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PENNSYLVANIA

OCTOBER 2018

P S YC H I AT R I S T NEWSLETTER OF THE PENNSYLVANIA PSYCHIATRIC SOCIETY

PRESIDENT’S MESSAGE Dear Colleagues, As you are well-aware, September was National Suicide Prevention Awareness Month. Over the last 20 years, suicide has become a major public health issue. It is the tenth leading cause of death in the United States. The number of individuals who die by suicide has been rising every year for the last 20 years. In 2016, around 45,000 individuals died by suicide in the United States. Most of these individuals either had a diagnosed or a diagnosable mental health disorder. It is also important to note that only a very small percentage of the individuals with mental health disorders die by suicide. We as psychiatrists are asked to screen for suicidality in different clinical settings. We are also well-aware that suicidality is a predictably unpredictable event. In addition, we are all aware of the risk and protective factors for suicidality. The risk factors are further divided into long and short-term risk factors. The long-term risk factors include: previous suicide attempts, family history of suicidality, Caucasian race, middle to old age, being single, having poor social support, drug and alcohol related problems, access to firearms, untreated or undertreated mental health syndromes. The short-term risk factors include: acute loss, acute stressors, intoxication, worsening of psychiatric symptoms. Similarly, the protective factors include: family and social support, access to mental health providers, compliance with any treatment recommendation, and religion to name a few There is a huge toll of suicide on the family members of the individual who died by suicide and their providers. No words can explain the loss of a loved one. Family members struggle and wonder how it could have happened and if they could have saved the life that was lost by doing something different. For a psychiatrist to lose a patient to suicide is a huge emotional and psychological toll. We question our decision making and competence, we struggle with the same questions that family members struggle with, ‘what did we miss?’ or ‘what could we have done?’. Suicide of a patient shakes our confidence.

by Ahmad Hameed, MD, DFAPA PaPS President

The majority of individuals who are having suicidal thoughts are willing to talk about their feelings and thoughts when asked in a nonthreatening manner. They are looking for help. Most of the time, we as mental health professionals are at the right place to talk to these individuals and help them. Our objective should be to reduce the incidence of suicide. As mental health providers, we need to be aware that screening for suicidality be part of our initial evaluation, subsequent follow-up, and discharge disposition. In addition to the psychiatric evaluation for lethality, there are numerous suicide rating scales that are available and can be used to screen for suicidality in different clinical settings. The risk for suicidality can be determined by judiciously combining the psychiatric evaluations and the available suicide rating scales. We must be mindful that the underlying psychiatric syndrome is aggressively treated and managed. Our ultimate objective is to bring our patients back to their baseline in terms of their symptoms and functioning (if possible). Similarly, acute events and stressors must be managed appropriately. Drug and alcohol related issues have to be managed aggressively. Access to firearms must be evaluated regularly. Appropriateness for the level of care can be questioned on each visit. If it is decided that individuals are treated in an outpatient setting, appropriate and timely follow-up appointments for med management, therapy, substance use and abuse treatment, and case management need to be made. Resources available in the community include the Suicide Prevention Lifeline (1800 273 TALK) and Crisis Text Line (741741). The Suicide Prevention Resource Center, American Foundation for Suicide Prevention, SAMSHA, and NIMH should be used to educate family members, patients and mental health professionals. Judicious use of crisis, local law enforcement and local emergency room is paramount in decreasing the incidence of suicide. Let’s join hands and make every effort to reduce the incidence of suicide in our communities.

Ahmad


TABLE OF CONTENTS

EDITOR’S COLUMN

2 | Two Books 3 | Activity Update 4 | Early Career Psychiatrist Update 5 | Chapter Highlights 6 | Is Organized Medicine Worth It? 7 | Meet Your Staff 8 | Welcome New Members 10 | Legal Insight 11 | Classified Ads

Don’t miss what PaPS is working on for you! Check out the Activity Update.

