Assembly members, who represent APA’s district branches, minority and underrepresented groups, and allied psychiatric organizations, voted to cut the Assembly’s budget by $265,000 for 2001, a reduction of 27 percent, and by $133,000 for the rest of this year

The 2001 savings come from a wide variety of line items including drastic cuts in food and beverage expenses, reining in travel costs, substantially reducing a contingency fund for special projects, and no longer funding an annual orientation for district branch presidents-elect. (The orientation will continue, but funding will come from elsewhere in the APA budget.) The bulk of the savings comes from a newly devised system of block grants that will be distributed to each of APA’s seven geographic areas.

In addition to the budget cuts, the Assembly will also change its funding of Area Councils. They will now be funded via a block grant to each Area, with the available dollars earmarked for the Areas being reduced. Under the block grant formula, 50 percent of the grant will be determined by the historic costs that the council incurred in conducting past Area Council meetings, while the remainder will be determined by the number of members in each Area. Area Councils can allocate the block grant as they see fit for their meetings and special projects—several are planning to meet in less expensive cities in the future and to hold their fall meeting in conjunction with APA’s fall component meetings in Washington, D.C., which most Area Council members attend anyway.

Another option is for Area Councils to cease funding expenses for each district branch deputy representative to attend Area Council meetings. This raised the ire of Area 7 delegates, led by Area 7 representative Louis Moench, M.D., of Utah, who emphasized that as a collection of small district branches spread over a huge chunk of the American West plus Hawaii and Alaska, cutting out deputy representatives would put that Area at a disadvantage. More populous states have multiple full representatives in place of deputies and would thus suffer little by eliminating the deputies’ travel costs. That’s because the APA Areas with large district branches would have to cut only one or two deputy representatives, while Area 7 would have to cut 11. Area 7 endures the greatest cut under the block grant formula, having to sacrifice about $10,000. Assembly Speaker Al Herzog, M.D., emphasized, however, that the Area allocations should allow for continued funding of deputy representatives if the Areas are frugal in how they use these funds.

The Assembly also took these actions:

• Voted to have APA advocate against mental health carveouts that "segregate psychiatric treatment from the body of general medical care in insurance and managed care programs." These entities make more difficult the already challenging goal of coordinating physical and mental health care, the paper notes, "reinforce the stigmatization of psychiatric illness," and compromise the quality of care patients receive.

• Asked the Board of Trustees to develop an APA policy statement calling for a moratorium on capital punishment in the U.S. Advocates for the position statement, led by Ramanbhai Patel, M.D., of the Bronx District Branch, pointed out that "death sentences are reserved for the poor," appear to be "applied in a racist manner," and may be more likely to be carried out on innocent people now that courts have "severely curtailed" prisoners’ appeals. The Assembly also asked for the input of the Council on Psychiatry and Law.

• Identified the need for a position statement that lays out "core principles" on end-of-life care. The Assembly referred the idea to the APA Committee on End-of-Life Issues. It suggested that APA consider adopting a document titled "Core Principles for End-of-Life Care" that was developed by the Joint Commission on Accreditation of Healthcare Organizations and representatives of several medical organizations.

• Rejected a proposal to rename DSM editions with Arabic rather than the traditional Roman numerals. Proponents of the change wanted, for example, the next major revision to be called DSM-5 and subsequent modifications to carry numbers such as 5.1, 5.2, and so on, similar to the way in which new software programs are usually identified.

Submitted by Robert Schorr, D.O., of the Central California Psychiatric Society and Yvonne Ferguson, M.D., president of the California Psychiatric Association, the paper argued that by adopting the change APA would not just be symbolically updating its image but adapting more to the computer-technology era.

Speaking for the reference committee that reviewed the proposal, Joanne Ritvo, M.D., of the Colorado Psychiatric Society said that committee members saw little reason to tinker with a volume that has worldwide recognition and sets a standard for psychiatric care. Constantine Lyketsos, M.D., who represents the Academy of Psychosomatic Medicine, suggested that the numbering system was about more than name changes and reflected a wish by some members for more frequent editions of the diagnostic manual. When the vote came, the numbering shift garnered little support.

• Approved APA’s 11th practice guideline, this one on treating patients with AIDS and HIV disease. The Assembly had previously reviewed the proposed guideline, and it came back after several suggested revisions were incorporated by the work group that developed the guideline. It will now be reviewed by a joint ad hoc task force of the Board and Assembly, and after that group endorses the guideline, it will go to the Board for final approval.

• Called on APA to explore the feasibility, fiscal implications, and other issues involved in holding an annual meeting in Hawaii or Las Vegas, both of which have been controversial sites when locations for future meetings are discussed by APA leaders and meeting planners. Earlier in May, the Hawaii House of Representatives and Senate passed a resolution supporting the Hawaii Psychiatric Medical Association’s interest in extending an invitation to APA "to seriously consider" holding a future annual meeting there. The resolution was delivered to the Assembly by Jeffrey Akaka, M.D., the Assembly’s deputy representative of American Indian, Alaska Native, and Native Hawaiian Psychiatrists.

• Agreed to have APA develop a mechanism for and analyze the costs of keeping APA’s practice guidelines current. Proponents of the proposal, introduced by members of the Washington Psychiatric Society, were concerned about the pace at which psychiatric knowledge is expanding in contrast to the five- to six-year schedule under which guidelines are updated. "Currency is the core to credibility," the proposal noted.

• Supported a resolution introduced by Assembly Speaker Al Herzog, M.D., to support the "Million Mom March," which took place that day in Washington, D.C. It said that the Assembly and Board support the goals of the march, including a call for mandatory handgun registration, licensing of gun owners, limits on gun purchases, including waiting periods, and the mandatory use of childproof safety locks. "Guns must be regulated to reduce the number and keep them out of the hands of those who could use them to kill other human beings," the resolution states. The Board unanimously endorsed the resolution at its meeting later that same day.