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2009 Legislation Summary
During the course of the 81st Texas Legislature from January to
June, 2009, the Federation of Texas Psychiatry tracked 294 bills that had the
potential of affecting the practice of psychiatry. Seventeen percent of the
bills were passed and became law, as follows:
|
Category |
Tracked |
Priority 1 |
Priority 2 |
Priority 3 |
Passed into Law |
% |
|
Mental Health |
33 |
0 |
31 |
2 |
8 |
24% |
|
Allied Health |
16 |
3 |
13 |
0 |
3 |
19% |
|
Substance Abuse |
4 |
0 |
4 |
0 |
0 |
0% |
|
Legal |
28 |
1 |
25 |
2 |
3 |
11% |
|
Children |
42 |
3 |
32 |
7 |
10 |
24% |
|
Economic |
76 |
2 |
64 |
10 |
7 |
9% |
|
Other |
95 |
3 |
62 |
30 |
18 |
19% |
|
TOTAL |
294 |
12 |
231 |
51 |
49 |
17% |
Although some bills were filed that would have harmed patients and the
practice of psychiatry, none were passed. Overall, psychiatry had a very
successful legislative session.
The Federation’s success during the Session can be attributed to several
factors: psychiatrists who have responded to the Federation’s program of
visiting with legislators and candidates during the election cycle, providing
important education about psychiatric issues and forming relationships;
psychiatrists who interrupted their busy schedules to come to Austin during the
Session to provide testimony on key bills; psychiatrists who reviewed bills and
provided input that resulted in lobbying strategy; Psychiatrists who responded
to legislative alerts and made contact with legislators; and psychiatrists who
attended Capitol Day along with coalition partners (Depression and Bipolar
Support Alliance, NAMI Texas and Mental Health America of Texas) to send a
strong and united message to legislators. The Federation’s success may also be
attributed to the "strength in numbers," (ie, representing over 40,000
physicians in Texas) and "united voice for psychiatry" afforded by the
Federation’s affiliated organizations: Texas Society of Psychiatric Physicians,
Texas Academy of Psychiatry, Texas Society of Child and Adolescent Psychiatry,
Texas Osteopathic Medical Association, and the Texas Medical Association.
The following is a summary of some of the Federation-tracked bills that
passed and became law:
CHILDREN
HB 2163 (S. Turner/C. Uresti) - The Health and Human Services
Commission shall conduct a study to determine the appropriateness and safety of
providing antipsychotic and neuroleptic medication through the Medicaid vendor
program to children under 16 years of age.
HB 1630 (E. Naishtat/K. Watson) - Requires that children must be
assessed by the Texas Youth Commission and the Texas Juvenile Probation
Commission for eligibility for the child health plan program prior to release.
SB 187 ( R. Deuell/E. Lucio III) - Provides for a Medicaid but-in
program for children with disabilities whose family incomes do not exceed 300%
of the applicable federal poverty level.
MENTAL HEALTH
HB 1067 (E. Naishtat/J. Nelson) - Allows for the reporting of suicide
data that does not name the deceased individual. Reported suicide data may be
used for suicide prevention purposes.
HB 2303 (V. Truitt/C. Uresti) - Includes within the scope of services
that may be rendered by a community center the treatment of persons with
developmental disabilities.
SB 1325 (J. Nelson/F. Corte) - Requires the Department of State
Health Services to develop a mental health intervention program for military
veterans and to include in the program peer-to-peer counseling.
ECONOMIC
SB 1 (S. Ogden/J. Pitts)- The General Appropriations bill. A total of
$85.1 million in new funds was appropriated for community mental health funding
for 2010-2011, including $56.2 million for the crisis mental health strategy,
$7.9 million for the adult mental health strategy and $5.6 million for the
children mental health strategy.
HB 1342 (J. Menendez/C. Harris)- Beginning September 1, 2013,
physicians will be required to use information technology that interfaces with
health benefit plans (copayments, coinsurance, applicable deductibles, benefits
and services, etc).
HB 1888 (J. Davis/R. Duncan)- Establishes ground rules for a health
benefit plan to follow in ranking physicians, classifying physicians into tiers
based on performance, or publishing physician specific information.
ALLIED HEALTH
SB 1291 (L. Van de Putte/T. Martinez Fischer) - Removes statutory
language that health insurance policies "may" require a physician’s
recommendation in order for an enrollee to see a licensed professional counselor
or a marriage and family therapist.
SB 381 (Van de Putte/C. Hopson)- Permits a physician to delegate
authority to a pharmacist to prescribe dangerous drugs in a hospital,
hospital-based clinic or academic health care institution.
SB 532 (D. Patrick/G. Coleman)- Broadens delegation of prescribing of
controlled substances by a physician to physician assistants and advance nurse
practitioners by increasing the number of persons allowed for delegation from 3
to 4, by allowing for the refilling of prescriptions, and to increase the period
for the prescription from 30 days to 60 days. It also expands from 60 miles to
75 miles the distance a physician assistant or advanced practiced nurse may be
supervised by delegating physician. Also, the time required for a delegating
physician to be on-site with an advanced practice nurse or physician assistant
is reduced from 20% to 10%.
