O’Donnell, P. J. (2007, November). Integrating psychology into the health care system. Pennsylvania Psychologist, 67(10), 3-6. more

November 2007 Update Licensure Renewal Reminder As noted in the October Pennsylvania Psychologist, PPA urges all psychologists to make sure that they have completed the mandatory continuing education requirements before the current biennial licensure period ends on November 30. In the past, the State Board of Psychology has disciplined some psychologists for stating that they had completed their CE requirements when in fact they had not. Psychologists who have not yet obtained their 30 hours of continuing education this renewal period may have the opportunity to attend PPA’s Fall CE and Ethics Conference, November 1 and 2, in Exton. In addition, psychologists can order home studies from PPA by calling 717-232-3817; ask for Katie Boyer. Up to 15 hours of continuing education per renewal period can be completed through home study. We encourage all psychologists to double-check to ensure that they have renewed their licenses by the end of this month. All licensed psychologists in Pennsylvania should have received their notices for licensure renewal from the State Board of Psychology by now. Psychologists must complete the renewal form and return it unless they intend to retire. The most common reason that psychologists inadvertently fail to renew their licenses is because they have neglected to notify the licensing board that their addresses have changed. The new renewal period begins on December 1. You can contact the State Board of Psychology at 717-783-7155 or through e-mail (st-psychology@state.pa.us). Do not send renewal materials to the PPA office. Psychologists who hold licenses in Pennsylvania and other states should be sure that they meet the continuing education requirements of all the states in which they are licensed. Several psychologists have been disciplined because they did not realize that courses that met the CE requirements in one state did not necessarily meet them in another state. House Bill 1000 Awaiting Action in State Senate House Bill 1000, sponsored by Reps. Kathy M. Manderino (D-Philadelphia) and George T. Kenney Jr. (R-Philadelphia) and 139 other representatives, was passed by the state House of Representatives in June. This is the bill that would allow managed care organizations to require only one initial authorization for an episode of outpatient mental health treatment. It is now in the Senate Banking and Insurance Committee, chaired by Sen. Donald C. White (R-Indiana County). It will be up to Senator White as to when to bring House Bill 1000 up for discussion and a vote. PPA government relations staff members have been meeting with senators and their staff members in Harrisburg, and many PPA members have been meeting with their senators in their district offices around the state. The purpose of these meetings has been to provide background information in enough depth so that they understand why the authorizations process is both intrusive and unnecessary. It dramatically increases the administrative costs of mental health insurance while providing no benefit. Throughout this fall PPA staff members have held, or are planning to hold, “Advocacy Day” meetings with PPA members in Erie, Pittsburgh, Indiana, State College, Lancaster, Scranton, Bethlehem, and Philadelphia. These meetings are in anticipation that a major effort will be necessary to move this bill through the Senate. We expect strong opposition from the insurance industry, which will want to preserve its prerogatives to conduct business without any further restrictions in state law. PPA’s effort will involve our registered lobbyists meeting with senators in Harrisburg, contributions to supportive candidates by PennPsyPAC, and – most importantly of all – meetings, phone calls, e-mails, and letters from the “grassroots.” In the end, the grassroots are the strongest element of our strategy and will make or break this legislative campaign. A complicating factor with House Bill 1000 is that an amendment was added in the House restricting insurance companies’ ability to deny reimbursements retroactively. It would allow a one-year period in which they could do so, but no longer. PPA supported this language in a separate bill, but we have concerns about it being in HB 1000. The amendment brings in other health care associations advocating for the bill, but it also expands its purview to all health care instead of just mental health, and so becomes a bigger target for the insurance companies fighting it. PPA’s position is that we will support the bill in its current form, but if the Senate decides that it cannot support the retroactive denial language, we would not oppose eliminating it as long as the original language on authorizations is preserved. Restricting authorizations is our number one legislative priority. In any case, PPA members are asked to be attentive to legislative alerts that will come out by e-mail, and to contact your state senator in support of House Bill 1000 at the appropriate time. November 2007 The Pennsylvania Psychologist Update 1 It could take years! Your earning power is the force that makes other things possible. Have you thought about what might happen to you and your family if you couldn’t work because of an illness or injury? The really astounding facts show that if you become disabled between the ages of 45-50 it could take more than three years (on average) to recover! 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For costs and complete details, call the number listed above. 