By Bob Hutzell and Rick Jennings (Written in 1993)
1980. The beginning of a decade. Vinton Rowley was IPA president for the first part of the year. Back then, we changed officers at the Spring Conference. In May, Pat Sullivan took over. Our Lobbyist was Judy Dierenfeld (she had replaced George Wilson back in 1978); Executive Secretary was Lil Bucksbaum; Legislative Chair, Herb Roth, and then Jane Bibber.
Member dues were $40 – that was lower than most comparable professional organizations in the state. In our elections, 42 members voted; elections were decided by one or two votes. We missed getting a seat on the APA Council of Representatives by a slim margin; we formed a coalition with Missouri for APA representation.
The Iowa State Board of Psychological Examiners was considered underfunded and lacking in sufficient secretarial support. Darrell Dierks, on his own time, was single handedly tracking each psychologist’s C.E. hours – everyone needed 20 per year, and 3% of licensees were denied license renewal because they failed to report the required hours that year. The Board was being sued by counselors in the Sioux City area, in part to declare the 1976 Psychology licensure law unconstitutional.
Our Psychology law underwent Sunset Review in 1980. When dawn arrived, after extensive effort,we survived. The Sunset Panel did recommend that the passing score on the licensure examination be lowered because ours was one of the highest in the nation. Also, the Panel recognized unlicensed practitioners to be a problem, and the Panel recommended that the state establish a study task force – which was never done.
Nationally, a Federal Appeals Court was deciding the “Virginia Blues” case in favor of Psychology. In brief, this early venture into the judicial arena by organized Psychology involved a decision by BC/BC to not pay Psychologists in spite of Virginia’s existing Freedom of Choice Law. Psychology sued on anti-trust grounds. The Court’s decision meant BC/BS could no longer arbitrarily choose to pay Psychiatrists but not Psychologists – at least in Virginia. When the U.S. Supreme Court declined to review the case, the Appeals Court decision held.
Also in 1980, the Ohio Attorney General was suing JCAH (the predecessor of JCAHO) for conspiring to suppress and eliminate Psychologists, in part because JCAH did not allow Psychologists hospital privileges such as admission and discharge.
In 1980, Michael Pallak, who earlier had been an Iowa Psychologist, was Executive Officer for APA. A hot topic at APA was licensure. The AMA PAC had contributed over $1,600,000 to political candidates in the recent federal elections, while Psychology’s PAC had contributed over $8,000.
Decisions were made and plans were laid in 1980 that had a profound effect on IPA throughout the years to follow. Similarly, decisions are now being made and plans
laid with our IPA Long Range Planning Committee, under the direction of Joan Laing that should guide and effect us during the rest of these 1990s.
Pat Sullivan wrote in a 1980 President’s Column in The Iowa Psychologist, “Psychology as a profession is presently a nearly impotent group in terms of impact upon the environment within which we operate while as an academic discipline Psychology is viewed as a rather esoteric social science that attracts awards from Senatorial watch dogs of the Nation’s purse strings.”Others agreed with them. They felt responsible to change IPA into a more potent force.
Pat declared at an IPA Annual Meeting, “We are no longer a ‘tea and crumpets’ organization, and he called for changes that could make our association more effective. To that end one of his stated goals as President was the reorganization of IPA. He set into motion an Ad Hoc Committee on the Structure and Function of IPA. Lil Bucksbaum, Dave Seaquist, and Dennis Harper constituted that Committee.
After close to a year’s work, the Ad Hoc Committee presented seven major recommendations. First, they recommended changing the fiscal year to January 1 to December 31, rather from the Spring meeting to the Spring meeting. That recommendation was quickly agreed upon at the 1981 Annual Meeting. All Executive Council terms were extended by eight months to accommodate the change.
Second, the committee recommended switching the Annual Meeting to the fall of each year. Much debate followed, with good reasons to change and good reasons not to change. In the end, no change was made, and the official Annual Meeting remains in the spring. However, since 1988 (or seven years after that 1981 recommendation for a Fall Meeting) we have had a Fall Convention to go along with our Annual Spring Meeting. We did not actually intend to start a Fall Convention in 1988. We had decided to celebrate our 40th anniversary along with the U of I Psychology Department’s 100th Anniversary Celebration in the Spring of 1988. The U of I changed the date of their celebration. They changed it again. By the time they changed from the Spring to the Fall, we felt pretty committed to celebrate with them. Yet we were also committed to a Spring Annual Meeting, so we just decided to have two meetings in 1988. Cathie Siders coordinated both with extreme competence. Margaret Koch designed t-shirts. The Fall meeting proved so successful we have continued to have one and it has retained its more academic tone compared to the Spring meetings.
