1 The President s Message Governance of the APA By Marc Graff, M.D. CPA President Who runs the American Psychiatric Association? Who should run the APA? The answers to these two questions are the heart of the argument that has been playing out for the last two Assembly meetings, and affect all members of CPA Marc Graff, M.D. The structure (on paper) of APA governance reminds one of pre-copernican astronomy. Cycles, epicycles and much hand waving to explain observations. The short course is as follows: All of us have a stake in a wellfunctioning APA that allows the voices of all psychiatrists to be heard. Those who don t vote in the upcoming APA election are abdicating their own responsibility to our organization and to themselves. The Medical Director s office, located mostly in Arlington, Virginia across the bridge from Washington, DC, has about 250 staffers. A few of the staff are psychiatrists or attorneys, but the vast majority are office workers who plan and run APA meetings, staff Committee and Council meetings, and provide member services, etc. The Board of Trustees (BOT) of the APA sets policy and has ulti- (Continued on page 12) CALIFORNIA PSYCHIATRIST The Newsletter of the California Psychiatric Association Volume 24, Number 4 Winter 2009 Inside This Issue Candidates Statements...Insert Capitol Insight: Integrate This!...Insert Legal Update: Why does the State of California Wish to Endanger...Page 3 Annual Meeting Report...Page 7 From the President-Elect Report on the 2009 CMA House of Delegates The California Medical Association is actively working on issues of importance to all physicians... By Barbara Yates, M.D. CPA President Elect The California Medical Association House of Delegates met in the Disneyland Hotel at the end of October for its annual meeting. The California Psychiatric Association was represented by its official delegates Ron Thurston, MD and Barbara Yates, M.D. Barbara Yates, MD as well as by many other psychiatrists in California that were attending in other capacities. Overall, over 500 physicians attend the four day meeting each year to hear updates from the leadership of the CMA as well as debate about a hundred resolutions. The CMA CEO Joe Dunn reported that CMA had been active on many fronts. We stopped Medi-Cal provider cuts through legal injunction, saving doctors more than $100 million and helping Medi- Cal patients keep their doctors. CMA put a bill on the Governor s desk that would protect patients from unlawful rescissions of their health insurance, and filed a lawsuit to exempt the Medical Board of California from any state furloughs in light of the months-long (Continued on page 12)
2 Page 2 Winter 2009 From the Editor... I am honored to take the reins of California Psychiatrist from such an outstanding predecessor, Dr. Ronald Mintz. Hopefully his years of tutelage as editor will allow for a seemless transition. On behalf of the Newsletter Committee many thanks, Ron, for your wisdom, dedication, and award-winning newslet- Yvonne B. Ferguson, M.D., MPH ters over the many years you served our organization in this capacity. In these troubled economic times, many of our cities commercial print media are folding. I hope to keep this news organ viable and of timely worth to its readers but I need your support in the form of dynamic dialog with the newsletter committee and guest columnists and in using us as an advertisement vehicle when appropriate. Contact us at: 1029 K Street, Suite 28, Sacramento, CA 95814; or Enjoy your reading. --Yvonne B. Ferguson, M.D., MPH, Newsletter Editor California Psychiatric Association 1029 K Street, Suite 28, Sacramento, CA Office FAX CPA Officers Marc Graff, M.D., CPA President Barbara Yates, M.D., CPA President-Elect Ronald Thurston, M.D., CPA Treasurer Thomas Ciesla, M.D., APA/CPA Area 6 Trustee Barbara Gard, CPA Executive Director Randall Hagar, CPA Gov t Affairs Director Lila Schmall, PAC Coordinator District Branches Central California Psychiatric Society (CCPS) Don Hilty, M.D., CCPS President Chris Stockton, Exec. Director Northern California Psychiatric Society (NCPS) Joanne Loritz, M.D., NCPS President Renee Georgulas, Executive Director ext. 105 Orange County Psychiatric Society (OCPS) Nicolas John van Nieuwenhuysen, M.D. OCPS President Holly Appelbaum, Executive Director San Diego Psychiatric Society (SDPS) Alexander Green, M.D., SDPS President Karen Dotson, Executive Director Southern California Psychiatric Society (SCPS) Robert Burchuk, M.D., SCPS President Mindi Thelen, Executive Director Check our WebSite at APA WebSite: California Psychiatrist Table of Contents Winter 2009 The President s Message: Governance of the APA...Front Cover Marc Graff, M.D. Report on the 2009 CMA House of Delegates...Front Cover Barbara Yates, M.D. Trustee s Report...Page 3 Thomas Ciesla, M.D. Legal Update...Page 3 Daniel H. Willick, J.D. The Emporer is Badly Clothed...Page 4 Roderick Shaner, M.D. Psychiatry s Essential Role in the Medical Home...Page 4 Timothy Murphy, M.D. and Richard Shadoan, M.D. The Evolving Face of Psychiatry: Demons, Molecules, and