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My name is Maria Elisa Hernandez-Hock MPAS, PA-C. I have been a psychiatric physician assistant for 16 yrs. All of my professional career has occurred in El Paso, TX. This region borders with New Mexico. West Texas as well as its neighboring state are areas that are medically undeserved. During 2020 when the world seemed to halt many of us psychiatric providers continued our duties and while we were not physically on the frontline we were part of an amazing effort to assist with the mental crisis that was a result of the pandemic. From our homes many us were afforded the capacity to reach our patients and curtail the mass anxiety and depression occurring at such a critical time of isolation.
Our saving grace was telemedicine which preserved our capacity to both keep our patients safe while managing their psychiatric conditions. For previous patients this meant there would be continuity of essential care and for our new patients calling our local crisis line it meant expedited attention to their acute needs. Many states removed licensing requirements to address this unpresedented situation but this was just a temporary waiver creating a time sensitive solution. Despite being three years post covid, these licensing barriers continue to exist weighing heavily to all medical providers and the patients served. Bureaucratic limitations should not only be addressed but eliminated through legislative changes. One means of resolution to address health equity is a compact PA license that would provide physician assistants an ability to expand care without the prolonged administrative process.
As a medical provider for a mental health authority during a public health emergency I can attest how necessary such legislation is. Our clinic is 4 miles away from the New Mexico state line but because there is no compact licensure patients from NM serviced by our clinic can not be seen in their homes. This would seem like a mere inconvenience to some but to those who know this area it is so much more. Sunland Park NM is mostly composed of a Hispanic population with a per capita income in 2021 of 19,000 dollars. Resources are scarce and for many transportation is a major hindrance. Many of the patients receiving inequitable access to medical care are those with the least resources and the greatest need from our military to our geriatric population to our patients experiencing cooccuring addiction and complex medical conditions. They all go unseen and unheard. Many counties in NM have few behavioral health providers and are unevenly distributed across the state with rural and frontier counties having even less providers.
According to a 2019 document by the Office of the Inspector General titled Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico’s Medicaid Managed Care 56% of patients with behavioral care needs go untreated. This percentage is not only staggering but a dismal view of what mental health care disparities look like in the United States. My story is one story but it is repeated across the country unfortunately. Why when we have the tools in telemedicine does legislation continue to impede a resolution to a massive problem? Why not have a national cohesive effort to fight the rates of suicide, depression, and substance abuse by providing PAs not only in psychiatry but medicine altogether an opportunity to reach across state lines and treat those who will eventually have worse outcomes and increased medical costs once their medical complexity is not treated proactively. The answer is simple, a PA licensure compact that would decrease the administrative and financial barriers and provide to many a resource that is not only necessary but life saving.
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