2 The Pennsylvania Psychologist Update November 2007 PennPsyPAC Critical to Advocacy Success PPA’s government relations program has yielded results. In the last few years our advocacy has produced: •enactment of a law prohibiting licensing board complaints against psychologists doing child custody evaluations for up to 60 days after the judge’s order •passage of a bill allowing minors over the age of 14 to consent to treatment and making it easier for parents to get their teenage children into treatment •the abolition of corporal punishment in public schools •defeat of a proposal that would have caused psychologists delinquent on their taxes to lose their license, even if the tax charge were in dispute or in error These things do not happen by accident. They are made possible by a coordinated campaign of advocacy in the state Capitol in Harrisburg, grassroots advocacy by members all around the state, and targeted contributions by PennPsyPAC. But our work is not done. We still have a long way to go on other critical issues such as restricting authorizations for outpatient mental health treatment. Well funded insurance companies and business complement our government relations efforts in Harrisburg and our grassroots efforts all around the state. It may be an unfortunate fact of life, but the fact is that in politics, money talks. State legislators determine to a great extent the conditions under which we practice – the rules that managed care organizations have to follow, the regulations governing school psychology, the licensing process for psychologists, and many other issues. If we want to have an impact on these kinds of policies we have to be players in the political process. And if we want to be significant players we will need to increase the amount that we raise and spend each year. In addition to campaign contributions, PennPsyPAC also funds advocacy days, in which we provide psychologists training on legislative issues and bring them together with legislators. Your contributions will fund these activities in Harrisburg and in other settings around the state. For the sake of your clients and your practice, please give generously to PennPsyPAC this fall when you receive our end-of-year appeal. PennPsyPAC exists to make campaign contributions to state legislative candidates who are sympathetic to psychology. groups are blocking these efforts. PennPsyPAC exists to make campaign contributions to state legislative candidates who are sympathetic to psychology. PPA cannot make such contributions from association funds, which is why we have a PAC. It is important to the field of psychology to help get compatible candidates elected or re-elected, and we can contribute to their campaigns only through a PAC. These donations represent one part of our overall strategy in promoting policies that will help psychologists and the clients we serve. They Integrating Psychology into the Health Care System Peter J. O’Donnell, M.A. There are many benefits and costs to clients, health care providers and the health care system of integrating health psychology services into the health care system. Working within a multi-disciplinary team setting, with a primary care physician, or as a solo practitioner are generally the various options. Integration within the system is the ideal, but collaborative relationships are probably the most common and realistic within the current health care environment. Various interventions in the continuum of care can vary from preventive to self-management programs to biopsychosocial therapy (Sperry, 2006) to medical crisis counseling (Pollin & Kanaan, 1995) to applied psychophysiological treatments (Gevirtz, 2006; McGrady, 2006; Isler, 2006). The relationship of health (behavioral medicine) psychology services and primary care health care delivery is an evolving relationship. As with any relationship the fundamentals are important. These include trust, proximity, flexibility, and communication, as well as the frequency and quality of interactions. The health psychologist working with or within a primary care setting will have to approach the delivery of coordinated care in a different manner than traditional clinical psychological applications, particularly those provided within a mental health care environment. The psychologist will need to provide focused assessments, utilize time efficiently, be decisive with limited available data, be able to quickly provide interventions and skills to facilitate change in others, have an appreciation of impacting the population en masse as well as individually, communicate well (and succinctly) with physicians, function as a team member, be flexible and available, have a working knowledge of medical systems, terminology and interventions, and be able to have humility in a hierarchical system (Gatchel & Oordt, 2003). Being adaptable, flexible and accommodating to the referral source (physician), the system (healthcare organization) and client are important. These traits, Continued on pg. 5 The Pennsylvania Psychologist Update November 2007 3 Mind/Body Health Public Education Campaign New Toolkit Available to APA Members Marti Evans, APA Public Education Campaign Coordinator for Pennsylvania The Mind/Body Health Public Education Campaign (PEC), sponsored by the American Psychological Association, seeks to educate the public about the connection between psychological and physical health and promote psychologists as health practitioners best trained to support the adoption of