PSYCHIATRISTVolume 61, Number 11 July 2013 Newsletter of the Southern California Psychiatric Society

The DSM-5 conference held in June was a great success. The material provided by thespeakers was informative and educational, and well received by the approximate 150 partic-ipants. It appears that this is the beginning of an amazing year for all of us. It is wonderfulthat we can have educational seminars presented by our own members. There is truly awealth of talent within our district branch, and I look forward to having this caliber of educa-tional material presented by our district branch for the remainder of the year.

This month’s winner is again Colleen Copelan, M.D. Her joke is: A young lad told his Fa-ther....”Father I am the greatest baseball hitter in the world, watch this." The lad went on to show his Fa-ther.....he threw the ball up and swung, and missed... he thensaid "wait, I am still the best baseball hitter in the world" againhe threw the ball in the air, swung and missed....".once moreFather,” the lad said...and again he threw the ball in the air,swung and missed...."Father" the lad said..."I made a mis-take.......I am the best baseball pitcher in the world !!!" I hopeto get some more participants. Remember, the winner re-ceives a free Starbucks gift card. All you have to do is emailyour entrees to my email address at: seesteve@yahoo.com.

We had our first meeting of the year, which was a dinner heldin conjunction with NAMI. I was pleased to notice that all ofour new Council members were present. It was truly an infor-mational based evening. Showing our support for NAMI andbeing able to have a wonderful discussion based on mental health issues is vital to our organization. I knowmany of the participants plan to attend the upcoming NAMI Walk, which will take place on October 5, 2013. Iam looking forward to being in-volved in the activities of that day.

It was noted at our last Councilmeeting that our membership hasdefinitely increased over last year.I think this reflects a renewed in-terest in our own field. It is worthyto also note that psychiatrists arebecoming more involved in the

(Continued on page 2)

The Year is off to an Amazing Start

P r e s i d e n t ’ s C o l u m n

Steve Soldinger, M.D.

In This Issue...Letter from the Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

SCPS Council Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

CPA Council Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

California’s Coordinated Care Initiative:

What Providers Need to Know . . . . . . . . . . . . . . . . . . . . . . . .10

DSM 5 Training Photo Gallery . . . . . . . . . . . . . . . . . . . . . . . . .11

Southern California

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community, as well as in the American Psychiatric Association. We are also making an attempt at greater out-reach to our residents and early career psychiatrists. As they say, “membership is its own reward.” I am surethat as more physicians become involved in our organization they will not be disappointed. There are opportu-nities to educate others in our field; there are opportunities for involvement in charity work for those who needit, and there is a chance to learn about the political side of being a psychiatrist or any other physician in thispresent time. These are invaluable opportunities that will continue to help our membership grow. I hopethose of us who have been members for a longer time period will find this as a wake-up call. Our organizationneeds members to run for office; become active on Council and to be involved in our various committees.Please contact me if you have any interest in these committees. You can also contact Mindi Thelen at our dis-trict branch office, who will be happy to provide you with information and/or a list of the committees.

On June 22 we had our California Psychiatric Association meeting. The meeting was quite an event with a lotof discussion about legislative issues that psychiatrists are faced with today. The major issues were MICRA,Parity, Laura’s Law and the Scope of Practice. There was also a variety of good reports presented from thevarious committees. SCPS was well represented by Dr. David Fogelson, M.D., our APA Assembly Represen-tatives, and me. Our Director, Mindi Thelen, was also in attendance. CPA is preparing for its Annual meetingwhich will be held in late September in La Quinta. It should also be mentioned that many of the committeechairmen and officers at the CPA meeting are from our district branch. Everyone from all the district branchesis doing an incredible job leading us through 2013.

This is a critical time as we all gear up for the changes the Affordable Care Act will bring to health care begin-ning next year. Many changes will occur. It is my hope that once the bugs are worked out this will representadvancement for the treatment of mental disorders never before seen in American healthcare.

