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The third special session of 2020 has adjourned...

12/21/2020

 
​“The vaccine is the light at the end of the tunnel, but we will be in this tunnel for several months. We need to keep doing what we’ve been doing to help our friends, neighbors and ourselves stay safe.”
OHA Director Pat Allen talks about the distribution of the COVID-19 vaccine.
 
 
December brought significant development on the policy front as state and federal lawmakers worked to bolster the nation’s ability to respond to the COVID-19 pandemic before the end of 2020.
  • State Telehealth pay parity: Andrew Stolfi, the Insurance Commissioner, announced an extension of the telehealth pay parity policy on par with in-person visits through June of 2021.
  • Special Session: The governor calls legislators into a third special session this year. A medical liability protection bill dies in committee. 
  • A federal COVID-19 relief package is passed. Provisions include an unexpected deal on “surprise” medical billing, which includes an independent dispute resolution process sought by physicians and hospitals rather than benchmarking to a reimbursement rate in federal law. 
 
Special Session Update
Protesters storm Capitol building, a last-minute medical liability protection bill fails. 
Gov. Kate Brown called legislators into an in-person one-day special session on December 21 for emergency COVID relief. The day started on a note of drama as approximately 300 far-right protesters stormed two separate entrances into the Capitol to protest the pandemic restrictions on business and calling for the arrest of Kate Brown. Some of the protesters carried firearms and bear spray and many did not wear masks. Members of the public were not allowed in the Capitol. Legislators and staff were asked to follow safety protocols, including donning masks. Sen. Dallas Heard, R-Roseburg, refused to do so.
 
The negotiated agenda was narrow, with five bills allowing cocktails-to-go to support restaurants; extension of the eviction moratorium and funding for landlords; liability protections for schools; and emergency appropriations. Public hearings were held in advance of the special session. A last minute bill on medical liability protections that was introduced on Saturday failed in committee due to a lack of votes from House Democratic members. This means no Oregon liability shield for hospitals and other health care providers in today’s special session. 
 
Summary of legislation
HB 4401 Housing Relief
  • Provides grants directly to landlords on behalf of financially distressed tenants for up to 80 percent of unpaid rent between April 1, 2020, and June 30, 2021. Requires landlords to forgive the remaining unpaid rent for qualified tenants. 
  • Distributes rent assistance to recipients of the CARES Act Emergency Solution Grants, which will make payments directly to landlords.
  • Prohibits eviction without cause until June 30, 2021. 
HB 4402 Liability Protections for Schools
  • Prohibits claims against schools from damages due to COVID-19 infections if the school is in compliance with the Governor’s Executive Orders during the COVID-19 emergency. 
HB 1801 Cocktails-to-Go
  • Allows restaurants during the pandemic emergency to sell and deliver mixed drinks in sealed containers to-go, similar to beer, wine and cider. Rules will limit the sale to two drinks per substantial food item ordered. 
  • Limits the fees that a third-party food platform (DoorDash, Grub Hub, etc.) may charge a restaurant to facilitate orders.
HB 1803 Medical Liability Protections (FAILED)
  • Limits liability of hospitals, health maintenance organizations, health care providers and locations where health care services are provided for certain claims arising during COVID-19 emergency period. Long-term and residential care facilities as well as correction facilities are not included. 
  • Liability protection is not given to acts taken with gross negligence; reckless, wanton, or intentional misconduct, false claims, fraud, or deceptive acts or practices. 
  • Liability protection also is not given to delays or cancellations of elective or non-urgent procedures that create an irreversible risk of harm to the patient. 
SB 5731 Emergency Appropriations
This is the $800 million budget bill for the special session. 
  • $100 million to the Emergency Board for appropriations
  • $400 million for the state’s response to the COVID-19 emergency
  • $100 million for wildfire recovery and prevention activities.
  • $150 million for housing relief fund created under HB 4401 (landlord compensation) 
  • $50 million for Housing and Community Services (rental assistance program)
 
Federal Update $900 million COVID stimulus deal
A ban on surprise medical billing is included in the package
Agreement has been reached on a COVID-19 relief package that includes a ban on surprise (out-of-network) emergency medical bills. While everyone agrees that patients should be taken out of the middle of billing disputes, the proposed solutions — such as benchmarking reimbursement rates in law — cut payments for providers, especially emergency physicians subject to EMTALA. This tilts negotiating leverage to insurance companies to lower payments to providers. The deal would allow for payers and providers to negotiate payment for federal ERISA (self-funded insurers) claims through an independent dispute resolution process sought by associations for hospitals and physicians. It would bar arbiters from basing their decisions on Medicare and Medicaid rates, which tend to be much lower than commercial rates. Patients would be charged the same for co-pays and deductibles as in-network services.
 