lifestyle and behavioral changes that improve overall health. Through national and grassroots outreach activities, the Public Education Campaign encourages the public to seek professional support from a psychologist for managing stress, chronic illnesses, and other mind/body health issues as well as treatment for mental health disorders. The new mind/body health toolkit contains information, resources and consumer materials to support community outreach presentations, media interviews and other local activities that address the topic of mind/body health. The toolkit includes the following elements: • A DVD overview of APA’s Mind/Body Health Public Education Campaign; • A portable flash drive that contains a variety of communications tools such as PowerPoint presentations and template media materials; • Mind/body health video news releases; • An interactive anatomical figure illustrating the physiological effects of stress; and • Frequently asked questions about using the toolkit. APA members can order the mind/body health toolkit by calling the Campaign Services Bureau at 202-336-5898, or e-mailing PracPR@apa.org. Additionally, if you are a current APA member, you can order up to 400 of each of the PEC brochures free of charge. Visit http://www. apahelpcenter.org/request/request_brochure.php for the new brochure order form. PPA needs the help of Pennsylvania’s psychologists to spread the message of how psychology can impact and improve daily living – and to make psychology a household word. Plan to conduct a mind/body health presentation to a community/business group to help us educate the public about the value of psychological health. After your presentation, please provide Marti Evans at the PPA office with the following details by calling 717-232-3817, or e-mailing mevans@papsy.org, so we can report Pennsylvania’s activities to APA: • Your Name • Name of the Group • Date of Presentation • Location of Presentation (city/state) • Number of Persons Present • Topic Psychologists, in particular, are the mental health professionals best trained to bring together research and practice to help people achieve mind/body health. We look forward to hearing about your presentation! Awards Dr. Roger D. Klein (left) received the Psychology in the Media Award from Dr. Richard Johnson at the PPA Convention in June for outstanding efforts in the presentation of psychology and psychological issues to the public. Winning the Science-Practice Research Poster Session Award at the PPA Convention were Dr. Dale J. Brickley (left) and Ellen Paliometros. It was presented by Dr. Charles LaJeunesse (right). Not pictured was cowinner Heidi McMullian. Winners of the Student Research Poster Session Awards in June were (left to right) Lacey Richards, of Penn State Greater Allegheny, who won the Undergraduate Award; Nicole Machinski, of Widener University, who won the Graduate Award; and Marissa Cangin, of Immaculata University, who won the Existential-Humanistic Theory and Application Research Award. They were presented by Dr. Marijo Lucas (right). Member News Dr. Sam Knapp, PPA’s Director of Professional Affairs, recently observed his 20th anniversary on the staff of the association. He has dramatically upgraded the position and become a critical resource for psychologists in Pennsylvania. He responds personally to more that 3000 inquiries per year from the membership on ethics, insurance reimbursement, licensing, and many other topics. His extensive knowledge and accessibility have prompted some members to declare that the price of PPA membership is worth it just for their consultations with Sam. He is the longest-serving Director of Professional Affairs among all of the state associations, and one of only two who is on staff full-time. 4 The Pennsylvania Psychologist Update November 2007 Integrating Psychology into the Health Care System Continued from pg. 3 characteristics and skills are important regardless of the setting in which the services are provided. The integration or embedding of health psychological services within the primary health care system has been shown to contribute to efficacy at many levels (Bruns, 1998; Gatchel & Oordt, 2003; Gevirtz, 2006). Reciting the mantra of real estate agents “…location, location, location” Gevirtz (2006) emphasized the importance of incorporating applied psychophysiological services within the delivery of healthcare. As a result of the direct incorporation of services within the health care system, Gevirtz (2006) reports that perceived stigma is reduced, the logistics of the referral are also facilitated and numerous opportunities of physician education are available. Termed “Integrated Primary Care,” Kaiser Permanente of Northern California and The Group Health Cooperative of Puget Sound have been leaders in this new way to deliver healthcare (Bruns, 1998). Kaiser found that integrating behavioral medicine specialists into primary care and providing classes and groups have decreased medical visits by approximately 30 to 40 percent (Bruns, 1998). Maximizing the needs of the population being served in a manner that provides the appropriate intervention at the opportune time, thereby maximizing the most efficacious utilization of available resources, is what healthcare management seeks to provide. The leveraging and the financial consolidation of interventions to maximize resources may be able to more fully be realized within a multidisciplinary integrated system, rather than being provided in the usual fragmented independent sources of care. Given that