Latest news with #DiMario
Yahoo
6 days ago
- Health
- Yahoo
Legislation allowing ADHD med refills for more than a month at a time gains speed at State House
Democratic lawmakers Sen. Alana DiMario of Narragansett and Rep. Michelle McGaw of Portsmouth are sponsoring not-quite-identical bills that would increase how much ADHD medication patients can receive at once. (Photo by Alexander Castro/Rhode Island Current) Availability of tightly regulated ADHD medications could improve under a pair of bills that continue to move through the Rhode Island General Assembly following a Senate floor vote Tuesday night. Bill S795 by Sen. Alana DiMario, a Narragansett Democrat, passed 36-0 and now joins the amended version of bill H5866 by Portsmouth Democratic Rep. Michelle McGaw, which passed the House 70-0 on April 22. Now each bill awaits a committee hearing in the opposite chamber. Both bills would allow for non-opioid Schedule II stimulants like Adderall, Ritalin, and Vyvanse, which are commonly used as ADHD treatments, to be prescribed and dispensed in larger amounts for doctor and patient convenience. Sen. Pam Lauria, a Barrington Democrat and nurse practitioner, stood to commend DiMario's legislation on the Senate floor, calling it 'an incredibly important bill, particularly as we are talking about the administrative burdens on primary care providers.' 'These are chronic medications that these people take every day, but every month, because of the very real safeguards for these medications, the extra time that it takes for primary care providers or psychiatrists… to do this work is cumbersome,' Lauria said. The 'cumbersome' refill schedule is exactly what DiMario's legislation wants to fix. Under current federal rules, providers can write three separate 30-day prescriptions for a total 90-day supply. Some states have adopted revised rules that allow patients to pick up all 90 days' worth at once, as Massachusetts did in 2024. In the Ocean State, however, patients still have to return to the pharmacy monthly and pick up the prescriptions one by one. Patients also have to contact their doctor to send in the second and third month's prescriptions, piling onto providers' workloads. Alas, there's one important difference between the bills: DiMario's version allows for patients to fill all 90 days at once, while McGaw's amended version caps fills at 60 days. DiMario said in a phone interview Wednesday that she believes the House and Senate will eventually agree on a version of the legislation as the state's legislative session winds down in the following weeks. 'We really believe that 90 days provides the most meaningful kind of time burden relief for patients and providers,' DiMario said. 'My position is that I'm strongly advocating for the 90 days, but I do believe that an agreement will be reached.' Greg Paré, a Senate spokesperson, did not immediately have scheduling details for the bills Wednesday, and noted that the bills' different time frames 'will have to be addressed.' McGaw agreed in a phone call Wednesday evening, saying that with the Senate's OK of a 90-day supply, the legislation is 'still sort of in limbo' until she can meet with the House committee chair and the senate's policy team. McGaw originally proposed a 90-day supply but reduced it to 60 days after feedback from some prescribers. She thinks a single version of the bill will eventually emerge after more conversations, acknowledging that edits to not-quite-identical legislation in both chambers is not uncommon as the legislative session nears its end. 'I would be happy with either version, whether we decide on 60 or 90 days,' McGaw said. 'In either case, it helps to reduce some of the administrative burdens for our physicians, and also helps parents or patients for whom it's a challenge to go to the doctor every month and get a new prescription.' On the Senate floor, DiMario said the bill builds on successful legislation last year that authorized electronic transfers of ADHD prescriptions, pending state adoption of new federal standards. Both last year's and this year's ADHD drug bills are designed to alleviate headaches for patients and providers alike amid pill shortages ongoing since 2022, attributed to a number of factors, including a sharp increase in adult diagnoses. The Drug Enforcement Administration previously faced scrutiny for limiting production quotas of Schedule II drugs, but it increased some of those quotas in 2024. An October 2024 edition of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report relayed that there were an estimated 15.5 million U.S. adults with an ADHD diagnosis in 2023; about half were diagnosed as adults. Roughly one-third of these adults take stimulant drugs for their condition, and shortages affected 71.5% of this population's access to their medications. A 2025 article in the American Journal of Managed Care noted that stimulant prescriptions have almost doubled in the past 10 years. 'There is only so much pharmaceutical companies can do when demand severely outweighs supply,' the authors wrote. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Boston Globe
16-04-2025
- Health
- Boston Globe
Decades of inaction have wrought R.I.'s primary care crisis. We must address it right now, then nurse the state back to health.