The ban takes effect in 2022. Oregon’s ban on balance billing took effect in March of 2018. Negotiations are underway on the interim out-of-network reimbursement rate, which expires 2022. 
 
Provisions of the federal stimulus package include the following:
  • $600 direct payments for those earning under $75,000 and $1,200 for couples earning under $150,000
  • Extended unemployment benefits
  • Rental assistance fund of $25 billion. Extends the eviction moratorium until Jan. 31
  • Additional $13 billion for the Supplemental Nutrition Assistance Program
  • Small business Paycheck Protection Program loan fund of $284 billion. 
  • $10 billion for child care centers
  • $68 billion to buy and distribute COVID-19 vaccines. 
  • Broadband access, $7 million.
  • Transportation funding for airlines, mass transit, highways and Amtrak.
  • $82 billion for schools and universities to assist with re-opening. 
  • $13 billion for farmers
  • Tax-deductible meals — a provision sought by President Trump as well as a last $1.4 billion installment for a wall on the U.S.-Mexico border. 
 
Interim Legislative Days 
Legislators convened for extended interim legislative days December 3-18, with House committees meeting the first week and Senate committees meeting the second week. All of the meetings were virtual. It’s expected that the Oregon Legislature will meet virtually (closed to the public) appearing in person only for votes for the first three months of session, which starts Jan. 19. 
 
The Spotlight Issue: COVID-19 Vaccine Distribution
Frontline health care workers were the first in line to receive COVID-19 vaccines, which arrived in Oregon on December 18. Oregon Health Authority (OHA) Director Pat Allen said Oregon will initially receive 147,000 doses. OHA has developed a plan for distribution which will factor in health equity. See the plan here.  Phase one will be health care workers who have the potential for direct or indirect exposure to patients or infectious materials and people in long-term care facilities. This population is about 350,000 and each will need 2 doses. The next phase will be other essential workers and people at higher risk of severe COVID-19 illness, including people 65 years of age and older. Pat Allen cautioned that we’ll be well into Phase III until we will be back to normal and people can stop wearing masks. His closing remarks: “Vaccines don’t save people — vaccinations save people.”

Special Session, Monday, Dec 21

12/17/2020

 
​The governor has called for a special session to convene Monday, December 21 to address a narrow 4-bill agenda for COVID-19 relief for families and businesses. Hearings are scheduled Thursday, Dec. 17 at 6 pm and again on Saturday, Dec. 19. Here are the priority issues:
 
LC 10 Cocktails to Go (Restaurant support)
LC 10 would allow the OLCC to authorize a full on-premises sales licensee, during the declared COVID-19 pandemic state of emergency, to sell and deliver mixed drinks in sealed containers for off-premises consumption similar to beer, wine, and cider. LC 10 also limits the fees that a third-party food platform may charge a restaurant for the facilitation of customer food and beverage orders.
 
LC 18 Eviction Moratorium (Eviction Moratorium and Landlord Compensation Fund)
Legislative Concept 18 extends the moratorium on eviction without cause through June 30, 2021. The concept also extends the moratorium on eviction for nonpayment through June 30, 2021, for tenants who declare a hardship. It establishes a landlord compensation fund to cover rental non-payment assistance and requires landlords to inform tenants of their rights to declare a hardship to protect them from eviction for nonpayment through June 30, 2021.
 
LC 21 Liability Protections for Schools (Return to school efforts)
LC 21 prohibits claims for damages arising from COVID-19 infections against school districts if the school district’s act or omission was made in compliance with the Governor’s Executive Orders, rules, or other forms of guidance. The concept does not provide liability protection for activities on school grounds by someone other than the school district, nor does it prohibit causes of actions based on workers’ compensation, occupational health and safety, wage and hour laws, discrimination, retaliation, or specialized instruction laws. The measure provides whistleblower protections under Oregon law. LC 21 sets up a mechanism for an early offramp for claims that may be barred, while allowing claims that show a genuine issue of material fact to continue through the court process.
 
