Rhode Island Governor Gina Raimondo’s proposed FY 2016 budget would consolidate 25 non-prescribing health professional boards into a single regulation and licensing board – a move that would combine psychologists with professions including cosmetologists/barbers, embalmers and athletic trainers.
The Board of Psychology currently has five unpaid members – four psychologists and one public member, according to Peter M. Oppenheimer, Ph.D., who is a member of the board and also president of the Rhode Island Psychological Association.
Under the governor’s proposal, the omnibus board would be chaired by the director of health and have 10 additional members, four of whom are licensed in any of the professions the board oversees. The director would also designate one non-voting “technical expert” from each profession on an “as-needed” basis. The board would be responsible for disciplining health professionals and overseeing license denial appeals. The Department of Health (DOH) would be responsible for routine license approvals. Under current statute, licenses are approved by individual boards and then processed through DOH.
Oppenheimer said the move came without warning or opportunity for public input. He said the proposal, Article 19, would put the public at risk of harm and have severe negative consequences for professional psychology and other professions.
“Omnibus boards tend not to do well with discipline cases, tending to be too harsh, so taking high-risk cases like personality disorders becomes unduly risky to the professional,” Oppenheimer said. Additionally, trying to innovate and adapt licenses to changes that are coming in healthcare policy may not be possible with such a setup.
“Above all of it, the purpose of professional regulation is to protect the public and that standard might fall apart here,” he said, as board members not familiar with the professions at hand may not understand the interpretation of law.
“Part of what I have learned over the past 10 years (as a board member) is it takes a lot of work to be up-to-date on credentialing issues and disciplinary issues,” he said. “Board members all bring considerable expertise. The four psychologists on the board all have been practicing 30 years or more.”
Even then, “There were times where we have sought consultations with particular people because the specific issues we were dealing with we recognized were beyond our collective expertise.”
Each profession has very different standards. “I cannot understand what a barber does, what kinds of standards they have,” he said. “Even social workers and licensed mental health counselors come from very different training.”
Oppenheimer expressed his concerns to state legislative leaders, as did a number of other organizations, including the Association of State and Provincial Psychology Boards, the Rhode Island Council of Child and Adolescent Psychiatry, and the Inter Organizational Practice Committee coalition.
“We have a lot of concerns with the proposal at this time,” said Rhode Island Rep. Raymond E. Gallison Jr., house finance committee chairman, noting that the committee has received feedback from many professionals in the health care industries.
“We’ll be carefully considering their needs and the safety of the public as we weigh the changes this article would make,” Gallison said.
Currently, only Kansas has an omnibus board that includes psychology, Oppenheimer said. Other states have tried it and gone back.
Oppenheimer said that while some of the work in processing licenses is bureaucratic, “if there’s anything about equivalency or unusual, you really do need people who know the particulars of the profession to review that,” he said. “Our law allows for equivalency, not just an APA program internship, so there are times we have to review applicants’ requests class by class.”
Board members also have to examine complaints and ensure they are clear on what standards of the law are being questioned. “We also need to be able to sort out what is really a complaint, versus someone upset about an adverse outcome, versus just an unhappy customer,” he said.
With the new board, there could conceivably be a finding against a professional before someone in that profession has reviewed the case, Oppenheimer said. “That’s very scary,” he said.
By Pamela Berard