Monday, May 2, 2016

AB 2086 (Cooley): deserves passage, vote AYE.


RESTORATION OF NEUROPSYCHOLOGY (AB 2086, Cooley)

In a fit of anti-legislative pique last year, Governor Brown vetoed legislation that had handily sailed though both houses of the legislature. The intent of that legislation was to preserve NeuropsychQMEs. One of the arguments in favor of so doing was that this group of experts was especially well versed in the evaluation of patients with Traumatic Brain Injury (TBI) and had been on-the-job as "licensed health care providers" for 22 years. Their special expertise was applicable for injured workers who sustained cerebral concussions and whose medical plight thereafter became known as post-concussion head syndrome. Since the release of the movie, CONCUSSION, this topic has become a favored conversational subject.


Now comes AB 2086 as an urgency measure sponsored by the California Society of Industrial Medicine and Surgery (CSIMS) and by the California Psychological Association (CPA). The California Neurology Society (CNS) is in support. The California Medical Association (CMA) which submitted amendments which were accepted is neutral on the bill although this writer and others will continue to nudge CMA  for full-fledged support. So far the bill has passed the Assembly Appropriations Committee.

The bill's intent is to restore the right of injured workers with TBI to get workers' comp evaluations from clinical neuropsychologists within the QME (Qualitative Medical Evaluator) framework. Governor Brown's veto last year of AB 1542 (Mathis & Cooley) which would have restored NeuropsychQME status in 2015 instead essentially abolished the NeuropsychQME category at the request of Industrial Relations Director Diane Baker -- at least for the time being. 

AB 2086 seeks to set aside this veto. In making her original recommendation last year Baker overrode the professional opinion of the California Psychology Association. Her reasons for so doing were never well understood but were thought to reflect her desire to maintain departmental authority. Governor Brown, for political reasons still not entirely known, obligingly followed suit. The legislature had the chance to override the veto but declined, preferring to develop new legislation this year. That is the basis for AB 2086.

The wisdom of this choice is that AB 2086 amends current law so that once passed it'll no longer be possible for Industrial Relations directors to obstruct the neuropsych evaluation process by refusing to recognize NeuropsychQMEs. It would "ensure that lack of official Medical Board of California (MBC) recognition cannot be used as grounds to not appoint certain physicians as QMEs" and for the purposes of QME designation that those specialties recognized by the administrative director would be recognized. 

References

California Medical Association Legislative Hot List, 4/26/16

The Weinmann Report, www.politicsofhealthcare.com, 10/15/15

Will the Gov. Avoid a Collision in Health Care Policy?,  workcompcentral, 10/07/15, by Dr. Robert Weinmann

Gov's. Veto of AB 1542 Leaves Brain-injured Workers to Fend for Themselves, workcompcentral, 10/09/15, by Steve Cattolica, AdvoCal/CSIMS

Neuropsych Bill Headed to Governor, CSIMS, 9/01/15

ADDENDUM, 7 MAY 2016

On 28 April 2016 the California Assembly passed AB 2086 by 76-0. The authors are Ken Cooley, D-Rancho Cordova, and Devon Mathis, R-Visalia. If signed into law the bill would become effective immediately. The bill has been introduced to the State Senate. We do not have information so far on committee assignment. Remember that last year Governor Brown vetoed a similar bill that handily passed both houses of the legislature. 

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