LC 28 General Fund Appropriations (Emergency Funding)
  • $400 million to be allocated for the state’s response to the COVID-19 emergency
  • $100 million for the state’s wildfire response and recovery
 
Liability relief for health care providers is not included in this agenda. The special session will be   in-person at the capitol but the hearings are virtual. 

Oregon General Election Update

11/4/2020

 
We don’t know who will be elected President of the United States at this time, but we do know that Oregon Democrats will retake control of all statewide offices with the election of Sen. Shemia Fagan to the Secretary of State’s Office. She replaces Bev Clarno, a Republican, who was appointed by Gov. Kate Brown after the death of Dennis Richard- son. Treasurer Tobias Read was elected to a second term. Oregon Attorney General Ellen Rosenblum, D, wins re-election. Democrats kept their supermajorities in the Ore- gon Legislature but the 60 percent needed to prevent a walk-out eludes them.
 
2020 General Election Snapshot
  • State Legislature: Democrats now control the House 38-22 and the Senate 18-12. They have a super majority, which allows them to raise taxes without Republican votes. They need 40 seats in the House and 20 in the Senate in order to constitute a quorum and prevent walk-outs.
  • Democrats lost one open D seat in the Oregon Senate but flipped an R seat.
  • In the Oregon House, Democrats lost two open seats but flipped an R seat. If trends hold the new makeup is House 37-23 and Senate 18-12.
  • Physicians Dr. Lisa Reynolds (D-36), Dr. Maxine Dexter (D-33) win their races for a two-year term in the House of Representatives. Sen. Elizabeth Steiner Hayward, a fellow physician, won her race in 2018. Senate seats are for four-year terms.
 
Ballot Measure Recap
  • Ballot Measure 107 Campaign Finance Reform PASSED
  • Ballot Measure 108 Increase Tobacco /Vaping/Cigar taxes: PASSED
  • Ballot Measure 109 Psilocybin: PASSED
  • •      Ballot Measure 110 Decriminalize personal possession of drugs: PASSED
  • Universal Pre-School passes in Portland
 
Congressional RacesU.S. Senate — Democratic Senator Jeff Merkley wins re-election. Sen. Ron Wyden, D, won re-election in 2016. U.S. Senate terms are six years.
 
U.S. House of RepresentativesSen. Cliff Bentz, R, becomes the newest member of Oregon’s Congressional Delega- tion. He replaces Rep. Greg Walden, R-District 2, who is retiring this year. The rest of

Oregon’s delegation was re-elected: Rep. Suzanne Bonamici, D-District 1; Rep. Earl Blumenauer, D-District 3; Rep. Peter DeFazio, D-District 4; and Rep. Kurt Schrader, D- District 5. U.S. House terms are two-years.
 
Governor Secretary of StateSen. Shemia Fagan, (D) wins her race against Sen. Kim Thatcher (R).
 
State Senate RacesFour new senators are elected to open seats
Senate seats are for staggered four-year terms. This year 16 of them were up for elec- tion and four new seats opened: Sen. Laurie Monnes Anderson, D-Gresham, Sen. Arnie Roblan, D, Coos Bay, Democrat Mark Hass, D-Beaverton and Sen. Herman Baertschiger, R-Grants Pass, are not running for re-election. The seats will be filled by Chris Gorsek, D-Troutdale, Dick Anderson, R, Lincoln City, Kate Lieber, D-Portland and Art Robinson, R-Cave Junction. An appointee will take the seat vacated by Democratic State Senator Shemia Fagan.
 
