1993 - 1994 Jon Nachison, Ph.D.
My presidential "year" began in the fall of 1993 when my predecessor, Steve Pfeiffer, relocated to Northern California leaving behind a healthy, solvent Association. What follows are a sampling of the issues that confronted Psychology and SDPA arranged in a roughly chronological order.
National Health Care was looming on the horizon. Washington was pushing a "managed competition" model, and the American Psychological Association was exploring each of the six proposed alternatives under the watchful eye of Bryant Welch, APA's senior policy advisor on national health care. Ultimately, this debate on health care died and the national discussion shifted to "who killed it."
Pat Deleon, secretary of the APA, was the guest speaker at our annual meeting in the fall of 1993 and spoke eloquently about the need for prescription privileges for psychologists. We subsequently created our prescription privilege task force with Bonita Hammell as our first chair. Bonita was instrumental in giving SDPA a strong voice in the State prescription privilege effort.
Locally the Dale Akiki trial captured the attention of the national media and raised a number of important issues for psychologists. For example: the accuracy of repressed memories, the impeachability of children's testimony, the conflict inherent in both treating and investigating the same patient for the court, as well as the role of psychologists as expert witnesses. SDPA responded by providing a round table discussion on the Akiki trial led by Bonita Hammell and a program on repressed memories presented by Michael Yapko.
SDPA became a participant in the Weed and Seed Program of the City of San Diego under a federal grant from the US Department of Justice through the efforts of Peter Libero and Cheryl Martin. This program was designed to empower communities by "weeding out' violent crime, drugs and gangs and "seeding in" community revitalization, economic redevelopment, jobs creation, and safe havens for parents and children.
The County of San Diego in concert with the California Department of Mental health began their development of a service delivery system for Medi-Cal using a managed care model. Our Association was actively represented by Lori Futterman, Vicki DiCicco and Robert Burgess.
Stephen Groban, the President of the San Diego Society of Psychiatric Physicians, and I met on a monthly basis to explore avenues for bringing our professions in closer alliance. Eventually, we invited our respective President Elects to participate in those meetings to insure the continuation of our effort.
Governor Pete Wilson continued to veto legislation designed to improve and humanize the delivery of health services through managed care and for the fourth year in a row, he attempted to target psychology for elimination from the State's Medi-Cal program.
This year SDPA made a commitment to become more involved at the State level. We attended CPA's Leadership Conference in Sacramento with the largest chapter delegation (six). For the first time our Association was well represented in all areas of conference activities. (Who knows -- someday we may actually have a CPA President from San Diego.)
SDPA, with the urging of Past President John McCarron, participated in the San Diego gun-exchange program, which brought together about 100 community leaders, physicians, psychologists and others with the San Diego Police Department to donate services in exchange for weapons. An excellent effort, thus far, has met only marginal success in this community.
On May 13, 1994, a jury in the Napa Valley Superior Court found two therapists, a psychiatrist and an MFCC guilty of malpractice. A father sued the therapists and the hospital for implanting false memories of paternal child abuse in his daughter. This was a landmark ruling. It marked the first time a non-patient, a third party, won a real malpractice suit against practitioners in a health care field extending the vulnerability of all psychologists.
The California Health Security Act (CHSA) was a Canadian-style single-payor health care delivery system that included broad-range mental health benefits and promised to rescue California from the abuses of managed care. I wrote about CHSA and arranged for a speaker to address questions in an open forum, although SDPA never officially endorsed the initiative. Naturally, the insurance companies spent millions in a disinformation campaign to discredit CHSA and it was defeated in November 1994. However, I still hear physicians and other health care professionals lamenting the lack of support for this legislation in todays managed care market.
CPA announced that beginning in January 1995, psychologists would be mandated to complete 36 hours of continuing education over a two-year period for license renewal. We revamped our Continuing Education Committee and gave it a more central role within the Association not unlike the newsletter. We also began planning for full day - workshops in areas targeted by CPA, such as chemical dependency, pharmacology, etc. The intention was to make the coming transition as easy as possible for our members, and I believe we were successful.
The Department of Health Services (DHS) rendered a decision that ordering restraints and/or seclusion is within the professional scope of practice of licensed psychologists in California. The California Medical Association and the California Psychiatric Association mounted an unsuccessful full-scale challenge to psychology, as these regulations were taken up at a public hearing. The broader issue was most likely to limit the practice of psychology in preparation for the upcoming debate on prescription privileges.
In January 1995, the SDPA celebrated its 35th anniversary, tracing its history back to the first meeting of the San Diego County Psychological Association in 1960 under its first President James Chipps.