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Pennsylvania considers letting psychologists prescribe medicine for patients

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Pennsylvania considers letting psychologists prescribe medicine for patients


(The Center Square) – Pennsylvania lawmakers are considering a shortcut of sorts to expand health care access: let psychologists, not just psychiatrists, prescribe medication.

A handful of states and the federal government already do so, but critics worry about a lack of proper training and other innovations of the past that have not panned out.

The proposal, House Bill 1000, is “about making desperately needed health care more accessible to more Pennsylvanians,” Rep. Dan Frankel, D-Pittsburgh, said during a meeting of the House Professional Licensure Committee on Monday. “This is a reasonable and commonsense way to expand access quickly to patients waiting desperately for health care access now.”

The bill would allow psychologists to qualify for prescription authority by meeting educational and training requirements set by the state Board of Psychology, granting them similar privileges as primary care physicians, nurse practitioners, and physician assistants for psychotropic medications.

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Iowa, Idaho, Illinois, New Mexico, Louisiana and Colorado already allow psychologists to prescribe medication, Frankel noted in his legislative memo for the bill, as does the U.S. military, the Public Health Service, and the Indian Health Service.

HB1000 “provides a solution to the psychotropic medication access crisis,” said Dan Warner, a licensed psychologist testifying on behalf of the Pennsylvania Psychological Association. “A national study found that only 18% of psychiatrists are accepting new patients.”

In Pennsylvania, the PPA found a significant number of psychiatrists had wait times of 6-8 weeks.

“Six to eight weeks when I’m waiting for a general specialist is not a big deal,” Warner said. “But when you’re talking about the reality of everyday needs of mental health medications, it is much too long to wait.”

For states that allow psychologists to prescribe medicine, Warner said mental health death rates “always” fell and states didn’t have a rise in “problematic safety issues” or overprescribing medications. Psychologists also saw more rural patients and patients on Medicaid, he said.

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Extra limitations on psychologists, however, could neuter the reach of an expansion.

“I encourage lawmakers to avoid making psychologists undergo unnecessary didactical clinical training,” said Jeff Singer, a senior fellow at the Cato Institute’s Department of Health Policy Studies and a surgeon in private practice in Phoenix.

Some states have required psychologists to train in surgery and other specializations before they could prescribe medicine, which Singer called “cynical attempts by entrenched incumbents to reduce competition.”

Rep. John Lawrence, R-West Grove, noted that previous attempts to expand health care access have fallen flat. Pennsylvania has struggled to quickly license nurses to work in the commonwealth, and a nurse licensing compact with other states has yet to get approved at the federal level.

“It’s very difficult to sort out these issues,” Lawrence said.

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The state psychiatry association came out against the bill.

“The reason is concern of training for their overall understanding of whole-health care and reducing it to one part when it’s much broader,” said Mary Anne Albaugh of the Pennsylvania Psychiatric Society. “The training that medical education affords is different than that of the training for psychologists.”

As things stand now, if patients can’t meet with a psychiatrist, they end up in local hospitals.

“Especially when you’re dealing with acute mental health problems, they’re going to emergency rooms,” Warner said. “You talk to ER directors, they are very often speaking about getting overwhelmed with mental health cases and not having sufficient psychiatric time to deal with it.”





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Pennsylvania

Suspect in killing of woman in Pa. motel in custody in N.J., cops say

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Suspect in killing of woman in Pa. motel in custody in N.J., cops say


A suspect in the homicide of a woman in Bensalem, Pennsylvania is in custody at the Trenton Police Department, police said Wednesday afternoon.

The suspect and victim’s identities have not been made public.

The Bensalem, Pennsylvania police and the Buck County District Attorney’s Office said in a statement that officers found a woman dead at the Sleep Inn & Suites, on Street Road, early Wednesday. They did not detail the circumstances of her death.



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Shapiro threatens to pull Pennsylvania out of PJM over electricity prices

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Shapiro threatens to pull Pennsylvania out of PJM over electricity prices


Pennsylvania Gov. Josh Shapiro (D) is warning regional electricity grid operator PJM that the state will consider leaving the organization if it doesn’t do more to protect consumers against soaring power prices.