the predominance of medical visits have a significant psychosocial component, the more lengthy issues and components of these aspects can be diverted to the care of a health psychologist. As a result physicians are freed to allocate their time and focus to the areas of their expertise. Numerous clinical practice guidelines recommend multidisciplinary interventions and addressing the biopsychosocial components to a variety of chronic illnesses. Within this model of healthcare delivery the health psychologist may consult with the organization to facilitate maximizing the needs of the population. They may also consult with physicians regarding the provision of care or directly provide service to the patients. If direct service delivery is done, a focused approach is needed to maximize utility. Briefer individual visits, group interven- Integration of services reduces duplication of ancillary services and higher efficiency tions, or prophylactic interventions may be provided. Patient communication training enhances patient participation in their healthcare, improves outcomes, and positively impacts the healthcare system (Post, 2006). Lynch and McGrady (2006) proposed a model for identifying, by recent life changes, high-risk (for stress-related illnesses) patients in family medicine and providing brief interventions (relaxation and problem solving). This model served to decrease anxiety with these patients. Pre-surgical or procedural education and stress management training have been shown to decrease complications and increase compliance with patients. As a result intervention models incorporating behavioral medicine specialists impact outcomes and resource utilization (Pollin & Kanaan, 1995). Shared medical appointments (SMAs), whereby the strength of group treatment is brought into the primary care model by both psychologists and physicians, have both advantages and disadvantages (Isler, 2006). The advantage is sharing information to a larger audience with less repetition, seeing more patients in less time, increased billing, and greater access by patients. The disadvantages are difficulties with billing for same day services by multiple providers, multiple patients’ documentation, attitudinal barriers, and maintaining confidentiality. There are a variety of models and ways that health psychologists are positively contributing to health care systems and physician delivery of services and, of course, to patient care. Integration of services reduces duplication of ancillary services and higher efficiency. By utilizing existing space, support staff, billing services, etc., the cost of providing services can be decreased. Other advantages are proximity and increased communication of health care providers. An advantage to the patient is increased coordination of service providers, more comprehensive care, greater availability of services, and one-stop shopping. The utilization of psychological serves within this context may be more palatable and more likely to be de-stigmatizing. The services are also more likely to be utilized if incorporated into the system, especially if the system receives increased benefits from the services, such as increased income, reduced costs and improved patient satisfaction. The drawback to providers of integration of health psychology services into primary care is the acceptance of a different systematic application of services within the context of multidisciplinary care. Being one team member rather than the primary care provider for some may be a difficult pill for their ego to be able to swallow. Increased volume and pace of patient treatments will Continued on pg. 6 APAIT Publishes Risk Management Book The American Psychological Association Insurance Trust recently published a book, Assessing and Managing Risk in Psychological Practice: An Individualized Approach. The Trust calls it “the most comprehensive risk management resource available today for providers of mental health services.” It has been distributed free to psychologists insured through APAIT; it is available to others for $39.95. They have developed a CE exam based on the book, which can be taken online at www.apait.org/CE. The Pennsylvania Psychologist Update November 2007 5 Integrating Psychology into the Health Care System Continued from pg. 5 usually be an adjustment as well. Less comprehensive psychometric applications may also be a change for psychologists overly invested in their testing skills. Territoriality of departments and professions may need to be overcome by practitioners and facilitated by management. Psychiatrists may be threatened by the inclusion of psychologists into a medical system. Mental health treatment should be differentiated from the services being provided within this model. Referrals and working relationships with existing providers and resources may help to clarify and facilitate each contributing role in maximizing the patient’s function. The billing for services of health and behavior procedural codes rather than for psychiatric services has not been fully accepted by commercial carriers, in contrast to their inclusion in Medicare, albeit at a reduced rate of reimbursement. In contrast to the integration of health psychological services into primary health care is the independent practitioner who offers services separate from physicians. Independently providing services is more difficult in many ways. Facilitating communication on an ongoing basis has to be done with greater effort. Less visibility can result in fewer referrals and decreased patient