California Psychiatric Association
Legislative Priorities for 2002
The status of legislative bills
changes often.
To get up-to-date information on the status of bills discussed on this web
site go to:
California
State Senate Bill Information
Approved by CPA Council October 5, 2001
NOTE: This document outlines the legislative priorities of CPA. They
are not in specific order of priority, since changing events change the
need to dedicate time and resources to different issues.
Psychologists practicing medicine. Protect public safety
by opposing attempts by psychologists to expand their scope of practice
to practice medicine without full medical school training, including their
efforts to acquire authority to prescribe brain medications.
Human Resources: Improve access to psychiatric care for all Californians.
This is to include increasing the numbers of psychiatrists being trained
and to assure adequate numbers of psychiatrists in both managed care programs
and in public programs, as well as supporting efforts to increase the numbers
of psychiatric specialist nurse practitioners and physician's assistants.
A CPA task force will develop detailed recommendations.
Managed Care: Modify the managed care environment to make it more
physician and patient friendly, including reducing the uncompensated regulatory
burdens imposed by managed care companies (the "hassle factor"),
pursuing the enactment of AB 1600, and assuring proper implementation
of AB 88, the law providing non-discriminatory health insurance coverage
for serious mental disorders. Continue to support SB 599, parity in insurance
coverage for substance abuse treatment.
Medi-Cal: Seek adjustments to Medi-Cal and managed care fee schedules
that assure adequate payment to psychiatrists for their services. This includes
assuring adequate psychiatric and other medical care for foster children.
MICRA: Protect the integrity of the California medical malpractice
law, the Medical Injury Compensation Reform Act (MICRA).
Patient Access to Needed Medications/Formularies: Advocate with
respect to Medi-Cal and managed care formulary issues consistent with the
policy adopted by the CPA Council at its March, 1997 meeting. Work to improve
access to modern psychiatric medications in the public mental health system
and jails.
Reform of Mandatory Treatment Laws (LPS): Pursue task force efforts
to update and revise the Lanterman Petris Short Act (LPS) in light of today's
circumstances. Support legislation that would revise LPS and allow for mandatory
outpatient treatment in certain well-defined circumstances, especially for
treatment noncompliant persons who are seriously and persistently mentally
ill persons who are likely to become a danger to themselves or others if
untreated. (AB 1421)
Penal System: Advocate for adequate psychiatric care for mentally
ill prisoners and detainees of the juvenile justice system, including modern
medications, and assure that the severely mentally ill and sexual predators
are not confused with one another.
Violence Prevention: Support legislation that embodies reasoned
regulatory action relating to violence. Support legislation that discourages
the purchase of handguns and places strong controls on availability of all
types of firearms to private citizens. CPA's legislative focus on domestic
violence is on the negative impacts of domestic violence and prevention,
not legal and criminal aspects. Focus on prevention of school violence through
removing disincentives to the identification and treatment of severely emotionally
disturbed children who may potentially be violent.
Public Mental Health System/including foster children: Assure
the integrity of, and adequate funding for, the public mental health system,
including assuring proper funding for medical treatment and full utilization
of the skills of psychiatrists. Priorities to include assuring that all
programs have good outcome evaluations, full funding for AB 1421, AB 1422,
and AB 34 programs, early diagnosis and treatment for foster kids, funding
for dual diagnosis programs and police training. (This includes opposing
AB 896 as it impacts the developmentally disabled mentally ill, supporting
improved jail programs, and opposing AB 225 & 681, relating to psychotropic
medications for foster children).
CALIFORNIA PSYCHIATRIC ASSOCIATION
Policy Regarding Medication Formularies
Adopted by CPA Council, March, 1997
Efficacy studies have demonstrated time and again that the effective
prescription and use of appropriate neuropsychiatric drugs reduces morbidity
and costs in the long run, and that the earlier in the course of a brain
disorder an effective medication is used, the greater its effectiveness.
For the good and welfare of the largest number of people, the California
Psychiatric Association recommends that managed care companies and health
insurance carriers be precluded from restricting a patient's access to any
effective central nervous system medication where the patient's physician
has determined that the patient would benefit from that medication.
The California Psychiatric Association supports legislation allowing
any drug that is approved by the federal Food and Drug Administration to
be approved for addition to the list of drugs covered by either Medi-Cal,
Medicare, or health care plans for the purpose of treating psychiatric disorders.
The California Psychiatric Association believes that such legislation
will be cost-effective and good social policy. Due to the severe side effects
associated with medications presently included on the Medi-Cal list of contract
drugs, and the drugs allowed by some managed care plans, for the treatment
of psychosis and psychiatric disorders, many patients are unwilling to take
the medications. In addition, some newer and more expensive drugs are much
more effective. Allowing the use of the most effective drugs with the least
side-effects may cost more out of pocket originally than providing a limited
formulary. However, studies show that total expenditures for the treatment
of psychosis and psychotic disorders, including nonpharmaceutical services
such as hospitalization (or incarceration) are not less expensive for states
with restricted formularies.
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