One important issue that keeps coming up whether in our own district branch, with NAMI and the CaliforniaPsychiatric Association, is the Conservatorship Law. The Conservatorship Law we use is from 1967. Thename of that act was the Lanterman-Petris-Short Act. This act has not been substantially changed in approxi-mately 45 years. Clearly there are a lot of changes that many different facets of our society would want.There are changes that psychiatrists, patients and legislature want. There are also changes that the legal sys-tem would like, as well as the various municipalities of California. We are now in various discussions withmost of these organizations and committees that will meet to decide the future of conservatorship law.

The CPA Council voted to award the APA/CPA joint Warren Williams, MD Award to Dr. Rod Shaner, MD for hisexceptional contributions to the profession of psychiatry; his work as Medical Director of the Los AngelesCounty of Mental Health; his involvement as Co-Chair of the CPA Public Psychiatry Committee for manyyears; his involvement as a representative of CPA; the California Coalition for Mental Health, and many otherservices for the care of the mentally ill and mental health policy over the years. We are lucky to have this ex-ceptional physician as part of our leadership at the SCPS.

I hope we all enjoy a fun and successful summer with lots of time to spend with our families and friends.

This photo was taken at the welcoming event forthe 12 new USC psychiatry residents at CasaNostra in downtown LA. SCPS’ contributionhelped sponsor this event.

Letter from the EditorThe Rumors of My Death Have Been Greatly Exaggerated

Not mine. My husband’s.

The Women’s Physicians’ Network of Ventura recently performed the simplest and most trust-worthy test of mental healthcare panel adequacy: They called everybody on the panel and askedfor an appointment.

After the survey, the Network sent a summary of findings to member physicians, myself included.The cover letter included this distressing news: “As many of you know, Dr. Thurston has been de-ceased for some time, yet he is listed as a psychiatrist taking on new clients.”

Why had no one sent flowers?

My husband was just as surprised but immediately saw the announcement as a rare opportunity to quote MarkTwain on death rumors. A Network spokesperson said she was “mortified”--another bon mot--to have confused himwith someone else but appreciated the humor with which the matter was laid to rest. She also explained that, be-lieving him departed, they felt it would have been "too insensitive" to call his office to check on availability. co-copelan@aol.com

Colleen Copelan, M.D.

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The annual joint SCPS Council/NAMI meeting was held on June 13th, 2013. The meetingwas opened at 7:10 PM by SCPS President-Elect Dr. Fogelson and Mark Gale of NAMISan Fernando Valley. After all the participants introduced themselves, the floor wasopened to NAMI members. A lively and informative discussion followed over the next hourand 45 minutes. Highlights included:

There were questions about the impact of the Affordable Care Act (ACA) and changes inparity for consumers, including those currently without insurance. Beginning in January,approximately 400,000 new members will be enrolled in Medi-Cal over the next three to

four years. One of the key changes for the Los Angeles County Department of Mental Health (DMH) in re-sponding to this influx will be targeted therapy, i.e., how do people get the attention they need in a timely fash-ion? It was pointed out that the ACA will not change the number of Full-Service Partnership (FSP) programs.Currently 40% of the MH clients are uninsured. The new funding stream provided by the ACA will allow ex-panded services. Some of the sources of funding will include Healthy Way LA and the Medicare/Medi-Cal dualeligible project. Also, Medi-Cal expansion will mean full benefits for mental health treatment as well as sub-stance abuse treatment. There will be a push to better integrate mental health and primary care. Already inSan Bernardino County, mental health clinics are being placed next to primary care clinics.

NAMI members identified the early 20’s as a particularly difficult age for consumers, when they are still on theirparents’ insurance and need to find a psychiatrist who takes that insurance, or have just begun with Medicareor Medi-Cal and need to find a psychiatrist who accepts one of these. The SCPS public directory does not pro-vide information about types of insurance accepted. Due to frequent changes in plans accepted by providers,it may not be feasible to do this.