Two Books by Edward C. Leonard, Jr., MD, DLFAPA The first book is to be read quickly so you may suggest it to patients and their supporters. Mind Matters: A Resource Guide to Psychiatry for Black Communities was written by ten African-American psychiatrists to introduce mental disorders and psychiatric treatment to nonprofessionals. I think psychiatrists may recommend it with confidence to prospective patients and those concerned about them. It is clear (deliberately written at a seventh-grade level), concise (175 pages), and inexpensive ($6 for the Kindle edition). Two of our members helped produce this fine book. Delane Casiano, MD, wrote the important chapter on depression. Karriem L. Salaam, MD, provides a solid description of common drugs, their benefits, and problems. Each of the major mental disorders has a chapter, and there are especially thoughtful comments on racism, healthcare inequalities, and how to prepare for the first visit. This book also would be a helpful resource for media, legislators’ staffs, and mental health administrators. The second book is written in an engaging and popular style following the great tradition of captivating storytellers – every detail is exaggerated, even the subtitle. The Molecule of More: How a Single Chemical in Your Brain Drives Love, Sex, and Creativity – and Will Determine the Fate of the Human Race is by Daniel Z. Lieberman, MD, and Michael E. Long.

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Although it is a bit pressured, I can’t resist this “biography of a molecule” written by a psychiatrist and a professional writer. Like all psychiatrists, I have followed research on dopamine after learning its role in Parkinson’s Disease and Schizophrenia. But this book also explores how a specific allele of the DRD4 gene may have helped my Irish ancestors flee hunger or survive new stresses in New York. It reports that the proportion of the 7R allele increases by 4.3% for every thousand miles of migration. Another factoid, that Japan has very little immigration and less than 1% of its population has Bipolar Disorder, is juxtaposed to the heavily immigrant US having over 4% Bipolar citizens. Presenting sexual pressure and creativity as dopaminergic, the book provides new views of Mick Jagger and Albert Einstein. Dopamine is thought to help us desire what we don’t have, to chase after new things and persons. An interesting contrast is made with what are called H&N (here and now) neurotransmitters, such as oxytocin, vasopressin, and endorphins, which are thought to allow us to experience what and who are nearby. H&N functioning is said to enhance empathy, which is curtailed by dopamine. Thus brilliant (dopaminergic) persons are often poor at human relationships. Read The Molecule of More for an answer to the question, “Were you born obnoxious, or must you practice?”

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by Deborah Shoemaker, Executive Director and Lobbyist

ACTIVITY UPDATE

Falling into opportunities as they present themselves Today is September 29th. I am on the train on the way to Philly for the APA Area 3 meeting. Waking up in our house is always an unexpected challenge – dogs barking or lying on your feet, reminding kids of lacrosse practice or finding out they forgot to tell you they need money to pay back a friend for food or, worse yet, they do not have any more bath gel and need to get a shower. Yes, it is chaotic, but amidst the unruly world around us, I am grateful to have a healthy family that has a roof over their head, food to eat and a world of opportunities around them. My parents always told us to pursue anything we have an interest until the door is closed. To this day, I am grateful for that advice. Did I always follow it? Of course not. But the fact that opportunities are around us for us to avail ourselves is the focus of my article. Working with all of you gives me the opportunity to affect change. I feel extremely grateful to work on causes near and dear to my heart… and often in ways I do not expect. I have the easy job, speaking with legislators and policymakers, drafting or assisting in drafting policy, reading legislation, and so forth. You have the hard job of treating patients and their families of choice when laws and regulations go awry or are not implemented as policymakers intend. We have recently lost some painful battles on scope expansion for certain mental health professionals. Although we went down fighting, legislators without clinical insight or practical experience changed the landscape. It is too early to see the impact of these changes, but we will watch closely and provide feedback to the state legislature if things go off the beaten path. Fortunately, there are brief glimpses of when things go as intended and life is better for it. Such as in the case of a few legislative initiatives we have been embarking on over the past year. I will focus my comments on two no-brainer opportunities the Society has focused on recently: substance use and guns. Opportunity to Affect Change in the Lives of Individuals with Substance Use Needs The Society has been working closely with the Wolf administration on addressing the opioid and heroin public health crisis surrounding us. During Governor Wolf’s tenure, funding for the expansion of Medication Assisted Treatment (MAT) is at an all-time high, and other initiatives are being funded as we speak. This week alone, the governor announced that the commonwealth received a $55.9 million SAMSHA grant. The administration plans to “focus on prevention, treatment, recovery, education, and training.” Three key projects will encompass this new funding: a $15 million supportive housing initiative, the creation of an Opioid Use Disorder Loan Repayment Program to entice health care professionals to work in Health Professional Shortage Areas, and significant expansion for all forms of MAT for individuals interfacing with the correctional system during re-entry into the community (yes, it needed to be bolded). The administration searches us out on a regular basis to assist in their efforts. We will continue to pursue opportunities to stand with the

