It’s 10 O’clock: Do You Know Where Your State Legislature Is?

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Some readers may recall the classic public service announcement when the announcer ominously intoned: “It’s 10 o’clock. Do you know where your children are?”

This popular PSA, which ran on radio and TV stations from the 1960s to the 1980s, warned clueless parents to doublecheck their children’s whereabouts, implying that delay could spell trouble—or worse.

Perhaps we need a similar PSA today? Not for modern parents, who can monitor their kids via smartphone apps, but for us, psychiatrists, to alert us to the timely happenings in our own state backyards.

We need to be aware because, while the foibles of federal officials are served up daily as media fodder, the actions of our own state legislative bodies are often hidden in plain sight. Yet, every day, in statehouses across the country, decisions are being made about issues that will shape the access, quality, and scope of the health care that we provide to our patients.

For example, these are some current issues that your state legislature may be working on:

• Prior authorization reform: Most of us know patients who have not received treatments they need because of burdensome preauthorization requirements. APA’s model legislation is being taken up by several states, including Maryland, Massachusetts, Montana, Nevada, and New Jersey, and APA is working in coalition with other physician specialties to advance this issue.

• Implementing the Collaborative Care Model: This evidence-based method safely increases access to quality psychiatric care. At least six states have signed collaborative care laws, while other states, including Arizona, Arkansas, South Dakota, and Wyoming, are working on these legislative initiatives.

• Addressing psychiatric workforce shortages: While passage last December of the Consolidated Appropriations Act of 2023 (HR 2617) offered our field future relief with newly minted graduate medical education slots, state legislation is still needed to address student loan repayment and other workforce issues (Congress Passes Spending Bill With Several APA Priorities).

• Telehealth access and reimbursement: Many states still lack payment, coverage parity, and audio-only laws for telehealth services. Now that the end of the Public Health Emergency has been announced (COVID-19 Public Health Emergency to End in May), new state laws are needed.

• Implementation of Mental Health Parity: Despite the 2008 federal law, mental health parity has not been fully implemented in most states; new state laws are needed to achieve true parity.

• Safe Prescribing: Patients deserve access to mental health care by qualified prescribers with quality medical training. We need to help stop the expansion of prescribing to practitioners with no medical training.

• Opposing the criminalization of the practice of medicine: Some states have bills that criminalize the practice of medicine or prevent patient access to care. Is your state considering such a bill?

Now that you’re aware of some of the critical issues that your state legislature may be addressing, explore these issues more deeply on APA’s website, www.psych.org. Then consider engaging in state advocacy by following these simple next steps:

• Do you know the names of your state legislators? Go to https://www.psychiatry.org/psychiatrists/advocacy.

• After identifying your state legislators, look them up online and on social media. Learn what they think about the issues you care about. For ideas about how to reach out and introduce yourself, go to https://votervoice.net/AmericanPsych/Campaigns/97931/Respond. Don’t be surprised when legislators respond! Most state legislators want to connect with their constituents—many will welcome your ideas, and some may even ask for guidance on specific mental health and substance use initiatives.

• Learn which issues your state legislature is working on. One easy way? Connect with your district branch (DB). Most DBs stay on top of the hot-button bills before their state legislatures. What’s more, DBs need your help with state advocacy. For example, you can help DBs by sharing a clinical vignette that illustrates why a bill is needed. (Of course, make sure to de-identify any patient stories before sharing.)

• Once you know a bill is on the docket, you can advocate in several ways: Email or call your state legislator and ask your representative to vote for or against the bill, email your colleagues to raise awareness, offer testimony at public hearings, and consider writing an op-ed for your local paper.

• Finally, stay on top of “all-things-advocacy” by signing up for APA Advocacy Alerts at https://votervoice.net/AmericanPsych/Register.

• Need help or advice? Reach out to APA staff by emailing [email protected].

Let’s work together to make a difference for our patients and our profession. Now is the perfect time to know where your state legislature is! ■

Katherine G. Kennedy, M.D., is chair of the APA Council on Advocacy and Government Relations and an assistant clinical professor at the Yale University School of Medicine, where she leads the Legislative Advocacy Skills Program. She is also co-editor of A Psychiatrist’s Guide to Advocacy from APA Publishing.