Yet, as a state, we have not properly maintained the health of our primary care environment, nor have we responded to the signs of its disintegration. Now we must respond to a full-blown crisis. Just as a person who suffers a heart attack receives emergency care and then is often advised to adopt lifestyle changes to restore their health, our state must deal with this crisis with emergency measures, as well as with medium- and long-term efforts to sustain and strengthen primary care. Get Rhode Island News Alerts Sign up to get breaking news and interesting stories from Rhode Island in your inbox each weekday. Enter Email Sign Up While our Advertisement One root cause is clear: Advertisement Senator Sosnowski has advocated for improved and equitable insurance payments to hospitals and providers for years. We must address reimbursement rates as an immediate step to maintain our current providers and recruit more to practice primary care here. That effort must include a Related : Another immediate need is addressing the extra stressors on our primary care providers. Senator DiMario has focused on better supporting the incredibly under-resourced mental health system that would help PCPs and patients alike. We must also demand that insurers reduce the needless administrative burdens they place on primary care providers, and increase patients' access to specialists to decrease time demands on PCPs. The R.I. Senate has focused on resolving these issues, and we currently have many bills under consideration to accomplish those goals. Rhode Island must also make a concerted effort to encourage medical students to specialize in primary care, and to choose Rhode Island when they graduate. Senator Lauria has introduced bills that focus on those goals. One would fund Related : Advertisement As we work to improve our primary care workforce, we must also build in a mechanism for accountability to consistently meet the health care needs of our communities. We need specific targets, action plans, and ongoing monitoring to first ensure every Rhode Islander has access to a primary care provider, and then to take earlier corrective action in the future, so we do not face this crisis again. We are all members of the Senate's commission exploring the education and retention of primary care providers in Rhode Island, whose charge, in part, is to consider the possibility of establishing a Our current primary care crisis is the product of decades of inaction. We urge our colleagues across state government to work collaboratively right now, and in the future, to nurse it back to health. Senators Pamela J. Lauria (D-Dist. 32, Barrington, Bristol, East Providence), V. Susan Sosnowski (D-Dist. 37, South Kingstown) and Alana M. DiMario (D-Dist. 26, Narragansett, North Kingstown, New Shoreham) are members of a Senate commission studying the education and retention of primary care physicians and the feasibility of establishing a medical school at URI.
Yahoo
03-04-2025
- Health
- Yahoo
R.I. lawmakers align on ADHD prescription bill. Doctors are more divided.
A pair of bills moving through the Rhode Island General Assembly would permit patients to fill multiple months of their ADHD medications — like methylphenidate, or generic Ritalin, shown here — in a single visit to the pharmacy. (Photo by Alexander Castro/Rhode Island Current) Legislation moving through the Rhode Island House and Senate could alleviate one pain point for parents: Filling a prescription for ADHD medications amid ongoing shortages. On Tuesday, the Rhode Island House Committee on Health and Human Services OK'd an amended version of H5866, a bill led by Portsmouth Democratic Rep. Michelle McGaw that would improve patients' access to prescription stimulants by allowing pharmacies to fill and dispense a 60-day supply rather than in 30-day increments as is currently allowed. The drugs are mainly used to treat ADHD and ADD, hyperactivity and attention deficit disorders, and since 2022 have consistently faced shortages nationwide. The bill's Senate duplicate — introduced by Sen. Alana DiMario, a Narragansett Democrat — was also heard in committee on Tuesday. It was held for further study, which is standard practice at a bill's initial hearing, but at least one of DiMario's colleagues on the Senate Committee on Health was supportive. 'As someone who has to do this, yes, it's very angst provoking for the provider and for the patient,' said Sen. Pam Lauria, a Barringon Democrat and primary care nurse practitioner. DiMario's bill would permit a more plentiful prescription by allowing pharmacies to issue a 90-day supply in a single filling. The original version of McGaw's bill also endorsed a 90-day supply before being amended on March 28 ahead of its second committee hearing. The house's legal counsel said at Tuesday's hearing that there had been comments from physicians which spurred the change but did not provide details. DiMario wrote via text message Thursday that for now, her Senate bill will retain the 90-day stipulation. 