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By Lisa Wesel
The PsychAlliance of Vermont, the year-old affiliation of 100 mental
health professionals with the state teachers' union, has raised
the profile of mental health issues in the state, say the group's
founders.
David Fassler, M.D., a child and adolescent psychiatrist in Burlington
and a member of the PsychAlliance's coordinating committee, says
a major success this year was the contribution the group made negotiating
mental health benefits for 600 faculty members at the University
of Vermont and 1,200 nurses at Fletcher Allen Health Care.
"Both are self-insured, so they are exempt from the state's parity
legislation, meaning there can be an attempt to provide very restrictive,
inadequate mental health benefits," Fassler explains. Having the
PsychAlliance take part in negotiations helped avoid that situation.
Mental health practitioners are legally prohibited from collective
bargaining, but the PsychAlliance is exploring the feasibility of
using the union to negotiate with the state for favorable Medicaid
rates. They also can avail themselves of other union offerings,
such as group health insurance and low-cost attorneys and lobbyists.
The PsychAlliance grew out of informal discussions about managed
care among psychologists, psychiatrists, social workers and alcohol
and substance abuse counselors. Early last year, the group affiliated
with the United Professions of Vermont, the state's branch of the
American Federation of Teachers, AFL-CIO.
They modeled their affiliation on a similar one between the New
York State Psychological Association and the New York teachers'
union. The PsychAlliance of Vermont is different in that it is separate
from Vermont's psychological association, and it is interdisciplinary,
while in New York the entire state association affiliated with the
union and the group includes only psychologists.
Jan Trepanier, executive director of the Vermont Psychological
Association, says her organization is not considering union affiliation
at this time. Fassler says he sees the PsychAlliance, which is made
up entirely of private practitioners, as an enhancement of the state
association. "State associations might be less likely to get involved
in mental health benefits in a contract negotiation because some
of their members might be managers," Fassler says. "We also are
not inhibited one way or another by the positions of the national
associations."
Despite apparent success in New York and Vermont, the idea of union
affiliation does not seem to be spreading. Representatives of the
American Psychological Association say they know of no other such
affiliation in the country. And two years ago, the Connecticut Psychological
Association rejected the idea outright.
"We had several members very interested in pursuing it, but the
board was evenly split," says Michael Schwarzchild, Ph.D., director
of the Center for Child and Adolescent Behavior in Brookfield. "The
discussions were pretty contentious, and that in and of itself was
a problem. The benefits would not have been commensurate with the
cost."
Schwarzchild, who was president of the state association at the
time and a member of the union task force, says the union would
have little to offer them because of the benefits they already receive
from their association.
In Massachusetts, the Massachusetts Nurses Association represents
state-employed psychologists, but the idea of affiliating with a
union does not appeal to the state psychological association.
"Because we're prevented from collective bargaining, there's nothing
compelling enough to make us consider it," says Elena Eisman, Ed.D.,
executive director of the Massachusetts Psychological Association.
Eisman says union affiliation could negatively impact the image
of the organization in the eyes of the state legislature. "For some
issues, it's better to come in as a group of professionals, and
for some issues, it's better to come in with the power of a union
behind you," she says. "We've gone in with an independent professional
image, and that has made people listen to us."
Sheila Comerford, executive director of the Maine Psychological
Association, says her members have not formally discussed the idea
of union affiliation, but the idea is intriguing.
"I've been looking into purchasing group insurance for our members.
(Union affiliation) is the only way it's possible," Comerford says.
"We've never actually put that on the table, so I don't know if
there's a critical mass of people who would support it. But I don't
think anything's off the table as things get more and more dire
in terms of insurance."
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