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2023 TEXAS LEGISLATIVE
SESSION WRAP-UP

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faces shortages of mental health professionals and limited resources breastfeeding, and addressing social determinants of health that
for treating substance abuse disorders. Expanding the availability impact maternal and child health outcomes are essential priorities.
of mental health services, integrating mental health into primary The GME Programs within the LSOM Obstetrics and Gynecology
care, and increasing funding for substance abuse treatment pro- (OBGyn) Department and Pediatrics Department are involved in mul-
grams are crucial steps to address this need. tiple efforts within the county, state and nation. The OBGyn residents,
The LSOM Child and Adolescent Psychiatry Fellowship (CAP) Maternal Fetal Medicine (MFM) and Gynecology Oncology (GY-
has increased the number of trainees due to support from the 86th NOnc) Fellows and faculty are the physicians caring for some of the
Texas Legislature, creating the Texas Child Mental Health Care Con- most complicated patients at UH, the only U.S. News and World Re-
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sortium (TCMHCC). Texas Child Psychiatry Access Network port Top Maternity Hospital in the region and a “Breast Feeding
(CPAN) is an initiative of the TCMHSCC to support family medi- Friendly" center. This includes supporting UH's Stork One, the dedi-
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cine and pediatricians across the State. LSOM GME programs capi- cated maternal transport team bringing patients to higher levels of care.
talize on their services and professional development offerings to The MFM and GYNOnc fellows and residents provide care through
provide more complex psychiatric care in primary care. The LSOM the “Placenta Accreta Spectrum Disorder" program to women from all
Pediatric Residents are trained to screen for mental health issues, in- over south central Texas with abnormal placentation and at high risk
cluding ADHD, Anxiety, Depression (both youth and post-partum) for maternal hemorrhage, transfusion and death. The GYNOnc Fel-
and Suicide ideation. They can evaluate screening tools and apply the lows are engaged in research protocols advancing therapies for women's
most current guidelines for all of these disorders, refer to therapy (even cancers. In the community, they engage in the UT Teen Health Pro-
introducing CBT for anxiety and depression for those patients unable gram, involved in education and reducing teen pregnancy.
to find a therapist), and treat with medication when indicated. Be- The LSOM Pediatric Residency implemented the evidenced-based
cause of screening, they can start to intervene earlier. Furthermore, SDoH screening and referral tool, WE CARE. Those with positive
the Texas Higher Education Coordinating Board (THECB) GME screens are offered information on resources in food, housing, parental
Expansion Grant prioritization of mental health specialties allowed education, employment, utility assistance and childcare when re-
the TIGMER Psychiatry Program to get substantive grant funding quested. The LSOM Neonatology Fellows are involved in outreach ed-
for their residency and expand access in locations noted in the first ucational efforts to primary care physicians and research projects to
section. Finally, the LSOM Psychiatry residents provide 24/7 inpa- improve child and maternal nutrition. With the opening of the UH
tient support for Bexar County's two Level 1 trauma centers and the Women and Children's Hospital comes a potential for expansion in
South Texas Veterans Healthcare System (STVHCS). training opportunities. Baylor Pediatric residents at the Children's Hos-
The LSOM, in partnership with the STVHCS, started its first fel- pital of San Antonio and the Family Medicine residents at the LSOM
low in the new Addiction Medicine Fellowship this July. Individuals and TIGMER are undoubtedly involved in newborn and childhood
with primary training in the following specialties can enter this one- initiatives. The future of pediatric care continues to look better for the
year training program: anesthesiology; emergency medicine; family county and region.
medicine; internal medicine; obstetrics and gynecology; pediatrics;
preventive medicine; or psychiatry. Beyond service to veterans, the 6. Health Disparities: Like many other areas, Bexar County ex-
fellows will work in clinical academic settings with Dr. Jennifer Potter periences health disparities, particularly affecting marginalized
(Vice Dean for Research, Professor in the Department of Psychiatry), communities, including Hispanic/Latino populations. Addressing
the Principal Investigator of the Big South/West Node of the Na- health disparities requires targeted efforts to improve access to care,
tional Institute on Drug Abuse Clinical Trials Network and Director health education and preventive services, as well as addressing social
of the Texas Medication for Opioid Use Disorder Initiative. Further, determinants of health, such as poverty, education and housing.
LSOM Pediatrics and OBGyn residents and fellows engage with pa- The LSOM GME changed its mission statement several years ago
tients enrolled in the Center of Health Care Services (CHCS) Mom- to move beyond improving healthcare through GME to impacting
mies Program providing prenatal and postnatal care to patients with health. As much as 80% of health happens outside of healthcare. In-
substance abuse disorders. stead, much of health is affected by structural and social determinants
of health. San Antonians in the zip codes on the inner west side have
5. Maternal and Child Health: Bexar County has specific health- an 18-year lower life expectancy than the San Antonians living 18 miles
care needs related to maternal and child health. Reducing infant out Bandera Road beyond loop 1604. Therefore, three years ago, we
mortality rates, improving access to prenatal care, promoting began orienting all incoming residents to SDoH in the context of San

32 SAN ANTONIO MEDICINE • August 2023