Recent Developments: Division of Government Relations Situation

I believe it is my duty to address a situation that has generated much debate among all of the APA communities: the recent APA staffing reductions. Notably, reductions involving the Division of Government Relations (DGR).

I am not a current member of the Boad of Trustees (BOT), and am therefore not privy to the discussions that took place which have led to the existing situation, but I can offer my perspective on the matter.

Based on the recent official communications from the APA and the exchanges in the various forums, it is my understanding that:

• The APA is facing a revenue shortfall for the coming fiscal year;

• ·To close the financial gap, a combination of using reserve funds as well as cost-cutting measures were decided on;

• The BOT recently approved moving forward with the proposed budget during the December 9th meeting;

• The proposed cost reduction decisions included the elimination of staff from various functions at the APA. However, the one measure causing the greatest level of concern lies with the Division of Government Relations, where three (3) positions within this group have been eliminated.

I know there are nuances that are not captured above, and I encourage members to read the exchanges posted in the various community groups, including the just-published FAQs.  I have carefully read these exchanges. Based on all of the information currently available, I would like to offer my key takeaways:

Communication – Two distinct issues emerged. In my view, there was a breakdown in communication between the Administration and the BOT. As acknowledged in the APA statement, decisions of this magnitude require open dialogue within the leadership. Further, the dissemination of information to our members was not timely, lacked clarity and left many members with more questions than answers.

Restructuring – Organizations restructure periodically based on growth, innovation, and strategic needs.  Every functional area within the APA should explore restructuring as part of their long-term planning. However, this should not be driven by operational or financial turmoil. In other words, organizations should not wait until a crisis emerges to consider, develop, and implement restructuring plans.

Relationships – Based on my experience in the advocacy arena, I know firsthand that effective roles in the Government Relations space require strong and lasting personal level relationships to have any meaningful impact. I am convinced that the remaining staff at the DGR are highly capable individuals with many cultivated connections. However, reducing the ranks in this functional area will decrease our reach. At the end of the day, the greater the number of people we have advocating and influencing policymakers for the betterment of our profession and patients, the stronger we are.

Short Term Results vs Long Term Impact – I believe it is critical to strike a balance between the short-term goals for the organization with its long-term strategic plans. Decisions that have an impact on the immediate future should not hamper the extended multi-year roadmap targets.

These issues raise many questions, including the following: Were there other viable options considered to address the situation? Could the same financial goal be met with fewer reductions in the DGR? Were there other operational sources of cost containment that could have mitigated these particular staffing reductions?

I feel compelled to share my views as it is evident that this situation has struck a nerve across our membership. The loss of staff in any functional area of our organization is painful and difficult. In the case of the DGR, given its nature, it carries repercussions that may last for years to come. Cultivating relationships in the legislative and regulatory arenas take years to develop – not weeks or months – and for our profession, time is of the essence.

I urge the leadership of the APA to revisit these decisions and reinstate at least some of the eliminated positions in the DGR.

Regardless of where you stand on this issue or how you feel about this situation, I hope we can all agree that we want what is best for our profession, our membership, and our patients. With all of the challenges we are facing, this is not the time to be divided. We must work together, now more than ever, towards a future state where the elimination of non-clinical burdens, addressing workforce challenges, tackling scope of practice, the advancement of health equity, among other key imperatives are all successfully dealt with. We do not have the luxury to take unnecessary risks that could have ripple effects far into the future, curtailing all the headway that has been accomplished over the past years. This requires ‘all-hands-on-deck’.

Let your voice be heard.

Theresa M. Miskimen-Rivera

December 18, 2023