Genes...Page 5 Barton Blinder, M.D. CPA and the Internet...Page 5 Peter Forster, M.D. Resident s View of the Annual Meeting...Page 6 Arash Khatami, M.D., Steve Koh, M.D., Larry Malak, M.D., and Kristine Munoz, M.D. A Very Special Evening... Sponsored by the California Psychiatric Political Action Committee (CPPAC)...Page 9 Lila Schmall National Poll Confirms Americans Support Curbs on Malpractice Lawsuits...Page 10 Californians Allied for Patient Protection (CAPP) Letter to the Editor...Page 10 Psychiatrist and APA Member Hosts Award- Winning Mental Health Series Healthy Minds...Page 11 New California Effort to Improve Quality of Diabetes Care...Page 11 Capitol Insight Special Insert Integrate This!...Page 1 Randall Hagar Department of Government Relations Legislative Reports Feature...Page 3 Red Flags Rule: Another Postponement for Psychiatrists...Page 4 DISCLAIMER The Advertisements, Letters to the Editor, Columns and Articles published in this newsletter state the authors opinions and do not represent endorsement of those opinions by the California Psychiatric Association. Information submitted by advertisers has not been verified for accuracy by the California Psychiatric Association
3 California Psychiatrist By Thomas Ciesla, M.D. Area 6/CPA Trustee The APA Assembly met in November and took actions to reduce its 2010 budget by a little more than $200,000. The Board accepted the changes from the Assembly and did not impose the $200,000 additional cut to Thomas Ciesla, M.D. the Assembly s budget that is still scheduled to go into effect for 2011, but which had been proposed to go into effect one year earlier, ie for the 2010 budget year. There will certainly be more discussion about that proposed cut during the upcoming year. This is a time of major change for our APA. The most obvious driver of this change is DCA, direct-toconsumer advertising by drug manufacturers. In the 2009 budget cycle, we faced a $7.8 million reduction in Legal Update By Daniel H. Willick, J.D., Ph.D. CPA Legal Counsel For at least the past 15 years, organized psychology and the State of California have been attempting to demedicalize the inpatient treatment of the mentally ill by enacting regulations authorizing psychologists to be attending clinicians with medical privileges and overall authority over the treatment of patients hospitalized and suffering from severe mental illness. These efforts ignore the fact that Trustee s Report Winter 2009 Page 3 projected revenue. Most of this reduction came from lower advertising revenue in our publications and associated with our Annual Meeting. Part of the shortfall was of our own making, the result of our decision to eliminate industry-supported symposia at the annual meetings. We anticipate that this decline in advertising revenues will grow worse as Pharma bellies up to the DCA bar. One of the guiding principles in forming BOT budget decisions is that we do not fund ongoing APA activities out of our reserves. Our reserves are used when unexpected and unbudgeted demands are made of the APA, such as the peremptory demands for documents made by Senator Grassley during the summer of It was very costly and consuming of staff time to retrieve, organize, and Why Does the State of California Wish to Endanger Hospitalized Patients Suffering from Mental Illness? CPA is committed to protecting patients from the substandard care which would result from adoption of the DPH proposed regulations, but can only carry on this fight with your continuing support. This is where you come in. What kind of APA do you want? (Continued on page 13) virtually all such patients are treated with powerful prescription medications and that a high proportion of such patients also suffer from serious non-psychiatric medical conditions. Psychologists are neither licensed nor trained to provide care for such patients. Nevertheless, in a stunning example of hubris, psychologists seek the authority to assume the overall medical control of Daniel H. Willick, Esq. the diagnosis and treatment of such patients. They have been joined in this endeavor by the California Department of Public Health (DPH) and its predecessor, the California Department of Health Services (DHS). For the past 15 years, the California Psychiatric Association (CPA) has fought a sustained and successful battle against these efforts to undermine patient safety. (Continued on page 13)
