Legislative Report
by Ron Spears, M.D., Legislative Chair

The 2003 state legislative session was dominated by the issue of tort reform. Senate Bill One was introduced by Senator David Williams and received much publicity among major news media organizations. This legislation was aimed at proposing a constitutional amendment to limit non-economic damages and to require alternative dispute resolution in cases involving heath care providers with the hope of limiting the sky-rocking malpractice rates faced by many physicians practicing in certain area such as obstetrics, surgery, and emergency medicine.

The main opposition to the bill was from the trial attorneys who are a very active lobbying force and tend to raise considerably more money than physicians. Over six hundred physicians marched on the capitol on one day in February. An overflow crowd of physicians and attorneys was present at the committee hearing. The KMA was very active in lobbying for the bill, and the support of physicians from across the commonwealth was impressive. Unfortunately, the politics of the Senate turned the issue into a partisan fight, and the true merits of the bill did not appear to be considered. The issue was voted down in a party line vote.

One measure that did pass was the mental health advanced directive bill that gives patients the right to refuse specific psychotropic medications (but not an entire class of medication), to refuse ECT, to name a preference for certain medications and a preference for emergency interventions. A copy of the advanced directive form and instructions to fill it out will be placed on our web page. The committee planning the implementation hopes to have a card for the patient to carry, much like an insurance card, which they can present at the emergency room. Our Executive Director, Theresa Walton, is a member of this committee.

Another bill of interest was aimed at eliminating the juvenile death penalty. Unfortunately, it was not called by the chairs of the Judiciary Committee of either house. This bill will again be filed in 2004. Other bills that did not pass were the Medicaid Buy-In Program and HB 205 which would have increased the tax on tobacco with the money to go to Medicaid, to DMH/MR for mental health and substance abuse services along with pay raises for school employees, smoking cessation programs, school construction, and the general fund. Every penny raised through a cigarette excise tax would generate $4-5 million for Kentucky.

In the upcoming session in 2004, consideration will be made to pursue tort reform again. The KPMA and KMA will also be on guard for non-physician prescribing bills and other bills that could adversely affect the practice of psychiatry and medicine.

KPMA and the Mental Health Coalition, worked hard to see than mental health did not take any cuts in the budget. We continue to monitor the Medicaid Crisis at both the state and federal level. KPMA is a member of a new coalition, the Kentucky Consortium for Medicaid.

This consortium successfully urged Governor Patton as co-chair of the National Governors Conference Committee on Medicaid not to endorse President Bush’s plan for medicaid reform.

To keep abreast of the national medicaid plans go to APA’s web page www.psych.org/pubpoladv/medicaidcrisis.cfm.

We are also keeping a close watch on the Medicare changes proposed by the President and Congress. At this writing, the results of these two issues are unclear.

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