The interface between the correctional system and mental health and was discussed. Parolees with seriousmental illness were identified as being at the “bottom of the food chain.” Parole clinics are being closed andcurrently there is roughly one psychiatrist and two psychologists for every 1000 parolee clients. Rural clinicsare closing their parole offices and using telepsychiatry instead. These changes flow from AB 109, the publicsafety realignment legislation. The lack of care for parolees is a major public safety issue. In Los AngelesCounty, inmates released from state prison onto County supervision (probation) are being assessed at the pro-bation “hub” when they report for their first probation appointment. So far 15,000 people have been releasedto community supervision in Los Angeles County. 60% of these have mental health and/or substance abuseneeds. The county has partnered with 10 community treatment provider programs and finds that there is ap-proximately a 50% show rate for appointments. Costs are higher than expected because many probationersneed residential care or housing assistance.

There is some opposition to expanding the LA county jails. Many people would rather use the money allocatedfor this for substance abuse and mental health treatment. The question was raised whether proposals for ex-panding the jail in LA should be scaled back, and if so, what could the county use the money for instead? Itwas suggested that additional housing programs as well as more local clinics would be helpful. Furthermore,there is a need for greater inpatient capacity in the jail, as well as the previously mentioned challenge of Stateparolees with severe and persistent mental illness. These clients cannot be placed on LPS conservatorshipdue to being considered the state’s responsibility, and as a result cycling through homelessness, parole viola-tion and subsequent incarceration, brief inpatient hospitalizations, and back to the street.

Another problem that was discussed was the issue of patients being discharged from acute care settings tooearly. There is a great demand for more stepdown facilities. One of the biggest problems is that it is hard to

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Council HighlightsJune 13, 2013Joseph Simpson, M.D., Secretary

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transition people from private hospitals to IMD or other stepdown facilities because the priority for these suba-cute care programs is public sector consumers. Often patients in private hospitals are discharged without aconservatorships being applied for due to the lack of appropriate discharge facilities to send them. Fundingfrom Proposition 63, the Mental Health Services Act, could be used for open stepdown facilities but not forIMD’s, which are locked. Furthermore, IMD’s face the IMD exclusion on federal funding, so patients residing inthem cannot use Medicare or SSI to pay for their housing and care.

A new policy in Los Angeles County involving conservatorship is that the public guardian has promulgated cri-teria under which an LPS conservatorship should be applied for. These include multiple involuntary hospital-izations within a six-month period, currently gravely disabled, probable cause for 14-day hold has been found,and the patient has a psychotic illness. If the patient meets these criteria then it will be incumbent upon thehospital to justify why they are not applying for an LPS conservatorship. The patient’s family members can dis-cuss these criteria with the treating hospital. The criteria can be found on the Los Angeles County DMH web-site.

Discharge planning is another challenge. Many patients are deemed ready for discharge from an acute carehospital but cannot return to live with their family. They are not eligible for many homeless outreach programs,because these tend to target those who have been homeless for extended periods. More supportive housingprograms are needed. Many IMD’s and even board and care homes are depressing places. It would be greatto help people before they become eligible for programs due to having become one of the long-term homeless.The next step up from a board and care averages $3000 per month which is not feasible for many or most fam-ilies. Advocacy dollars are going to the chronically homeless instead of those who are in earlier stages of ill-ness. Private insurance companies have no model for implementing FSP-type care delivery. They onlyprovide for standard outpatient or crisis inpatient care, which in many cases are not sufficient for optimum re-covery.

Another new protocol for LPS proceedings in Los Angeles County is that the patient must be advised of the ap-plication for a conservatorship five days prior. They can then go to court to challenge their continued detentionand the treating psychiatrist will be required to attend the hearing. This is because there have been essentiallyno due process provisions during the temporary conservatorship. Unfortunately this will require more advanceplanning for the hospital and might deter some providers from applying for conservatorships.

After discussing these key issues the meeting switched gears to discuss another very important topic: NAMI-Walks. The 2013 NAMIWalks event in the LA area will be on Saturday, October 5 at 10 AM in Santa Monica.All NAMI services are provided for free, and sponsorships are very important to our different levels of sponsor-ships ranging from a logo on the website and the T-shirt, to a booth or table at the walk. Sponsorships start at$250. There will also be a kickoff luncheon on August 8. Sign up online at www.NAMIwalks.org/Los AngelesCounty. A $1500 pledge helps 25 families attend the family-to-family course.