4 Page 4 Winter 2009 The Emperor is Badly Clothed California Psychiatrist By Roderick Shaner, MD As Prop 63 (Mental Health Services Act, MHSA) approaches its five year anniversary, some supporters appear grimly determined to celebrate it as an unqualified success. This requires a deaf ear to mounting criticism that Roderick Shaner, M.D. could lead to the undoing of the Act and a loss of critical resources for those with mental illness. A more honest appraisal would offer a better bulwark against subsequent attempts to further slash mental health funding. It could also provide a foundation for constructive MHSA changes. Rose King, an insider in MHSA development, recently filed a Whistleblower Complaint... alleging serious mismanagement of MHSA. Rose King, an insider in MHSA development, recently filed a Whistleblower Complaint Report with the California State Auditor, alleging serious mismanagement of MHSA. She decries faulty implementation leading to disorganized, fragmented, wasteful, and ineffective spending. If not intelligently addressed, her critique could serve as a justification for rescinding the Act and depriving the entire mental health system of funding. The voters passed MHSA in order to help those with serious mental illness get care. This goal should be top priority. A clinical look at MHSA implementation suggests some key problems and some common sense fixes. First, the stringent prohibition against most inpatient services has led to a de facto denial of access to care for those whose mental illness places them in greatest danger. Emergency (Continued on page 14) Psychiatry s Essential Role in the Medical Home By Timothy Murphy, MD and Richard Shadoan, MD In October, the Collaborative Family Healthcare Foundation held a major four day conference in San Diego, largely focusing on the integration of mental health care with physical health care. The meeting was not advertised to psychiatrists. Even in San Diego, it was difficult to find a psychiatrist who had heard anything To remain relevant to the country s evolving healthcare system, psyciatrists must demonstrate a commitment to working with their medical colleagues to provide the very best for patients. about it. Many of the presentations and the attendees were psychologists. This lack of psychiatric involvement was unfortunate for delivery of good healthcare. The Medical Home movement is not new, but it is garnering new interest and energy as the nation grapples with reform of its health care system. This model addresses problems of quality and inefficiency related to the increasingly fragmented nature of healthcare in the United States. With an emphasis on primary care, the Medical Home model attempts to improve the communication and coordination among all care providers, even putting them under a single roof in some cases. Many primary care providers have developed the impression that psychiatrists lack the interest or the time to work in partnership with them in the care of patients who suffer from a combination of physical and emotional illnesses. To remain relevant to the country s evolving healthcare system, psychiatrists must demonstrate a commitment to working with their medical colleagues to provide the very best for patients. Joining the medical team is good for patients and their primary care physicians, and can also be very gratifying for psychiatrists. Those who have developed closer working relationships with primary care physicians often report that their practices have become more interesting and satisfying. Certainly for younger (Continued on page 15)
5 California Psychiatrist The Evolving Face of Psychiatry: Demons, Molecules, and Genes Barton Blinder, MD For the past few years, I have had the pleasure and opportunity of teaching the history of psychiatry to our residents at UCI. The long struggle from society s view of mental illness emerging from contempt/ superstition/ stigma to compassion/understanding/ Barton Blinder, M.D. medical research has been hard won and littered with pitfalls and cul-desacs. The greatest deterrents to progress have come from unitary theories of causation and treatment that denied or avoided the complexities of human development, the multiplicity of bio pyschosocial determinants, and the force of cultural and spiritual heterogeneity. From terror of demonology, the elusiveness of bodily humors, the absurdity of mesmerism and phrenology and in recent years, the parent bashing of the schizophrenic and CPA and the Internet Winter 2009 Page 5 refrigerator mothers we have endured long periods of stagnation. The era of asylums and state hospitals has evolved into psychiatry in the community with great accomplishments as well as continued challenges and disappointments. Advances in neuropharmacolgy have lessened suffering from psychosis, mood, anxiety, and cognitive impairments yet challenged us to continue to address the mind and life of each patient in a comprehensive and truly effective manner. How to integrate the autobiographical complexity of each patient s adversities and strengths, with their biogenetic vulnerabilities into a meaningful diagnostic formulation and treatment plan must continue to be a hallmark of our specialty and never relinquished. Dissolving the mind-brain barrier and integrating psychotherapy and pharmacotherapy should be an (Continued on page 15) Peter Forster, MD, Chair, Information Technology Taskforce The internet. Some of you live on it, some of you avoid it, and some of you don t quite know what to do with it. This is what makes the charge of the newly formed Task Force on Information Technology of the CPA somewhat daunting. Peter Forster, M.D. Almost everyone agrees, however, that CPA could be doing a better job of using the internet to