Government Relations Update
by Ken Certa, MD
Our legislature has still not been able to fix on a budget for the commonwealth, now nearly four months overdue. It is hard to say just why the sides are so dug in, but there are a few possibilities:
1. The shutdown of the federal government, with its real world consequences, has made the state’s problems look fairly minor.
2. As always, there are divergent views between the two political parties, and factions in them, at work. The budget is significantly bigger this year; does it need further trimming? There are political maneuverings with an eye to future elections, which can include Senate/House members attempting to strengthen or impair the perception of the governor’s effectiveness through agreement/disagreement with his proposals.
3. The lack of public push-back has been notable, and until pressure builds there is not much incentive to do anything.
It is likely that once school districts begin complaining loudly (as some already have) that the lack of state money is casting doubt on a return to classes after the winter break, there is likely to be enough pressure to break the deadlock.
Our legislative efforts continue to focus on opposing HB 1000, psychologists prescribing. We have had strong work by members of the Government Relations committee as well as other PaPS members to lobby their elected officials to help prevent this from moving forward. So far so good.
We are also watching other issues in the hopper. HB 1859 on Extreme Risk Protection Orders passed the house but has had no movement in the senate. It is hard to see it moving in the current political climate.
SB 955 authorizing a mental health license plate was passed out of the senate nearly unanimously. Action in the house is pending. The license plate will have a picture of the Liberty Bell with a teal and purple ribbon, and the words “Mental Health Matters.”
Part of our overall legislative strategy involves partnering with other organizations: one of the most important is the Pennsylvania Medical Society. The weekend of October 18 the PAMED House of Delegates met in Hershey; there was an in-person and a virtual component. Dr. Hope Selarnick and I attended, ensuring that the voice of psychiatry is heard as policy is crafted. Relevant resolutions (which when passed become the policy of the Pennsylvania Medical Society) which I testified on include:
A resolution asked for PAMED to advocate for legalization of psilocybin, as well as developing a program to educate physicians about the advantages of its use. We were opposed to this at this time, amending the wording to call for limiting use to research protocols, and rescheduling after the FDA has approved its use.
A call for PAMED to advocate for a ban on gender-affirming care for minors was proposed. We supported keeping the government out of the consulting room and opposed such a ban (consistent with APA policy). The proposal was not adopted.
We were able to help amend a resolution calling for state and federal investment in rural health infrastructure and workplace incentives to include “physician-led behavioral health” along with other specified services.
With our support, the House of Delegates has PAMED on record as opposing work requirements for Medicaid. While we agree that work is useful, noble, and something that is part of healthy adult functioning, we are concerned that the logistics of checking this as the federal administration requires is not possible with the current department of welfare system, will be costly to implement, and will disenroll many thousands of people.
We participate with the Pennsylvania Medical Society in much of our lobbying, and appreciate their great support for our efforts to oppose psychology prescribing. I hope many of our members will consider involvement with PAMED, as a means to help all of us in medicine.