The report of LPS Task Force II, “Separate but Equal,” is available at www.LPSreform.org. There are 14 rec-ommendations on how to modernize and rationalize the LPS law.

A bill authored by Sen. Darrell Steinberg, SB 364, currently would provide for a family member’s name and theinformation they provided in a 5150 application to be given to the patient. No other state has such a provision.This is potentially extremely dangerous as a consumer released too early, without recovering from theirepisode, could become enraged at what their family member said about them. Unfortunately, the statewideNAMI organization endorsed the bill, not realizing that it included this provision. It is opposed by the nationalTreatment Advocacy Center as well as the California State branch of TAC. Psychiatrists and other non-NAMImembers such as law enforcement personnel need to write to Sen. Steinberg and get him to change the lan-guage of the bill.

The joint session was adjourned at 8:55 PM.

The Council held a brief business meeting immediately following the joint session. The meeting was called to

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order by President Dr. Soldinger, at 8:58. The previous meeting’s minutes which had been emailed to theCouncil were approved unanimously. Three new members-in-training as well as three new general memberswere unanimously approved for membership. Total membership is currently just over 1000. At the time of themeeting, there were 140 people signed up for the DSM-5 educational meeting coming up that Saturday, June15 at the Olympic Collection. Dr. Silverman gave the Treasurer’s report. A motion was made to accept theTreasurer’s report. All voted in favor, none opposed.

There was no old business. New business: it was suggested that DSM-5 presentations could be given asGrand Rounds and these would be a good recruitment tool to get residents to join SCPS/CPA/APA. Video ofthe June 15th meeting could also be used as a teaching tool.

Dr. Soldinger adjourned the meeting at 9:16 PM.

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California Psychiatric AssociationCOUNCIL MEETING NOTES

Respectfully submitted by David Fogelson

Mr. Willick discussed the definition of conflict of interest; he explained that appropriate lobbying must be divorcedfrom contributions to candidates and that contributions to candidates must be divorced from lobbying efforts. An-nounced that Patrick Kennedy will appear at Senator Beall’s hearing to support parity under the Affordable CareAct.

Dr. Thurston explained that the trial lawyers want to overturn MICRA; they want to overturn caps on awards forpain and suffering which are currently set at $250,000. He noted that if there are no caps, pain and sufferingawards are subjectively determined by idiosyncratic jury composition. He noted that articles have appeared inthe LA Times and other publications that are suspected as having been planted by the trial lawyers. He says theyhave the same theme: bad doctors hurt good patients. He reviewed work by Dr. Robert McCarron of the Inte-grated Care Work Group that is tasked with identifying issues with the primary care shortage that results in noone interested in providing psychiatric care except for nurse practitioners eager to expand their scope of care.He said this may be an appropriate place to expand telepsychiatry in order to provide much needed services toremote areas.

Timothy Murphy, M.D., said the DSM 5 conference held in San Diego went well. He noted that San Diego Countyis sponsoring a pilot project to consider the feasibility of implementing Laura’s Law.

The Legislative Report was given by Randall Hagar, Government Relations Director.

Ed Rudin Award – Recommendation of the CPA GA Committee: Barbara Gard, CPA Executive Director; TheCouncil voted to award the Edward Rudin, MD award for contributions to the Government Affairs efforts of CPAover the years to CPA Executive Director, Barbara Gard.

COMMITTEE REPORTS

Federal Legislative Report Melinda Young, MD Area 6 Federal Legislative Representative

Dr. Young warned there could be as much as a 2% cut in Medicare reimbursement to physicians due to imple-mentation of sequestration by the federal government to control federal spending. Dr. Young stated that therewas concern that the independent payment advisory board tasked with reducing Medicare spending as part of theaffordable health care act was comprised by non-physicians. Dr. Young noted that the physician Sunshine actwill go into effect on January 1, 2014 at which time payment to physicians by third parties of $10 or more will bepublished. Please refer to www.psychiatry.org/sunshineact for more information.