communicate, and that is where the task force comes in. Composed of representatives from almost all of the district branches (Bob Dolgoff, NCPS; Steve Koh, SDPS; Don Hilty, CCPS; Marc Graff, SCPS; Alex Green, SDPS; Yvonne Ferguson, Newsletter Editor) is there a psychiatrist from Orange County who would like to join? the group is interested in looking at the whole spectrum of ways that CPA could use the internet. Complicating the task is the fact that use of the internet is something that is changing rapidly, so CPA is likely to always be playing catch up. The group is looking at a few areas to start with, including how we distribute news, how we use the website to store information, and how we contact individual members. Currently CPA is in a minority in not distributing an electronic newsletter. On the one hand, we know the advantages of electronic distribution (it is faster, wastes less paper, and allows you to store a copy if you want to without creating a lot of clutter in your home). On the other hand, we don t want an electronic newsletter to prevent us from keeping in touch with all of our members. Almost everyone agrees that our website could be improved. We are interested in finding out what kind of information you want access to on the website. We also need to decide what information should be posted on the current website and what information, if any, should be stored on a password protected portion of the site. Currently we use and the phone as our primary (Continued on page 16)
6 Page 6 Winter 2009 Residents View of the Annual Meeting California Psychiatrist By Arash Khatami, MD; Steve Koh, MD; Larry Malak, MD and Kristine Munoz, MD California Psychiatric Association s (CPA) 21 st Annual Premier Conference was held from October 9 to 11th at Dana Point. We were able to attend the entire conference as members-in-training (MIT), supported by San Diego Psychiatric Society, and to take advantage of the educational seminars, network with psychiatrists from all over California, receive mentoring, meet role models in our field, and learn more about the role and importance of organized psychiatry in patient care. It was a valuable experience. We not only were able to represent our training programs well, but also to gain perspective on CPA President Marc Graff MD welcomes numerous challenges everyone to the Legislative Luncheon facing psychiatric care in our state. In spirit of encouraging other residents and early career psychiatrists to become more involved with CPA, we would like to take this opportunity to give a glimpse into our experiences at this year s Annual Premier Conference. During a concurrent educational seminar, Dr. Dennis Greenberger, co-author of Mind over Mood, presented Annual Meeting Program Chairs, Yvonne Ferguson, MD,MPH and Barton Blinder, MD presiding at CME sessions. Both were awarded a 2009 President s Award by Dr Graff. Dr Blinder as the founder, Chair and Co Chair of the Annual Meeting and Dr Ferguson for her many contributions as Chair and Co Chair of the Annual Meeting, as Past President and as the Current Newsletter Editor for CPA. the basic principles of cognitive behavioral psychotherapy applied to depression and anxiety disorders. He introduced pragmatic models to better understand and conceptualize these disorders. The audience was left with a clearer sense of how CBT p r i n c i p l e s, strategies and methods can be effective with Dr Graff presents the APA/CPA Warren Williams Award their patients. for 2009 to Barton Blinder, MD for his outstanding contributions to the profession of psychiatry. Following the presentation, some of us had an opportunity to speak with him about the current obstacles in the application of CBT in the inpatient setting and discussed potential solutions. In another setting, Dan Willick, Esq. reviewed a variety of legal issues affecting psychiatrists in California. One major concern facing California is the decision by the court to release 40,000 inmates from the prison system. The community mental health care systems are not equipped to handle this influx of new patients and it is unclear how adequate mental health care will be delivered to them. Another issue is the proposal to expand the scope of practice of psychologists in California hospitals. The proposal would allow for non-medically trained professionals to be responsible for admitting and discharging, ordering restraints and any other medical issues. This would prove to be detrimental to patients overall care. The first plenary session was by Dr Dilip Jeste who is Professor of Psychiatry and Estelle and Edgar Levi Chair in Aging at UCSD. As an esteemed r e s e a r c h e r, clinician, teacher Dr Ron Thurston (right) presents a Fun Run Award to Rod Shaner, MD. Additionally, Dr Shaner and Donald Sharps were the joint recipients of the CPA Edward Rudin, MD Award for exceptional contributions to the CPA in state Government Affairs. Drs Shaner and Sharps are Co chairs of the Public Psychiatry Committee. Dr Sharps was not able to attend the meeting so Dr Shaner accepted the award in his behalf.
