JUNE / JULY 2005 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. 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 ...... 6 training program for persons authorized to more local authorities; or b) a determina- improve the delivery of mental health ser- Call for Nominations ...... 3 provide medical consent; h) a provision for tion that a local authority has substantially vices. The Commission is to adopt rules set- Editorial Board ...... 6 the participation of the person authorized failed to meet the terms and condition of ting minimum standards to permit the use Federation Update ...... 3 to consent to medical care for a foster child the performance contract. A local mental of trained qualified mental health profes- It Takes a Psychiatrist ...... 2 in each appointment of the child with the health authority may serve as a qualified sionals in presenting Medicaid recipients for provider of medical care; and, i) a provision service provider (an entity that meets telehealth or telemedicine consultations to Latest News from the Academy ...... 2 for the summary of medical care to be requirements for service providers estab- be conducted by psychiatrists at distant Mental Illness Awareness Week ...... 5 reviewed by the court. lished by the Health and Human Services sites. The Texas State Board of Medical Resident Paper Competition ...... 5 A foster child who is at least 16 years of Commission) and make every reasonable examiners is to adopt rules to establish Texas Senate Recognizes TSPP ...... 6 age may consent to the provision of medical attempt to solicit the development of an requirements for a physician delegating a TSPP Annual Convention ...... 4 care if the court with continuing jurisdic- available and appropriate provider base continued on page 3 TSPP CME Accreditation ...... 3 tion determines that the child has the that is sufficient to meet the needs of con- Welcome New Members ...... 5 It Takes a Psychiatrist… Gary L. Etter, MD, President, Texas Society of Psychiatric Physicians

ast year, my predecessor, Dr. Clay sions for advocacy. With our reorganization, LSawyer, established as his theme: “It our Chair of Government Affairs, Dr. Martha takes a physician...,” which basically under- Leatherman, our skilled and dedicated lob- scored the need for a physician to be a psy- byist, Steve Bresnen, and all of the many Gary L. Etter, MD chiatrist. This certainly was an appropriate members who have been active in meeting action papers which are then sent to our theme as we entered a legislative year, and with our legislators, have said that this has Executive Council for consideration. It is a faced another effort by the psychologists to been one of the most successful legislative simple system that works. The decisions are membership recruitment and retention obtain prescribing privileges. This year, I years ever. The psychologists were not even not made by a small group of individuals which have not worked, would also be wanted to expand on that theme. It does able to find a sponsor for their prescribing behind a closed door. When I have attended considered not being responsible. None of take a physician… to be a psychiatrist, and bill, whereas in the last two sessions, they these meetings over the years, I am amazed us could stand idly by and do nothing. We it takes a psychiatrist… to be involved. were able to find a sponsor, and were able at the fact that there are so many previous are indebted to our three APA Assembly We now have the structure established to get a bill to committee. I believe it has Presidents of the organization who remain Representatives for their hours of hard for organized medicine and psychiatry in everything to do with the strength of our actively involved, and there are so many work in the negotiations. These members Texas that allows ALL psychiatrists to join unified voice in our lobbying efforts. It also who have remained committed over the include: Dr. David Axelrad, Dr. Priscilla and be involved in making the decisions is a result of the relationships that we have years by serving on various committees. Ray, and Dr. Clay Sawyer. TSPP has contin- that affect psychiatry in Texas. The established with our elected officials. They What motivates these people? I believe it is ually called for mediation in this matter if Federation of Texas Psychiatry, an organiza- know who their constituents are, and they out of a true commitment to service. They negotiation failed. This was also recom- tion of organizations, was established to quite frankly have told us that they listen to are not here to list it on their C.V., or to mended unanimously in an action paper provide a unified voice for psychiatry. It Texans who know what is best for Texans. As “move up the ladder” in organized medi- by the APA Assembly in November 2004. includes TSPP, the Texas Academy of we have said many times: “All politics is cine. It is not self-serving, and certainly Until recently, the APA has resisted media- Psychiatry, the Texas Society of Child and local.” It requires a strong local district shouldn’t be. I believe that it is out of a com- tion. However, they are now willing to Adolescent Psychiatry, the Texas branch with strong local leadership. mitment to do whatever is necessary to move to what they are calling “assisted Foundation for Psychiatric Education and The strength of our organization is continue to provide the best care that we negotiation,” with a third party for one Research and now we are extremely happy based on various factors. First and fore- can to our patients. I want to thank those of day. We want to move to resolving this to announce that it also includes the orga- most is a strong staff who is working daily you who have served over the years. issue so that both organizations can focus nizational membership of the Texas for the organization. We have without The conflict between the APA and TSPP their time and energy on more important Medical Association. This underscores the doubt the most qualified and committed continues. I want to go on record by saying matters. strong alliance that psychiatry has had with Executive Staff of any of the District that I am supportive of resolving this con- I would hope that you would embrace the TMA, which has been very helpful to Branches of the APA. John Bush and flict in a way that would preserve the long this year’s theme of “It takes a psychiatrist TSPP over the years. We are now able to go Debbie Sundberg work tirelessly for the relationship between the two organiza- to be involved.” I would invite every psy- to our legislators as a member organization organization. I am convinced that they do tions. However, I am not going to do any- chiatrist in Texas to do so. If you are not on of the Federation, and say that we represent not see this as much as a job, but as a com- thing that would jeopardize TSPP. I feel a committee, please consider joining one the majority of psychiatrists in Texas, and mitment to what they feel is best for our that the APA is only as strong as its district in your area of interest. If you are on a over 40,000 physicians in Texas who are patients. I have said many times that those branches. In the long run, the steps that we committee, please attend your meetings. supportive of continuing to provide the of us who have been the most involved in have taken to maintain and strengthen Our TSPP Annual Convention and highest quality of psychiatric treatment in TSPP still would not have the time TSPP should only serve to benefit the APA. Scientific Program is November 4-6 at the Texas. The Texas Academy of Psychiatry has required to run the day to day operations When I along with the other officers Hyatt Regency Hotel in Austin. Dr. Bud also been established to provide an organi- of the organization. We all have very busy assumed office this April, we took an oath Holcomb has arranged a very interesting zation for those psychiatrists, who may practices, and the majority of us practice which included having a fiduciary respon- and informative program: “The Dynamic have not been involved in organized psy- away from Austin. We all are deeply sibility to the organization. To ignore this Spectrum of Clinical Psychiatry.” Please chiatry for years, and for various reasons, indebted to these two individuals. would also serve to ignore the Texas laws begin making plans now to attend. I thank have chosen not to be a member of We are also strong because of our mem- for non-profit organizations. To ignore the you again for the opportunity to serve as APA/TSPP. bers. TSPP is truly member driven. Our membership trends of the last several your President and ask for your support in The legislative session is now over, and members volunteer for committees. Our years, or to repeatedly try methods of the coming year. we have had one of our most successful ses- committees discuss issues and develop

