NEWSLETTER
Volume 3, Issue 3 - January 20, 2023
Will This Death Force Change?
"BRITNEY SPEARS CAN BE CONSERVED, AND MARK RIPPEE CANNOT?"
The memorial of Mark Rippee, a blind, mentally ill homeless man, was held last week in Solano County. Mark died homeless in his hometown on November 29. It was noted by a Sacramento Bee reporter that Senator Eggman was the one state official who attended the memorial service. She had met Mark after an article was published on him over the summer. The Senator said, “At one time, we thought they were solving a problem,” but then we “created a whole other world of problems. We’ve turned a blind eye, and said no, they have rights. And Mark, like so many others, died with his rights on.” “Let us have Mark’s living and dying be one more step” toward fixing the laws that let him die... “You have my commitment” to make sure that happens. Read more here.
So, What Can Be Done?
Last night, CSAP's Government Affairs Committee (GAC) recommended that the Board sponsor, along with other entities, Senator Eggman's newest package of conservatorship / LPS related legislation. At a minimum, Senator Eggman will introduce legislation regarding hearsay, changing the definition of grave disability, and to require a real-time database of available beds statewide. These bills as introduced, will most likely look a lot like SB 965, SB 1154, and SB 1416 from the last legislative session. Please note that the starting point this year for the proposal to change the definition of grave disability will be modeled on what is already in law for persons in the California Department of Corrections and Rehabilitation (CDCR). It is the view of the GAC and the Board that this definition will need wordsmithing to be most acceptable from CSAP's perspective. Thus, CSAP will convene a subcommittee with representatives from each of the five District Branches to convene with Senator Eggman and her staff to discuss further.
Prescribing Issues
Are you and your patients experiencing problems filling prescriptions for controlled substances??
Members from across the state are reporting difficulty filling prescriptions for controlled substances. While there are known shortages of some medications, the issue seems to be creeping outward such that patients are being refused based on non-shortage-related issues. Recent communications from the APA related that the large pharmacies are flatly denying problems and pharmacists are only reporting the shortages.
We need your help to further understand these issues and ways to address them. If you/your patients have been experiencing problems, please use this link to complete a very brief survey. We need doctors from every District Branch to please respond to this survey. You can submit a response for each time you've had an issue.
CSAP Prescribing Issues Survey
You can use this form multiple times to report on different issues. The form also has plenty of space for prose responses. You can also email issues to Paul@syaslpartners.com.
You may view more data on drug recent shortages here.
Parity
This week, CSAP's advocates at SYASL, along with other similarly-interested statewide organizations, met again with staff from the Department of Managed Health Care to discuss the proposed SB 855 regulations. As the saying goes, the fur flew a little but in the end perhaps a better result when the regulations are adopted. Hopefully more on this next week, including a taste of the back and forth between advocacy organizations and the department. Sorry it can't be in this week's newsletter; it will take time to anonymize and summarize the Zoom meeting and subsequent written back and forth.
Legislation
You may review the most up to date list of bills tracked by CSAP here.
CARE Court
The Judicial Council has released “Rules and Forms: Community Assistance, Recovery and Empowerment (CARE) Act (Proposal W23-10)”. The public comment period on the proposal runs from December 14, 2022, until January 27, 2023.
https://www.courts.ca.gov/documents/w23-10.pdf
It does appear that there will be "clean up" legislation in 2023, which can mean a lot of things. SYASL advocates are participating in various forums where changes to the new law are being discussed. Among the new proposals: allow counties to prioritize admission to services to those most in need as well as possibly expand the definition of diagnoses for which individuals can be referred and treated and provide explicit authorization for the counties to share medical records / history with protections against liability. Much more to come on this over the upcoming weeks and months. Reminder that Los Angeles County now wants to operationalize its program sooner than later along with the other eight counties in Cohort 1.