The spotlight racesSenate District 5 (South and central coast): Flipped seat D to R
Republican Dick Anderson, a former Lincoln City mayor is leading Melissa Cribbons, the Democratic candidate in the open seat vacated by Sen. Arnie Roblan, D.
District 10 (South and West Salem; part of Polk County): Flipped seat R to D Democrat Deb Patterson, a pastor, has won the race over incumbent Sen. Denyc Boles, to finish the remaining two years of Sen. Jackie Winter’s term. Sen. Winters died of cancer in 2019. The seat will be up for election in 2022. Boles works in community rela- tions at Salem Hospital.
District 27 (Bend and surrounding area): Republican incumbent Tim Knopp of Bend, executive vice president of the Central Oregon Builders Association, is narrowly leading Democrat Eileen Kiely of Sunriver, a retired Daimler Truck North America executive.
 
State House RacesTwelve new state representatives are elected
The spotlight races:District 9 (South coast, from Coos Bay to Lincoln County): Flipped seat D to R Republican Gerald "Boomer" Wright of Reedsport, retired Mapleton school superinten- dent, wins this open seat vacated by Caddy McKeown of Coos Bay after four terms.
District 19 (South Salem, Aumsville and Turner):
Republican appointee Raquel Moore-Green of Salem, consultant, wins the seat former- ly held by Denyc Boles.
District 20 (South and West Salem; part of Polk County): Democratic incumbent Paul Evans of Monmouth, community college instructor and communications consultant, wins his rematch against Republican Selma Pierce of Salem, retired dentist.
District 26 (Wilsonville, Sherwood, parts of Clackamas, Washington and Yamhill coun- ties): Democratic incumbent Courtney Neron of Wilsonville, teacher, wins re-election.

District 32 (North coast, also part of western Washington County): Flipped seat D to
R. Republican mayor Suzanne Weber of Tillamook, wins the open seat vacated by De- mocrat Tiffiny Mitchell of Astoria in this district with a 5 percent Democratic edge. District 37 (Tualatin, West Linn):Democratic incumbent Rachel Prusak of West Linn, nurse, wins re-election
District 47 (East Portland): Democratic incumbent Diego Hernandez wins re-election. District 52 Democratic incumbent Anna Williams of Hood River, academic adviser and adjunct faculty for online college program, wins her re-match against Republican Jeff Helfrich of Hood River, project manager at Hood Tech Aero and retired Portland police sergeant.
District 54 (Bend): Flipped R to D. Republican incumbent Cheri Helt of Bend, small- business owner, has lost the race by a large margin to Democrat Jason Kropf of Bend, a deputy district attorney in Deschutes County.
 
Sources: Portland Tribune, Oregon Secretary of State Election Results, NPR Nov. 4, 2020 10:32 a.m.

OPPA statement on the passing of Measure 109

11/3/2020

 
The Oregon Psychiatric Physician’s Association is disappointed that Measure 109, The Psilocybin Mushroom Services Program, has passed in the state of Oregon. We remain concerned that psilocybin is not FDA approved, clinical trials are still ongoing, and psilocybin administration would not require medical oversight for the treatment of Oregonians with mental health conditions. Now that this measure has passed, we look forward to the opportunity to work with the Oregon legislature, the Oregon Health Authority and the Psilocybin Advisory Board to make the use of psilocybin as safe as possible for Oregon residents suffering from mental health conditions. As an organization of Oregon psychiatrists working together to ensure humane care and effective treatment for all persons with mental illness, we will continue our vision to advocate for evidence based, safe and accessible quality psychiatric care for Oregonians. 
​

News Release: Tips for good mental health during social distancing precautions

3/17/2020

 
Portland, OR - March 17, 2020
 
Due to the COVID-19 epidemic, the Centers for Disease Control and Prevention (CDC) has recommended social distancing to slow the spread of infection.  Oregonians will spend more time at home as a result which can have negative consequences on mental health.  Mental health experts are providing information about how to combat feelings of isolation with social distancing precautions.
 
“Isolation is generally not good for your mental health,“ says Dr. Dan Bristow, M.D., President of the Oregon Psychiatric Physicians Association.  Bristow adds, “There are ways you can feel less isolated and stay socially supported during these uncertain times.”  Bristow offers the following tips during times of social distancing.
 
1.     Try to keep a regular routine as much as possible.  While your routine will be different compared to before, you can still set a routine that keeps your day organized and focused.  Have a regular schedule for work or study.  Take breaks and eat meals at regular times.  Try to maintain the same sleep schedule.  Consistency helps structure your day and gets you acclimated to the new routine quicker.
 