The Latest News from the Academy R. Sanford Kiser, MD, President, Texas Academy of Psychiatry

he Texas Academy of Psychiatry had its Psychiatry, an organization of organiza- Tfirst meeting in Dallas this April. In tions. The Federation – comprised of the operation for approximately 6 months, the Texas Society of Psychiatric Physicians, the Academy has been involved in basic startup Texas Academy of Psychiatry, the Texas activities. Foundation for Psychiatric Education The creation of the Academy was in Research, the Texas Society of Child and R. Sanford Kiser, MD response to survey results that found that Adolescent Psychiatry, and the Texas over 80% of Texas psychiatrists who were Medical Association – has established a grassroots basis, with person-to-person State of Texas to advance the interests of not members of either TSPP or APA wanted powerhouse of critical mass and thereby contacts as the basis for communication. our profession, to improve the treatment to be a part of organized psychiatry. Many created a powerful aggregate voice. The We have been gratified to see signs of a of the mentally ill, to advance the stan- of the respondents indicated that they recently concluded successful legislative “halo” effect from these developments, with dards of all psychiatric facilities and wanted to be involved at the state level. session has been the first fruits of this effort. membership interest in both TSPP and the services, to promote psychiatric research That finding was important, for it revealed The Texas Academy of Psychiatry has Academy increasing. and education, to establish cooperation the existence of a critical need that was not now completed routine startup functions, The next stage of development of the among all parties interested in mental being met. In light of the fundamental such as adoption of bylaws, election of offi- Texas Academy of Psychiatry will include health, to educate the public, to advocate maxim that “All politics is local,” Texas psy- cers, incorporation as a Texas nonprofit cor- organization of committees and planning for our members and their patients, and to chiatry had to respond. poration, establishment of an IRS Federal for future meetings. work in concert with all interested parties One means to fill that void was the cre- Identification Number, etc. The Academy has no plans to take posi- in advocating for eliminating barriers and ation of the Academy. Another element has Recruitment for membership in the tions on social issues. Instead as stated in stigmas adversely affecting persons with been the creation of the Federation of Texas Academy continues to be on an informal our bylaws, we will be a resource in the mental illness.

