Dear Colleagues,

I had the pleasure of meeting with the Commissioner of Mental Health, Marie Williams, LCSW, last Wednesday. Dr. Burley, the Medial Director and Assistant Commissioner was also there, as were Anne Carr and Meagan Frazier from Smith, Harris and Carr, our lobbying firm. We had a very productive meeting, discussing a wide range of issues from scope of practice to insurance parity.

I believe it is safe to say Commissioner Williams is very supportive of our views regarding insurance parity, however, she encouraged us to actively report any issues we find to the Department of Commerce. Unfortunately, the state is not out looking for problems. We must bring these instances to their attention. Complaints drive the system. If anyone has questions or complaints, please contact Shawndell at MHA, and she can help facilitate getting the issues to the right place. The APA office of practice development is also collecting data to bring to CMS and the insurance industry to help level the playing field.

We also discussed recruitment of psychiatrists to Tennessee. There is clearly a shortage and I hope we can work with the training programs to expand the psychiatric foot print in our state. However, this led to the main discussion point of Advanced Practice Nurses signing as a second signature on Emergency Commitments. Again, the TPA is opposed to this move on several levels, including the fact this would essentially give the Nurse admission authority as well as change the law requiring a physician to be involved in the Commitment process. Dr. Burley described the difficulty they are having in recruiting psychiatrists and filling positions in the state hospitals. We discussed the statewide crisis of psychiatric patients in emergency departments, and the difficulty in getting them to proper evaluation and care. I believe the Commissioner is not ready to move forward on the APN issue without our support, and they are not bringing this up in the new legislative session.

All in all a very positive meeting. I stressed to Commissioner Williams the resolve of the TPA to be a leader in the effort to improve access to Psychiatric care in Tennessee and our desire and willingness to “be at the table” as these critical decisions are made.

Hope everyone had a Happy Thanksgiving. I look forward to the next year for the TPA.

Best regards,

Rodney A Poling MD DFAPA President, Tennessee Psychiatric Association.