It’s a big week in Texas. Starting today, more than 600 new laws approved by state legislators and signed by Governor Greg Abbott go into effect.
They run the gamut from changing the composition of county boards, to lowering the cost of gun licenses and a statewide ban on texting while driving.
Healthcare laws and health policy can be polarizing – on the national level, and in Texas. This legislative session, mental health, women’s health and public health were on lawmakers’ minds.
While many proposals died quietly in committee, or made the news each day, some important – and even bipartisan – proposals made it quietly to the Governor’s desk.
First, a new law that may help telemedicine fill an important niche, especially in providing psychiatric care.
Thomas Kim, MD, is an Austin psychiatrist who works out of his house. He’s looking at his next patient on a computer screen. Kim is able to provide therapy remotely through telemedicine – a visit that’s like Facetime or Skype using video and audio except it uses more secure technology to protect personal medical information.
Kim says telemedicine had its genesis when people in prison needed help and couldn’t have a face-to-face visit with a specialist.
"What started out of necessity has blossomed," he said.
Now, telemedicine is used for rural Texans, who in many cases, don’t have a psychiatrist in their county or even in the next county over. And it’s not just for adults. Texas has a shortage of pediatric specialists, and telemedicine helps fill a need for children in mental hospitals.
Kim said these remote visits are great for people who wouldn’t otherwise have access, but complicated when it comes to billing and determining what constitutes a telemedicine appointment.
For years, the language in Texas was vague, pointing to a need for a traditional in-person meeting to establish a therapeutic relationship. This session, Kim lobbied for Senate Bill 1107, which clarifies what counts as a telemedicine visit. And it passed.
"This is an evolution, a maturation of existing guidelines, which unfortunately, got kind of bogged down," Kim commented. "I don’t think that we should over regulate telehealth lest we choke innovation off."
The law going into effect this week allows Texans to set up an appointment, get help, and get a bill, from someone you have never met face to face. Kim says this will boost access to telemedicine in Texas.
Next, women’s health and a new law designed to help new mothers and their babies, like Connie Delarosa of San Antonio, whose son was born 11 weeks early.
"He was so tiny and had all these wires on him and I was scared to hurt him," she explained. Delarosa's son spent several months in the ICU. "Now mommy instincts are kicking in," the new mother said.
Caring for a newborn baby can be exhausting and stressful. Some new mothers need help so that don’t become overwhelmed.
This year, state lawmakers took note. Starting Friday, Texas will require Medicaid and the Children’s Health Insurance Program – or CHIP – to cover the cost of screening the mother for post-partum depression during a well baby or pediatric appointment with their child. The idea is to stave off maternal mental health issues that can affect the entire family.
And, finally, there's a new law addresses a public health concern, specifically an emerging infectious disease: Zika.
Last fall, Cameron County health workers went door-to-door warning residents about disease-ridden mosquitos. When the mosquito-borne virus showed up in Texas in Brownsville in 2016 and Hidalgo County this year, Texas became only the second state in the continental U.S. besides Florida to deal with cases Zika from local mosquitoes.
"This is something you always prepare for, but you just never know when it’s going to happen," commented Cameron County's Health Administrator Esmeralda Guajardo. "You wait for it."
But Texas lawmakers wanted to be proactive. New legislation effective September 1 opens the door for more medical and epidemiological information to be shared with federal partners like the Centers for Disease Control.
That’s important because, as Representative Bobby Guerra of McAllen puts it, mosquitoes don’t know borders. Guerra also successfully pushed lawmakers to allocate more resources for the Texas Department of State Health Services to track, study and prevent Zika, improving vigilance against possible outbreaks.