OTHER - CORPORATE PRACTICE OF MEDICINE
SB 1705 (R. West/J. Pitts)- Allows the Dallas County Hospital
District to employ physicians. Employment contracts may not exceed 4 years. Each
employed physician shall report to the chief medical officer. This legislation
may not be construed as authorizing the Dallas County Hospital District to
supervise or control the practice of medicine.
OTHER - TEXAS MEDICAL BOARD
HB 732 (W. Hartnett/J. Huffman)- In the annual update of a
physician’s profile, the Board must remove any record of a formal complaint if
the complaint was dismissed more than 5 years before the date of the update and
the complaint was dismissed as baseless, unfounded, or no action was taken
against a physician’s license as a result of the complaint.
SB 292 (J. Nelson/S. King)- Each license holder shall submit to the
Texas Medial Board telephone numbers, fax numbers and email addresses that the
Board may use to contact the license holder in an emergency.
Bills that Failed to Pass
Perhaps, the bills that failed to pass may be more news-worthy, as follows:
Children
HB 3127 (S. Turner) - Prohibits the administration of a psychoactive
or psychotropic medication to a child younger than 11 years of age if the
medication is not listed as approved for use with a person of the child’s age.
The list of acceptable medications will include psychoactive or psychotropic
medications approved by the FDA.
HB 3662 (S. Turner)- If a child in the managing conservatorship of
the state is prescribed three or more psychotropic drugs, the state will refer
the child’s case to HHSC to be reviewed by a physician to determine whether or
not the child medical treatment is consistent with standards of care for a
patient diagnosed with the child’s mental disorder or documented symptoms.
Mental Health
SB 750 (J. Zaffirini)- Addresses consent procedures for psychoactive
medications in residential care facilities.
SB 1627 (J. Wentworth)- Requires that all patients committed to
temporary or extended inpatient health services provide fingerprints for
retention by the bureau of identification and records. Also requires the
collection of a DNA sample from persons found manifestly dangerous in an order
the person to extended mental health services or is committed to a maximum
security unit.
SB 1665 (J. Wentworth)- Allows a judge to find a person who is
committed for extended mental health services as "manifestly dangerous" if the
judge or jury finds the proposed patient is likely to cause serious harm to
others. It also establishes procedures for post-commitment treatment and
supervision of persons with mental illness who are found to be manifestly
dangerous.
SB 2247 (J. Zaffirini)- Prohibits a health care practitioner from
issuing a prescription drug order for a PRN psychoactive medication administered
by injection to a person who is in a residential treatment center unless the
drug is administered in a psychiatric emergency or under court order.
Legal
HB 1150 (S. Thompson)/ SB 168 (R. Ellis)- Changes to standard not
guilty by reason of insanity from "did not know that the conduct was wrong," to
"did not appreciate that the conduct was legally or morally wrong."
SB 1626 (J. Wentworth)- A professional is required to report to a law
enforcement agency any threat a patient communicates against a reasonably
identifiable person if the professional determines in good faith that disclosure
of the threat is necessary to protect the health or safety of a person.
SB 1623 (J. Wentworth)- Establishes a procedure to provide "federal
prohibited person" information to the FBI for use with the National Instant
Criminal Background Check System. "Federal prohibited person" includes persons
ordered by a court to receive inpatient mental health services.
Economic
SB 1257 (K. Averitt)/HB 2750 (C. Eiland)- TMA’s centerpiece for its
health insurance reform agenda. Provides accountability and transparency in the
way health insurance companies conduct business.
SB 586 (J. Carona)/HB 1442 (K. Hancock)- Health insurers may not
prohibit, penalize, terminate or restrict a preferred provider from
communicating with a patient about the availability of out-of-network providers
for the provision of the insured’s medical or health care services.
Allied Health
HB 3465 (J. Keffer)- Includes in the definition of "practitioner,"
licensed allied health professions in Texas of psychology, professional
counselors and chiropractors and licensed by other states and Canada, such
licenses allowing for the prescribing of dangerous drugs.
HB 696 (R.Orr)/SB 680 (G. Hegar)- Replaces physician-delegated model
of care with an open-ended and loosely structured "prescriptive authority
agreement" between a physician and a advanced practice nurse or physician
assistant. There are no requirements for supervision and unclear
responsibilities for the Texas Medical Board.
HB 858 (J. Laubenberg)/SB 484 (R. Deuell)- Requires a psychological
associate to practice under the supervision of a psychologist in order to
practice psychology.
HB 2023 (J. Laubenberg)- Establishes criteria under which a
psychologist may delegate authority.
Other- Corporate Practice of Medicine
SB 1500 (R. Duncan)- Allows hospitals in counties of 50,000 or less
population to employ physicians and retain all or part of the professional
income generated by the physician for medical services provided at the hospital.
Other- Texas Medical Board
HB 3816 (F. Brown)- Proposes significant changes in the operation and
procedures of the Texas Medical Board, including: 1) creation of an advisory
panel to receive and investigate complaints concerning the operations and
disciplinary actions taken by the Board; 2) a person filing a complaint against
a physician must swear under oath to the truth of the statements in the
complaint; 3) a physician who is subject of a complaint is to receive a copy of
the complaint without redaction; 4) the physician who is subject of the
complaint is to be given the identity and qualifications of each expert
physician who reviewed the complaint; and 5) the Board may not require a
physician to practice medicine in any particular manner.
For details about specific bills, please visit
http://www.legis.state.tx.us
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FEDERATION
OF TEXAS PSYCHIATRY
