June-July 2005
Total Page：16
File Type：pdf, Size：1020Kb
JUNE / JULY 2005 Texas Psychiatrist 2005 Legislative Session It’s Over! he 79th Legislature ended its 140-day dren. These media accounts became the capacity to consent to Tsession on May 30 after passing almost focus of various anti-psychiatry groups to medical care. If a child 1,600 bills and resolutions. During the seek legislative reform to ban or at least who is at least 16 years of course of the 2005 Legislative Session, the restrict the administration of psychoactive age and who has been Federation tracked 213 bills that could medications to children. This misguided determined to have the effect psychiatric care and the practice of effort to single out psychiatric care as a capacity to consent to psychiatry. Of this total, 51 bills were passed major problem of the foster care system was medical care refuses to and sent to the Governor. directly confronted by the Federation and consent to medical care Overall, the session was a positive one its coalition partners, including numerous and the responsible for psychiatry and psychiatric patients. The child and adolescent psychiatrists with agency for the child positive outcome can be attributed in part experience in the foster care system. The believes that the medical to the essential grassroots advocacy pro- Federation coordinated a lobbying effort care is appropriate, the grams conducted by the Federation’s coali- involving numerous medical specialty orga- agency may file a motion tion partners (TSPP, Academy, TSCAP, and nizations, foster care providers and mental with the court requesting TMA) during the legislative interim. health advocacy organizations which an order authorizing the provision of med- sumers in its service area. Forming relationships with legislators and sought to ensure that psychiatric care be ical care. The motion must include a state- SB 325 by Senator Judith Zaffirini and informing them about issues of importance considered as “medical care” and that psy- ment prepared and signed by the treating Rep. Elliot Naishtat prohibits restraints that: to psychiatry during the interim period chotropic medications not be singled out physician that the medical care is the a) obstructs a patient’s airway, including a resulted in a more informed legislature but instead should be considered as a com- proper course of treatment for the foster procedure that places anything in, on, or about mental health issues. Also contribut- ponent of “medical care.” These efforts to child. over the patient’s mouth or nose; b) impairs ing to the positive outcome were the mem- integrate psychiatric care into medical care The only reference to psychotropic med- the patient’s breathing by putting pressure bers who came to Austin to participate in were successful and should be a model for ications is a section in the bill that requires on the torso; or, c) interferes with the resi- Capitol Day and to visit with members of future attempts to separate psychiatric care the Department of State Health Services to dent’s ability to communicate. A prone or the legislature during the course of the ses- from medical care. study the level of care system the depart- supine hold may be used only if the person sion. Also contributing to our success were SB 6 was signed into law by the Governor ment uses to determine a child’s foster care administering the hold: a) limits the hold to members who responded to requests to tes- with an effective date of September 1, 2005. needs to ascertain whether the system cre- no longer than the period specified in rules tify before various legislative committees, The new law calls on the Health and ates incentives for prescribing psychotropic to be promulgated; b) uses the hold only as often on very short notice. And finally, the Human Services Commission to collaborate medications to children in foster care. a last resort when other less restrictive Federation’s lobbyist, Steve Bresnen, kept with health care and child welfare profes- interventions have proven to be ineffective; our interests before members of the sions to design a comprehensive, cost- State Board of Medical Examiners and, c) uses the hold only when an Legislature and fought hard for our issues. effective medical services delivery model Through the sunset process, the State Board observer, who is trained to identify the risks As a result of this preparatory work and vigi- which will include the following: a) the des- of Medical Examiners was continued with associated with positional, compression, or lance during the session, the Federation did ignation of health care facilities with exper- the enactment of SB 419 introduced by restraint asphyxiation and with prone and not have to issue any legislative alerts dur- tise in the forensic assessment, diagnosis, Senator Jane Nelson and Rep. Burt supine holds who is not involved in the ing the session....the first time this has and treatment of child abuse and neglect as Solomons. The Governor has signed the bill