Dr. Young reviewed that the APA has become aware that CPT coding changes have led to insurance companiesviolating parity of health care services; she asked us to let Mr. Hagar and the APA know of any cases we havecontact with.

Later in the afternoon Dr. Young explained that the assembly meets four times per year and that the legislativecommittee meets twice per year.

Dr. Arroyo described efforts to create a bill that limit placement of adolescents into solitary confinement who sufferfrom mental disorders. He described work being done to insure safe prescription of psychotropic agents to chil-dren.

Dr. Shaner said there was good news on budgets. He said that individuals who are at 138% of the poverty line orbelow would now be covered by Medicaid. Mental health and substance abuse benefits will have parity. He re-viewed concern that Darryl Steinberg’s bill, SB 364, does unusual things to 5150 rules; it does not define what anLPS designated facility should be. He discussed AB 109 which mandates release of prisoners into the general

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population due to over crowding.

Mr.Willick discussed the court order reduction of number of prisoners. Discussed issues related to forensic evalu-ations, Tarasoff cases, and abuse cases as they relate to the duty to protect and reporting obligations.

Andrew Blaine, M.D., Discussed unmet need for facilities to house the most violent and unstable of psychiatricprisoners including repeat offenders. He noted the need for enhanced inpatient facilities that provided for singlerooms with a toilet for such patients.

Treasurer’s ReportThe Council voted to keep CPA dues for 2014 the same as for 2013 and in order to boost the financial health ofCPA the Council agreed to ask all of the DBs to publicize the CPA Annual Meeting as much as possible since thesuccess of the meeting is most important and to actively recruit new APA members.

Agreed to ask the Annual Meeting Planning Committee to consider a $50 refund for MITs attending the CPA An-nual Meeting if they stay for the entire meeting including the Legislative Luncheon and the PAC dinner. Councilmembers were asked if they would make $20 contributions to help pay for an MIT/ECP reception during the An-nual Meeting.

The Council thanked CCPS for a generous contribution to CPA of $5000, one half of which is to go to the DBs tosupport fellowships for MITs to attend the CPA Annual Meeting.

Approved the inclusion in the 2014 budget proposal an invitation to the newly elected DB officers and AssemblyRepresentatives, MIT Dep Rep, and ECP Dep Rep who will take office in May of 2014 to attend the CPA Councilmeeting and Advocacy Day in March 2014 and to include some orientation training for them during the meeting.

Approved using funds from the Roy Smith Foundation grant to support travel for Patrick Kennedy for testimonybefore the California Senate Select Committee on Mental Health on mental health parity.

Council voted unanimously to contribute $1000 per month, up to maximum of $7000, for the life of the CaliforniaMedical Association’s current scope of practice contract with the Mercury public relations firm. CMA has askedfor help from specialty societies and anticipates a 5-month run on the Mercury contract which will focus on threebills which separately propose expanded scope for nurse practitioners, optometrists and pharmacists.

Board of Trustees Report Marc Graff, MD Area 6 TrusteeHe announced that Saul Levin is the new medical director of the APA and that this will represent a major transitionfor the organization. He said President Jeffrey Liberman was making good first impressions and doing a good jobwith media.

It was announced that the California delegation to the assembly must be reduced from 9 members to 7 based onoverall state membership to the APA. We were asked to begin to think about how this should be accomplished.

It was agreed to inquire whether a booth could be set up for the purpose of assisting members in registering forCURES.

The Council voted to award the APA/CPA joint Warren Williams, MD Award to Rod Shaner, MD for his exceptionalcontributions to the profession of psychiatry and the care of the mentally ill through his work as Medical Directorof the Los Angeles County of Mental Health, as Co Chair of the CPA Public Psychiatry Committee for many yearsand as a representative of CPA on the California Coalition for Mental Health and many other services to the careof the mentally ill and mental health policy over the years.

All DBs were reminded that 2014 is an election year for CPA President Elect and Treasurer as well as MIT andECP Deputy Representatives and they should be thinking of candidates and submit suggestions to the Nominat-

ing Committee Chaired by Brenda Jensen by September 1.

