CAPITOL HILL WEEK – Highlights for the week of February 25-28

NASHVILLE, Tenn. – Legislation which aims to improve health outcomes for infants born to drug-addicted mothers won passage in the Senate Health and Welfare Committee on Wednesday.  Senate Bill 459, sponsored by Senator Ken Yager (R-Harriman), encourages pregnant women who misuse prescription opioids to access early prenatal care and drug rehabilitation.  In exchange, they would be given a safe harbor from having their parental rights terminated through a petition filed by the Department of Children’s Services due to prenatal drug abuse.  The safe harbor only applies if the mother meets certain requirements set out in the bill to protect the health of the fetus.

“The Safe Harbor Act of 2013 provides a woman with a strong incentive to do the right thing for her baby,” said Senator Yager.  “Children are the innocent victims of the prescription drug epidemic.   Early prenatal intervention can help stabilize the mother and hopefully curb the number of premature births or deaths and a host of other severe symptoms the drugs can have on the baby.” 

Addiction to opiates can result in the infant having Neonatal Abstinence Syndrome (NAS), which occurs when the mother’s drugs are cut off at birth.  NAS can cause the infant to have poor nervous system irritability, tremors, weight loss, stiff muscles, seizures, inconsolable crying and gastrointestinal disorders.  Carla Saunders, a Neonatal Nurse Practitioner and Advance Practice Coordinator for the Pediatrics Medical Group at East Tennessee Children’s Hospital, told committee members their hospital is averaging about one baby per day born with NAS.  She said NAS babies often require ongoing medical care costing an average of $40,000 before they are released from the hospital.  This is in addition to later healthcare costs, additional school needs and social services to ensure that they reach their maximal potential through childhood. 

The Safe Harbor provision only applies if the mother is seen by an obstetrician provider within the first 20 weeks of her pregnancy who determines that she has used prescription drugs that could jeopardize the fetus.  After being referred to treatment, the woman must begin drug abuse or drug dependence treatment before her next regularly scheduled prenatal visit, and maintain compliance with both her prenatal care and substance abuse rehabilitation through the pregnancy.  The bill requires treating physicians to give priority at public treatment centers to pregnant women seeking care through provisions of the legislation.

“As many law enforcement folks have said about the broader substance abuse epidemic, we cannot arrest our way out of the problem,” said Tennessee Commissioner of Health John Dreyzehner, who also testified before the Senate Health Committee.  “I don’t think we benefit mother or child by discouraging her from seeking prenatal care in any way.”

Dreyzehner said approximately 60 percent of the 90 NAS cases reported so far this year in Tennessee are women who are in some type of medically supervised therapy. 

Yager, who sponsored two laws passed during the 107th General Assembly to curb prescription drug abuse, said the bill dovetails with the Haslam Administration’s ongoing efforts to identify and curb the over-prescription of opiates.   The bill now goes to the Senate floor for final consideration.

SENATE FINANCE COMMITTEE IS BRIEFED ON EFFECTS OF SEQUESTRATION ON TENNESSEE’S BUDGET

The Senate Finance Committee heard testimony from State Budget Director David Thurman regarding the effects of an estimated $100 million in cuts to Tennessee’s budget from the federal sequestration plan.  Unless a last minute agreement is reached in Washington, the sequestration cuts made under the federal Budget Control Act of 2011 are effective on March 1.   The result is $1.2 trillion in across the board spending cuts nationwide over the next ten years, equally split between defense and domestic spending.
 
For Fiscal year 2013 alone, it is estimated that federal spending will reach $3.803 trillion.

“The largest impact we would incur totals about $100 million on the revised delayed sequestration,” said Thurman.  The cuts were delayed after a last minute deal was struck between Congress and President Obama on January 1.  “In Education, Title I and Special Education are going to be the programs that see the largest cuts within the first year, but there are a lot of unknowns as to how that would play out as far as the timing and setting the parameters of these cuts.  There’s a lot of flexibility that OMB (federal Office of Budget Management) has. They also have some flexibility with the federal agents as well, so we’re in a wait and see mode.”
 