'We just had the hearing so the [Committee] Chair will review all the testimony and decide how to proceed,' DiMario wrote, 'but to my knowledge there isn't a compelling reason to shorten the timeline to 60 days given those prescriptions can be written 90 days at a time in three separate prescriptions already.' DiMario and McGaw's bills are written to permit larger prescriptions for 'non-opioid, non-narcotic Schedule II substances.' Schedule II drugs can be very habit-forming, but have at least some specific clinical applications, including prescription stimulants like mixed amphetamine salts (Adderall), Ritalin and Vyvanse, which are used to treat ADHD and ADD. Since 2007, the Drug Enforcement Administration has allowed doctors to write prescriptions for 90 days' worth of Schedule II medications. But these 90-day prescriptions cannot be picked up all at once, and they can't be sent to a pharmacy at the same time. A physician must write three separate prescriptions, three months in a row. The patient will then see their doctor for another round of prescriptions, and the cycle begins anew. Multiple prescriptions may also be written for different strengths, to divvy up a larger dose and get around shortages. DiMario also sponsored a successful bill signed into law by Gov. Dan McKee last year that prepares state health officials to adopt a 2023 federal standard that allows for electronic transfers of ADHD prescriptions — another common obstacle for patients and doctors alike, as federal prescription regulations plus continued shortages frequently complicate accessibility for patients. Dr. Gregory Fox, a pediatrician speaking on behalf of the Rhode Island chapter of the American Academy of Pediatrics, told senators Tuesday the bill was a 'no-brainer' from a physician's perspective as well. 'I sat down with my two nurses today and they told me, when they arrived this morning, there were 20 refills for ADD prescriptions waiting for them, and then many, many, many come on through the day,' Fox said, estimating that his office nurses spend 'at least three or four hours of administrative time per day on ADHD prescriptions,' which DiMario's bill would slash by a third. Supportive testimonies for the legislation for DiMario's bill and McGaw's original draft came from the Rhode Island Pharmacists Association as well. Dr. Howard Schulman, an internist and primary care doctor based in East Providence who said he often tried to bring a 'from the trenches' perspective on health care to lawmakers in his public testimonies, was the lone person to submit a letter Tuesday against the bill. In a phone call Wednesday, Schulman noted he was more comfortable with the 60-day rule over the 90-day proposal. He emphasized that he understands the motivation for the legislation, and has empathy for the lawmakers who expressed frustration at having to refill their kids' medicine over and over. 'This bill, if we pass it, is going to make my life better,' said Rep. Jennifer Boylan, a Barrington Democrat, at the initial March 18 hearing of McGaw's bill. 'I'm one of the parents that is going to the pharmacy three times a month. They cannot synchronize the prescriptions. I'm calling the doctor for three different prescriptions every single month. It's ridiculous.' But Schulman was not convinced it was wise to increase a patient's supply of drugs that can become more habit-forming with higher doses, especially when the drugs are often shared among young people. 'I'm always trying to minimize the amount,' said Schulman of the stimulant prescriptions he's been writing for 15 years in his practice. 'There's a fair number of people who are on it, [but] I'm not giving it out like candy.' Schulman prescribes at most 60 milligrams once a day — half the amount some patients say they're taking when they arrive at his office from other prescribers. Schulman also asks his patients to read 'Generation Adderall,' a 2016 New York Times article that detailed one woman's account of dependence and eventual cessation from the popular amphetamine. Asked if filling even larger prescriptions for the drugs could exacerbate existing shortages, Schulman chuckled but didn't speculate. He said his concern was with lawmakers who aren't doctors 'regulating something that could affect people getting addicted to it.' Schulman said he hoped the Rhode Island Department of Health would have something to say about the bill. But the state health department 'has no position on this bill,' Joseph Wendelken, an agency spokesperson, wrote via email Wednesday. The House bill will now go to a floor vote, likely the week of April 21, said House spokesperson Larry Berman in an email Thursday. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
27-03-2025
- Politics
- Yahoo
The student and teacher on R.I. Board of Education can't vote. This bill would empower them.