Assembly Committee Assignments
Assembly Speaker Rendon has released committee assignments for the 2023-24 Regular Session. Assemblymember Jim Wood will remain the Chairman of the Health Committee and Assemblymember Joaquin Arambula remains the Chairman of the Assembly Budget Sub Committee on Health and Human Services. You may view a full list of the chairs and members of the policy and budget committees CSAP's priority bills and budget interests will pass through this year, here. Committee assignments in the Assembly may change later this year when Speaker-elect Rivas takes over from Speaker Rendon.
CMA
Reminder: Phase II of Medi-Cal Rx transition begins January 20
Reminder that Phase II of the California Department of Health Care Services (DHCS) Medi-Cal Rx transition begins January 20, 2023. In Phase II—which will be implemented in two waves—Medi-Cal Rx prescribers will again be required to submit prior authorizations (PAs) for the remaining drug classes. Read more here.
Congress eliminates need for waiver to treat opioid use disorder
In its year-end omnibus legislation passed on December 23, 2022, Congress took steps to a expand access to medication-assisted treatment for opioid use disorder. Under the new law, physicians no longer must obtain a special federal waiver to prescribe buprenorphine, which is used to treat patients with opioid use disorder. Going forward, all prescriptions for buprenorphine only require a standard U.S. Drug Enforcement Agency (DEA) registration number. Additionally, there are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine. Read more here.
Overdose Prevention Sites
San Francisco Mayor London Breed and Supervisor Hillary Ronen have announced local steps the City is taking to address a recently identified permitting barrier to moving forward with a non-city funded Overdose Prevention Site. Read more here.
State Updates
Equity Working Group
The CYBHI Equity Working Group met this week. You may view SYASL Staff notes here.
First Quarterly CYBHI Public Webinar
Please join the California Health & Human Services Agency (CalHHS), in partnership with its departments, on February 1, 2023, from 2 p.m. to 4 p.m. for a webinar on the Children and Youth Behavioral Health Initiative (CYBHI). February’s webinar will provide a closer look at the recently released CYBHI January 2023 Progress Report; share updates on recent developments, work-to-date, and upcoming next steps of the Initiative and its workstreams. Register here.
Grant Opportunities and Opportunities for Public Comment
We are regularly notified of grant opportunities and opportunities to comment on draft behavioral health regulation. For information on the latest opportunities, see here.
Fed / APA Update
Assembly Profile of Courage Award
The deadline for all Assembly award nominations is Wednesday, March 1, 2023. Award descriptions and eligibility information are listed below.
The Assembly Profile of Courage Award recognizes an APA member who has, at risk to her/his professional and personal status, taken an ethical stand against intimidating pressure for the good of patient care and in keeping with APA Principles of Ethics.
- Nominee must be an APA member in good standing
- Nominee has performed a deed-on behalf of a patient, patient group, patient care, or APA ethical principle-involving personal risk to reputation, finances, and/or safety
- The actions are worthy of members' consideration and recognition and serve as an example of commendable ethical behavior worthy of emulation
Send letters of nomination to amoraske@psych.org by March 1, 2023. Nominations are reviewed by the Assembly Awards Committee.
End of Year Federal Package
- Federal end-of-year package includes several APA wins, including:
- Adding 200 GME slots, designating 100 specifically for psychiatry and psychiatry subspecialties
- State grants and technical assistance to primary care practices to implement CoCM
- States grants for insurance department to enforce and ensure compliance with the mental health parity law
- Full APA statement here
- Pharmacy Concerns
Voting Deadline Approaching
The polls for APA's 2023 Election opened on Jan. 3. Cast your vote online with your psychiatry.org username and password until the polls close on January 31.
Review the individuals running for office, and learn more about the candidates’ backgrounds, platforms, and vision for the future of psychiatry at psychiatry.org/election.
All members are expected to abide by the APA Election Guidelines: Only approved campaign activities, managed by the APA Election Office are permitted. Use of any APA listservs, including the Member-to-Member listserv, for campaigning is not permitted. Please refrain from using any APA listserv for campaign purposes.
If you have any questions, contact the APA Election Office at election@psych.org.
Worth a Read
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