2 TEXAS PSYCHIATRIST JUNE/JULY 2005 Federation Update Conway McDanald, MD, Chairman, Federation Delegate Assembly T E R A I O N D O E F he Federation of Texas Psychiatry, a Academy of Psychiatry, and the Texas F coalition of professional organizations Society of Child and Adolescent Psychiatry. # # T T united in advocacy for quality psychiatric The Texas Foundation for Psychiatric E Y X R A T care, is pleased with the outcome of its Education and Research is an Associate S I A P C H inaugural Legislative Session. The united member. S Y and strong voice of the Federation was rec- The Federation launched its website in ognized by the Texas Legislature in 2005, May, providing each member organization program. Additional information about the resulting in legislation that was generally an opportunity to publish information of malpractice program is included on the Conway L. McDanald, MD supportive of quality psychiatric care (see importance to members and the public. If you Federation’s website. page 1). haven’t visited the website (www.txpsych.org), The Federation is also pleased to Bylaws requested by the Delegates from The Federation continues to grow. we encourage you to do so. announce that it has launched a Job Bank TSPP. The TSPP Delegates requested the Joining the Federation recently as an The Federation is pleased with the on its website. The Federation invites cor- amendment to help clarify the mission of Associate member was the Texas Medical response by psychiatrists in Texas to the porations, organizations and individuals to the Federation which has been misunder- Association. The TMA’s support of the Federation’s relationship with the post career opportunities on the Job Bank stood by the American Psychiatric Federation reflects their strong support of Cunningham Group. The relationship was that may be of interest to Texas psychia- Association. In taking this action, the psychiatry in Texas. The voting members of formed to help psychiatrists identify and trists. Check it out. Federation is hopeful that it will help end the Federation now include the Texas obtain malpractice insurance. Hundreds of The Federation Delegate Assembly has the dispute the APA has with TSPP over its Society of Psychiatric Physicians, the Texas psychiatrists have already responded to this voted to approve an amendment to its participation in the Federation.

2005 Legislative Session — It’s Over! continued from page 1 service to be performed by a qualified men- reason of insanity may not be committed to a jury shall determine that a defendant is not resulting in: a) denial of coverage; b) refusal tal health professional who is authorized to mental health facility or ordered to receive guilty by reason of insanity if: a) the prosecu- to renew coverage; c) cancellation of cover- be a telepresenter. outpatient or community-based treatment tion has established beyond a reasonable age; d) limitation of the amount, extent, or for a cumulative period that exceeds the doubt that the alleged conduct constituting kind of coverage available; or, e) a determi- Legal maximum term provided by law for the the offense was committed; and, b) the nation of the rate or premium to be paid. HB 291 by Rep. Tony Goolsby and Senator offense for which the acquitted person was defense has established by a preponderance SB 50 by Senator Jane Nelson and Rep. John Carona allows a court to release to a tried. On expiration of the maximum term, of the evidence that the defendant was Larry Taylor allows a physician of a health victim or victim’s guardian or close relative the acquitted person may be further confined insane at the time of the alleged conduct. The maintenance organization or a preferred information about a defendant acquitted by in a mental health facility or receive outpa- jury may not be informed of the conse- provider to request that the contract of the reason of insanity, including name, address tient or community-based treatment under quences to the defendant if a verdict of not insurer or insurer’s clearinghouse may not and telephone number. civil commitment proceedings. Psychiatrists guilty by reason of insanity is returned. refuse to process or pay an electronically HB 2518 by Rep. Garnet Coleman and or psychologists appointed by the court to submitted clean claim because the claim is Sen. Robert Duncan requires that a mental conduct examinations pertaining to the Economic submitted together with or in a batch sub- health court must: a) ensure a person eligi- insanity defense must be licensed in Texas. HB 386 by Rep. Dan Gattis and Senator mission with a claim that is not a clean ble for the mental health court program is Psychiatrists appointed must be certified by Steve Ogden requires a pharmacy to offer a claim. provided legal counsel before volunteering the American Board of Psychiatry and patient the option of paying for the pre- to proceed through the program and while Neurology with added or special qualifica- scribed medication at a lower price instead Allied Health participating in the program; b) allow an eli- tions in forensic psychiatry and have experi- of paying the amount of the copayment, if Sunset bills re-authorizing the licensing of gible person to choose whether to proceed ence or training consisting of: a) at least 24 the price is lower than the amount of the psychologists (HB 1015), professional coun- through the mental health court program or hours of specialized forensic training relating patient’s copayment. selors (HB 1283), social workers (SB 415), proceed through the regular criminal justice to incompetency or insanity evaluation; b) at HB 1771 by Rep. Dianne Delisi and and marriage and family therapists (HB system; c) allow a participant to withdraw least five years of experience in performing Senator Jane Nelson requires that the 1413) all passed without expansions in from the mental health court program at criminal forensic evaluations for courts; and, Health and Human Services Commission scope of practice. I any time before a trial is initiated; d) provide c) eight or more years of continuing educa- develop an integrated care management a participant with a court-ordered individu- tion relating to forensic evaluations. In addi- model of Medicaid managed care. The alized treatment plan indicating the services tion, a psychiatrist appointed by the court as model is to be a non-capitated primary care that will be provided to the participant; and an expert must have completed six hours of case management model. e) ensure that the jurisdiction of the mental required continuing education in courses in HB 2678 by Rep. John Smithee and health court extends at least six months but forensic psychiatry in the 24 months preced- Senator Kel Seliger prohibits an insurer that Earn does not extend beyond the probationary ing the appointment. If the issue of the writes professional liability insurance for period for the offense charged if the proba- defendant’s sanity is submitted, the jury or physicians from considering whether, or the 14% annual tionary period is longer than six months. judge, depending on who is the trier of fact, extent to which, a physician provides ser- SB 837 by Senator Jeff Wentworth and Rep. shall determine and specify in the verdict vices to individuals who are recipients of Terry Keel requires that a person acquitted by whether the defendant is guilty, not guilty, or Medicaid or covered by the child health Return. not guilty by reason of insanity. The judge or plan program, including any consideration