Sen. Alana DiMario, a Narragansett Democrat, presents legislation that grants voting rights to student and teacher representatives on the Rhode Island Board of Education before the Senate Committee on Education during a March 26, 2025, hearing. (Screencap/CapitolTV) A student and a working teacher already have seats at the table of the Rhode Island Board of Education. They just can't vote on any matters of importance. But they could under a bill sponsored by Narragansett Democratic Sen. Alana DiMario heard Wednesday evening before the Senate Committee on Education. DiMario's bill would grant voting privileges to Council on Elementary and Secondary Education's ex officio members, the state's Teacher of the Year and the head of the Student Advisory Council, which is composed of high school sophomores through seniors. 'They could come to the meetings, they could participate, but they weren't truly decision makers,' DiMario said in a phone interview Wednesday afternoon. Decisions by the commissioner of the Rhode Island Department of Education (RIDE) are still subject to the approval by the eight-member Council on Elementary and Secondary Education. This K-12 council is part of the larger 17-member Board of Education, first established in 2014 to oversee all levels of education from kindergarten to university. Membership across both councils is determined by governor appointees. The House version of the bill, led by Rep. David Morales, a Providence Democrat, was introduced on Feb. 28 but has yet to be scheduled for a hearing. DiMario's bill was held for further study Wednesday by the Senate committee. In her testimony, DiMario cited Article 12 of the Rhode Island State Constitution, which allows the General Assembly to 'adopt all means which it may deem necessary and proper to secure to the people the advantages and opportunities of education.' 'I believe that allowing for the Teacher of the Year as well as the chair of the Student Advisory Council, to have full voting seats on that council will be a means to that end,' DiMario told her fellow senators on the committee. This year's bill layers together two previous legislative efforts. RIDE announces the state's Teacher of the Year from the prior year's batch of District Teachers of the Year, an honor determined by the district's own teachers. The state's top teacher was granted a voteless seat at the table in 2023, although the bill became law sans Gov. Dan McKee's signature. Sen. Valarie Lawson, an East Providence Democrat who is president of the National Education Association of Rhode Island, led the legislation for the student voting powers in recent years. But Lawson, who began her tenure as majority leader in January, has 'a lot on her plate,' DiMario said. So this year Lawson and DiMario combined their efforts into the current bill, which features both women plus eight other Democrats as sponsors. An overfull plate was also one of the reasons cited by RIDE in its public opposition to the bill at Wednesday's hearing — a concern relayed from Gabriella Bautista Bolvito, the current chair of the Student Advisory Council and a senior at Classical High School in Providence. In her written testimony, Bolvito wrote about one of the first K-12 council meetings she attended, in which the council members were readying the fiscal 2026 budget. They could come to the meetings, they could participate, but they weren't truly decision makers. – Sen. Alana DiMario, a Narragnsett Democrat 'I knew little of what a budget entailed but was happy to be present in the conversation and to have the opportunity to give my input when necessary,' Bolvito wrote. 'As a 17-year-old with only an intro level Macroeconomics course in my back pocket, the prospect of potentially having to vote on a matter as serious as RIDE's budget is daunting. Although I hold several leadership positions. RIDE's area of focus is still foreign to me.' Bolvito did not attend the hearing, but quoting parts of her testimony in person for the Senate committee was Andy Andrade, special assistant to the commissioner for legislative relations at RIDE, who also argued that, rather than the power to contribute to K-12 council decisions, students would be better served by sitting on their local school boards. 'It seems to me that the best place for a student…would be to be a member of their local school committee, where they have a vested interest, where they know the issues, and they would be, I think, much more effective in that role,' Andrade said. 'A commitment as a voting member would be challenging for any student with many responsibilities in and out of school.' Sen. Tiara Mack, a Providence Democrat who has previously supported lowering the voting age, disagreed. 'I was a little disappointed to hear that one of our students didn't feel like they were given the tools or empowerment to engage civically within our state at a variety of levels,' Mack said. 'I think our young people are smart, and when given the proper tools, empowerment and resources, I believe they can engage in multimillion dollar decisions … and I think we should be giving our young people more opportunities to authentically engage in civics.' Two people spoke up on behalf of the bill in person, while a packet of nine written submissions from members of Young Voices, a youth-led Providence nonprofit focused on empowering students of color in the state's urban core, rallied in support of the bill. 'People constantly ask us to be involved civically, but then we lack the opportunity to do so,' Krissia Diaz, a Classical student, wrote in a testimony. 'Give us the opportunity to have a real say as to what happens in our schools. . 'We need to pass this bill, youth deserve to use their voice rather than have decisions made for them by officials who haven't stepped foot in a school for more than fifteen years.' It's not unheard of for states' boards of education to grant voting rights to student or teacher representatives. Massachusetts gives its student education board member voting rights, making it one of seven states that did so, according to 2022 data from the National Association of State Boards of Education. Some states have guardrails in place, like Maryland, which gives its student representative a say in the boardroom without being able to vote on personnel matters or certain appeals, according to state law. As for teacher representatives, their governing powers on school councils also vary by state. DiMario said the bill eliminates the need to identify and appoint new representatives for the student and teacher council seats, as they would be filled by existing office holders. The Teacher of the Year would sit on their council seat the year following their tenure as the state's top teacher. DiMario's bill would use the Senate, rather than the governor, to appoint the two new seats. 'I do expect that there could be some questions about that separation of powers issue,' DiMario said, adding that she's not sure if the governor would support the legislation. A spokesperson for Gov. Dan McKee did not immediately respond to a request for comment Wednesday. 'I think it's a fundamental approach to policy, I believe very strongly in that whole idea of 'Nothing about us, without us,'' DiMario said. 'We can only make our best decisions about what is going to solve a problem when we talk to people that are closest to that problem. To me, this is just a piece of that.' 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