Advocating to strengthen the psychology workforce and improve health equity

Impact as of August 2023

In a significant step towards strengthening the psychology workforce across the United States, Senators John Barrasso (R-Wyoming) and Michael Bennet (D-Colorado) introduced the Accelerating the Development of the Advanced Psychology Trainees (ADAPT) Act (S.2511opens in new window) on July 26, 2023. The introduction of this legislation comes as the direct result of APA Services’ targeted advocacy work over the last 2 years, which included members across the association conducting nearly 500 meetings with congressional offices to advocate for increased support for psychology trainees. If passed, the ADAPT Act would establish Medicare coverage of behavioral health services provided by advanced psychology trainees by directing the Centers for Medicare and Medicaid Services (CMS) to develop a Medicare modifier that would allow doctoral interns and postdoctoral residents to bill for behavioral healthcare services provided under the supervision of a licensed psychologist.

On March 27, 2023, nearly 200 clinicians, applied psychologists, researchers, educators, and students met virtually with members of Congress and staff as part of the APA Services Advocacy Summit on Strengthening the Psychology Workforce to Improve Health Equity. Nearly half of the participants were new to advocacy. Attendees hailed from 49 states, as well as Puerto Rico and Washington, D.C., and represented 13 APA divisions and 44 state, provincial, and territorial psychological associations.

Following panel discussions and issue briefings on March 26, advocates met with their congressional representatives to elevate three important legislative requests addressing different aspects of the psychology workforce crisis, all with important implications for equity in mental health services. Specifically, they encouraged members of Congress to:

• cosponsor the Increasing Mental Health Options Act (S. 669) (PDF, 57KB)opens in new window;
• support legislation allowing reimbursement for advanced psychology trainees for supervised services provided in Medicare (PDF, 287KB)opens in new window; and
• support $30 million in funding for the Graduate Psychology Education Program and $36.7 million for the Minority Fellowship Program (MFP) in FY24. 

APA President Thema Bryant, PhD, and APA CEO Arthur C. Evans Jr., PhD, gave opening remarks followed by a presentation on current political dynamics in the 118th Congress by APA’s Chief Advocacy Officer Katherine McGuire, MSc. Participants then heard from experts in targeted panel discussions on barriers to health equity in underserved areas and how strengthening support for psychology trainees can reduce health disparities.

Addressing obstacles and barriers to health equity in underserved areas

The first panel of the day focused on the barriers that Medicare beneficiaries in underserved and rural areas face in accessing mental health treatment. Moderated by Jessica Smedley, PsyD, this panel featured Emily Selby-Nelson, PsyD, J’Dene Rogers, PhD, and Lisa Lind, PhD. Selby-Nelson led with a discussion on the unique barriers to services faced by those in rural areas, such as stigma surrounding mental health, the great distances patients often must travel to access services, and the dearth of services available. She also discussed the challenges faced by providers in these areas, such as professional isolation and burnout, and finished by emphasizing that advocacy is key to minimizing barriers and improving access to care. Next, Rogers and Lind spoke about their experiences working with older adults and the high demand for psychological services among this group. They explained the challenges that providers working with older adults face in providing care due to Medicare requirements for physician oversight in certain settings like long-term care facilities. These requirements lead to delays in providing care while psychologists must wait for physicians to sign off on patients’ care plans, which can lead to the deterioration of patients’ mental health and increase feelings of frustration and burnout among providers. They explained that the Increasing Mental Health Options Act (S.669) would remove those requirements, thus improving timely access to care for their patients. 

Reducing health disparities by strengthening support for psychology trainees

The second panel focused on the importance of expanding the psychology workforce by supporting advanced psychology trainees. This panel was moderated by APA President-Elect Cynthia de las Fuentes, PhD, and featured Jeff Baker, PhD, ABPP, Molly Gabriel-Champine, PhD, and Juventino Hernandez Rodriguez, PhD. Baker began the panel with a discussion on the national training landscape and key trends and challenges that psychology training programs are facing. Gabriel-Champine then spoke about the differences in funding for medical trainees and advanced psychology trainees and emphasized the importance of federal funding programs for psychology such as the Graduate Psychology Education Program (GPE) and MFP. Finally, Hernandez Rodriguez discussed his experiences with GPE and MFP funding, and explained how both programs increase training opportunities for psychology students, expand and diversify the psychology workforce, and expand access to mental health care, specifically for those in underserved populations. 

Following the panel discussions, summit participants were trained on the three legislative requests in preparation for their Hill meetings. APA Senior Director for Congressional and Federal Relations Scott Barstow, MSc, briefed participants on the Increasing Mental Health Options Act (S.669). This bill would remove unnecessary barriers to accessing mental health care by amending the Medicare statute to allow psychologists meeting existing Medicare participation requirements to practice independently in all covered treatment settings, as they are allowed to do under private sector health plans, in tricare, and within the Veterans Health Administration. It was followed by a presentation on legislation that would allow Medicare reimbursement for supervised services provided by advanced psychology trainees by APA Legislative and Regulatory Officer Andrew Strickland, JD. Strickland also discussed the appropriations request for GPE before APA Senior Director of Congressional and Federal Relations Serena Dávila, JD, explained the request for MFP. Following the issue briefings, APA’s Director of Grassroots Engagement Doris Parfaite-Claude, MPP, led a presentation on how summit attendees can communicate effectively with members of Congress, including how to build rapport, build and deliver a pitch, and follow up with congressional offices after their meetings.

Bryant awarded two presidential citations to psychologists whose work and advocacy efforts have advanced psychology. Tonya Wood, PhD, was honored for her work to advance health equity for underserved communities, improve the lives of at-risk youth, and for addressing the impact of infertility on women and their families. Nancy Sidun, PsyD, ABPP, ATR, was honored for her leadership in bringing a feminist and social justice perspective to psychological science and for advancing human rights and health equity to improve the treatment of survivors of human trafficking. 

McGuire then presented the Friend of Psychology Award to Alex Gajewski for his work to advance psychology. During his time as a staffer for Senator Ron Wyden (D-OR), Gajewski co-led work on a bipartisan comprehensive mental health care access bill that APA Services will continue to advocate for in the 118th Congress. McGuire also presented the Congressional Champion Award to three members of Congress whose work prominently supports psychology. Senator’s John Barrasso, MD, (R-WY) and Michael Bennet (D-CO) were honored for their bipartisan leadership in supporting reimbursement for advanced psychology trainees in Medicare. Senator Catherine Cortez Masto (D-NV) was honored for her work on legislation aimed at creating better integration of mental and behavioral health and physical health services, as well as expanding access to crisis care, and mental health in schools.

You too can elevate the important issues from this summit. The Advocacy Office circulated an action alert to our networks with the three legislative requests on the day summit participants met with their congressional delegations. Psychologists and psychology advocates lent their voices to amplify the work of their colleagues who attended the summit, sending just over 1,400 messages to Capitol Hill last week. You can help keep the momentum going by taking two minutes to participate in our action alertopens in new window.

For more information, contact Scott Barstow, Andrew Strickland, Alexandra Ginsberg, or Serena Dávila.