Emergency Medicine Legislative Day 2015

Legislative day 1

IUEM Residents attended the annual Emergency Medicine Legislative Day at the Indiana Statehouse, organized by Emily Fitz (PGY3 EM Chief Resident and INACEP Resident Representative) and Lindsay Weaver (Emergency Medicine Associate Professor). Throughout the day, several legislators from both the house and senate stopped by to discuss issues in healthcare with the residents.

Dr. Tim Brown (Chair of Ways and Means), Dr. Jennifer Walthall (Deputy State Health Commissioner), and Dr. Heidi Dunniway (President of the ISMA) also participated by sharing their thoughts and individual experiences in advocating for patients through healthcare policy. It was enlightening to hear the extent of their dedication and passion for advocacy, and the ways in which a physician can become a leader in their field.

During her reflections on advocacy and resident impact on health policy, Dr. Jen Walthall aptly described, “residents are adorable but ruthless” in creating positive change in the legislative arena, and if “you are not at the table, then you are on the table.”

At this time, the Indiana legislation is considering the following bills:

  • Naloxone prescriptions for lay people (abusers, family and friends)
  • Needle Exchange Programs
  • Funding for more Residency spots in Indiana
  • Programs to enroll prisoners in Medicaid Prior to Release so they can get mental health medications
  • Increase in Medicaid coverage for psychiatric medications and inpatient detoxification

Dr. Lindsay Weaver reflected on the following recent legislation. “A bill that would increase malpractice caps was defeated earlier this year.  However, it is expected that the malpractice law will continue to be under attack over the next several years.  Thankfully, being at the statehouse and showing interest year after year will give us a voice in this debate.”

Several presentation were prepared and given by IUEM residents:

Emily Fitz, EM PGY3, Chief Resident:  “Legislative Day Overview”

  • 6th year of the program
  • Put together and run by IUEM residents
  • Sponsored by INACEP and IUEM
  • Our collaborations have brought about real change. Examples include the – Lifeline Law and Narcan for first responders

Sarah Hemming-Meyer, EM PGY2:  “Mental Health”

  • Mental health affects everyone- 1/4 adults, 1/10 children, 26% homeless and >50% inmates
  • Access to Care is directly related to Funding-HIP 2.0 expansion of Medicaid will have provide services to some people, but more funding is needed
  • We support the currently bills that are at this house & senate–Bill 1448 & Bill 1269
  • B1448–widening Medicaid coverage for approved FDA drugs with aid with substance withdrawal and inpatient detoxification
  • B1269–Department of Corrections become POA and assist inmates with Medicaid application not only while in prison and when released to ensure proper medications and support for inmates with mental illness.
  • National shortage of providers- increase funding for loan reimbursement, psych residency spots to increase # of psychiatry providers.

Kyle Yoder, EM/Pediatrics PGY5, Chief Resident:  “Prudent Lay Person” 

  • “Emergencies” are defined by the patient, not the doctor‬
  • A layperson cannot be expected to be able to differentiate a serious medical condition masquerading as a common medical condition
  • As emergency medicine doctors, we sometimes practice outside of the scope of our “medical specialty” because we are the only medical access for a portion of the population and because we took an oath to do what’s best for our patients

Rob Cantor, EM PGY3:  “Opiate Abuse and the Heroin Epidemic”

  • Opioid abuse is becoming an epidemic issue affecting our city, state and country.  Americans comprise <5% of the world’s population yet we consume ~80% of the world’s opioid supply.  120 people die in the U.S. every day from an opioid drug overdose.
  • Opioid abuse does not discriminate.  It affects all socioeconomic classes and ages, and being unemployed/homeless are not good predictors of abuse.
  • Recent increased restrictions on opioid prescribing has had several unintended consequences.  This includes a worsening heroin epidemic as well as HIV outbreaks in select communities as a result of increased intravenous drug abuse.
  • Senate Bill 406 (SB406), if passed, would allow physicians to prescribe Naloxone OTC without examining the patient for whom the drug is intended.  It would also allow for family/friends/first responders to administer this medication to individuals experiencing an expected opioid-related overdose.  We support passage of this bill which, when used in conjunction with current 911 Good Samaritan laws, can help save lives.
  • We have several goals looking towards the future.  We request continued support for state-side databases such as INSPECT.  We need additional funding for addictions counselors and facilities across the state.  We need improved resources and treatment options for individuals with mental health.  Our vision is to better identify patients who have a high risk of opioid abuse/addiction/overdose so that they can be treated appropriately either in chronic pain programs, with addiction specialists, or in various opioid clinics around the state.

David Hillhouse, EM PGY3:  “Malpractice and Increasing Residency Positions”

  • 1/4 of our residents choose to stay in IN
  • Opening up more residency spots will also keep good physicians in IN
  • A big reason residents choose to stay is because the malpractice laws are favorable (medical review board especially)
  • Maintaining the malpractice environment will keep physicians from leaving and will encourage more new physicians to come to IN

The following residents attended Legislative Day to meet their legislators and support their colleagues: Kailyn Kahre-Sights, Alex Rhea, Kara Reynolds, Beth Beard, Kyra Reed, and Dan Elliot.  Thanks also to Dr. Frank Messina, (Staff Emergency Medicine MD at Eskenazi), who was in attendance and reflected, “I think that it is important that we be involved at the level decisions are made.”

Legislative Day 2

Thank you to Dr. Emily Fitz and Dr. Lindsay Weaver for organizing a successful Legislative Day, and also to everyone for your participation and for representing Emergency Medicine in Indiana!

Submitted by Kyra Reed, PGY-3 EM/Pediatrics

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