Call to Action for any Telepsychiatry Advocates in Michigan: We need your immediate help to advocate for a change to a bill with language that would be a major threat to all telepsychiatry operations in the state of Michigan.
Bill 0753 has made it to the governor’s desk and aims to set appropriate standards for telehealth. However, a section of it poses a major barrier specific to the practice of telepsychiatry.
Section 16286 of the bill states that a health professional who is providing a telehealth service may prescribe the patient a drug only if the drug is not a controlled substance.
As a Michigan-licensed child and adolescent psychiatrist with over 17 years of telepsychiatry experience and an advocate for the proper adoption of telemedicine, I’d like to shed some light on how this rule could affect care.
The prescription of stimulants is the bedrock of work as a child and adolescent psychiatrist and without the ability to prescribe stimulants, the efficacy of that work is severely challenged.
Given the severe shortage of child and adolescent psychiatrists, the proven efficacy of telepsychiatry for children, and the large number of telepsychiatry programs already operating in Michigan, this restriction would be an unnecessary and major hindrance to care.
I share a cautious and considered approach to prescribing all Schedule II drugs and understand the potential for abuse of many of these drugs by unscrupulous prescribers and insidious consumers. I fully believe that are certain Schedule II drugs that should not be prescribed through certain types of telemedicine encounters and believe that some regulation in this area is appropriate. However, there are examples of Schedule II drugs, like stimulants for ADHD, that can and should be prescribed through appropriate telemedicine encounters.
Therefore, I strongly suggest a revision that allows for a telepsychiatry exception so that the myriad of Michigan organizations that are currently operating telepsychiatry programs are not majorly restricted by this rule.
Please join me in contacting Governor Snyder’s office or calling them at 517.335.7858. Your short message in opposition of Section 16286 of Bill 0753 could save Michigan community mental health centers from losing a valuable resource in telepsychiatry.
Thank you for your help with this important matter and please spread the word.
Below is a message to Governor Snyder you can copy and paste to use in this form:
I am writing in opposition to Section 16286 of Bill 0753 which states that a telehealth provider may not prescribe controlled substances. While I respect the intention of this section to reduce the abuse of opioids and controlled substances within the state, as it is written, this language would restrict the appropriate prescribing of controlled substances in the instance of telepsychiatry. Telepsychiatry is utilized as a tool to increase access to care, particularly child and adolescent psychiatrists, across many clinics in Michigan. The prescribing of controlled substances for the treatment of ADHD in children is extremely common and clinically appropriate and must not be restricted. Section 16286 of Bill 0753 would be a major blow to many community mental health centers across the state that rely on telepsychiatry to get access to child and adolescent psychiatrists. I implore Governor Snyder to reevaluate this language in Bill 0753.
UPDATE: Michigan passed the telehealth bill at the end of 2016, that, while well intentioned, had a section slip through with concerning language for telepsychiatrists The prescribing of controlled substances is, of course, vital to our work as psychiatrists, so InSight is collaborating closely with the Michigan Health & Hospital Association and the State of Michigan to get a legislative fix in place before the bill goes into effect on March 1.