governor in his quest to positively impact change. But rest assured, we will also let him know when the administration is going off the beaten path. Here is a link to the press release. Opportunity to Positively Change the Firearm Discussion Another opportunity that somewhat fell into our lap relates to the devastation of self-harm from the use of guns. With the limited days left in this two-year legislative session, the state legislature feels compelled to address gun violence and public safety in some fashion. House Bill 2060, proposed legislation seeking to remedy domestic violence concerns, is a top priority for the Wolf administration and various consumer organizations. As is the case with most proposed gun bills, their passage is somewhat controversial with certain gun rights groups. We have not taken a stance per se but have expressed support with the overall concept of the bill. I am pleased to announce that the bill is now on the governor’s desk with the expectation of a quick enactment. Here is a link to House Bill 2060. This spring, Representative Todd Stephens contacted us to seek clinical input on House Bill 2227. If enacted, this legislation would create Extreme Risk Protection Orders (ERPOs) to ensure that the rights of individuals with mental health needs are protected throughout the gun revocation/restorative process. Under the leadership of our Clinical and Government Relations Committees co-chairs, we reviewed his bill and provided some insights. We did not focus our energies on it in the spring because we were fighting some scope battles and putting our energies in ensuring that the Mental Health Procedures Act was not opened. As stated above, circumstances beyond our control doomed us on one account. However, in the summer, we were contacted again by Representative Stephens asking us to take another look at the now-amended legislation to see if we could provide more directed support. Given this prime opportunity to directly affect change, we enlisted the support of the APA and experts within our membership. We were informed that Dr. Alisa Gutman, a child and adolescent psychiatrist at UPENN, was independently taking the bull by the horns, writing an opinion piece in central Pennsylvania’s Penn Live and contacting her colleagues across the commonwealth in rural areas to engage them in supporting this bill. In mid-August, I scheduled a conference call between Dr. Gutman, Tim Clement (APA), Lois Hagarty and I to inform Dr. Gutman of the Society’s efforts, seeking ways in which we can work together. Subsequently, Dr. Certa, government relations co-chair, led us in an extremely productive meeting with Representative Stephens in his district office where we formally expressed our support for House Bill 2227, and reinforced our willingness to engage our PAMED colleagues and membership in grassroots support for the passage of this legislation. Tim Clement (APA) worked closely with us to draft a letter to members of the PA House. Dr. Certa also took the bull by the horns by engaging PAMED via personal calls and emails to their key leaders, even introducing a House of Delegates resolution for consideration at their annual meeting in Hershey on October 27th – 28th. Although there is considerable opposition from our friends at the National Rifle Association and other unexpected stakeholders, Representative Stephens is determined to see it through until it becomes law. Thanks P E N N S Y LV A N I A P S Y C H I AT R I S T | O C TO B E R 2 0 1 8

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to our clinical and government relations committee leadership and to Dr. Gutman for taking this important opportunity to change the lives of the citizens of the commonwealth in their times of need. It is also refreshing to see a public official who sees this issue as a public health emergency and not as solely an individual trying to get their keep their gun or refusing to seek treatment because they are afraid they would indefinitely lose their gun.

In closing, I want to encourage your involvement in the Society on whatever level you feel comfortable. Volunteer to serve at the chapter level. Volunteer to serve at the state level on a committee. Express your willingness to be a state or chapter leader. I know you are busy, we all are way too busy. Your missed opportunity could make a difference in the lives of your patients, their families of choice and how you will be able to practice daily. Check out our website or email to get involve.

EARLY CAREER PSYCHIATRIST UPDATE by Hetty Eisenberg, MD, MPH As we enter the midterm election season, there is an opportunity – not only to cast our votes in November – but also to anticipate the next chapter of Pennsylvania legislature. After the election, some of our legislators will be the same, and some will be different. Some will enter determined to accomplish tasks, and many will be eager to hear from their constituents. All will begin the new session in 2019 with fresh openness, renewed determination, and shifting priorities. This presents an opportunity for us. Advocacy remains one of the cornerstones of PaPS, and it is what draws many of us to participate in the organization. There are numerous elements necessary for successful advocacy. As psychiatrists, we typically have not had the experience or training in advocacy that some in other professions have. Quite the contrary, in psychiatry we sometimes feel the need to remain apolitical to maintain a neutral stance with our patients. As ECPs, we are focused

on establishing the foundation of our careers, rather than using our experience as a platform from which to work for change. However, I feel that being psychiatrists makes us particularly wellsuited for advocacy. In our partisan culture political efforts may feel confrontational or polarized, but above all advocacy requires building successful relationships. Building relationships is exactly what we, as psychiatrists, are trained to do. Moreover, as ECPs, we are the future of psychiatry, and for this reason our voices are particularly powerful. When the new session of the Pennsylvania General Assembly convenes in 2019, I am eager to visit Harrisburg to locate the offices of my newly elected representatives and introduce myself to their staffs. I would love to convene a group of ECPs to meet at the State Capitol in Harrisburg and share this experience together – each of us visiting our respective representatives. This would be the first step towards building relationships with our representatives. It would also be a way to become more familiar with the infrastructure of the State Capitol. Please let me know if you are interested in joining, and if you would like to help organize this pilgrimage!

