2002 Legislative Session
by Ron Spears M.D.

The 2002 state legislative session recently ended and was dominated early by redistricting issues and later by partisanship. Legislation to license professional counselors and to expand duty to warn provisions to other mental health providers was passed and was not opposed by the KPA. Senate Bill 2 was followed with great interest as it would have addressed the organization and funding of the Commission on Services and Supports for Individuals with Mental Illness, Alcohol, and Other Drug Abuse Disorders. It included addressing ways to improve mental health screening, treatment, and suicide prevention in Kentucky jails. It also added new members to the HB843 commission and strengthens the local process. This bill passed the Senate in late January and the House on April 15th with changes that the Senate did not have time to concur which killed the bill. Fortunately, the commission does not sunset until April 2004, so there is still time to work on passage of enabling legislation.

Legislation was also proposed for an "Advanced Mental Health Directives" for psychiatric patients much like a Living Will. This document would be written while the person was competent and put in effect when they were in a crisis. After much discussion and concern on the part of the psychiatric and psychological communities, this legislation was never formally drafted. A major concern is the liability issue. An amendment was filed with Senate Bill 2 to study the feasibility of implementing advance directives in the future. In spite of the bill's failure, such a study is currently underway. KPA members of the work group are Drs. Scott Hedges, and Todd Cheever. Our Executive Director, Theresa Walton, and the KMA lobbyist are also members.

The budget negotiations have had one bright spot in the last few months as funding was included to address early childhood mental health treatment, the completion of the crisis stabilization units, and supported employment as well as items mentioned above. Mental Health was one of the very few areas where proposed spending was increased.

SB38 amended two pieces of legislation passed in the 2000 session closing loopholes in the External Review process for appeals, and in the one which required "Prompt Pay" by insurers.

Medicaid underwent significant changes. A waiver program for children diagnosed with autism or other pervasive developmental disorders (HB 455), the requirements of a cop-pay for pharmaceuticals, the creation of a mechanism to reduce pharmacy cost (HB103) and legislation to reduce pharmacists' dispensing fee (HB 117). Even with these changes, the anticipated shortfall in the next budget for Medicaid is over $200 million.

At the federal level, the major concern has been the passage of a Psychologists Prescribing Bill in New Mexico. The APA and the New Mexico district branch were very active in trying to defeat this legislation and much was learned from their experience. Other states are likely to see more of this type of legislation. The APA is currently building up a legislative fund specifically for this type of legislation. The APA is also working with the district branches on a strategy to defeat similar legislation in the future. Watch your newsletter and the KPA web page for updates in the future.

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