restraint, is ensuring the patient’s breathing occurred. pediatric centers of excellence; b) a into law with an effective date of September is not impaired. The Health and Human Another first occurred during the ses- statewide telemedicine system to link 1, 2005. TSPP was an active participant dur- Services Commission is to develop rules to: sion. On May 18, the Texas Senate passed a investigators and caseworkers with pedi- ing the sunset review process, submitting a) define acceptable restraint holds that Resolution recognizing the Texas Society of atric centers of excellence or other medical recommendations for reform (Texas Society minimize the risk of harm to a patient; b) Psychiatric Physicians (see page 8). experts for consultation; c) identification of of Psychiatric Physicians Newsletter, govern the use of seclusion of patients; and, The following is a summary of some of a medical home for each foster child at August/September 2004, page 4). c) develop practices to decrease the fre- the bills tracked by the Federation that were which the child will receive an initial com- The bill renamed the Board to the Texas quency of the use of restraint and seclusion. passed by the Legislature. The bills may be prehensive assessment, as well as preven- Medical Board and defined procedures that SB 826 by Senator Leticia Van de Putte read in their entirety by visiting the tive treatments, acute medical services, and may improve due process of physicians and Rep. Garnet Coleman authorizes the Federation’s website (www.txpsych.org) and therapeutic and rehabilitative care to meet who are investigated based upon com- Health and Human Services Commission to selecting “Read Bills from the Current the child’s ongoing physical and mental plaints received by the agency. conduct a study examining the feasibility Legislative Session” within the Public Policy health needs throughout the duration of the and effects of providing 12 months of health link. child’s stay in foster care; d) the develop- Mental Health services under the Medicaid program to ment and implementation of health pass- HB 224 by Rep. Frank Corte and Senator women who are diagnosed with postpar- ports which will include information such Florence Shapiro allows a facility to con- tum depression and who are eligible to Foster Care SB 6 by Senator Jane Nelson and Rep. as the name and address of a child’s physi- tinue treatment of a patient who is younger receive Medicaid services. Suzanna Hupp brings major reforms to cians and health care providers, a record of than 18 years of age as a voluntary patient if SB 1340 by Senator Frank Madla and Rep. child protective services in a 257 page bill. each visit to a physician or other health care the patient’s parent, managing conservator Dianne Delisi authorizes the Health and Prior to the start of the 2005 Legislative provider, a list of the child’s known health or guardian objects to the patient’s written Human Services Commission to implement Session, the media carried numerous sto- problems and allergies, and information on request for discharge. The bill also allows a pilot program under which Medicaid ries about failures of the foster care system. all medications prescribed to the child in for the administration of psychoactive med- recipients in need of mental health services Included in these stories were accounts of adequate detail to permit refill of prescrip- ication to a patient who is younger than 18 are provided those services through tele- inappropriate prescribing of psychoactive tions; e) the establishment of a manage- years of age if the patient’s parent, manag- health or telemedicine. The pilot program medications to children in the foster care ment information system that allows ing conservator or guardian objects to the must be designed to: a) enhance the delivery system. Compounding the effect of these monitoring of medical care that is provided patient’s refusal the administration of a psy- of mental health services to recipients; b) media accounts were pronouncements by to all children in foster care; f) the use of choactive medication. ensure adequate supervision of social work- the FDA about potential dangers of pre- medical advisory committees and medical HB 2572 by Vicki Truett and Senator Kyle ers, psychologists, and other licensed pro- scribing psychoactive medications to chil- review teams to establish treatment guide- Janek restricts the Health and Human fessionals who are not psychiatrists and who lines and criteria by which individual cases Services Commission from decreasing the provide services through the use of tele- of medical care provided to children in fos- number of local mental health authorities health or telemedicine; and, c) enable the I NSIDE ter care will be identified for further, in- from the number that existed on January 1, state to determine whether extension of the depth review; g) the development of a 2005 except on: a) a request from two or use of telehealth or telemedicine would Calendar of Meetings .