First Responders

176 petitions

Update posted 2 weeks ago

Petition to Greg Abbott, Ted Cruz, Texas State House, Texas State Senate, Louie Gohmert, Alma A. Allen, Al Green, Joaquín Castro, John Cornyn, Eddie Bernice Johnson, Lloyd Doggett, Kevin Brady, Henry Cuellar, Kay Granger, Tony Tinderholt, Michael Burgess, Michael T. McCaul, Judith Zaffirini, Texas

Allow TX dentists to use Telehealth to screen, triage, consult and increase access to care

4/23/20 This petition originated on April 1st after it was posted and stated on the TSBDE website that dentists were not allowed to use teledentistry due to no laws permitting it and board rule 108.8(c)(2)(C). The use of telehealth technology has not only been shown to increase access to care, but currently as social distancing continues, telehealth is a tool that can be used to eliminate possible exposure to Covid 19 by live video consults, triaging, and advanced communications with patients.  As I have been hearing from dentists both on and off this petition, I have become more aware of their concerns currently and how they have used or would be using telehealth technology.  Dentists have expressed concerns of contracting the virus, and are diligently implementing new protocols for infection control and PPE to protect patients and employees. In addition, some TX dentists have  concerns that, due to current law, they are not being compensated for their time or knowledge in numerous telephonic or screening consults. Others, such as a pediatric dentist have stated “telehealth makes individual and risk based preventive interventions easier, faster, and more effective. Telehealth integrates nicely with the dental home concept and the Texas first dental home initiative.”  Still other cosmetic and orthodontists have supported using telehealth technology to monitor and track Invisalign and orthodontic patients respectively. We are seeking Governor Abbotts waiver to expand telehealth options to TX dentists and dental specialists with allowance of compensation and/or insurance reimbursement. Thank you April 1st, 2020Dear Governor Abbott,                    During the current crisis and mandates many dental offices have had to close entirely or limit their office locations and/or times for emergency services only. For those dentists who are still serving patients, the risk of exposure to Covid 19 is real for them and the patients as well as over burdening the resources of fewer amount of offices and PPE. For some patients who are immunocompromised, the risk for them may be too great to visit a dental office with an urgent dental concern. There is also a concern that patients with a NTDC (Non Traumatic Dental Condition) may present to an ED, thereby further taxing a system and possibly exposing themselves and others to Covid 19. As research has shown, please see below, the large majority of patients who present to an ED with a dental urgency are stabilized with a prescription(s) and sent home. With today’s technology, there are highly reputable platforms available for telehealth, both secure and HIPPA compliant, even some used by NASA, GE Healthcare, and Cleveland Clinic. With these platforms, dentists would be able to video screen and triage patients, who either need to present for treatment or can be stabilized with a prescription, if necessary, and scheduled for a next possible date. In addition, several major dental insurance companies are allowing the codes D0140 (limited screening problem focused) and D0170 (problem focused established patient) to be covered with telehealth. This would help in prioritizing patients who absolutely need to be seen in office and also allow patients with a dental concern to remain in their home and given an Rx, if necessary, especially forthose with an immunodeficiency. Thank you, Leanne Tessandori, DDS Emergency Department Referral Programs for Non-Traumatic Dental Conditions, 2015, astdd  National Hospital Ambulatory Medical Care Survey 2009-2010 National Emergency Department 2006

Leanne Tessandori, DDS
3,554 supporters
Update posted 2 months ago

Petition to Florida Governor, Donald J. Trump, Marco Rubio, Rick Scott, Donna E. Shalala, Carlos A. Gimenez, Debbie Mucarsel-Powell

MASS TESTING for Covid before any orders for social distancing are relaxed!

Experts are unanimously and universally recommending MASS TESTING of the population for the COVID 19 virus as a prerequisite to "restarting" the economy or relaxing social distancing orders.  The US is testing at a rate of less than 3.2 per thousand, in eleventh place among industrial nations.  This is unacceptable, as mass testing is the only way to isolate the COVID 19 virus in our communities and slow its spread considerably. Social distancing alone, without testing, is just a momentary pause (at considerable expense both socially and economically); but premature loosening measures will be counterproductive, and will only result in further harm to the population and economy.  The people demand that our local, state and federal leaders commence a massive project (with the help of private industry and capital) for universal testing across the country before any relaxation of standards are considered.  Time is of the essence.   The people are living in a state of permanent anxiety and it doesn't help when we see the lack of coordination across the spectrum to tackle this severe health crisis.  People are dying and suffering unnecessarily while we spend valuable time bickering about the details.  There will be time for that AFTER we defeat this pandemic.  The urgent and most consequential action to be taken right now is MASS TESTING - let's get it done! 

