New Mexico American Psychiatric Ass'n:

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edieb

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This was just disseminated from the APA:
Dear Friends,

By now most of you have heard that the rules and regulations implementing the Prescribing Psychologist Statute in NM were filed. The regulations become effective 01/07/05. However, it disheartens me to say that we are not out of the woods yet. There are some who continue to maintain that language in the Statute calls for a restricted formulary.

After many months and numerous unsuccessful attempts by many individuals, including legislators, state officials, board members, and others to resolve the issue, and with the advice from the NM Superintendent of Regulation and Licensing and the Governor's Attorney, we have decided to return to the Legislature and attempt to amend the Statute and correct the problem. The Governor does not want to see the regulations challenged and have to go through months or even years of litigation. Thus, we are hoping to have his support during the upcoming legislative session. I was able to speak with Governor Richardson night before last and he is supportive of the Prescribing Psychologists' Statute and desperately wants to increase mental and behavioral health care for New Mexicans in need.

Even though it has been almost three years since we passed the Bill, I want all of you to know that Elaine and I have stood firm in our insistence that a "Best Practices Model" approach to psychopharmacology is the only model we would accept. This is what we lobbied for when we passed the Bill, this was the intent of the Legislature, and this is what the formulary subcommittee of the original joint committee, which was chaired by a psychiatrist recommended to the Medical and Psychology Boards. Unfortunately, some have not agreed with us and because of our position on this issue we have been criticized and undermined by joint committee members, conference committee members, and others who have agreed with the Medical Board on developing rules and regulations that would restrict our formulary.

Now, we found out that the NM Medical Society is supporting the NM Medical Board and the NM Psychiatric Association in maintaining that we be able to prescribe only under a very limited formulary. So, as far as I'm concerned the NM Medical Society is going back on their word. Something I hope to point out to our supporters in the Legislature. Moreover, we now have information that the American Psychiatric Association dished out $100,000.00 to repeal our law in NM. Obviously, they are going to fight our attempt to pass the amendment.

Those of you who are able and willing to assist us again, please contact me back channel. We are going to need additional resources very soon. This thing is not over and Elaine and I sure don't plan on quitting now. I have tried to point out all along that one of the reasons we are in this mess is because at no time during any of the critical negotiations with the Medical and Psychology Boards did anyone see fit to include, prescribing psychologists who have been through the training and participated first hand in the legislative process, at the negotiating table. I am very pleased that Louisiana psychologists did not make this same mistake and I urge all the other states to follow Louisiana's lead when the time comes to implement your statute.

Respectfully and Sincerely,

Mario Marquez

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edieb said:
Unfortunately, some have not agreed with us and because of our position on this issue we have been criticized and undermined by joint committee members, conference committee members, and others who have agreed with the Medical Board on developing rules and regulations that would restrict our formulary...

Now, we found out that the NM Medical Society is supporting the NM Medical Board and the NM Psychiatric Association in maintaining that we be able to prescribe only under a very limited formulary.

Why would you NOT want a limited formulary? The training course does not prepare them to be medical doctors, by any stretch of the imagination. Plan on practicing outside your scope, perhaps? Please don't make the argument that there are off-label uses for non-psychotropic medications. Something that technically physicians shouldn't be routinely doing is in no way acceptable for prescribing psychologists to even consider.

I can't imagine what your malpractice premiums will be.
 
I guess my question would be: restricted to what? Dentists have a restricted formulary...that's the real-life model I keep hearing about. :confused: Even some physicians are not supposed to prescribe outside their area -- like my PCP doesn't like to prescribe elaborate dermatology meds and won't do it because "we're not supposed to really prescribe stuff like that".
 
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I agree there should be a realistic limited formulary, and I am sure there is. I think the issue is over schedule II meds like ritalin etc.. In that case it is silly as we could do much less damage to a kid with daily ritalin than daily olanzapine, VPA.. etc.. which are not controlled at all.

:cool:
 
edieb said:
This was just disseminated from the APA:
Dear Friends,

By now most of you have heard that the rules and regulations implementing the Prescribing Psychologist Statute in NM were filed. The regulations become effective 01/07/05. However, it disheartens me to say that we are not out of the woods yet. There are some who continue to maintain that language in the Statute calls for a restricted formulary.

After many months and numerous unsuccessful attempts by many individuals, including legislators, state officials, board members, and others to resolve the issue, and with the advice from the NM Superintendent of Regulation and Licensing and the Governor's Attorney, we have decided to return to the Legislature and attempt to amend the Statute and correct the problem. The Governor does not want to see the regulations challenged and have to go through months or even years of litigation. Thus, we are hoping to have his support during the upcoming legislative session. I was able to speak with Governor Richardson night before last and he is supportive of the Prescribing Psychologists' Statute and desperately wants to increase mental and behavioral health care for New Mexicans in need.

Even though it has been almost three years since we passed the Bill, I want all of you to know that Elaine and I have stood firm in our insistence that a "Best Practices Model" approach to psychopharmacology is the only model we would accept. This is what we lobbied for when we passed the Bill, this was the intent of the Legislature, and this is what the formulary subcommittee of the original joint committee, which was chaired by a psychiatrist recommended to the Medical and Psychology Boards. Unfortunately, some have not agreed with us and because of our position on this issue we have been criticized and undermined by joint committee members, conference committee members, and others who have agreed with the Medical Board on developing rules and regulations that would restrict our formulary.

Now, we found out that the NM Medical Society is supporting the NM Medical Board and the NM Psychiatric Association in maintaining that we be able to prescribe only under a very limited formulary. So, as far as I'm concerned the NM Medical Society is going back on their word. Something I hope to point out to our supporters in the Legislature. Moreover, we now have information that the American Psychiatric Association dished out $100,000.00 to repeal our law in NM. Obviously, they are going to fight our attempt to pass the amendment.

Those of you who are able and willing to assist us again, please contact me back channel. We are going to need additional resources very soon. This thing is not over and Elaine and I sure don't plan on quitting now. I have tried to point out all along that one of the reasons we are in this mess is because at no time during any of the critical negotiations with the Medical and Psychology Boards did anyone see fit to include, prescribing psychologists who have been through the training and participated first hand in the legislative process, at the negotiating table. I am very pleased that Louisiana psychologists did not make this same mistake and I urge all the other states to follow Louisiana's lead when the time comes to implement your statute.

Respectfully and Sincerely,

Mario Marquez

Hi edieb,

Thanks for the info. Any suggestions as to how those of us outside NM can be of help to Dr. Marquez?
 
The original formulart is listed on the Georgia Psychological Association website; it includes all the antipsychotics, mood stabilizers, anti-convulsants, psychostimulants, hypnotics, anxiolytics, anti-depressants and some anti virals.
I am not sure as to what this limited formulary consists of; however, I imagine it is just anxiolytics and/or antidepressants. There is little doubt in my mind the AMA and the American Psychiatric Ass'n will lose this round. The formulary was agreed upon 2 years ago, and it is going to be hard to go back on that agreement.
LA is making quick progress; the law should be implemented 1/20/04

++++For the momentum to persist, it is really important everyone join Division 55 of the APA!
 
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