APRIL/MAY 2021 Texas Psychiatrist T E R A I O N D O E F F ★ ★ The pandemic continues... T E Y X R A T S I A P S Y C H J. Clay Sawyer, M.D., DLFAPA, Chair, Texas Federation of Psychiatry t will come as no surprise that we con- Itinue to be gripped by the Covid-19 pan- Our opposition to the first three bills stems from our continuing demic. On top of that, our entire state was paralyzed in mid-February by a severe win- ter storm which left millions of Texans concern for patient safety. Nurses and psychologists all do without power, without heat, and without water; for many, this severe situation lasted tremendous and valuable work within the fields for which they for days on end. In Waco alone, we had six J. Clay Sawyer, MD, DLFAPA inches of snow preceded by nearly an inch are trained, but none are trained to be physicians. of ice and followed by more ice, with sub- freezing temperatures (the coldest: 1 degree be gradually increasing yet again. As a below zero) for eight consecutive days. our support for SB 672 regarding collabora- If you would like to comment to the nationally-known expert recently stated, Other areas of the state experienced even tive care. legislature on this issues (please do – num- “Now is not the time to spike the ball before worse conditions. Early analysis appears to Our opposition to the first three bills bers matter!), you can use this weblink: crossing the goal line!” show that sensible preparations for winter stems from our continuing concern for texmed.org/grassroots . TMA’s home web- We cannot yet let down our guard and storms on the part of Texas’ energy industry patient safety. Nurses and psychologists all page (texmed.org) has a wealth of informa- assume that the worst is over, not with new had been advised, but never took place. do tremendous and valuable work within tion on these and other issues of great mutant forms of the virus beginning to The Texas Legislature is presently attempt- the fields for which they are trained, but concern to the practice of medicine in Texas. appear in Texas (some of these mutants are ing to address this calamity. none are trained to be physicians. We have And, you can find even more resources on feared to be more easily transmissible and Speaking of the Legislature, the Federa - always maintained that only those fully our own webpage (txpsych.org). Please let potentially more lethal than the original tion is actively at work in our ongoing tasks trained as physicians are qualified to bear your voice be heard! form of the virus), and certainly not with the of advocating for our patients as we offer the tremendous responsibilities involved in Finally, I must address the continuing illusion that those who have been fully vac- education to legislators in the issues being a physician and in delivering the pandemic. I have spoken to more than a cinated need no longer take precautions. It involved in that advocacy effort. The foci of highest quality care to our patients – we are few people who truly believe that the pan- is our responsibility to continue to educate our concerns are as follows: our opposition responsible for their very lives, and the demic is over because of the lifting of the the general public that masking, distancing, to House Bill (HB) 2029 and Senate Bill (SB) intense training and education we undergo mask mandate in mid-March. This belief hand-washing, and avoidance of large 915, both of which would grant APRNs are truly the minimum requirements for could not be further from the truth! The crowds in general (and close proximity situ- independent practice privileges; our oppo- assuming this tremendous obligation to the “lowered numbers” regarding new cases, ations in particular) must be maintained sition to HB 1462 which would grant pre- general public and in earning the trust they hospitalizations, and fatalities leveled off until we attain true herd immunity. scribing privileges to psychologists; and, place in us. after a period of decline, but now appear to We owe our patients no less. ■ T E R A I O N D O E F F ★ ★ Make Your Voices Heard T E Y X R A T S I A Debra Atkisson, M.D., DFAPA, Vice Chair Public Policy, Texas Federation of Psychiatry P S Y C H he 87th Legislature is meeting now. holistically using the biopsychosocial also. Prescribing medications without med- TAnd many nonphysicians are making model. ical training is a prescription for disaster. their voices heard loudly about how they The bills we MUST speak out about are Let your Representative know about the can solve the healthcare needs of Texans as HB2029 by Stephanie Klick, which will be dangers involved in letting this bill move soon as the legislature votes for them to heard in the House Public Health