access. Referral to outside practitioners requires a lot of motivation for the client and referrer (Gevirtz, 2006). Pollin and Kanaan (1995) indicated that establishing a separate freestanding medical crisis counseling clinic was more problematic than having one integrated into other medical practices or healthcare systems. The problems included funding and organizational demands. The financial viability of freestanding clinics is much more difficult, especially given that patients with chronic illness have a greater demand on their resources (particularly time and revenue). There can be a high rate of missed appointments due to changing physical status and transportation issues. Having a private practice may provide greater autonomy, independence and freedom. In a private practice there is less linkage, affiliation, less of a patient pool to draw upon, and less diversity of patients. Leveraging time and minimizing the impact of missed appointments by utilizing group treatment formats may be reduced. In a solo practice there is more time spent devoted to marketing, educating referral sources, more time and effort spent communicating with referral sources. All of this is placed upon the solo practitioner’s lap as well as covering the cost of overhead, supplies, billing, and collection. Capitated services or other financial contractual issues may be more prohibitive as an independent provider as compared to offering services as part of a coordinated package of services integrated into a medical service delivery system. Healthcare systems, primary care physicians, psychologists and patients all benefit when health psychology services are incorporated at some level with their primary health care services. How this occurs will continue to evolve. This evolutionary model will force payer sources and delivery systems to revamp archaic models and may even require legislative action. The health care crisis here in the United States screams for change as various pressures mount. The time may be ripe for this model. References Bruns, D. (1998). Integrated primary care. Retrieved February 17, 2007, from http://www.healthpsych.com/practice/ipc/primarycare1.html Gatchel, R. J., & Oordt, M. S. (2003). Clinical health psychology and primary care: Practical advice and clinical guidance for successful collaboration. Washington, DC: American Psychological Association. Gevirtz, R. (2006, Winter). Applied psychophysiology/biofeedback in primary care medicine. Biofeedback, 34(4), 145-147. Isler, W. C. (2006, Winter). Collaborative approaches in primary care. Biofeedback, 34(4), 151-154. Lynch, D., & McGrady, A. (2006, Winter). Identifying and treating stress in primary care medical patients. Biofeedback, 34(4), 148-150. McGrady, A. (2006, Winter). Introduction to the special issue on primary care. Biofeedback, 34(4), 131-133. Pollin, I., & Kanaan, S. B. (1995). Medical crisis counseling: Short-term therapy for long-term illness. New York: W. W. Norton & Company. Post, D. (2006, Winter). Building communication skills in primary care. Biofeedback, 34(4), 134-136. Sperry, L. (2006). Psychological treatment of chronic illness: The biopsychosocial therapy approach. Washington, DC: American Psychological Association. 6 The Pennsylvania Psychologist Update November 2007 CLASSIFIEDS JOB OPENING - We are seeking a licensed clinician (Psychologist, LCSW, LPC or LMFT) to join our established outpatient practice in Western Montgomery County. Part-time. 2 to 4 days per week including evenings. One evening plus a Saturday or Saturday alone are also options. A great opportunity to become part of a friendly and supportive group of professionals. If interested send resume and cover letter to Mark Greenberg, Ph.D., Clinical Director, Psychology and Counseling Associates at magreenberg@ comcast.net or call (610) 970-5234 x206 for more information. INSUR SERVICES INC—THE CURE FOR YOUR BILLING PROBLEMS! We offer a complete billing service customized to your practice, large or small, allowing you more time to do the kind of work you were trained to do. With 15 years experience exclusively in the mental health field, working with all insurance types including, traditional managed care, HMO, auto accidents and Workers’ Comp. Also specializing in provider application preparation, compliance books, confidential client contact and electronic billing without the use of a clearing house. A Member of the Better Business Bureau in good standing. Please contact Ronda White at 800-608-7298, insusvci1@msn.com. PRACTICE BILLING SERVICE (PBS) is now offering services for behavioral health providers and medical practices. PBS’S highly experienced staff with over 25 years of billing experience for a large behavioral health group practice obtains authorizations, submits electronic claims, received payments, follows up with insurance/managed care companies and reconciles patient accounts. PBS will save your practice money by reducing your overhead costs and increase your profits. Call Dr. Sid Portnoy, Director, of Practice Billing Service, at 215 699-3901. Email: DrSid@PracticeBillingService.com. WHAT WOULD YOU DO WITH MORE FREE TIME?