APA October Course of the Month -

Major Depression in Children Recent research suggests that the Child Behavior Checklist (CBCL) Anxiety/Depression scale can help identify children at highest risk for pediatric major depression (MDD) and, if implemented clinically, could cost-effectively screen children and identify those most in need of early intervention. This presentation provides an overview of MDD in children and articulates the use of the CBCL to identify children at greater risk for depression. Presented by Kenny Lin, M.D. of Massachusetts General Hospital.

Click here to access the Course of the Month and sign up for updates about this free member benefit.

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CHAPTER HIGHLIGHTS

CENTRAL CHAPTER

President Update | Kawish Garg, MD, FAPA 2018 CPPS Residents’ Night Our annual Residents’ Night was held on Thursday, August 23rd, at the Colonial Golf & Tennis Club, in Harrisburg, PA. During the evening, Andrew Davis, MD, from Penn State Health, was presented the PRMS Resident Achievement Award which is presented to a resident who stands out in their commitment to their job duties during residency. Also, new this year was a Resident Poster Competition. Poster winners were: First and Second Place – Nuzhat Hussain, MD, Penn State Health Third Place – Mohammed Basith, MD, Penn State Health Planning for future CME and social events is underway, so please watch the website and your email for details.

LEHIGH VALLEY CHAPTER

Save the Date! Lehigh Valley Psychiatric Society Holiday Social Thursday, December 13, 2018 6:00 – 8:00 pm Melt, 2880 Center Valley Parkway, Center Valley, PA

WESTERN CHAPTER

President Update Elizabeth Ramsey, DO, President Happy Fall! We are enjoying a beautiful autumn season following a wonderfully warm summer. I want to recognize one of our most active members, Dr. Mary Anne Albaugh, who was recently awarded Distinguished Life Fellow of the American Psychiatric Association (APA). Dr. Albaugh sets the standard for excellence in allegiance to the profession of psychiatry. She is an outstanding clinician, supervisor, mentor, teacher, leader, collaborator, and advocate. She is the epitome of clinical competence, professionalism, and commitment to psychiatry. Congratulations Dr. Albaugh! We appreciate your continued leadership and guidance. Our new chapter officers are President-Elect Dr. Gianpiero Martone and Secretary– Treasurer Dr. Prianka Sinha who are completing their child and adolescent psychiatry fellowships in Erie, PA. Dr. Dennis Borczon remains the councilor. Our chapter appreciates their energy and enthusiasm for organized psychiatry. This is a busy time for our members and residents. On August 16, 2018, we held our third annual WPPS Residents’ Day for the psychiatry residents of Lake Erie College of Osteopathic Medicine (LECOM) in Erie, PA. The theme of

PITTSBURGH CHAPTER

Pittsburgh News & Notes Greetings to the Members of Pittsburgh Psychiatric Society! Amit Chopra, MD, FAPA, President, Pittsburgh Psychiatric Society Our Residents’ Research and Awards Night was held on Monday, September 24th, at the DoubleTree by Hilton, Downtown Pittsburgh. Residents, medical students and psychiatric nurse practitioner students were invited and encouraged to display their research. During the evening, we honored our Lifetime Achievement Award winners. Sabato Stile, MD, was awarded the Community Psychiatry Lifetime Achievement Award; and Swami Nathan, MD, DLFAPA the Academic Psychiatry Lifetime Achievement Award. Roger Haskett, MD, DLFAPA, received the Academic Psychiatry Lifetime Achievement Award at a previous meeting. Gina Goszinski, MD, from Allegheny Health Network, was presented the PRMS Resident Achievement Award. This award is presented to a resident who stands out in their commitment to their job duties during residency. Dr. Goszinski was nominated by Gary Swanson, MD. The research competition winners were also announced. The winners were: First Place – Gil Hoftman, MD, PhD Second Place – Elizabeth Kistler, MD (tie) Second Place – Elyse Steiner, DO (tie) Honorable Mention – Elizabeth Hale, MD Honorable Mention – Benjamen Gangewere, DO Congratulations to all awardees!