The third recommendation of that Ad Hoc committee started in 1980 was the development of written job descriptions for each office, to eventuate in an IPA handbook. After many re-inventions of the same wheel, false starts, and good intentions gone astray, the pieces were eventually brought together by Phil Laughlin. Nine years after the recommendation was made, the 1990 Executive Council Members received the inaugural issue of a permanent handbook, intended to be updated and handed down to future officers.
The 1980-81 Ad Hoc Committee’s next recommendation was that the concepts of geographical groupings and of divisions of members be encouraged. Actually, the Committee’s emphasis was on groupings such as the then existing Central Iowa Psychological Association (CIPA) and Upper Mississippi Valley Psychological Association (UMVPA). IPA eventually decided, however, to go with the Divisions concept. Division I (Practitioner Psychologists) was formed at the 1988 Annual Meeting while Bob Hutzell served as President. The Iowa Association for the Advancement of Psychology voted itself out of existence in 1988, with the intent that its members would direct their resources to IPA Division I. So the recommendation for emphasis of groupings within IPA took seven years to get off the ground. Division II (Division of Academic and Teaching Psychologists) was initiated one year later in 1989 while Tom Bartsch was IPA President. Division III (Students Division) initiated in 1990 while Scott Shafer was IPA President.
That Ad Hoc Committee formed by Pat Sullivan next recommended that a permanent educational committee be established. Many of our members were expressing difficulty meeting continuing education requirements in 1980. Tom Hannum filled the role for a number of years. In 1990 the CE Committee was combined into the Conventions Committee.
The Ad Hoc Committee also recommended that the Past-President, President, and President-Elect function as a three-member management team. This has been approximated, more or less, over the years. Constant recommitment to this ideal is required for it to work. Often times the Past-President had assumed an inconsequential role. Then the Past-President disengaged, and IPA lost valuable talent. In recent years, changes have been made to encourage the three persons in the Presidential track to develop as a team. In the late 80’s, all three were sent to the annual APA State Leadership Conference, giving them a chance to know each other better and to strategize together. That practice was changed in the early 90’s. The responsibility for conventions are now assigned to the Past President and this will encourage the Past-President’s continued involvement in IPA management. Previously, conventions were the responsibility of the President- Elect.
The seventh recommendation by the Ad Hoc Committee from1980-81, its last, probably has had the greatest impact on IPA: an Executive Secretary providing both administrative and legislative services should be employed. The Executive Council was polled. Past-Presidents were polled. The membership was polled. Decision: a paid Executive Secretary should be hired, with five primary duties: process membership, receive and transmit mail and information, develop new membership, coordinate Executive Council activities, and serve as legal address of the corporation.
Hiring an Executive Secretary was considered a major step forward, although we had approximated such on several occasions in our history. In the early 80’s few state psychological associations had paid executive staff. APA had no Practice Directorate to support the establishment of such positions. An Executive Secretary was seen as necessary if IPA was to become proactive. Up to that time, IPA had taken some proactive initiatives, but most lacked sufficient resources to be effective.
Ads appeared in TIP and in major newspapers throughout the state in late ’82, advertising to fill the position. The number of applications is unknown – early on, the number reached 15. By the end of the year, through determined effort on the part of then President John Tedesco and others, the AD Hoc Committee’s seventh recommendation was implemented. Craig Rypma, with a new IBM computer, and working his doctorate, was hired for a part-time position. Changes would need to come fast; the association was not generating funds to pay Craig. Rather, he was to be paid from reserves. Unless our funding situation changed drastically, it was estimated that we could not continue to pay him longer than approximately three years. One of Craig’s strongest assets was his motivation to “wheel and deal” with the State Legislature. Many remember Craig’s work most for his efforts on SF 414. Craig did another history-changing feat for Iowa Psychology prior to SF 414. In 1983, he arranged for TIP to be printed by Brennan Printing in Deep River, where the printing remains to the date of this writing. When Bob Hutzell and Sandy Nett edited TIP in the late 1970’s, it was being printed somewhere at ISU. In 1980, we changed to printing at the Easter Seal Society of Des Moines, but the process was extremely cumbersome. We published 12 issues per year back then, we were always off schedule, and we always worked on three or four issues simultaneously. Brennan Printing changed this. Quality was excellent; turn-around time was minimal . In 1986, Mary Eggert Jerkins took over as TIP editor. Jan Lewis edited for about a year, starting mid-1990. Now Rex Shahrairi is Editor. Throughout these changes, Bob Brennan and his crew have continued to take care of the bulk printing, assembling, and mailing of TIP in a very efficient manner.