TSPPs CME Accreditation Call for Nominations The 2006 Texas Society of Psychiatric Physicians’ Annual Convention and Scientific Limited Liability Program will be held November 3-5, 2006 at the Westin Galleria Hotel in Dallas, Texas. TSPP members interested in being considered for appointment as the 2006 Scientific Partnerships Program Chair should submit a brief resume outlining qualifications and knowledge of the CME process by August 1, 2005. 100% secured with As the Scientific Program Chair you will be appointed to the CME Committee and, in consultao0tion with the CME Committee, identify topics of interest expressed by the membership, write the program’s objectives, develop the content, and select appropri- residential ate speakers for the program. You will be responsible for promoting the meeting to the membership by articles in the Texas Psychiatrist and notices to Chapters. real estate deed of trust. On May 4, the Texas Medical Association In addition, as Scientific Program Chair you will be nominated as TSPP Vice President conducted a CME re-accreditation site sur- and be appointed to the TSPP Executive Committee. As a member of the TSPP Executive Up to 36-month term. vey of the Texas Society of Psychiatric Committee you will be responsible for participation in Executive Committee meetings Physicians. TSPP was the first medical spe- and telephone conference calls required to conduct business between Executive cialty society and the only one accredited by 9% monthly cash flow. Council meetings. TMA between 1986 and 2005. Since its initial 1 provisional accreditation in 1986, TSPP has On-site at the Scientific Program, you will preside over 1 ⁄2 days of the CME Program and Minimum $50k been re-accredited with full accreditation assist in the introduction of speakers and keeping the program on schedule. status in 1993, 1997 and 2001. Pictured are Additional information may be obtained by contacting the TSPP Office at 512/478-0605. persons involved in the re-accreditation site For prospectus survey: (first row left to right) Billie The TSPP CME Committee will receive and review applications for the position of TSPP Dalrymple, TMA CME Director and Scientific Program Chair and forward recommendations to the TSPP Nominating call weekdays, Accreditation Surveyor, Debbie Sundberg, Committee. The Nominating Committee will review the applications and forward its TSPP Assistant Director, Rege Stewart, MD, recommendations for approval to the Executive Council. evenings or weekends TSPP Immediate Past CME Committee Deadline for Submission of Applications: August 1, 2005 Chair and Consultant, (second row left to right) Conway McDanald, MD, TSPP CME Send your resume to: 512/258-9900 Committee Chair, Jefferson Nelson, MD, Texas Society of Psychiatric Physicians Past CME Committee Chair and Consultant 401 West 15th Street, Suite 675, Austin, Texas 78701 (Austin) to the CME Committee, and Mark Gregg, or, fax it to 512/478-5223 or send it by email to [email protected]. MA, TMA Accreditation Surveyor.

JUNE/JULY 2005 TEXAS PSYCHIATRIST 3 Texas Society of Psychiatric Physicians 2005 Annual Convention and Scientific Program he 2005 TSPP Annual Convention and Spectrum of Clinical Psychiatry,” features November 4, the TSPP committees will Bresnen of Austin (TSPP Special Service TScientific Program to be conducted at the following speakers: Larry Ereshefsky, meet and TSPP will conduct its Annual Award). the Hyatt Regency Hotel in Austin on PharmD, Kevin Gray, MD, Laurence Awards Banquet, this year recognizing On November 5, the Annual membership November 4-6 features an outstanding McCullough, PhD, Charles Raison, MD, Bernard Gerber, MD of (TSPP meetings of TSPP and the Texas Foundation program offering 10 Category I credits, Zachary Stowe, MD, and Karen Dineen Distinguished Service Award), Robert M.A. for Psychiatric Education and Research will including 2 hours of credits in medical Wagner, MD, PhD. Hirschfeld, MD of Galveston (TSPP be conducted. Also, the TSPP Executive ethics. The program, “The Dynamic In addition to the Scientific Program, on Psychiatric Excellence Award), and Steve Council will meet.