forward. have the privilege of independent practice. Committee this week. This bill gives Positive bills filed to help the healthcare We physicians value the work our non- Advanced Practice Nurse Practitioners the of Texans include SB 672 by Senator Dawn physician team members provide in the legislative approval to practice medicine Buckingham, which directs the Health and care of patients. Physicians know what independently – without going to medical Human Services Commission to establish a Debra Atkisson, M.D., DFAPA patients need best and we should be lead- school. Senator Kelly Hancock in the Senate Medicaid collaborative care model as well ing the team that provides that care. Business and Commerce Committee has as providing for the reimbursement for All of us attended medical school for filed a companion bill SB915 which services provided under the model. sight of the Texas Department of Insurance. four years and completed 18,000 to 20,000 approves the independent practice of Telemedicine has proven to be a modality Companion bills include: HB 522 by Rep. hours of postgraduate training. Nurse Nurse Practitioners. The coalition of Nurse that can reach healthcare needs. A number Julie Johnson; HB 988 by Rep. Art Fierro; Practitioners complete 500 to 1500 hours of Practitioner supporters have made their of bills have been filed to support the ongo- and SB 228 by Sen. Cesar Blanco. training. Nurse Practitioners are valuable voices heard – loud and clear – to our legis- ing practice and reimbursement of We have a duty to Texans to speak out members of our team, but do not have the lature. telemedicine/telepsychiatry. Those bills about what can help their healthcare – and education and experience to practice medi- A bill in the House Public Health include HB 515 by Rep. Tom Oliverson what can harm them. Make your voice cine. The rigorous training and experience Committee granting psychologists the abil- which ensures payment parity between heard this week to your Representative, we receive prepares us to treat patients ity to prescribe medications independently, medical services and telemedicine/tele- Senator, and House Public Health HB 1462 by Vikki Goodwin, has been filed health services for plans under the over- Committee. Texans need your voice! ■ I NSIDE Calendar . .8 VIRTUAL VIRTUAL Congratulations, TSPP New Officers . .3 TSPP/TAP TSCAP CME Program Foundation 2021 . .5 Spring CME Program Legislative Session Update . .2 Child Psychiatry TSCAP Virtual Live CME Webinar . .6 Cutting Edge at the Crossroads Focus on At Risk Populations Time for Action . .3 Psychiatry in the Time of COVID and Social Change TSPP President’s Message . .3 TSPP Spring Virtual CME . .4 APRIL 17, 2021 JULY 24, 2021 T E R A I O N D O E F F ★ ★ T Legislative Session Update E Y X R A T S I A P S Y C H Eric Woomer, Federation of Texas Psychiatry Public Policy Consultant he 87th Texas Legislature was in full Advanced Practice Registered Nurses Telepsychiatry allows psychiatrists to become Tswing when it encountered an unprece- (APRNs): APRNs are telling lawmakers they a part of a patient’s care team at a distance by dented hurdle in the middle of February. need the authority to diagnose and prescribe collaborating with primary care physicians Already faced with the challenges of COVID- independent of physician supervision, but do and other providers. To protect patients from 19, the Capitol was shut down by an extraor- not have the needed medical and clinical the risks of COVID-19, Texas has in place flex- dinary winter weather event that training. Physician training is very different ibilities for telemedicine and telehealth dur- overwhelmed the entire state. The severe from that of an APRN: A primary care physi- ing the public health emergency. Gov. Abbott weather nearly collapsed the state’s energy cian completes between 12,000 and 16,000 in his State of the State address made Eric Woomer grid, and left millions of Texans without hours of competency-based, clinical training, telemedicine and telehealth flexibilities an power and water for days, causing a shift in compared with only 500 to 720 hours for emergency item, calling on the Legislature to focus at the Legislature. APRNs. make these flexibilities permanent beyond Reacting to the extreme winter conditions APRNs argue they will improve access to the pandemic. and responding to the suffering of millions of care in rural and underserved areas of the Filed Legislation: Several bills have been law prohibits states from using Medicaid to Texans has become a priority of state govern- state. However, in data from other states filed related to telemedicine and telehealth pay for care provided in inpatient private psy- ment.