Springer (R-Muenster) that allows for the provision of artificially administered nutrition and hydration as life-sustaining treatment in certain cases. TMA also negotiated a measure to ensure hospital ethics committees establish policies to handle conflicts of interest; that measure did not pass. Instead, a palliative care and quality of life advisory council established by House Bill 1874 will study an array of issues to increase awareness of and improve access to palliative care. TMA also supported House Bill 2541 to ensure health plans cover certain
treatments for enrollees diagnosed with terminal illnesses, which did not pass; and House Bill 751 to set requirements for prescribing and pharmaceutical sub- stitution of biologic products, which did. Representative Zerwas authored both bills.
MENTAL HEALTH BILLS VETOED AMID OTHER PUBLIC HEALTH GAINS Texas took another big step forward on public health, starting with early passage of Senate Bill 97 by Senator Hinojosa. The first-time regulation of e-cigarette sales in Texas applies many existing state rules on tobacco cigarettes to vapor products, foremost barring sales of e-cigarettes to minors. “I’m glad we took a stand; finally, Texas is brought into the mainstream with
this issue, and we join a majority of states that now have this language in law,” Dr. Van Ramshorst said, pointing to studies showing e-cigarette use among ado- lescents has tripled in recent years. “Teenagers have the perception e-cigarettes are not as dangerous, and they are actually more likely to use them.” TMA Associate Director of Public Affairs Troy Alexander adds that the bud-
get “significantly strengthened” funding for tobacco cessation and chronic dis- ease prevention, while the Ebola outbreak in Texas led lawmakers to dedicate $20 million to surveillance of infectious diseases. Mental health funding, anoth- er shared priority among medicine and lawmakers, got a significant boost over last session for services like outpatient treatment for adults and children, autism intervention, and early treatment to reduce neonatal abstinence syndrome. Governor Abbott wasted no time, however, taking his veto pen to a top prior-
“It goes back to managed care taking taxpayer dollars and doing what they are supposed to do.”
ity of TMA’s Behavioral Health Task Force. Senate Bill 359 by Royce West (D- Dallas) would have allowed physicians to initiate a four-hour hold on patients who voluntarily seek emergency care but want to leave even though the doctor believes the patient poses a danger to self or others. Citing “serious constitu- tional concerns” that “would lay the groundwork for further erosion of consti- tutional liberties,” Governor Abbott vetoed the bill, saying “medical staff have options at their disposal” and “should work closely with law enforcement to help protect mentally ill patients and the public.” A diverse coalition of homeschool advocates, scientologists, political activ-
ists, and antivaccination groups urged the veto, saying SB 359 conflicts with individual and parental rights, including the right to refuse medical treatment. “The governor should have reached out to physicians and other medical per-
sonnel who provide care in the real world of our emergency rooms before veto- ing this legislation. They would have told him about the patients they encounter who pose a real danger to themselves or to those around them,” Dr. Garcia said in response. The governor also vetoed House Bill 225, a TMA-backed bill offering “Good
Samaritan” legal protections for drug users who remain on the scene after re- questing emergency services for someone who overdoses. He suggested it would invite “misuse by habitual drug abusers and drug dealers.” SB 359 and HB 225 represented two or more sessions of work by TMA’s
Behavioral Health Task Force, and a coalition that includes TMA, the Texas Hospital Association, the Texas Society of Psychiatric Physicians, and the Texas Pediatric Society.
August 2015 TEXAS MEDICINE 41
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