the day was “Physician Wellness” and our featured speaker was the highly esteemed Dr. Raymond Truex, Jr., a retired neurosurgeon and current medical director of the Pennsylvania Physicians’ Health Program. Dr. Truex’s lecture, “Physician Resiliency – My Journey,” started with a very personal account of his career including his struggle with addiction. His words were greatly appreciated by the residents and students who were touched by his candor. We were extremely thankful for his openness and encouraged by his successes in recovery. Dr. Elizabeth Ramsey gave a lecture, “Physician Burnout and Wellness,” which detailed many strategies to combat burnout and optimize wellness. Overall, the residents learned the symptoms of physician burnout but most importantly were encouraged to focus on personal wellness to minimize the risk. On September 19, 2018, our chapter held its annual risk management CME event sponsored by Professional Risk Management Services, Inc. (PRMS). Our speaker, Ann McNary, JD, expertly guided us through the risks of prescribing controlled substances and what prescribers may do to minimize risk for ourselves and our patients. Our group had many questions which were skillfully answered by Attorney McNary. The collegial group enjoyed the interactive discussion of a complex topic. We look forward to more CME events and a continued partnership with PRMS! On October 24, 2018, our chapter co-sponsored the second annual WPPS Resident Poster Night in conjunction with LECOM. The posters were judged by chapter members and prizes were awarded to the top three posters. For information on chapter events, please continue to review our website. If you have any ideas about how our chapter may better serve you, please do not hesitate to contact me. Comments and suggestions are always appreciated. Thank you! I hope you enjoy a peaceful holiday season.

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Is Organized Medicine Worth It? by Kenneth M. Certa, MD, DLFAPA At the latest meeting of the Philadelphia chapter of the Pennsylvania Psychiatric Society, Dr. Camille Paglia, Philadelphia Psychiatric Society president, mentioned comments she heard from some of our younger members expressing skepticism about belonging to our organization. One issue cited as a reason for this was Maintenance of Certification (MOC), presumably the lack of APA action in getting rid of the requirements for MOC. As someone who has been involved at many levels in the fights over MOC, among other things, I am struck by how poorly the message has gotten out about how much work has been done, as well as what real accomplishments have been gained. I will get back to exactly where things have gone with MOC in a minute, but I hope to remind all our PaPS and APA members that the organization is alive and kicking, and kicking hard against the many forces out there that seek to bring us and our patients down. Unwarranted scope of practice expansion, unreasonable prior authorization requirements, patently obvious phantom networks, unjustified CME requirements for license renewal, unpredictable drug shortages, onerous documentation requirements, and insulting reimbursement rates, are all issues that APA, AMA, PaPS, PAMED, and many other organizations are fighting daily. Testifying before regulatory bodies, working with legislators and their staffs, providing comments on draft regulations, and developing position statements takes time and effort which most physicians do not have. Without the efforts of our professional organizations, things would go south very quickly. I am sure most people know at some level that there is someone out there making sure that the state does not decide to change commitment criteria or insist that physicians accept Medicaid as a requirement for licensure, or whatever; that someone is a staff person paid with the dues money of our society, or the many volunteers who devote our time. Concerning MOC: Pennsylvania has been at the forefront of the pushback against MOC, chiefly through our internal medicine colleagues and the Pennsylvania Medical Society. Through perseverance we have been successful in convincing ABIM to

place a moratorium on MOC requirements. The American Board of Psychiatry and Neurology (ABPN), in large degree because of strongly worded action papers passed by the APA Assembly and a Board of Trustees work group, has made major modifications to its requirements. The pilot program of reading articles instead of a high stakes’ exam is one example. The expansion of what can be counted to satisfy Performance in Practice requirements is another. They have also loosened some of the requirements concerning who can sit for the exam (psychiatrists trained in osteopathic residencies are no longer excluded.) Much of the problem with changing MOC requirements rests with the American Board of Medical Specialties (ABMS), to which ABPN belongs, which set them up to begin with, and which many other specialty boards value highly. ABMS has taken a position that MOC should be for all, and the procedureoriented specialties are not about to argue for change. Getting out from under ABMS would be a risky undertaking, since there are many certification boards out there which are of questionable validity. There are many reasonable, very different opinions out there about what should be done on many fronts. Again, with MOC – ome think that the only thing required should be the exam every 10 years; others think that the high stakes exam should go, in favor of better CME with testing (like in the pilot.) We have some members who think that fighting scope expansion is a hill to die on; others think that since there will never be enough psychiatrists to go around, we should welcome the help and let the public decide whose skills they value most. All of this is to say that undertaking a profession such as psychiatry, or medicine in general, entails an obligation to make sure that the profession stands for something. Our professional societies are the best means to make that happen. There are many good people working hard to safeguard what is good and prevent what disasters await the unprepared. I wish all psychiatrists would recognize that their membership is what keeps the fires burning, so that we continue to be able to practice what we have learned for the betterment of our patients.