7 California Psychiatrist Winter 2009 Page 7 Assembly Member Robert Blumenfield gave a rousing address as the Keynote Speaker at the Legislative Luncheon. and current APA Trustee-at-large, his presentation was in three parts. First, he presented a historical background of psychiatry in America and how it shaped current APA s d e v e l o p m e n t over the years. Then he discussed the current state of psychiatry. While acknowledging that there were difficulties in our field, he was optimistic in his view that our field will continue to thrive with continued advancements in research, clinical care and policy innovations. He concluded by giving us a glimpse into new research involved in successful aging and potential avenues for further discoveries and innovations in caring for the mentally ill. He was clearly hopeful and inspiring in regards to our profession s future. To truly understand the importance of advocacy, it is helpful to actually meet the law makers. We had the unique opportunity to attend presentations given by Assembly Member Robert Blumenfield and State Senator Lou Correa during the Legislative Luncheon and PAC Major Donor Dinner, respectively. Each touched upon the recent economic crisis that faces California and its potential impact on the healthcare system. We met with Mr. Blumenfield Drs Dev GnanaDev, the California Medical Association President and Marc Graff, CPA President, chat before the start of the Leadership Academy where Dr GnanaDev gave a inspiring talk on organized medicine activities. following the PAC donor dinner Saturday evening and discussed recent developments in public policy with regards to mental healthcare. The Leadership Academy was highlighted for MITs and it featured Dr Ronald Thurston as CPA s Government Affairs (GA) Chair, Dr Dev GnanaDev as the California Medical Association s (CMA) President, and Mr Randall Hagar as the CPA Government Affairs Director in a panel discussion. Each panelist reviewed the recent events in Sacramento and Dr Ronald Thurston gives thumbs up to participation in the CPA Government Affairs activities at the Leadership Academy. Washington pertaining to healthcare reform and legislative issues of concern to physicians. Mr Hagar gave a first hand overview of the legislative process and advice on the most effective ways in which to advocate on our issues ( advocacy pearls ). Dr GnanaDev shared a step by step history on the current healthcare reform process and valuable insight into the decision making process involved in CMA s responses and reactions to the current proposals. Leadership is fostered from interacting with role models and it was refreshing to hear active physician leaders like Dr GnanaDev being part of the discussion at the national level. Perhaps the most memorable comment by the panelists came from Dr Thurston who described how he keeps his medical license between that of his APA and CMA m e m b e r s h i p cards. I truly believe that these organizations protect my identity as a physician and (Continued on page 8) State Senator Lou Correa, the Keynote Speaker, encourages the crowd to be engaged with what is happening in the state at the CPPAC Major Donor Dinner. Ron Thurston MD presents the First Place Men s Award in the Fun Run to the usual winner, marathoner Tim Murphy, MD.
8 Page 8 Winter 2009 California Psychiatrist Residents View of the Annual Meeting continued that is why I belong to them. The Sunday morning course on Understanding the Role of Vietnamese Culture in Psychiatry was both informative and thought provoking. Dr. Nguyen s description of the impact phases of migration have on current Vietnamese Americans prompted discussions about the importance in understanding culture in historical context when establishing a treatment plan. His discussion on the i n t e r n a l c o n f l i c t s faced by m a n y First Place winner in the Women s Fun Run Kristine Munoz, Vietnamese MD (center) and fellow runners Colleen Copelan, MD (left) Americans and Teri Mawhinney (right). r e g a r d i n g conformity versus individualism can be further applied to other cultural groups in the United States. As MITs, learning how to apply this knowledge in this phase of our careers will allow for more positive outcomes when providing care for patients of different cultural backgrounds. Sunday s first plenary session featured Dr. Susan Wood, former member of the Food Dr Rod Shaner and Barbara Yates, MD, CPA President and Drug Elect visit at the Saturday evening reception. Administration. She spoke on several topics concerning conflicts of interest that arise in FDA s decision making process. As an example, she highlighted some of the political conflicts that arose during the approval of the morning after pill. Dr. Wood also highlighted changes to the pregnancy warning label. The final plenary session on Reducing Mental Health Disparities in Latinos at the Service Delivery Entry Point discussed key issues in Latino Mental Health. Dr. Aguilar-Gaxiola s illustration of the growing population of Latinos in the United States underscores the importance of recognizing the three key issues in Latino mental health: access to care, the growing health care disparities and current d e m o g r a p h i c trends. He demonstrated the imminent need to address these issues for the growing Latino population. He fostered discussions from Dr Dilip Jeste during his enthusiastically received CPA members of presentation on Mental Health Care: Yesterday, Today, and Tomorrow. ways to increase adherence with treatment plans and work through language barriers. He closed with the description of a best practice training model (IMPART) of a combined psychiatry and family or internal medicine training with a focus on treating underserved populations. We have tried to highlight some of the activities at the 2009 CPA conference but in the end there is no substitute for actually being there. As residents, we work and study hard at our home institutions and our perspectives are often limited. In long hours of training, a sense of fellowship with our profession is often lacking. Involvement and participation with CPA is that fellowship. What better way to become an active participant than to be present and be counted! The conference was a great learning experience, but more so than that, it energized us to be more Dr Joe Mawhinney enjoys Assemblyman Blumenfield s speech at the Legislative Luncheon. involved in our local branch of CPA and gave us a greater appreciation of our professional fraternity.