DAILY SCHEDULE

FRIDAY, NOVEMBER 4 SATURDAY, NOVEMBER 5 4:00 pm - 4:15 pm Refreshment Break 7:00 am - 8:00 pm Registration/Information 7:30 am - 6:00 pm Registration / Information w/Exhibitors 5:30 pm Exhibits Tear Down 7:30 am - 6:00 pm Committee Meetings 7:30 am - 8:30 am Complimentary Continental Breakfast for Program 5:40 pm - 7:00 pm Executive Council 12:00 pm - 1:15 pm Member Luncheon Registrants w/Exhibitors 12:00 pm - 5:00 pm Exhibits Set-Up 7:30 am - 5:30 pm Exhibits SUNDAY, NOVEMBER 6 6:00 pm - 7:30 pm Exhibits Open / 8:45 am - 5:15 pm Scientific Program 7:30 am - 1:00 pm Registration / Information Welcome Reception 10:30 am - 10:50 am Refreshment Break 7:30 am - 9:00 am Complimentary Continental with Exhibitors w/Exhibitors Breakfast for Program Registrants 7:30 pm Annual Awards Banquet 12:20 pm - 2:00 pm Annual Business Meeting / Luncheon w/Exhibitors 8:00 am - 12:20 pm Scientific Program

Scientific Program Schedule available online at www.txpsych.org or to request additional information, contact TSPP at [email protected] or call 512-478-0605.

MEETING LOCATION T EXAS S OCIETY OF P SYCHIATRIC P HYSICIANS The Annual Convention and Scientific Program will be held November 5-6, 2005 at the Hyatt Regency Austin Hotel, 208 Barton 2005 ANNUAL CONVENTION & SCIENTIFIC PROGRAM Springs Road, Austin, Texas. Conveniently November 5-6, 2005 • Hyatt Regency Austin Hotel, Austin, Texas located in the heart of Austin’s business dis- trict near the State Capitol, the hotel offers Please complete this form and return it with your check, money order or credit card information for your registration and event fees to the Texas breathtaking views of Town Lake and the Society of Psychiatric Physicians, 401 West 15th Street, Suite #675, Austin, Texas 78701 by October 24 to receive the discounted registration fee. glittering Austin skyline. Make plans for a Registration forms and payments by credit card may be FAXED to TSPP at 512/478-5223. relaxing and stimulating weekend enjoying the many activities TSPP has arranged, including an outstanding CME program. NAME E-MAIL During your leisure time, enjoy the outdoor heated pool and spa, fitness center and ADDRESS CITY STATE ZIP PHONE nine miles of beautifully landscaped hike n’ bike paths on the shores of Town Lake. A NAME(S) GUEST(S) ATTENDING (for name badges) short distance away is shopping, historic 6th Street and the Warehouse REGISTRATION FEES Entertainment District. We know this will Indicate the NUMBER of individuals who are registered for each event in the appropriate enrollment category listed below. Please note the enrollment be a meeting and weekend you will not fees are PER PERSON and your payment should reflect the proper fee for the number of individuals registered per event. want to miss! DISCOUNTED DISCOUNTED REGISTRATION AFTER REGISTRATION AFTER NUMBER ATTENDING EVENT (If postmarked before 10/24) 10/24 NUMBER ATTENDING EVENT (If postmarked before 10/24) 10/24 DISCOUNTED REGISTRATION FEES TSPP/TEXAS ACADEMY OF PSYCHIATRY MEMBER LUNCHEON SCIENTIFIC PROGRAM - Saturday and Sunday TSPP has arranged a special discounted rate I for program registrants at the rate of #I TSPP/Texas Academy of Psychiatry # TSPP/Texas Academy of Psychiatry Member $190 $235 $149.00 single or double occupancy. Hotel Member Luncheon - Friday $15 $20 #I TSPP/Texas Academy of Psychiatry MIT/ Medical Student $ 25 $ 35 reservations may be made by referring to WELCOME RECEPTION - Friday Evening #I Non-Member $235 $290 the group name “Texas Society of #I NOT Registered for Scientific Program $40 $50 Psychiatric Physicians” and calling the #I Non-Member MIT/Medical Student $35 $50 #I Registered for Scientific Program No Chg No Chg Hyatt Reservations Department at 512/477- #I Allied Health Professional $ 105 $130 1234 or toll free 1/800-233-1234. TSPP Members/Texas Academy of Psychiatry #I Spouse $ 95 $120 Discounted room rates are only available if Members/Non-Members/Spouse/Guest #I Advocacy Organization Leadership $ 35 $50 reservations are made BEFORE October 13. AWARDS BANQUET – Friday Evening Discounted meeting registration fees are #I Awards Presentations/Banquet $25 $35 ANNUAL BUSINESS LUNCHEON available to individuals who register #I Annual Business Luncheon – Saturday $15 $20 BEFORE October 24. Mail or FAX your reg- istration form and payment using your VISA or MasterCard to TSPP, 401 West 15th Street, I If you require any Suite #675, Austin, Texas 78701 or if paying # Vegetarian Plate Requested special assistance * No add’l charge if requested by credit card, FAX your registration form to to fully participate in TOTAL REGISTRATION prior to 10/24 this conference, please $ 512/478-5223. ** After 10/24 & On-site add add’l contact TSPP at FEE ENCLOSED $5.00 for each Luncheon/Banquet Fee (512) 478-0605. Cancellation policy: In the event of cancel- lation, a full refund will be made if WRIT- METHOD OF PAYMENT - Make checks payable to “Texas Society of Psychiatric Physicians” TEN notice is received in the TSPP office by October 24, 2005, less a 25% handling Method of Payment charge. NO REFUNDS will be given after October 24, 2005. I Check I VISA I MasterCard Credit Card #______Exp. Date ______

