rye Awards. He first introduced the winner of the Catchers in the Rye Award to an individual, Dr. Michael Jellinek. Dr. Jellinek made quick remarks thanking the Academy for this award. Dr. Mark Borer introduced the winner of the Catchers in the Rye Award to a regional organization, the New Jersey Council on CAP. Dr. Ted Petti, President of this regional organization, gave brief remarks thanking the Academy for this award. Dr. Marian Swope introduced the winner of the Catchers in the Rye Award to an AACAP committee, the Substance Abuse and Addiction Committee. Drs. Kevin Gray and Catherine Martin, the Co-chairs of the committee, gave brief remarks thanking the Academy for this award. Open Forum #2 AMA Report, Louis Kraus, MD, David Fassler, MD Dr. Kraus announced that the AMA will be coming out with a comprehensive paper on juvenile delinquency and the needs of these children. Dr. Kraus announced that Dr. Jack Macintyre will be running for the AMA Board. They invited Assembly delegates to submit ideas for resolutions to them. For example, Dr. Fassler explained how California currently supports increased funding for law enforcement training on mental health intervention. Virginia ROCAP: Collaboration on use of psychotropic medications in children, Bela Sood, MD Dr. Sood thanked AACAP for the $3,000 Advocacy and Collaboration Grant. She discussed the problem of CAPs being called pill pushers and over prescribers and presented their accomplishments to date with their project with the Governor s office and statewide efforts. 10

11 Warren Ng, MD Dr. Ng introduced a motion written by Jeanne Holzgrefe, MD for AACAP on Gun Safety and Public Health approach ACTION: THE BELOW MOTION PASSED AND WILL BE BROUGHT TO COUNCIL. AACAP ASSEMBLY ENDORSES AND RECOMMENDS THAT COUNCIL ENDORSE AND ACTIVELY WORK TO INITIATE AND SUPPORT WITHIN AACAP A PUBLIC HEALTH CAMPAIGN TO PROMOTE GUN SAFETY THROUGH PUBLIC HEALTH EDUCATIONAL APPROACHES WHICH MAY INCLUDE COLLABORATION WITH VARIOUS OTHER PROFESSIONAL ASSOCIATIONS AND GROUPS INCLUDING APA, AAP, AMA, AND OTHER GROUPS WORKING TOWARD THE PUBLIC HEALTH AND SAFETY OF CHILDREN, ADOLESCENTS AND ADULTS, AND ENDORSES ACHIEVING THESE ENDS BY WORKING THROUGH EXISTING TASK FORCES AND COMMITTEES OF AACAP AND/OR BY NEW TASK FORCES OR COMMITTEES OF AACAP AT THE NATIONAL AND GRASS ROOTS LEVELS. Old Business There was no old business. New Business There was no new business. Information/Reference (online) Previous Assembly Executive Committee Members Terms AACAP Mission Statement AACAP Organizational Chart AACAP Staff List Assembly EC Disclosures of Affiliations ROs with EFT (electronic funds transfer) Next Assembly Meeting: Saturday, April 16, 2015 in Washington, DC. Thank you for your participation. If any issues arise in your Regional Organization that you need to discuss, please contact Genifer Goldsmith at ggoldsmith@aacap.org 11