Thursday, October 15, 2015

NO, THE GOVERNOR DID NOT AVOID A COLLISION IN HEALTH CARE POLICY


Governor Brown in his veto message of AB 1542 (Mathis & Cooley) said "this bill undermines the Division of Workers Compensation's authority ... when it determines eligible medical specialties ... that power resides with the physician's licensing board. If the Board of Psychology believes there is value in recognizing neuropsychology as a subspecialty, it should do so."

It turns out that the Governor knowingly acted on an incorrect opinion from the Department of Industrial Relations (DIR) and from Christine Baker in particular. It seemed lost on the Governor that AB 1542 was supported by the California Psychology Association and by the Board of Psychology. It was well known to Governor Brown, or should have been, that the Board of Psychology does not formally recognize or enfranchise subspecialties. However, the Board of Psychology does recognize the American Psychological Association (APA) of which it is a member. The subspecialty of clinical neuropsycholgy is in fact recognized by the the APA, a fact that the Governor, in his zeal to support Christine Baker, ignored. By his veto  Governor Brown evidently felt he was supporting "the Division of Workers Compensation's authority." Regrettably, the reverse is true now that NeuropsychologyQMEs have been relegated to the basement of medical and psychological evaluation and treatment for injured workers with traumatic brain injuries (TBIs). These injured workers will no longer have the direct access to NeuropsychQME evaluation as they have had for the last 22 years. Employers will find that assigning TBI patients to appropriate return-to-duty status has just been made more difficult. Trades where head injuries are more common, e.g., construction, working at heights, or around heavy equipment, have just been made more risk laden by Governor Brown's arbitrary veto. 

By contrast Governor Brown signed AB 2127 (Cooley) last year so that high school athletes who sustain TBIs can get direct access to health care providers. These health care providers are supposed to be trained to recognize and evaluate concussions and TBIs. It looks like Gov. Brown feels that injured workers do not need the same access to first level responders as do high school athletes who get hurt playing football, or soccer. 

We understand that the underpinnings of the Governor's veto was his desire to support DIR Christine Baker and the Division of Workers Comp as seen through her eyes. What's too bad is that in this effort the injured workers who do construction and other risky jobs have been short-changed, actually, to put it bluntly, they've been torpedoed. 

To correct this egregious mistake, it would help if the Board of Psychology changed its policy to provide formal recognition to NeuropsychQMEs and if Mathis, Cooley, and others would reintroduce a revised version of AB 1542 in 2016.