SOCIAL ACTIVITIES Name of Cardholder (as it appears on card) ______The weekend’s activities kick off with a complimentary wine and cheese reception Signature ______with exhibitors for convention registrants and their spouse/guest. Following the Credit Card Billing Address ______reception, the TSPP Annual Awards ADDRESS CITY STATE ZIP Banquet will be held honoring the 2005 CANCELLATION POLICY: In the event of cancellation, a full refund will be made if written notice is received in the TSPP office by TSPP Award Recipients in recognition of October 24, 2005, less a 25% handling charge. No refunds will be given after October 24, 2005. their outstanding contributions to Return to: TSPP • 401 West 15th Street, Suite #675 • Austin, TX 78701 • (512) 478-0605 • FAX (512) 478-5223 Psychiatry.

4 TEXAS PSYCHIATRIST JUNE/JULY 2005 Mental Illness Awareness Week – 2005

lanning should be underway in each programs to reach as broad an audience as To apply for these MIAW grants, Chapter a condition of accepting a grant from the PTSPP Chapter for Mental Illness possible; and 3) to involve community lead- Presidents should submit the Chapter’s Foundation, a Chapter receiving a grant is Awareness Week 2005, the first week in ers, policymakers, educators, clergy, the grant request to the Foundation prior to expected to submit a brief written report October. The purpose of MIAW is to increase media etc. in delivering positive and infor- August 1. A Foundation Grants Review about its MIAW activities to the Foundation the public’s understanding of mental ill- mative messages about psychiatric illnesses. Committee will evaluate grant requests and by November 1. nesses and psychiatric treatments. MIAW Again this year, the Texas Foundation for will forward funding recommendations to Mental Illness Awareness Week is an provides an annual opportunity to address Psychiatric Education and Research will the Foundation’s Executive Committee for excellent opportunity to educate the public three primary goals: 1) to encourage psychi- provide grants to TSPP Chapters to help final approval. An important consideration about mental illnesses and to foster atrists to collaborate with mental health underwrite the expenses of MIAW activities. in determining funding amounts will be the working relations with patient advocacy advocacy organizations in the planning and Each Chapter President will receive infor- level of participation by psychiatrists in groups in each community. TSPP and the implementation of MIAW activities; 2) to mation about funds available for each MIAW activities. Funds will be distributed Foundation encourages all Chapters to produce a variety of educational outreach Chapter as well as grant application forms. to Chapter Presidents by September 15. As participate this year. If you have not yet made your 2005 contribution to the Texas Foundation for TEXAS FOUNDATION FOR Psychiatric Education and Research, please PSYCHIATRIC EDUCATION AND RESEARCH consider sending your tax deductible dona- tion to the Foundation today! I

I am pleased to support the Foundation with a contribution of:

I $50 I $100 I $250 I $500 I $1000 I $______CALL FOR ENTRIES I am pleased to support the Foundation with a pledge of $ ______payable ______2005 TEXAS SOCIETY OF DONOR INFORMATION Contact me about a PLANNED GIFT as follows: PSYCHIATRIC PHYSICIANS

