“I’VE BEEN STANDING AT THE EDGE OF THE WATER”
The Importance of Focusing Upon the Bigger Picture: Generating tremendous enthusiasm from our public service colleagues, then-interim CEO Cynthia Belar and President Tony Puente established the APA Office of Military and Veterans Health Policy, appointing long-time staffer Heather O’Beirne Kelly as its first director. The VA is the largest employer of psychologists and leads the way in developing cost-effective, integrated, interdisciplinary health care initiatives; telehealth (tele-psychology), and quality internship and most recently post-doctoral training opportunities. As always, there remain many areas for psychology to provide visionary leadership and innovative clinical services. The Secretary of the VA reports that even today, 20 Veterans commit suicide daily and as the special edition of the Division 18 journal Psychological Services highlighted, under the editorship of Lisa Kearney, Jack Tsai, and Thomas O’Toole, the issue of Veterans’ homelessness remains a national tragedy. One of Heather’s personal priorities is to educate and excite our next generation of colleagues regarding their societal responsibility to become personally engaged in order to bring the best of psychological knowledge to focus upon the nation’s societal priorities.
This spring Heather invited mental health psychology and nursing graduate students and faculty at USUHS to attend a special presentation/Congressional briefing in the House of Representatives entitled “Veterans Health Research: A Showcase of Advancements.” Medical and clinical psychology graduate student Omni Cassidy: “I attended the Veterans Health Research briefing on Capitol Hill, which showcased groundbreaking technological advances in medical and prosthetic research for military Veterans. The briefing was hosted by the Friends of VA Medical Care and Health Research (FOVA) whose executive committee includes a number of organization representatives, including APA’s Heather Kelly, Director of Military and Veterans Health Policy. The showcase highlighted four outstanding projects.
“Dr. Ann Spungen from the Bronx VA Medical Center discussed the ReWalk exoskeleton, an exoskeleton suit that provides powered hip and knee motion to help those with spinal cord injuries to stand and walk. Dr. Leigh Hochberg from the Providence VA Medical Center discussed his research project, BrainGate, which is a system that uses brain electrodes to identify neural signals that help a user control the movement of electronic or robotic devices. Dr. Gary Goldish from the Minneapolis VA Healthcare System has worked with engineers and Veterans to develop a standing wheelchair prototype that allows individuals to move from a traditional seated position to an upright standing position in order to increase function, mobility, and reach. Lastly, and the one I found particularly fascinating, was Dr. Dustin Tyler from the Louis Stokes Cleveland VA Medical Center. He discussed his work on developing sense of touch for those with prosthetic limbs. Through an electronic nervous interface connected to the prosthetic limb that his team developed, sensors can measure the pressure applied to the prosthetic limb and send electrical signals to other parts of the arm and then to the brain allowing the user to sense what he/she is touching.
“The most incredible and noteworthy portion of the briefing were the showcases of the devices and the testimonies from Veterans themselves who’s quality of life has been significantly improved through these technologies. Through tear-stained eyes, one Veteran user of Dr. Tyler’s ‘sensing’ prosthetic hand expressed his immense gratitude for the opportunity to feel the sensation of squeezing a piece of fruit – something many might take for granted. And, most importantly, his new ability to pick up his granddaughter and actually feel her in his hand, a sensation he hasn’t felt in a long time and one he was not sure he would be able to do again. These projects, and many more through the VA, highlighted the enormous impact research funding has on the lives of those who have risked their lives for the freedoms we experience every day.” Thanks to the vision and dedication of Robert Zeiss and his successor Ken Jones, the VA Office of Academic Affiliations currently supports approximately 440 post-doctoral positions annually, which allows the next generation of psychologists to actively engage in interdisciplinary, collaborative research and practice initiatives and thereby move the nation’s rehabilitation efforts into the 21 century – in many ways, these post-doctoral opportunities are implementing the vision of former APA President Jack Wiggins and then-VA Secretary Anthony Principi.
The Best of Public Service: This spring the VA Psychology Leadership conference celebrated its 20th anniversary in San Antonio – formerly known as the Dallas conference having been established in 1998 with the strong support of Russell Lemle and APA’s Randy Phelps. Over the years, many Hawaii colleagues have attended. APA President Tony Puente, on the 125th anniversary of APA, presented his friend and colleague Kathy McNamara with a Presidential Citation. “She has served the profession of psychology in countless ways from being in the leadership of the AVAPL, the Department of Veterans Affairs, the National Academies of Practice and the American Psychological Association including serving on its Board of Directors…. To the Veterans and their families, she is known as Dr. Mc. To the Veterans on the Island of Moloka’i she is known as the Mother Teresa of Moloka’i. She has not only touched the minds and hearts of the Veterans and their families but also the people of Hawaii…. APA and AVAPL are so proud to have Dr. McNamara be one of us. May our careers and our lives reflect the humbleness, kindness, warmth, passion and success that she brought each Veteran and the field of psychology. Thank you, Dr. McNamara for allowing us to be part of your life and for you to have so deeply influenced ours.”
The Bipartisan Congressional Budget Office (CBO): On May 4, 2017 the American Health Care Act of 2017 [HR 1628] passed the U.S. House of Representatives. CBO and the Joint Committee on Taxation (JCT) estimate that HR 1628 would reduce the cumulative federal deficit over the 2017-2026 period by $119 billion. However, in 2018, 14 million more people would be uninsured under this legislation than under current law [ObamaCare (ACA)]. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under the age of 65 (Medicare eligible) would be uninsured, compared with 28 million who would lack insurance that year under current law.
Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states where wavers are sought from the Essential Health Benefits (EHB) requirement because their premiums would continue to increase rapidly. Further, CBO and JCT estimate that services or benefits likely to be excluded from the EHBs in some states “include maternity care, mental health and substance abuse benefits, rehabilitative and habilitative services, and pediatric dental benefits. In particular, out-of-pocket spending on maternity care and mental health and substance abuse services could increase by thousands of dollars in a given year for the nongroup enrollees who would use those services. Moreover, the ACA’s ban on annual and lifetime limits on covered benefits would no longer apply to health benefits not defined as essential in a state.” “One day I’ll know, how far I’ll go.” Aloha,
Pat DeLeon, former APA President – Hawaii Psychological Association – June, 2017