Watch your inbox!

Membership renewals are coming your way! Renew your APA membership here today. 6

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Meet Your Staff | Part 2 In this issue we introduce our Meeting Managers, who work hard to bring you the CME and social events held throughout the year. Staff, working from their Harrisburg-based office, are available to answer members’ questions about membership benefits, meeting updates, and assist with our members’ needs. Judy Clapp, CMP has over 14 years of experience in strategic event planning, sourcing, contract negotiation, budgeting, and onsite logistics. Judy previously managed events for several associations in the DC Metro area. She earned her Certified Meeting Professional (CMP) credential in 2009. Contact Information: Email: jclapp@pamedsoc.org | Direct Dial: 717-909-2682

Jordan Dale serves as meeting manager for the Small Chapter Coalition, providing meeting management services on a part-time basis including CME, educational/social event planning, and exhibit/sponsorship coordination. Contact Information: Email: jdale@pamedsoc.org

April Rose, new to PaPS, has been with the PAMED’s Specialty Society Management Services (SSMS) since March. April comes from the hospitality industry, and has experience in the sales, operations, and coordination of large-scale events. April’s role with PaPS is planning educational and social events, negotiating contracts, coordinating exhibitor/sponsorship, and obtaining CME. April loves spending time with friends and family, kayaking, and listening to music. Contact Information: Email: arose@pamedsoc.org | Direct Dial: 717-909-2697

Karin Travitz has a broad marketing background and came to us with experience in event planning project management, sales, and fundraising. A promoter of music and the arts, Karin has taught many students the art of playing the piano. She also enjoys gardening (when the deer don’t eat the vegetables), baking, and spending time with her husband, Mike, and daughter, Kaylena. Contact Information: Email: ktravitz@pamedsoc.org | Direct Dial: 717-909-2685

Jessica Winger has served PaPS meeting needs for many years and has been with the SSMS for 18 years. Jessica plans educational and social events, negotiating contracts, coordinating exhibitor/sponsorships, and obtaining CME. Jessica loves spending time with her daughter, volunteering at her school, going to the gym, and traveling. Contact Information: Email: jwinger@pamedsoc.org | Direct Dial: 717-909-2693

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SENIOR PSYCHIATRISTS FREE Membership Register Today!

Welcome New Members BENEFITS: • The Senior Psychiatrists, Inc. are giving each Distinguished Life Fellow APA, Life Fellow APA, & Life Member APA a FREE membership • Special programming in conjunction with the APA Annual Meeting • Awards Reception at the APA Annual Meeting • Opportunity to contribute to the Senior Psychiatrist publications • Networking with fellow senior psychiatrists, including many past APA Leaders mentorship opportunities • Opportunity to participate in specially designed webinars • Let your voice be heard at APA

REGISTER TODAY www.seniorpsych.org (443) 597-0066 8

We welcome the following new PaPS members and congratulate those Members-In-Training who have recently achieved General Member status (effective July 5, 2018 – September 30, 2018). CENTRAL Members in Training Nataliya Bilger, MD Hassaan Gomaa, MD Tuna Hasoglu, MD Luke David Piper, MD Sheharyar Sarwar, DO General Member Anne V. Dall, MD Mary E. Rahn, MD NORTHEASTERN Members in Training David Eisenberg, MD Shevani Uveni Ganesh, MD Ukpere Nimtor, MD Khaled H. Said, MD General Members Tuhim Gupta, MD Atika Zubera, MD PITTSBURGH Members in Training Alexandra T. Fortunato, DO Ravneet Kaur, MD Jose O. Mantilla-Rivas, MD Christie S. Sylvester, MD General Members Elizabeth Wolf Fourcade, MD Louis Kenneth Hauber, MD Jessica Kettel, MD Konasale M. Prasad, MD Rebecca Roma, MD Sharvari Pradip Shivanekar, MD