Name______I A Bequest RESIDENT PAPER COMPETITION Papers are now being accepted for the Address ______I A Gift of Insurance 2005 Residents' Paper Competition! Entries must be an original work pro- ______I A Charitable Trust duced by a resident member of TSPP while in residency training. The paper may be a piece of original research, Telephone ( )______literature review or discussion on a topic of interest to psychiatrists and Please make your check payable to “Texas Foundation for Psychiatric Education and Research” should be 10-12 typewritten, double- 401 West 15th Street, Suite 675, Austin, Texas 78701. spaced pages (excluding references). In Thank you for your support! Your contribution is tax deductible to the full extent of the law. the case of multiple author papers, the resident must be the one who has done the bulk of the research and writing. A statement to this effect must accom- Welcome New Members pany the paper from the co-authors. TSPP NEW MEMBERS The winner will be announced in advance, and the paper presented at the The following membership applications have been approved by the TSPP Executive Committee and have been transmitted to the APA. November 5-6, 2005 TSPP Annual Member in Training McClam, Michael, MD Karakoc, Tayfun, MD Transfer from Other District Scientific Program at the Hyatt Regency Ali, Farida Y., MD Ortiz, Waleska C., MD Matorin, Anu, MD Branches Hotel in Austin, Texas. All papers Ballard, Rachel R., MD Xia, Guohua, MD Moukaddam, Nidal, MD Cruz, Yvette M., MD entered in the competition will be Bhargava, Sharlaw, MD Ybarra, Christie A., MD Istafanous, Ihab M., MD Brasier, Cynthia, MD General Member Johnson, Douglas, MD recognized at the meeting. The winner Chaudhry, Asif, MD Member in Training to Deuter, Melissa, MD Kim, Bernard, MD will receive a certificate presented in Flores, Virginia, MD General Member Kassaw, Kristin, MD Light, Stacy, MD recognition of the presentation, as well Gazarov, Aleksandr, MD Al Jurdi, Rayan, MD Schneider, Laurie, MD Mehta, Sejal, MD as a $250 honorarium and waiver of the Guchereau, Michelle, MD Ballard, Tiffany E., MD Stanfield, Peter, MD Ruiz, Rafael, MD Judd, Kathryn, DO Brooks, Karen M., MD Wolski, Irene, MD Starling, Kelley, MD scientific program registration fee and one night’s hotel accommodation at the host hotel. Runners-up will be invited You have just been subpoenaed. to present their papers as posters, the poster session to be held Friday, Saturday and Sunday, November 4-6 Do you know how to respond? during the hours of the welcome recep- tion and scientific program. Residents If you have your malpractice insurance through The Psychiatrists' Program submitting papers will be notified of the you can rest assured. With a simple toll-free call, a risk manager can assist you judges’ decision no later than with the immediate steps you need to take to protect your practice. September 30. As a Program participant, you can call the Risk Management Consultation The 2005 Scientific Program, will Service (RMCS) to obtain advice and guidance on risk management issues address the following: encountered in psychiatric practice. Staffed by experienced professionals with • Ethical Challenges in Assessing both legal and clinical backgrounds, the RMCS can help prevent potential Patients’ Decision-Making Capacity professional liability incidents and lawsuits. • Update on Childhood Major Depression If you are not currently insured with The Program, we invite you to learn more about the many psychiatric-specific benefits of participation. Call today to • Psychiatric Medications and receive more information and a complimentary copy of "Six Things You Can Pregnancy Do Now to Avoid Being Successfully Sued Later." • Dr. Parkinson’s Omission: the Clinical Faces of Lewy Body Dementia

SEND TWO COPIES THE PSYCHIATRISTS’ PROGRAM OF YOUR MANUSCRIPT TO: The APA-endorsed Psychiatrists' Professional Liability Insurance Program Texas Society of Psychiatric Physicians 401 West 15th Street, Suite 675 Call: 1-800-245-3333, ext. 389 ~ E-mail: [email protected] Managed by: Austin, Texas 78701 Visit: www.psychprogram.com DEADLINE FOR SUBMISSION OF

Managed by Professional Risk Management Services, Inc (In California, d/b/a Cal-Psych Insurance Agency, Inc.) PAPERS IS AUGUST 1, 2005