Pablo Casasnovas
447 supporters
Started 5 months ago

Petition to Riverside county sheriff department, DA Mike Hestrin, Sheriff Chad Bianco, Riverside County Board of Supervisors, Chuck Washington, Kevin Jeffries, Karen Spiegel, V. Manuel Perez, Jeff Hewitt, Peter Aldana, Paul Angulo, Jon Christensen, Phil Williams, Kathleen Kelly, Tami Scott, Niamh Ortega, Tina Daigneult, Aaron Brown, Countywide Oversight Board for the County of Riverside

Implement PERT in Riverside County to decrease police presence on mental health calls!

The implementation of a PERT program in Riverside County would not only decrease police presence during emergency responses to a person experiencing behavioral health issues, but it would also ensure that a licensed mental health clinician is always in attendance with a law enforcement officer to assess the person in distress. All law enforcement officers are trained on behavioral health awareness, response, and de-escalation tactics.  Law enforcement officers in Riverside County have a history of being negligent to de-escalate behavioral health-related crises and unnecessarily using excessive force on behavioral health calls which ultimately caused the death of Matthew Tucker in 2016 as well as the unjust mistreatment of Joseph Ramirez in 2020. PERT is a program used in San Diego County and should be a model for all counties to partner their law enforcement agencies with mental health providers and emergency medical services to provide the safest assessment and assistance. ~What is PERT? The Psychiatric Emergency Response Team (PERT) is a program of Community Research Foundation (CRF) in partnership with San Diego County Health and Human Services (HHSA), San Diego County law enforcement, emergency medical services (EMS), and consumer advocacy organizations. PERT contributes to the well-being of persons living with mental illness by actively and compassionately assisting those in crisis who come to the attention of law enforcement and EMS to access appropriate services through on-scene assessments and referrals. PERT pairs a licensed mental health clinician with a law enforcement officer/deputy or EMS community paramedic. The teams ride together in the field for their entire shift and are first responders to assist persons in behavioral health related crises. PERT provides training to all San Diego County law enforcement agencies, as well as fire service personnel and dispatchers on behavioral health awareness and response, including de-escalation. Vision: Persons living with mental illness will have access to and be referred to programs at the appropriate level of service and no person will be hospitalized or incarcerated unnecessarily. Mission: PERT provides effective and compassionate crisis intervention to persons (including their family members and supports) living with mental illness who are contacted by law enforcement officers/deputies and EMS. The goal is to safely and effectively de-escalate crises and provide appropriate referrals that offer the least restrictive level of care, thus avoiding unnecessary hospitalization and incarceration. PERT is recognized as a "best practice" model that epitomizes law enforcement, EMS and clinicians working together to provide the best service options for persons living with mental illness. PERT Cores Values: We believe that persons living with mental illness should be compassionately assessed and be referred to assistance that is appropriate to those needs. We believe that first responders and behavioral health clinicians have a responsibility to collaboratively work together with persons living with mental illness, their family and support persons, and the community as a whole to ensure that people receive the level of care they require. We believe that on-scene partnership of behavioral health and first responders contributes to the well-being of persons living with mental illness and to the community. We believe that outreach efforts to marginalized groups in the community assist persons to meet identified needs and assist communities to recognize and address larger issues related to community health and safety.  History: In the early 1990's, there were several officer involved shootings and critical incidents involving persons living with mental illness. At that time, there was a gap in collaboration between law enforcement and mental health providers. The community at large, mental health consumers, family members, San Diego County HHSA, and law enforcement agencies convened to recommend that officers/deputies receive additional training in recognizing and responding to persons experiencing behavioral health issues and acquire clinical support from behavioral health professionals. Hence, PERT is the result of community partners collaborating to provide optimal service for persons (and their family members and supports) living with mental illness, including the provision of training to public safety personnel throughout San Diego County.   ~Information provided by Community Research Foundation.    

Temecula Protest
30 supporters