Scope-of-practice creep and access to mental health care are among the 57 charges Texas Lt. Gov. Dan Patrick recently issued for Senate committees to study ahead of the 2025 legislative session. The Texas Medical Association’s advocacy for medicine-friendly policy also continues apace during the interim, with the association closely monitoring several of these charges.
Meanwhile, TMA’s Council on Legislation is culling a list of legislative priorities for the upcoming session, following the success of this approach in advance of the 2023 session. Zeke Silva, MD, a radiologist in San Antonio and the incoming council chair, says this process is guided by TMA policy and member physicians.
One through line is scope creep, which topped TMA’s 2023 list and remains a constant battle, as evidenced by the Texas Senate Health and Human Services (HHS) Committee’s charge to examine “whether regulatory and licensing flexibilities could improve access to [primary and mental health] care, particularly in medically underserved areas of Texas.”
Dr. Silva says this language could allude to independent practice for nonphysician practitioners (NPPs) and other scope infringements.
While acknowledging the role NPPs play in the health care team, “we will not compromise on physicians leading the health care team,” he told Texas Medicine Today. “That is a nonstarter for us.”
The Senate HHS committee is also evaluating mental health care access at large, reflecting the Senate’s interest in behavioral health. Additionally:
- The upper chamber’s Finance Committee is charged with monitoring the implementation of Senate Bill 30, which allocated $2.2 billion to expand mental health services and inpatient facilities across the state.
- The Health and Human Services Committee is charged with reviewing care options for “the growing population of Texas children with high acuity mental and behavioral health needs.”
- The Veterans’ Affairs Committee is charged with making recommendations to improve access to mental health care for veterans, including those in rural areas.
Michelle Romero, TMA’s associate vice president of public affairs, says the association has long advocated for state investments in mental health infrastructure, which has paid off in recent years through measurable workforce gains and other improvements.
“That’s a bright spot, highlighting the success and the need to keep funding these services,” she said.
Alongside scope and mental health care issues, TMA is tracking other charges, including those regarding:
- The development of a state regulatory framework for artificial intelligence development and use;
- The Texas health insurance market and alternatives to employer-based coverage;
- The implementation of Senate Bill 7, from 2023’s third special session, which prohibits employers, including physician offices and health care facilities, from mandating COVID-19 vaccines among employees;
- Initiatives to improve the oversight and containment of Medicaid spending;
- Funding for cancer prevention efforts at the Cancer Prevention and Research Institute of Texas; and
- The sale of legal “intoxicating hemp products.”
The Texas Legislature will reconvene for its 89th session on Jan. 14, 2025.
For more information about TMA’s state advocacy, check out its dedicated webpage.
Emma Freer
Associate Editor
(512) 370-1383