JUNE/JULY 2005 TEXAS PSYCHIATRIST 5 Texas Senate Recognizes TSPP

On May 18, 2005, the Texas Senate adopted Senate Resolution 940 recognizing the Texas WHEREAS, The Texas Society of Psychiatric Physicians has taken a leadership role in edu- Society of Psychiatric Physicians, as follows: cating policymakers and the general public about mental illnesses and psychiatric treat- ments; and WHEREAS, The Texas Society of Psychiatric Physicians has been the professional organiza- tion in Texas representing psychiatry since 1956 and will celebrate its 50th Anniversary in WHEREAS, The Texas Society of Psychiatric Physicians has been since 1986 the first and 2006; and only medical specialty society in Texas accredited for continuing medical education by the Texas Medical Association; and WHEREAS, The Texas Society of Psychiatric Physicians is recognized for its role in defining quality psychiatric care for patients in Texas in all practice settings, including both the pri- WHEREAS, The Texas Society of Psychiatric Physicians is recognized for its leadership role vate and public sectors; and in providing quality continuing medical education for its members and other physicians in Texas; and WHEREAS, The Texas Society of Psychiatric Physicians has encouraged and supported the active involvement of patient and mental health advocacy organizations in the public pol- WHEREAS, The Texas Society of Psychiatric Physicians has consistently advocated for the icy arena through the establishment and nurturing of the Mental Illness Awareness interests of patients and the eradication of discrimination and stigma against persons with Coalition; and psychiatric illnesses; and

WHEREAS, The Texas Society of Psychiatric Physicians has had a long and effective partici- pation in the legislative process and been proactive in advancing quality medical and psy- chiatric care for the citizens of Texas based on the latest advances in science; and

WHEREAS, The Texas Society of Psychiatric Physicians helped in the establishment of the Legislative Mental Health Awareness Group, a group of legislators with an interest in better understanding mental illness and its treatment; and

WHEREAS, The Texas Society of Psychiatric Physicians is recognized for its role in encour- aging the establishment of the Federation of Texas Psychiatry, an umbrella organization that will bring together medical organizations in Texas representing some 50,000 physi- cians to form a united voice advocating for patients and quality psychiatric care; now, therefore, be it

RESOLVED, the Senate of the State of Texas, 79th Legislature, commends the Texas Society of Psychiatric Physicians for bringing together many diverse groups of physicians, patients and mental health advocacy organizations in the service of the mental health of Texans of all walks of life; and be it further

RESOLVED, That a copy of this Resolution be prepared in honor of the Texas Society of Receiving the Resolution on the floor of the Senate were John Bush, Executive Director, Gary Etter, MD, TSPP President, and Psychiatric Physicians’ 50 years of service to Texas and as an expression of esteem from the Clay Sawyer, MD, TSPP Immediate Past President. Texas Senate.

FEDERATION OF TEXAS PSYCHIATRY CALENDAR OF MEETINGS The Federation was established on July 1, 2004 with the following purposes:

JULY A. to promote the common professional interests of psychiatrists; B. to facilitate the coordination of and work in concert with state professional psy- 22-24 TSCAP Summer Meeting chiatric associations and state professional subspecialty psychiatric associations, “The Adolescent Brain: Developmental, Psychotherapeutic to unify programs that advance public and professional education and advocacy and Pharmacologic Issues” for psychiatry and persons with psychiatric illnesses; Lakeway Inn Conference Resort on Lake Travis C. to provide centralized services to state professional psychiatric associations and Austin, TX state professional subspecialty psychiatric associations; D.to make psychiatric knowledge available to other practitioners of medicine, to sci- OCTOBER entists, and to the public; and, E. to promote the best interests of patients and those actually or potentially making 20-23 6th Annual Medical Fiction Writing for Physicians use of mental health services. Sea Crest Oceanfront Resort and Conference Center Cap Cod, Massacheusetts The TEXAS PSYCHIATRIST is published 5 508/457-1111; [email protected] 9 4 e X 1

times a year in February, April, June, August, g D T

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and October. Members of Federation member I N o o I T P T A R N

S . P S organizations are encouraged to submit arti- t NOVEMBER i S R U . m P A r

cles for possible publication. Deadline for U e 4-6 TSPP Annual Convention and Scientific Program submitting copy to the Federation Executive P “The Dynamic Spectrum of Clinical Psychiatry” Office is the first day of the publication month. Copy must be edited, acceptable for Hyatt Regency Austin Hotel publication. Austin, TX Display advertising is available and publica- 4 TSPP Committee Meetings tion is determined on a case by case basis by the Editorial Board. The Editorial Board Member Luncheon reserves the sole right to accept or reject any Welcome Reception with Exhibitors submitted advertising copy. Annual Awards Banquet EDITORIAL BOARD 5 TSPP Scientific Program Joseph Castiglioni, Jr., MD

Annual Business Meetings Edward L. Reilly, MD y r t a

Executive Council Meeting i

MANAGING EDITORS h c y 6 TSPP Scientific Program John R. Bush 5 s 7 6 P

Debbie Sundberg e t s L i a A u I S x

Federation of Texas Psychiatry R , t e E 1 e T T

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6 TEXAS PSYCHIATRIST JUNE/JULY 2005