APA's Joint Reference Committee (JRC) will get a chance to review and comment on its own death warrant.

Last month the Association's Board of Trustees referred to the JRC an action paper from the Assembly designed, in effect, to eliminate the JRC.

The action paper, approved by the Assembly in November, would end independent meetings of the JRC on a trial basis; instead, the JRC would meet only concurrently with the Assembly.

The ultimate intention of the action paper, however, is to abolish the 23-member panel, a point reiterated at last month's Board meeting by former Assembly Speaker Roger Peele, M.D., the author of the action paper.

The Board's decision to refer will allow the JRC itself to consider the action paper at its meeting in February.

The paper from the Assembly was one of several reflecting concern among representatives about the Association's ability to meet member needs in a timely and cost-efficient manner.

The Board also approved a motion from the Assembly to "seriously consider" continuing the current APA dues moratorium through 1998.

Peele told Trustees, as he told Assembly members in November, that elimination of the JRC would save $80,000 and make it considerably easier for action papers brought to the Assembly to move quickly to the Board for consideration.

Composed of two members of the Assembly, two of the Board of Trustees, and the medical director, along with all council chairs as nonvoting members, the JRC acts as a "clearinghouse" between the Board of Trustees and the Assembly.

Peele has argued that many action papers brought by Assembly representatives and other members must travel a tortuous bureaucratic route before being looked at by the Board of Trustees: typically, from the Assembly to the Joint Reference Committee, then to a relevant council or component, then back to the Assembly again before being forwarded to the Board of Trustees.

At the Board meeting last month, Peele cited the example of an action paper he brought to the Assembly calling for the "very disabled psychiatrically ill" to have a psychiatrist as their primary care physician. The action paper was referred to the Joint Reference Committee four years ago and never heard of again, Peele said.

As in the Assembly--which debated Peele's action paper at length before approving it in November--several leaders at the Board meeting said that elimination of the JRC would have unforeseen implications.

APA President-elect Herbert Sacks, M.D., called the action paper "not capricious, but wrongheaded."

Sacks said the Joint Reference Committee meetings bring together "people with considerable expertise in very specific fields" and are vital to informed debate about complicated issues.

Moreover, Sacks said that elimination of the JRC would require council and component chairs to be present at the Assembly meetings--a fact that would itself be costly and logistically difficult.

"In accordance with [Peele's] proposal, the Assembly would have to squeeze 11 council reports into its already overwhelming schedule," Sacks said. "Any opportunity for reflection, thought, or cross-fertilization would be markedly diminished."

Finally, Sacks warned against radically changing the structure of the Association without "an overarching strategic plan" and added that far-reaching changes in the Association governance should be deferred until Medical Director-designate Steven Mirin, M.D., has assumed his new role at APA.

Mirin spoke in favor of the need for streamlining the Association, but also of the importance of a strategic plan.

"I hope in the next year or two we will come out at the end with a strategic plan, a business plan, and a streamlined and effective mechanism for moving the business of the organization forward," Mirin said.

It was past APA president John McIntyre, M.D., who urged that Peele's action paper be forwarded to the JRC for consideration, prior to being acted on by the Board.

McIntyre expressed support for the intent behind Peele's action paper and added that an "evolutionary process" over the years has been bringing the Assembly, components and council chairs closer together.

Yet he added that many of the complications cited by Sacks and others could be ironed out by the JRC in February.

The referral motion requires that the JRC report its recommendations back to the Board of Trustees at its March meeting.

(Psychiatric News, January 3, 1997)