Shapiro’s letter marks a sharp escalation of his dispute with PJM, the largest U.S. wholesale power market and transmission coordinator, serving 65 million people from the Atlantic Seaboard to Chicago.

The risk of more power price escalation “threatens to undermine public confidence in PJM as an institution,” Shapiro said in his letter to Mark Takahashi, chair of PJM’s board of managers.

In a statement Tuesday, PJM said, “We appreciate the governor’s letter and have reached out to his office to discuss next steps.”

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Group weighs potential and peril of performance funding for Pa. universities • Pennsylvania Capital-Star

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Group weighs potential and peril of performance funding for Pa. universities • Pennsylvania Capital-Star


A group of lawmakers, university administrators and the head of the Department of Education heard Tuesday about the possibilities — and perils — of tying public funding of state-related universities at least in part to their performance and students’ academic outcomes.

The Performance-Based Funding Council was created by the General Assembly last summer and tasked with making recommendations on a performance-based funding formula by the end of April. Members include four lawmakers, Interim Acting Secretary of Education Angela Fitterer and three non-voting members from the state-related schools that would be affected: Penn State, Temple University and the University of Pittsburgh. Lincoln University, an HBCU and a fourth state-related university, would not be affected.

Currently, the three state-related schools collectively receive more than $550 million in state funding annually. The move to a performance-based funding formula has been supported by lawmakers from both parties, as well as Gov. Josh Shapiro.

“These legislative hearings offer a unique opportunity to fundamentally reassess how we align public resources and educational outcomes,” said Rep. Jesse Topper (R-Bedford), the council chairperson. “I believe we need to show the public how those resources are used and why — why we invest in higher education.”

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More than 30 states already use a performance-based funding model. According to testimony heard by the council, the most common academic targets in states with performance-based funding models include graduation rates, student retention and degree or credential completion. But a potential formula could also take into account factors like research output, administrative efficiency, and employment rates of graduated students.

While policies vary greatly around the country, about 10% of money sent to four-year schools in states with performance-based funding formulas is based on the targeted metrics, according to testimony by Andrew Smalley, a policy specialist who focuses on higher education at the National Conference of State Legislatures.

But experts warned that coming up with a comprehensive formula can be “daunting.”

“Everyone knows that colleges and universities subject to these formulas find themselves in a bit of a Catch-22,” said Charles Ansell, vice president of research, policy and advocacy at Complete College America, a nonprofit focused on best practices in higher education. “They need funds for their performance and improved graduation rates, but they cannot access funds without demonstrating improvement first.”

One potential solution, another expert testified, could be awarding funds based on improvements at an individual school over time instead of an arbitrary benchmark, like graduation rate, that applies to all schools.

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Experts also warned that some performance-based funding models can exacerbate disparities in educational outcomes between high- and low-income students, and between white and minority students.

“Performance funding is typically tied to advantages for the advantaged students and disadvantages for the disadvantaged,” said Justin Ortagus, an associate professor of higher education administration and policy at the University of Florida. Though he noted that a funding formula can take these pitfalls into account by incentivizing enrollment and degree or certification attainment for students in impacted groups.

Speakers also highlighted the benefits of performance-based funding models. Ortagus noted that they can promote institutional accountability.

It could also provide predictability when it comes to school budgets.

As it stands, Pennsylvania’s method for funding these universities requires a two-thirds vote of the legislature, which has led to months-long delays in the past. Creating a predictable funding formula that would be distributed through the Department of Education would mean future appropriations would only require a simple majority.

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Moreover, lawmakers could use performance metrics to encourage specific educational outcomes. Part of the funding formula, for example, could rely on students enrolling or graduating in programs of study that would lead to them entering high-demand fields in the job market.  

The state could also target specific outcomes based on goals like increasing low-income, veteran or minority student graduation rates, encouraging adult education and incentivizing students to enter high-demand jobs by focusing on particular majors. And the formula can be adapted when new needs or issues arise.

“It’s very common for states to revise these frequently,” Smalley said.

The council expects to hold three more hearings, some at the campuses of affected state-related universities.  Its recommendations are due to the legislature and governor April 30.

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