New Texas Medical Association policy recognizes people with disabilities as a “health disparity population” for the first time, a move designed to improve care for those who are often inadvertently overlooked or excluded in medical settings.
It was just one of several important policy changes the House of Delegates made in public health at TexMed 2023 in Fort Worth May 18-20, including improving monitoring for cannabis products and promoting firearm safety. The measures were vetted by TMA’s Reference Committee on Science and Public Health.
About 12% of Texans were disabled in 2019, according to the Texas Workforce Investment Council, and this is expected to increase as the overall population ages. Disabilities cover a range of issues, including vision, hearing, and movement.
The new TMA policy:
- Calls on public health researchers to include people with disabilities as a separate demographic group because they are frequently excluded from medical research and would benefit from inclusion.
- Encourages improved education in medical schools and among health care professionals about the resources that address barriers to care. More than one-third of U.S. physicians know little to nothing about their legal responsibilities related to the Americans with Disabilities Act, which requires providing reasonable accommodations in the health care setting, according to a January 2022 survey in Health Affairs.
- Urges improvements to electronic health records and other electronic access points to acknowledge disability status.
To address the explosion of cannabis-related products in Texas, the House also called for TMA to encourage surveillance and research investigating health outcomes associated with the use of hemp-derived THC isomers, or derivatives, such as delta-8 THC. This includes better laboratory testing of those isomers and improved state and federal labeling and regulation, as many delta-8 THC products may be packaged in brightly colored containers featuring sweet or fruity flavors, candy-themed images, and cartoon characters attractive to children and adolescents. The Centers for Disease Control and Prevention and the Food and Drug Administration have both expressed concern about these products.
Delegates also addressed two issues tied to firearms safety, approving a policy to support 1) mandatory firearm safety education prior to buying a firearm for anyone 18 to 21 years old, modeled after Texas’ mandatory hunter safety education; and 2) a 72-hour waiting period between the time of purchase and receiving the firearm for people in that same age group. Anyone who has had formal firearms training, such as members of law enforcement or the military, would be exempt from both the training and the waiting period.
But house members voted to further study an item calling for TMA to encourage including emergency hemorrhage control in school curriculum as early as grade 7. The resolution also recommended that the classes would need to be funded by the state and adapted from the Stop the Bleed program, with TMA acting as a resource.
A proposal calling on TMA to develop policy that guides parents and caregivers regarding the healthy use of social media and smartphones also was referred for more study. Under the resolution, TMA would advocate for state laws requiring large social media companies to share data with researchers, set restrictions on data mining among minors, and establish an internet age of majority for unsupervised use. TMA’s delegation to the American Medical Association would also advocate for federal legislation to establish an internet age of majority.
On other public health measures, the House voted in favor of:
- Expanding peer-to-peer consultation with infectious disease specialists throughout the state by working with Texas medical schools, academic hospitals, and health systems to encourage the adoption of programs tied to or patterned after Project ECHO.
- Addressing the need to improve treatment for opioid use disorder through two policies that prompt TMA to 1) evaluate data about opioid deaths and disabilities and identify legislative barriers to care for high-risk individuals who would benefit from opioid antagonists like naloxone and naltrexone; and 2) support state efforts to improve payment rates for physicians who prescribe buprenorphine; the elimination of preauthorization requirements for that medication among insured patients who have opioid use disorder; and increased education about prescribing.
- Opposing obstacles or penalties that discourage evidence-based medicine, including censure of licensure as well as civil or criminal charges against physicians, patients, or others who participate in a patient’s care.
- Improving pediatric psychiatric care through several measures, including maximizing outpatient primary and behavioral health care, supporting more accessible outpatient services, and emphasizing behavioral health screening.
- Creating two separate policies regarding LGBTQ patients – previously under one umbrella policy – that spell out more specifically TMA’s opposition to conversion therapy and support for gender affirming care.