In 1985, when Tom Sannito was President, we added another publication vehicle, the IPA Bulletin Board. One intent was to establish a method to distribute legislative information rapidly,with substantial detail, on an “as needed’ basis, and to the entire membership. We distributed one issue, to see if we could make it work, and it did. But we did not use it again until 1988, partly because of financial problems. Starting in 1988, the IPA Bulletin Board filled in the months between four to six annual TIP issues. It was produced by Bob Hutzell and Phil Laughlin. In 1992, Maureen Rank took over the primary work, and the name became the IPA Bulletin to signify the changed. If you wondered why, in 1988, the IPA Bulletin seemed to start with Volume 2 it was because Volume 1 was published as a solitary issue over two years earlier.
Back to SF-414: Craig Rypma, Tom Sannito, Bill Wimmer, Rick Jennings – all were major players in SF-414. Rick had become President in 1984. Bill was hired as our Legislative Counsel in1983 during Dennis Harper’s presidency. IPA, with tireless efforts by Herb Roth, had been pushing the Legislature for a Freedom of Choice law. About two thirds of the states had such laws; Iowa did not. We had pushed for such a law for many years. This time changed our tactics. This time, instead of fighting the “good fight” for the “right reasons,” we fought with money and power in the form of legislative expertise behind us.
The money for our Legislative Council came largely from the Iowa Association for the Advancement of Psychology. IAAP was started in 1981 by Allan Demorest, Herb Roth, and Pat Sullivan. Over the few preceding years, a difference of opinion had grown in IPA with regard to the amount of the IPA budget to be allocated for legislative efforts that were viewed by some as primarily designed to benefit the independent practitioners. It was also readily apparent that IPA’s budget could not support a substantial legislative effort. What is most amazing about IAAP was that those of us who had been involved in IPA for a number of years could remember substantial and lengthy discussions at the Annual Meeting over such meager increases in dues as five to ten dollars. It was amazing that through IAAP about 25-35 psychologists contributed amounts up to $1000. The amount of money raised over approximately a three year period was impressive, particularly within the context of skepticism, potential contributors understandably had due to the unsuccessful Freedom of Choice efforts for many years prior to 1984.
The major insurance carriers came to realize that if Psychology got a FOC bill through the Legislature, so would several other professions. The insurance carriers knew they could fight us and make our task very difficult and expensive, but they believed that we could win in the long run. They felt they could prevail over the other professions if IPA did not open the door. So they decided it was in their best interest to strike an agreement with IPA. If IPA would agree to a “permissive option” bill (allowing insurances to pay whatever professionals they desired), then they would help us get the bill through, they would make third-party payments available to psychologists, and they would encourage other insurance companies to do the same. If IPA would not agree to “permissive option,” then, only after extended fight, insurances would probably end up having to pay psychologists.
Rick Jennings recalls, “…we were advised that even if freedom of choice was mandated, it was very likely that we would still have to pursue the implementation of the law through litigation which was likely to be costly both financially and in terms of time and energy. In other words, it was likely that we would have to in fact sue those insurance carriers who would refuse to comply with the law. At that point it was felt that they were likely to do so because our mandate would have constituted the first mandate and would have been seen as a precedent for other much more expensive mandates such as in the field of chiropractics. Thus, once it became apparent that we were likely to be successful with our effort at a mandate, the major insurance carriers felt it would be best to voluntarily recognize our services for reimbursement rather than to experience the undesirable precedent which the mandate would establish. Our second major reason for accepting the “permissive option” was that it began our relationship with insurance carriers on a favorable, collaborate basis, in that we were accepting their offer of reimbursement rather than requiring such. Thirdly, we were well advised by Mr. Wimmer that since this was IPA’s first major exposure to the legislature, we would do well to please the legislature by working out a compromise satisfactory to all parties, which is typically the legislature’s preference when and if it can be accomplished.”
IPA chose to switch its goal from Freedom of Choice to Permissive Option. Barring the arrival of then unknown revenues, we would not have had the financial resources to continue the fight for long if we had decided to continue the push for the complete implementation of pure Freedom of Choice.