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PHILADELPHIA Members in Training Michael Antzis, MD Abena Apraku, MD Jacob D. Buinewicz, MD Aatequ Ismail, MD Nathaniel J. Kohlenberg, MD Justin Thomas Lee, MD Edward C. Nunziato, MD Leigh J. Ocker, DO Alisa M. Olmsted, MD Meghan O’Rourke, DO Jankiben Patel, MD Martin Witkin, DO Triston A. Wong, MD Chen Zhou, MD Fellow Jacob Widroff, MD General Members John M. Balaicuis, MD Barbara Davis, MD Mia S. Everett, MD Ruth F. Frank, MD Chioma Iheagwara, MD Jasmin Lagman, MD Kathryn J. Newton, DO Adam Drew Sciolik, Md Sundeep Virdi, MD Monica L. Vega, MD WESTERN Members in Training Yueling Li, MD David H. Snow, DO Brenton J. Song, DO


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LEGAL INSIGHT

By: Julia Coelho, Esquire McNees Wallace & Nurick LLC, PaPS General Counsel

Restrictions on Employing or Contracting with OIG Excluded Persons: Are you screening your employees and contractors properly? The Office of Inspector General (OIG) of the U.S. Department of Health & Human Services is charged with identifying and eliminating fraud, waste and abuse in federal health care programs. In carrying out its mission, the OIG has authority to exclude1 individuals and entities (collectively, “excluded persons”) from participation in the Medicare, Medicaid and other Federal health care programs. The principal effect of an OIG exclusion is that Federal health care programs are prohibited from paying for items or services provided by an excluded person, or at the medical direction or prescription of an excluded person. An excluded person who, directly or indirectly, submits a claim for payment in violation of this prohibition may be subject to civil monetary penalties (CMP) of up to $10,000 for each claimed item or service, and an assessment of up to three times the amount claimed for each item or service. In addition, OIG may deny reinstatement of the excluded person’s participation in Federal health care programs. The scope of this exclusion and corresponding prohibition on payment is deceptively broad. The prohibition on payment goes beyond patient care services and includes, for example, administrative and management services provided by excluded persons, even though these services are generally not separately billable to federal health care programs. The prohibition applies to all methods of federal health care program payment such as payments derived from itemized claims, fee schedules, cost reports, capitated payments, and bundled payments. Further, the prohibition affects excluded persons and health care providers that contract with or employ excluded persons. Health care providers may be subject to CMP liability if they submit claims to a federal health care program for items or services provided by persons whom the provider knows or should know are excluded. Given the significant liability exposure from a potential violation, health care providers that furnish items or services, in whole or in part, to federal health care program beneficiaries are strongly encouraged to implement screening procedures to ensure they are not hiring or contracting with individuals or entities excluded by the OIG. While most providers perform some level of screening of employees and vendors, their screening procedures are often not rigorous enough and may fall short of providing adequate protection. Whether you are opening a new practice, or have an established practice with screening policies already in place, consider the following “best practice tips” to further compliance and minimize your risk of overpayment and CMP liabilities: • Screen employees and contractors initially prior to hiring or contracting. Repeat screening process periodically to determine

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the exclusion status of current employees and contractors. Monthly screenings are recommended for the most accurate results as OIG updates its database monthly. • Search the employee or contractor information against the OIG’s List of Excluded Individuals and Entities (LEIE)2 available on the OIG website. The LEIE is accessible through a searchable online database and downloadable data files. • Retain documentation of the initial name search performed and any additional searches conducted to verify results of potential name matches. All names used by the employee or contractor and known to the provider (e.g., if searching for a married individual, his or her maiden name) should be searched. Check your search results by verifying both the individual or entity name and matching the corresponding Social Security Number (SSN) or Employer Identification Number (EIN). • If a provider has arrangements with contractors and subcontractors that provide items or services for which the provider receives federal health care program reimbursement, the provider is responsible for ensuring that the contractor/ subcontractor’s employees are not excluded persons. The provider may choose to screen the employees directly or may rely on the contractor or subcontractor’s own screening procedures. As the provider is ultimately liable under the statute, the provider should validate that the contractor/subcontractor is conducting the screening on its behalf and include a screening requirement in the provider’s contract with its vendors.