2.     Stay as active as possible.  This might mean getting outside for regular walks.  If that’s not possible, regular stretching, yoga, and meditation are options to help your body and mind feel its best.
 
3.     Limit social media and use reliable sources of information.  Scrolling social media feeds habitually tends to not help you feel connected or boost your mood.  Social media can also spread misinformation that does not help you stay accurately informed.  Stick with reliable sources of information (eg, www.cdc.gov).
 
4.     Stay in contact with friends and family.  While open-ended social media use might not help you stay connected, using social media to communicate with loved ones can be very uplifting.  Emailing, phoning, or video calls can help you stay connected to friends and family.  Good social support can boost mood and prevent feelings of isolation.
 
5.     Be flexible and realistic about the time it takes to adjust.  Adjusting to your new routine will take time.  Set realistic expectations for yourself.  Don’t expect to be as productive immediately in your work or studies from home.     
 
 
Due to recommendations for social distancing, Dr. Bristow will be available for interviews by video conferencing March 17, 2020 via GoToMeeting.  Video links are available at the time of interview scheduling.
 
Contact:

Dan Bristow, M.D.
President - Oregon Psychiatric Physicians Association
focusonmentalhealth@gmail.com
Phone: 503-608-8791

Message from President Dan Bristow MD

3/17/2020

 
Colleagues,
 
The COVID-19 pandemic has presented us with uncertain times.  We are used to caring for others while often neglecting ourselves.  Our role is no doubt important in public health.  But our own health and the needs of our loved ones require attention too.  We cannot care for others effectively and consistently without awareness of what we need to do the job (physically and emotionally).  As we navigate this pandemic, I hope you take care of yourselves and your loved ones.  It is extremely important.  
 
I have added some telepsychiatry resources at the bottom of this email.  Using telepsychiatry (which is supported by Oregon and federal law) wherever feasible is advised to allow care to continue without added infection risks.  President Trump has also announced that Medicare will cover telehealth services for Medicare patients, even those services delivered through FaceTime and Skype (non-HIPAA compliant equipment) in order to increase access.  The President has stated that HIPAA would not be enforced for these methods of delivery.
 
Finally, at the end of this email, you will find a press release that OPPA sent out to over 50 Oregon media outlets this morning providing tips for good mental health despite social distancing precautions.  These tips were gathered from APA recommendations and evidence-based research that supports these interventions.
 
Take care,
 
Dan
 
Dan Bristow, MD
President – Oregon Psychiatric Physicians Association
 
___________________________
 
Telepsychiatry (State and Federal clearance of its use)
 
Oregon Health Authority (OHA) has issued temporary rules for telemedicine reimbursement for Medicaid (https://www.oregon.gov/oha/HSD/OHP/Policies/130-0610-031620.pdf). 
For private insurers who offer mental health benefits, they are required by Oregon law to reimburse HIPAA-compliant live telepsychiatry provided the psychiatrist is enrolled with the insurer.  https://olis.oregonlegislature.gov/liz/2015R1/Downloads/MeasureDocument/SB144/Enrolled
 
Trump's declaration of coverage of Medicare telehealth coverage using non-HIPAA compliant software:
https://www.washingtonexaminer.com/news/trump-says-medicare-will-cover-telehealth-services-for-beneficiaries-in-self-isolation  
___________________________
 
Telepsychiatry Toolkits from APA and AACAP
 
American Psychiatric Association – Telepsychiatry Toolkit
https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/toolkit
 
American Academy of Child & Adolescent Psychiatry – Telepsychiatry Toolkit
https://www.aacap.org/AACAP/Clinical_Practice_Center/Business_of_Practice/Telepsychiatry/toolkit_videos.aspx
 
____________________________
 
Talking to kids about COVID-19
 
MIND Institute – Talking with kids about COVID-19
https://childmind.org/article/talking-to-kids-about-the-coronavirus/
​

KGW: Assuming mass shooters have a mental illness is dangerous, experts say

8/7/2019

 
https://www.kgw.com/article/news/health/assuming-mass-shooters-have-a-mental-illness-is-dangerous-experts-say/283-36f2b95a-b45b-45aa-8290-1c597f1cacdd