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California’s Coordinated Care Initiative: What Providers Need to Know

By: Harbage Consulting

Some people with multiple chronic conditions see an average of 14 different doctors and fill 50 prescriptions a year,with little to no coordination. This is particularly common among people with both Medicare and Medicaid, referred toas “dual eligibles” or Medi-Medis here in California. To address this problem, the federal Medicare program and thestate Medi-Cal program are partnering to launch the Coordinated Care Initiative. The Coordinated Care Initiative in-cludes Cal MediConnect, a program specifically designed for Medi-Medis, who are often sicker and poorer thanother patients.

As many providers know, today’s health care delivery system simply doesn’t always support the care coordinationmany people need. With the programs in silos, often the communication between preferred providers and othertypes of facilities the patient may visit is lacking. This leads to increased risk of admission to the hospital or nursinghome, and patients bouncing in and out of the hospital because of a prescription drug error or a lack of appropriatefollow-up treatment. This also leads to higher costs throughout the system.

The Coordinated Care Initiative aims to treat every patient like one person with a complete set of needs and benefitsand aims to give doctors and other medical professionals the support they need and deserve. It will be implementedno sooner than January 2014 in eight counties: Alameda, San Mateo, Santa Clara, Los Angeles, Orange, SanDiego, Riverside and San Bernardino.

If you are in one of these eight counties, here is what you should know:

There are two main parts to the Initiative. The first, the Cal MediConnect Program, is a voluntary three-year pro-gram for Medi-Medis that will coordinate medical, behavioral health, long-term institutional, and home-and commu-nity-based services through a single health plan. The second, Managed Medi-Cal Long-Term Supports and Services(MLTSS), requires almost all people with Medi-Cal (including Medi-Medis) to join a Medi-Cal managed care healthplan to receive their Medi-Cal benefits, including LTSS and Medicare wrap-around benefits.Patients will get noticed about their options. Medi-Medis and people with just Medi-Cal will receive informationabout their choices. Through a process known as passive enrollment, they will automatically be matched up with thehealth plans that have a network that matches their historical claims data. If they do not take any action, they will beenrolled in that plan. To change which plan they would like, your patients can call Health Care Options at 1-800-430-4263. To get counseling, they may want to reach out to your county’s local HICAP at 1-800-434-0222, as theywould for other Medicare questions.Patients have to choose a Medi-Cal health plan no matter what; they can opt out of Cal MediConnect. Pa-tients who are in a Medi-Cal health plan can still use their Medicare card to see their doctors, pharmacists, hospital.Patients who don’t want to get all their benefits through one plan can decide to opt out of Cal MediConnect – for justtheir Medicare benefits, but must still select a health plan for their Medi-Cal benefits.If you aren’t already in the network of the plan/s in your county, you may want to join. You should considerreaching out to provider relations with the plan/s in your county. The program is still under development, but it’s agood time to start a conversation about what kinds of credentialing might be required or whether the plan worksthrough a medical group or IPA. Continuity of care rights mean a patient can likely keep seeing an out-of-network provider for some time

after initial enrollment. For Medicare services, this is for six months, and for Medi-Cal services, this is for twelvemonths – if you and the plan come to agreeable terms. Your patient can contact the plan and let them know that heor she wants to continue services with you as part of the continuity of care rights. You can also contact the plan toraise this.

Under the Coordinated Care Initiative, enrolled beneficiaries will have one point of contact for all their covered bene-fits. They will have one health plan membership card and access to a nurse or social worker whose job is to act as acare coordinator or navigator and help beneficiaries receive the services needed to achieve their personal heathgoals and continue living in the setting of their choice. The state is developing care coordination standards that willguide how services are linked.

To learn more, and to find out about opportunities like webinars on the Coordinated Care Initiative, visit www.calduals.org and sign up for the email list.

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The following photos are from the DSM 5 Training held on June 15, 2013.To order audio and syllabus:http://www.socalpsych.org/events.html

Lawrence Gross, M.D. Mary Ann Schaepper, M.D.

