Capitol Update: TAFP responds to attacks on scope with new resource

posted 03.03.11

Your Academy recently published a policy brief addressing common arguments for expanding advanced practice nurses’ scope of practice and providing evidence for upholding current scope laws in Texas.

Titled, “The Question of Independent Diagnosis and prescriptive Authority for Advanced Practice Registered Nurses in Texas: Is the Reward Worth the Risk?” author Marie-Elizabeth Ramas, M.D., asks three questions. Should the state of Texas redefine the practice of medicine, and what governing board should regulate nurses practicing medicine? What should the minimum standard of education be to practice medicine in Texas? Will expanding nurses’ scope of practice discourage medical students from pursuing family medicine, consequently damaging the primary care workforce?

Ramas, a third-year family medicine resident at the Conroe Family Medicine Residency Program, says that important reforms have already been set in motion to increase access to high-quality primary care in Texas and to support a collaborative, team-based model, which medical and economic researchers believe can provide higher quality care to patients for less cost.

She writes in the report: “The Legislature should continue to support the numerous programs past Legislatures initiated to encourage our best and brightest to become primary care physicians, and to increase integration and coordination of our health care delivery system so that every Texan has a primary care medical home. That is the right answer for Texas.”

Ramas’ research was funded in part through the TAFP Foundation James C. Martin, M.D. Scholarship. This policy brief is the first in a series; TAFP will publish additional policy briefs as the session progresses. To read the brief, go to the www.tafp.org/advocacy/resources and look for it in the “multi-page policy document” section. Or access a direct link here.

Priority one for HHSC, House subcommittee: Reduce cuts to primary care services in Medicaid

As subcommittees in both the House and Senate continue to work through the budget, the House Appropriations Subcommittee on Article II has made the restoration of most of the proposed cuts to Medicaid payments for primary care services its top priority. The subcommittee agreed that if funds become available during later stages of the budgeting process, payment for primary care services for children in Medicaid and for CHIP should be cut by only 2 percent rather than 10 percent.

Commissioner of Health and Human Services Tom Suehs began suggesting this concept several weeks ago, and this week, he presented the commission’s list of priorities to the subcommittee.

Once the budget moves out of committee and is passed by the full House, it will be taken up by a conference committee. If the state comptroller reports that extra funds are available, the conferees will consider priorities set by the various committees and subcommittees working on the budget.

Texas Public Health Coalition holds “Saving Money, Saving Lives” press conference

The Texas Public Health Coalition, of which TAFP is a charter member, held a press conference on Tuesday, March 1, to highlight public health bills they believe can solve the state’s massive budget crisis and health crisis. Both tobacco-cessation programs and obesity-prevention programs were cut severely in the House and Senate budget proposals. Funding for tobacco-cessation programs was cut about $20 million over the biennium. Funding for state obesity-prevention programs was cut entirely—totaling $4.8 million—and funding for public school health programs suffered a $65 million cut.

“Solid science has shown that cutting budgets for tobacco-control and obesity-reduction programs has a negative impact on both the physical and the fiscal health of the state,” said Susan Rudd Bailey, M.D., president of the Texas Medical Association, at the conference.

Joining Bailey were Susan Sportsman, R.N., Ph.D., president of the Texas Nurses Association; and Kimberly Avila Edwards, M.D., of the Dell Children’s Medical Center. They asked state legislators to support several bills filed this session.

• House Bill 670 by Rep. Myra Crownover, R-Denton, and Senate Bill 355 by Sen. Rodney Ellis, D-Houston, which would prohibit smoking in public places and workplaces;
• S.B. 268 by Sen. Carlos Uresti, D-San Antonio, which raises the legal age to buy tobacco products from 18 to 19;
• S.B. 186 by Sen. Jane Nelson, R-Lewisville, and H.B. 280 and H.B. 281 by Rep. Carol Alvarado, D-Houston, which would require Texas high school students to complete an additional one-half credit of physical education and one-half credit of health for graduation;
• H.B. 127 by Rep. Alvarado, which bans the sale of unhealthy drinks to students in schools; and
• S.B. 224 by Sen. Nelson, which requires schools to report students’ fitness and academic scores to the Texas Education Agency.

To view a video of the press conference, go to the online press release. To view a one-page flyer on the press release and other top priority issues of the Texas Public Health Coalition, go to www.texmed.org/publichealthcoalition.

Thanks to the Physicians of the Day

A special thanks to the Physicians of the Day who served Feb. 21-28, 2011, as part of TOMA week. TAFP and the Texas Osteopathic Medical Association have a long-standing relationship and we’re happy to welcome our TOMA colleagues in primary care fields to spend a day at the Capitol Health Clinic treating legislators and their staffs. Participating physicians were: David Beyer, D.O., of Fort Worth; Robert Deluca, D.O., of Eastland; Audrey Jones, D.O., of Alamo; Steven Yount, D.O., of Bastrop; and Brent Sanderlin, D.O., of San Marcos.

Thanks, also, to our faithful TAFP-member volunteers who served March 1-3: Rebecca Gladu, M.D., of Baytown; Larry Kravitz, M.D., of Austin; and Joe Anzaldua, M.D., of Sugar Land.

For more information on the Physician of the Day program and to volunteer for the remaining spots in March, April, and May, go to www.tafp.org/advocacy/get-involved/physician-of-the-day. If a spring date doesn’t work for your schedule, e-mail Anna Jenkins at ajenkins@tafp.org to be placed on the contact list in case the legislature convenes for a Special Session is this summer.