KGW: Psychiatrist shortage is a national crisis as need for mental health care grows

8/1/2019

 
https://www.kgw.com/article/news/investigations/psychiatrist-shortage-is-a-national-crisis-as-need-for-mental-health-care-grows/283-9fbb919a-0877-4622-b708-1860e56dcc44

January 2017 Legislative Preview

1/15/2017

 
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APA News & Notes

1/1/2017

 
What’s New at the APA
  • APA President Maria Oquendo witnessed President Barack Obama signing the 21st Century Cures Act into law on December 13. The far-reaching legislation includes a number of provisions designed to reform and improve the nation’s mental health care system. For more information on what the 21st Century Cures Act does for psychiatry and our patients, read Dr. Oquendo’s blog on the subject.
  • Voting for APA Elections begins on January 3 and ends January 31. APA’s Elections page hosts videos where candidates for President-Elect and Secretary discuss their positions on issues important to APA and psychiatry. The page also provides information about the APA Elections, including the entire slate of candidates, key dates, voting information and results from previous elections.
 
Mark Your Calendar
  • APA Elections voting window (January 3 – 31)
  • National Eating Disorders Awareness Week (February 23 – March 1)
 
January Course of the Month
Each month, members have access to an online course on a trending topic. The January course is Evaluating and Managing Agitated Patients, taught by Rachel Glick, M.D., University of Michigan. This presentation reviews evolving approaches to managing agitated patients and offers suggestions to help not only psychiatric residents and trainees, but also seasoned emergency department and psychiatric emergency services staff to manage difficult patient populations. Access the course here.
 
Applications for APA/APA Fellowships Due January 31!
APA/APAF Fellowships are designed to help residents, fellows and early career psychiatrists explore interests and develop their leadership skills. APA/APAF Fellowships can be completed during your regular residency training program. The APA is now accepting applications for each of its eight fellowships, including research, leadership, child and adolescent, and substance abuse. Applications must be submitted by January 31. Link: https://psychiatry.org/residents-medical-students/residents/fellowships

Registration Now Open for the 2017 APA Annual Meeting

Join us at the 2017 Annual Meeting in San Diego from May 20-24. APA’s Annual Meeting is the premier psychiatry event of the year. With over 450 educational sessions and courses, there is no better event to help you expand your knowledge, network and meet certification and licensure requirements. Members receive a steep discount on registration. Link: http://psychiatry.org/psychiatrists/meetings/annual-meeting

​Call for Abstracts for 2017 IPS

The scientific program committee is now accepting submissions for consideration for the 2017 IPS: The Mental Health Services Conference to be held October 19-22, 2017, in New Orleans. The theme for this meeting will be “Optimizing Access & Effective Care.” Abstracts may be submitted at http://apapsy.ch/2017-ips-submissions. The submission site closes on January 10, 2017, at 11:59 pm ET. All submissions must be complete at that time, including disclosures for all presenters and co-presenters. Because of space limitations, we are asking that all submissions (even long-standing recurring sessions) be submitted through the abstract submission site. If you have questions please contact the Office of Scientific Programs via program@psych.org.
 
Submit Proposals for WPA World Congress in Berlin, Germany
The World Psychiatric Association (WPA) XVII World Congress of Psychiatry (WCP) is scheduled to take place October 8-12, 2017, in Messe Berlin, Germany. The WCP 2017 Scientific Committee invites groups and individuals to submit proposals for a variety of sessions, including Regular Symposia, Zonal Symposia, Section Symposia, Workshops and Oral and Poster Presentations. Please note that all congress participants are obliged to pay the congress fee, including chairpersons, speakers and ePoster/poster presenters. The deadline for Regular, Zonal and Section Symposia and Workshops is January 16, 2017. The deadline for Oral and Poster/ePoster Presentations is March 27, 2017.
 
Get ready for MINDGAMES!
MINDGAMES, the APA’s national residency team competition, is a fun way for residents to test their knowledge on patient care, medical knowledge and psychiatric history while earning bragging rights for their program. Registration for the preliminary qualification exam will open in January and take place in February. The top three teams will advance to the national MINDGAMES final competition, at the APA Annual Meeting! Stay tuned for further rules and dates. Visit MindGames for more information.
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