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David Fogelson, M.D. Steve Soldinger, M.D.

Larry Lawrence, M.D.

Our Attendees Our Attendees

Our Panel of Trainers with ProgramCommittee Chair, Michael Gales M.D.(right)

DISCLAIMERAdvertisements in this newsletter do not represent endorsement by the Southern Cali-

fornia Psychiatric Society (SCPS), and contain information submitted for advertising

which has not been verified for accuracy by the SCPS.

ALL EDITORIAL MATERIALS TO BE CONSIDERED FOR PUBLICATION IN THE NEWSLETTER MUST BE RECEIVED BY SCPS NO LATER THAN THE 5TH OF THE PRECEDINGMONTH. NO AUGUST PUBLICATION. ALL PAID ADVERTISEMENTS AND PRESS RELEASES MUST BE RECEIVED NO LATER THAN THE 5TH OF THE PRECEDING MONTH.

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SCPS OfficersPresident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Steve Soldinger, M.D.President-Elect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . David Fogelson, M.D.Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Joseph Simpson, M.D.Treasurer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Heather Silverman, M.D.Treasurer-Elect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sophie Duriez, M.D.

Councillors by Region (Terms Expiring)Inland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mubashuir Farooqi,M.D. (2015)San Fernando Valley . . . . . . . . . . . . . . . . . . . . . . . . . . . Davin Agustines, D.O. (2013). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Steven Horwitz, M.D. (2016)

San Gabriel Valley/Los Angeles-East. . . . . . . . . . Hanumantah Damerla, M.D. (2015)Allen Mogos, M.D. (2013)

Santa Barbara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paul Erickson, M.D. (2015)South Bay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mary Read, M.D. (2016)South L.A. County . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dharmesh Sheth, M.D. (2016)Ventura . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vacant (2013)West Los Angeles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Erick Cheung, M.D. (2014). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marcy Forgey, M.D. (2016). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Michael Gales, M.D. (2016). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Roderick Shaner, M.D.(2015)ECP Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anita Red, M.D. (2014)ECP Deputy Representative . . . . . . . . . . . . . . . . . . . . . . . Arsalan Malik, M.D. (2015)MIT Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . Devinb Stroman, M.D. (2014). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rebecca Van Horn, M.D. (2014)

Past Presidents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kathleen Moreno, M.D.Mary Ann Schaepper, M.D.

Larry Lawrence, M.D.Federal Legislative Representative . . . . . . . . . . . . . . . . . . . . . . Steve Soldinger, M.D.State Legislative Representative . . . . . . . . . . . . . . . . . . . . . . . Ronald Thurston, M.D.Public Affairs Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eric Levander, M.D.

Assembly RepresentativesLawrence Gross, M.D. (2013) Mary Ann Schaepper, M.D. (2016)Ronald Thurston, M.D. (2014)

Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mindi ThelenDesktop Publishing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mindi Thelen

CPA OfficersPresident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ronald Thurston, M.D.President-Elect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Timothy Murphy, M.D.Treasurer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William Arroyo, M.D.Trustee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marc Graff, M.D.Government Affairs Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Randall Hagar

SCPS NewsletterEditor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Colleen Copelan, M.D.

Editorial CommitteeRonald Thurston, M.D.

SCPS website address: www.socalpsych.org

© Copyright 2013 by Southern California Psychiatric Society

Southern California PSYCHIATRIST, (ISSN #10476334), is published monthly, exceptAugust by the Southern California Psychiatric Society, 2999 Overland Ave., Suite 208,Los Angeles, CA 90064, (310) 815-3650, FAX (310) 815-3650.

POSTMASTER: Send address changes to Southern California PSYCHIATRIST, South-ern California Psychiatric Society, 2999 Overland Ave., Suite 208, Los Angeles, CA90064.

Permission to quote or report any part of this publication must be obtained in advance fromthe Editor.

Opinions expressed throughout this publication are those of the writers and do not nec-essarily reflect the view of the Society or the Editorial Committee as a whole.The Edi-tor should be informed at the time of the Submission of any article that has beensubmitted to or published in another publication.

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