Transcript Kathy Hutto - Occupational therapy

IT’S A NEW BALL GAME!
WHAT TO EXPECT FROM THE
TEXAS LEGISLATURE
KATHY HUTTO
GOVERNMENTAL AFFAIRS CONSULTANT
JACKSON WALKER L.L.P.
PRESENTATION AT TOTA MOUNTAIN CENTRAL
CONFERENCE 11/7/14
NEW LEADERSHIP
 Republicans swept statewide
offices for the 10th consecutive
election
 Governor - Greg Abbott
1st new Governor in 14 years
 Lt. Governor – Dan Patrick
THE ONLY RETURNING PLAYER
 Speaker of the House Joe Straus
 1st
elected to the House in 2005
 1st elected Speaker in 2009, so this will be 4th
Session
 Will be challenged, but should be
easily re-elected
 House viewed as the calm port in
the upcoming storm.
CHANGE IN LINEUP
 HOUSE
 23 new members
 If Rep. Lois Kolkhorst wins Glenn Hegar’s old
Senate seat, will have 24 new House members
 98 Rs v. 53 Ds (gain of 3 by Rs)
 10 Chairmen not returning including some on
key committees to OTs :
Appropriations
Public Health
Higher Education
LINEUP CHANGES GREATER IN SENATE
 8 of 31 Senators will be Freshman. More
conservative
 13 of 31 will have 2 years or less experience
 6 Chairman not returning plus threat to not
appoint any “D” Chairs
would knock out 6 more
LOOMING ISSUE
School Finance
 Judge John Dietz, 250th District Court, on 8/28/14 declared the Texas
school finance system violates the Texas Constitution on the issues of equity,
adequacy, and a state property tax, but does not violate the “taxpayer
equity” provision of the Constitution. Judge Dietz’ ruling enjoins the state
from distributing any funds under Chapters 41 and 42 and Section 12.106
(charter schools) after July 1, 2015 if the constitutional violations are not
remedied by the Legislature.
 The case was appealed directly to the Texas Supreme Court by Attorney
General Abbott— which automatically stays the injunction — and most likely
we will not see a ruling from the Supreme Court until next summer, after the
84th Legislature adjourns.
 If the Texas Supreme Court upholds the findings on equity and a state
property tax, it will not necessarily require the state to spend additional
money on public education, though the legislature has typically responded
with higher funding. If the Supreme Court upholds the finding on
adequacy, it would more than likely necessitate and increase in state
funding.
OTHER BIG ISSUES
 Water
 Transportation
 Immigration/Border Security
 School Choice
 Gun Rights – campus carry/open carry
 Transparency in spending/end fund
diversions
 Social issues
ONGOING CHALLENGE
 HHSC directed to achieve Medicaid savings
of $400 million in General Revenue from 25
cost containment initiatives
 One initiative = phase down Medicaid rates
which are above Medicare rates
 Also, develop a more appropriate fee
schedule for therapy services, requiring
providers to submit their NPI on each claim
(at a minimum, name of provider)
Pediatric Study Forthcoming
 HHSC has commissioned A&M to perform an
independent review comparing Texas
Medicaid’s authorization policies, rates and
utilizations patterns for pediatric acute therapy
(OT, PT and Speech) to those in other state
Medicaid programs and commercial insurance
plans.
 Findings expected this Fall and will impact the
budget as HHSC will be expected to
come up with more cost savings.
SUNSET
 All Health and Human Services
agencies under review
o
o
o
o
o
Health and Human Services Commission
(HHSC)
Department on Aging & Disability Services
Department of State Health Services (DSHS)
Department of Assistive & Rehabilitative Services
Department of Family & Protective Services
DSHS SUNSET RECOMMENDATION
To allow DSHS to focus on public health matters instead of occupational licensing, transfer
12 regulatory programs from DSHS to the Texas Department of Licensing and
Regulation (TDLR), and require TDLR to create associated advisory committees
for each profession in place of existing boards and committees. In absorbing these
functions, TDLR should create a focused health section to ensure development of related
expertise.
Phase 1 (FY 2016–2017)
 a. Athletic Trainers
 b. Dietitians
 c. Hearing Fitters and Dispensers
 d. Midwifery
 e. Orthotics and Prosthetics
 f. Speech-language Pathologists and Audiologists
Phase 2 (FY 2018–2019)
 g. Code Enforcement Officers
 h. Laser Hair Removal
 i. Massage Therapists
 j. Mold Assessors and Remediators
 k. Offender Education Providers
 l. Sanitarians
DSHS RECOMMENDATION (CON’T)
Four boards are being transferred to the Texas Medical Board
 a. Medical Physicists
 b. Medical Radiologic Technologists
 c. Perfusionists
 d. Respiratory Care Practitioners
Four will be retained at DSHS, but their placement will be considered
during the Sunset review of the structure of the mental and behavioral
health components of the health and human services system.
 a. Chemical Dependency Counselors
 b. Marriage and Family Therapists
 c. Professional Counselors
 d. Social Workers.
Based on the lack of need for continued state intervention in certain
activities and occupations, the Legislature should deregulate 11
programs, including:
 Dyslexia Therapists and Practitioners
 Opticians
IMPLICATION FOR OTs AND COTAs
 1st phase of move of health care licensing
agencies to TDLR begins September 1, 2015.
 Sunset review of TBOTE, TBPTE, &
ECPTOTE begins with self-evaluation report
in summer of 2015.
 Sunset date for TBOTE, TBPTE and the
Executive Council of PT & OT Examiners is
September 1, 2017.
FOCUS FOR TOTA IN UPCOMING SESSION
 Role of OT as Mental Health Professional
BIG CHALLENGE – NO ONE AT THE CAPITOL
THINKS OF OTs AS HAVING A MH ROLE
EDUCATING LEGISLATORS & THEIR STAFF
AS TO WHAT THAT ROLE IS AND YOUR
EDUCATIONAL PREPARATION WILL BE KEY
TO OUR SUCCESS.
IT TAKES A VILLAGE!
OT’S ROLE IN MENTAL HEALTH SERVICES
 Help individuals modify behaviors that interfere with
effective emotional, social or intellectual functioning
 Increase individual’s ability to live as independently as
possible while engaging in meaningful & productive life
roles
 Work with clients to establish goals related to improving
participation in one’s home, school, workplace, and
community.
 Teach and facilitate skills in the areas of problem solving,
medication management, home and community safety,
social skills, activities of daily living, vocational and leisure
interests, stress management, and more.
WHY IS OT IMPORTANT IN MH SERVICES?
 Improves symptom and medication
management as well as increases social
skills, social participation, and personal
well-being
 Decreases negative psychological
symptoms, hospital admissions and
readmissions, poor treatment compliance,
and social exclusion
LEGISLATION
OUR CHAMPION – Representative Garnet Coleman (DHouston)
 OUR BILL – Will add occupational therapists to the definition
of non-physician mental health professional in the Texas
Mental Health Code, Chapter 571.003(15), Health and Safety
Code.