There are mandatory and permissive grounds for exclusion. For example, the OIG is required to exclude persons convicted of any of the following criminal offenses: Medicare or Medicaid Fraud; patient abuse or neglect; and felony convictions for other health care-related fraud, theft, or other financial misconduct. The OIG may, but is not required to, exclude persons based on any of the following permissive grounds: fraud in a program (other than a health care program) funded by any Federal, State or local government agency; suspension, revocation, or surrender of a license to provide health care for reasons related to professional competence, professional performance, or financial integrity; or defaulting on health education loan or scholarship obligations. These are not complete lists; additional grounds for exclusion are set forth at 42 U.S.C. 1320a–7 and 42 U.S.C. 1320c–5. 1

While the LEIE is the primary database for exclusion screenings, Providers may choose to conduct additional screenings beyond the LEIE (e.g., National Practitioner Data Bank) to uncover the existence of other sanctions or violations. 2


Classified Ads

Human Services Center, one of the largest Community Mental Health Centers in western Pennsylvania, located approximately 50 miles north of Pittsburgh, in scenic, rural, western Pennsylvania, is seeking a licensed psychiatrist for our Adult Services. Physician will provide medical diagnosis and treatment of patients including psychiatric evaluation, medication management and medication groups. Must be PA licensed and certified in Medicare and Medicaid. Salary, hours and benefits will be negotiated with successful candidate. For consideration, send your CV to: John Baird, HR Manager, Email: jbaird@humanservicescenter.net, Phone: 724-510-3268

The Penn State Health Milton S. Hershey Medical Center Department of Psychiatry is currently recruiting board eligible/ certified psychiatrists for inpatient and outpatient positions in both adult and child psychiatry. We are a growing, vibrant department in a strong academic medical center. We host specialty clinical and research programs, including research that crosses the translational spectrum. Our educational programs include adult psychiatry residency, child fellowship, psychology internship, externship and post-doctoral fellows. We have a strong collaboration with basic and clinical science in other neuroscience disciplines across several Penn State campuses. With our clinical partner, the Pennsylvania Psychiatric Institute, the Department staffs several outpatient and partial hospital programs for children and adults, 89 inpatient beds, ECT and other neuromodulation services, specialty sleep and eating-disorders programs, and expanding psychiatric consultation and integrated care programs for Hershey Medical Center. Successful candidates should have strong teaching as well as clinical skills and, optimally, potential for scientific and scholarly achievement. We offer an attractive compensation package commensurate with qualifications. Tenure-track positions are possible. May be eligible for J-1 Waiver. For consideration, send your CV to: Jenna Spangler, Physician Recruiter Phone: 717-531-4271 Email: jspangler2@pennstatehealth.psu.edu The Penn State Health Milton S. Hershey Medical Center is committed to affirmative action, equal opportunity and the diversity of its workforce. Equal Opportunity Employer – M/W/V/D

Lancaster Behavioral Health Hospital (LBHH) is a brand new freestanding 126-bed psychiatric hospital that promotes wellness by providing strength-based, trauma informed care. We believe recovery is possible for every person with a psychiatric diagnosis. The collaborative, creative, therapeutic culture of LBHH will allow you to teach medical students, residents, fellows, and Nurse Practitioner students in a unique academic to be the future leaders in behavioral healthcare. Lancaster Behavioral Health Hospital will focus on the care of those seeking general psychiatric acute care in addition to a number of specialty inpatient services. Older Adult/Psych Med, Inpatient Dual Diagnosis, Adolescent and Women’s Trauma To learn how you can make a difference and for more information, please contact: Frank Zura, M Ed Physician Recruiter at 609.833.0858 or by email.

LICENSED PSYCHIATRIST

PrimeCare Medical Inc. provides comprehensive healthcare services to county jails, prisons, and juvenile detention centers throughout the Northeastern United States. We are currently seeking a Licensed Psychiatrist to work full time in the medical department at the Dauphin County Prison located in Harrisburg, PA. The Psychiatrist will provide service to the inmate/patient population utilizing current standards of psychiatric practice and will assume responsibility for clinical management of the mental health program in accordance with NCCHC/ ACA Standards and PCM policies and procedures. PrimeCare Medical provides competitive salaries, paid time off, 401k with match, medical, dental, and vision coverage. Qualified applicants will be licensed to practice psychiatry in Pennsylvania, will be board certified or eligible, and maintain a current DEA number. To apply you can email your resume / CV, fax the resume / CV to (717)651-1865, or call into PrimeCare Medical’s corporate office at 1-800-2457277 and ask to speak to a recruiter.

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Pennsylvania Psychiatrist - October 2018  

Pennsylvania Psychiatrist - October 2018  

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