For SF-414 to pass, a mechanism to identify psychologists qualified to receive third-party payments would be necessary. Our licensing law as (and is) generic; specialties were ignored. It was decided that Health Service Provider (HSP) status would be the mechanism for identifying qualified practitioners. A few psychologists who were unlikely to meet the criteria for HSP objected – vigorously. In fact, their intense, last-minute lobbying efforts raised many issues with the Iowa Legislature and drew attention directly to the fact that there were deficiencies in our Iowa Psychology law. In 46 other states, the independent practice level required a Doctoral degree. It became apparent that unless our licensure law was revised, we would suffer low credibility with the Iowa Legislature in the years to come. Thus, IPA proposed to amend the Psychology law to require a Doctoral degree in Psychology for licensure, and also establish a HSP category. HSPs would be required to have a license and two years of supervised experience in an organized health service setting. In turn, HSPs were to be deemed legally qualified to diagnose, evaluate, and treat mental illness and nervous disorders, while other Licensed Psychologists were not (and are not). Compared to the difficulties that had preceded this point, the amendment went through with relative ease. In the end, SF-414 was supported by APA, Blue Cross/Blue Shield, and the Iowa Medical Society.
We learned much about politics from SF-414. Although our successes have been relatively modest since, they have not been unimportant. Our next major evolvement in political awareness started during the presidency of Ann Ernst in 1987. This coincided with the evolution of APA’s Office of Professional Practice, which is now APA’s Practice Directorate. Ann had connections with U.S. Representative Tom Taukee. Ann appointed our first Federal Grassroots Coordinator, David Christiansen. Ken Hutchinson took over as Coordinator in 1988. Many of us made trips to Washington, D.C. in the late 80’s to help push through the inclusion of psychologists in Medicare.
Between SF-414 in 1984, and Ann Ernst’s presidency, in 1987, there were some difficult financial years for IPA. As mentioned, we were not generating funds as an organization to pay the Executive Secretary that we had hired in late 1982. He was paid from our reserves. Revenues did not increase, and our funds diminished. Our legislative work, which culminated in SF-414, was expensive. Our 1985 convention was a big success spiritually, but a liability financially. Tom Sannito began personally conducting workshops and donating the profits to IPA. Despite Tom’s heroic efforts, which resulted in contributions of around $3000, the time of living off our reserves without increasing our overall revenue was over.
When Carl Davis took over as President in 1986, finances were a life or death matter for IPA. A deficit was carried forward into our 1986 budget. TIP was cut back to four issues in 1986, and the IPA Bulletin Board, barely off the ground, was shelved. Bill Wimmer took a 1/3 cut in salary. At the end of 1986, due to reprioritization and the fact that we had no known source of revenue to continue the salary, the Executive Secretary position was eliminated.
Phil Laughlin, a 15-year member who had served IPA previously on the Continuing Education Committee, as Chair of the Membership Committee, and as Treasurer, volunteered to be Executive Secretary at no cost for 1987. He brought both organizational and financial skills which we could not afford. Then, he coordinated the writing of a grant which was funded in 1987 by the APA Practice Directorate at $13,000 for purposes of hiring an Executive Director. We hired him. Next he spearheaded a $17,000 grant proposal to the Practice Directorate for the purposes of hiring a Public Relations Coordinator, which was funded in 1991, and we hired Maureen Rank.
That’s a little of the 1980’s history of our organization. Obviously many interesting stories are left out: like our sometimes cold relationship with the Iowa School Psychologists Association; our history of encouragement of women’s issues; two IPA Presidents who were elected but never served; our excursion in Peer Review; the efforts that went into establishing and maintaining our inclusion in Medicaid; prestigious awards we have presented over the years; the professional comic who appeared at one of our Annual Conventions; why IPA stood alone as the only State Psychological Association to support the reorganization of APA; why our logo so closely resembles the old APA “spaghetti” logo; and many others.
As you can see, much of what came to pass during the 1980s for the betterment of Iowa Psycholoogy was envisioned early in the decade by that Ad Hoc Committee of Lil Bucksbaum, Dave Seaquist, and Dennis Harper. A lesson we can learn from history is that the visions of today can have a major influence on the practice of Iowa Psychology, and that influence will take several years to be fully realized, longer than we like to think. Using the past as a guide, we can see that the visions of today may not become realities until the turn of the century. And what about the year 2000? How will that be different if you become involved right now. Your involvement can have a meaningful influence on our future.