9 California Psychiatrist Winter 2009 Page 9 A Very Special Evening... Sponsored by the California Psychiatric Political Action Committee (CPPAC) By Lila Schmall, CPPAC Coordinator On Tuesday, December 8, 2009, Robin Cooper, MD, hosted a dinner party at her residence in San Francisco. Dr. Cooper is, in addition to being an NCPS member, the Northern California representative for the CPA to the California Mental Health Coalition. This event was not just any dinner party, but a fundraising event. Thirteen local psychiatrists attended to support a very special guest, Assemblymember Jim Beall, Jr. (D-Santa Clara). Mr. Beall was also the recipient of the prestigious Jacob Javits Award from the American Psychiatric Association (APA), presented to him at the annual meeting of the APA this May. The evening was an outstanding success, which would not have been possible but for the hard work and dedication of Dr. Cooper, and Dick Shadoan, MD, who is among many other things, a former President of the CPA who also lives in San Francisco. The process raised over $2,000 in contributions from individual attendees for Mr. Beall s election campaign. If you can imagine a wide array of delicious food prepared by the host, a bottle or two of wine, and sitting down to amiable and stimulating conversation in a wonderful setting (Dr. Cooper has a delightful residence perched on a small hill in San Francisco) you get the picture of a very successful 2-½ hours with one of the legislatures preeminent mental health champions, and a strong friend to psychiatry. Mr. Beall demonstrated why in Dr. Shadoan s words He is a person we all need to get behind in future years as in conversation with attendees he showed his mastery of the politics and policy of health care reform, the state budget, his authorship of a bill to establish mental health insurance parity for all DSM disorders, his concern for the mental health of foster children, and many other topics of interest to psychiatrists. Of particular interest to Mr. Beall was a conversation about phantom panels in private managed care, as several psychiatrists related their experiences with patients who could find no psychiatrist available to them from their health plans list of providers. Mr. Beall was also impressed to meet the local mental health director (a CPA member), the Chief of Psychiatry at San Francisco General Hospital, and the President-elect of the local medical society. Dr. Cooper also reported that having a round table discussion where we all learn from each other and in a small group that is more personal than the usual fundraiser event, is very special. Mr. Beall spent a good deal of his time really listening to the psychiatrists who came. It is in such circumstances that relationships are forged that will last a long time and will hopefully be mutually beneficial to all involved. This event is a template for what can happen in other locations around the state: there are other legislators who are worthy of and need the support of psychiatrists and I hope local psychiatrist leaders can step up to the plate and host similar events for them and forge relationships for the future. CPPAC raises funds in order to support state legislators who understand the issues facing psychiatry and support psychiatry as a profession. Please send a donation today to CPPAC at: California Psychiatric Political Action Committee 1029 K Street, Ste. 28, Sacramento, CA Please fill out the requested information below (required by state campaign reporting laws). Name Employer Address Home Phone Office Phone Fax District Branch Amount: $1000 $500 $250 $150 Other o Check enclosed- Make checks (corporate checks okay) to: CPPAC o Or charge my: (circle one) VISA Mastercard o Charge full amount OR o Equal Monthly Installments (credit cards only, $100 minimum) Credit Card Number: Expiration Date Thank you for your contribution Contributions not deductible on Federal Income Tax