—Treat more patients? Relax? Enjoy your family? If you are doing your own billing, MPMS can give you 2-5 more hours of free time each week. MPMS will process patient statements and authorizations to ensure you are maximizing reimbursement. Our processes ensure patient confidentiality. Call us today at 877-591-2455 or visit us at www.mpms.info. We are ready to submit most claims in less than one week. “I LOVE YOU MADLY! WORKBOOK: Insight Enhancement about Healthy and Disturbed Love Relations” ($12.99) and other books by Robert M. Gordon, Ph.D. for students, patients or home study CE credits. Go to www.mmpi-info.com or call 610-821-1072. SCHOOL PSYCHOLOGY BOARD SEEKS NOMINATIONS The PPA School Psychology Board is seeking nominations for the Award for Distinguished Contributions to School Psychology, to be presented during the Annual Convention at the Hilton Harrisburg. For each nomination you would like to make, please prepare a one-page narrative describing the person’s contributions, and prior to December 31, 2007, send the information to the following address: Pennsylvania Psychological Association of Graduate Students A division of the Pennsylvania Psychological Association Announcing the 2nd Annual Community Service Project! PPAGS is excited to announce the 2nd Annual Community Service Project (CSP) for graduate students! The CSP challenges individuals or teams of graduate students to develop and provide a service to an underserved population in their immediate areas. The work of 3 CSP teams will be showcased in the Pennsylvania Psychologist. One team will be chosen to receive an award to be given at the PPA Annual Convention. This will be a great opportunity for students to gain experience, to give back to the community, and to receive recognition. Be sure to visit the PPAGS Web site at http://www.papsy.org/PPAGS/index. html to learn more about this exciting program and to download an application. School Psychology Board c/o Gail Karafin, Ed.D. Pennsylvania Psychological Association 416 Forster Street Harrisburg, PA 17102-1748 gkarafin@yahoo.com The Pennsylvania Psychologist Update November 2007 7 November 2007, Volume 67, Number 10 The Pennsylvania Psychologist Update Editor .....................................................David L. Zehrung, Ph.D. PPA President .................................... Andrea M. Delligatti, Ph.D. PPF President ..................................... Arnold T. Shienvold, Ph.D. Executive Director .................................. Thomas H. DeWall, CAE The Pennsylvania Psychologist Update is published jointly by the Pennsylvania Psychological Association and the Pennsylvania Psychological Foundation in January, February, April, May, July/August, August, October and November. The Pennsylvania Psychologist Quarterly is published in March, June, September and December. Information and publishing deadlines are available from Marti Evans at (717) 232-3817. The PPA Web site is: http://www.PaPsy.org. Articles in the Pennsylvania Psychologist represent the opinions of the writers and do not necessarily represent the opinion or consensus of opinion of the governance, members or staff of PPA. Acceptance of advertising does not imply endorsement. The Pennsylvania Psychologist 416 Forster Street Harrisburg, PA 17102-1748 PRSRT. STD. U.S. POSTAGE PAID Harrisburg, PA Permit No. 1059 PSYCHOLOGY IN THE MEDIA AWARD ENTRIES SOUGHT PPA members who have presented psychology and psychological issues to the public are encouraged to apply for the 2008 Psychology in the Media Award. Members who have written newspaper or magazine articles, or books, have hosted, reported or produced radio or TV shows or commercials about psychology or have designed psychologically oriented Web sites are eligible for the award. Some of the work must have been published or broadcast during 2007. The winner will be honored on June 20, 2008, during the Annual Convention. The deadline for entries is December 31, 2007. An application form must accompany all entries and is available at www.papsy.org, or please contact: Marti Evans, Conference Manager Pennsylvania Psychological Association 416 Forster Street, Harrisburg, PA 17102-1748 717-232-3817 • mevans@papsy.org CE CALENDAR The following programs are being offered either through co-sponsorship or solely by PPA. KEY: Date and Title of Program Location Contact person’s name/ telephone number Various Internet Techniques for Mental Health Professionals—eight-part telecourse Pauline Wallin, Ph.D. (717) 761-1814 or pwallin@paonline.com November 1-2, 2007 Fall Continuing Education and Ethics Conference Exton, PA Marti Evans (717) 232-3817 March 27-28, 2008 Spring Continuing Education and Ethics Conference Harrisburg, PA Marti Evans (717) 232-3817 June 18-21, 2008 Annual Convention Harrisburg, PA Marti Evans (717) 232-3817 Pennsylvania’s Psychology Licensing Law, Regulations and Ethics* 6 CE Credits Pennsylvania Law, Ethics, and Psychology (Fourth Edition)* 6 CE Credits A History of the Pennsylvania Psychological Association 6 CE Credits For all of the Home Study CE Courses above contact: Katie Boyer (717) 232-3817 secretary@papsy.org. For C.E. programs sponsored by one of the Regional Psychological Associations in Pennsylvania, visit http:// www.papsy.org/resources/regional.html. HOME STUDY CE Competence, Advertising, Informed Consent and Other Professional Issues* 3 CE Credits Ethics and Professional Growth* 3 CE Credits Confidentiality, Record Keeping, Subpoenas, Mandated Reporting and Life Endangering Patients* 3 CE Credits Foundations of Ethical Practice* 6 CE Credits Ethics and Boundaries* 3 CE Credits Readings in Multiculturalism 4 CE Credits * This program qualifies for three contact hours for the ethics requirement as mandated by the Pennsylvania State Board of Psychology. Registration materials and further conference information will be mailed to all members. If you have additional questions, please contact Marti Evans at the PPA office.