Thurman said he expects the OMB to roll out parameters and information about how to implement the reductions immediately after the deadline. After Tennessee receives instruction to the agencies and program directors affected, state administration officials  will develop a plan based on the positions, programs and dollars sequestered.

“There’s a lot of questions about timing.  The federal fiscal years goes until October, so those cuts could occur in next fiscal year, not this one,” Thurman added.
 
The cuts amount to approximately $85 million in the state’s general fund, with the largest being Title I funds and Special Education.  Other cuts include an estimated $15 to $16 million in federal highway funds, $1 million to vocational education, $2 million to improving teacher quality, $1.6 million in substance abuse treatment, $4 million in rehabilitation services, $3 million in low income home energy assistance, $3 million in children’s services, $2 million for HIV/AIDS treatment, $2 million for social services and $500,000 for mental health programs.

Earlier this month, Senate Majority Leader Norris (R-Collierville) who is sponsoring Governor Bill Haslam’s budget legislation, questioned Tennessee’s Adjutant General Max Haston regarding the impact of sequestration on Tennessee’s military. In response to Norris’ questions, Haston said they are already experiencing reductions in travel budgets and training events. He alerted lawmakers that if cuts to federal defense spending continue, it will greatly impact the readiness of all National Guard units across the nation.

Norris was appointed this week to serve on the Veterans Affairs Subcommittee of the Senate State and Local Government Committee.

 “Sequester is an evil,” said Norris. “But it has become a necessary evil given the dysfunction in D.C.  It is for those of us who carry and balance our budgets in state government each year to mitigate the failure of our federal government.”

“Tennessee has worked diligently to manage our finances in a fiscally responsible manner,” said Senate Finance Committee Chairman Randy McNally (R-Oak Ridge).  “We are 48th lowest in the nation in per capita debt and 47th in per capital tax burden, all while balancing our state budget.    Although some federal officials will make the cuts as visible as possible, we must remember it is a decrease in the increase in spending.  It does very little to balance the federal budget or address the $17 trillion deficit.”

The full Senate approved Senate Joint Resolution 38, sponsored by Senator Jim Tracy (R-Shelbyville), on Monday night urging Congress and President Obama to immediately adopt a balanced budget.  Forty nine states, including Tennessee, maintain balanced budgets through a constitutional requirement or by state statute.

BILL TO ALLOW REFERENDUMS ON WINE SALES IN RETAIL FOOD STORES MEETS FIRST HURDLE WITH APPROVAL IN SENATE STATE AND LOCAL GOVERNMENT COMMITTEE

After a spirited debate, legislation that would let Tennesseans vote on whether to allow the sale of wine in retail food stores via a local referendum overcame its first hurdle this week by a vote of 5 to 4 in the Senate State and Local Government Committee.  Senate Bill 837, sponsored by Senator Bill Ketron (R-Murfreesboro), would give municipalities in those communities that currently allow retail package stores, liquor-by-the-drink establishments or both to hold a referendum on the sale of wine in retail food stores during the next general election. The authorization law would take effect on Jan. 1, 2014 and would allow a referendum to be held after that date.

“Tennesseans deserve the opportunity to vote on this issue,” said Senator Ketron. “Currently, municipalities decide whether to allow retail package stores or liquor-by-the drink in their communities, so it makes sense to also take the issue of where to sell wine to the voters, as well.”

In order to place the referendum on the ballot, a petition must be presented to the county election commission. The petition must include signatures from 10 percent of the county’s population that voted in the last gubernatorial election. The legislation as written provides the exact ballot question that will be asked of voters.

The legislation will require any retail food store that sells wine to participate in the Tennessee Alcoholic Beverage Commission’s Responsible Vendor Program, which requires retailers’ employees to complete training on the responsible sale of alcoholic beverages.

Thirty-six states, including six of Tennessee’s border states, allow the sale of wine in retail food stores.

BILL REQUIRES LEGISLATURE TO CONSIDER IMPACT OF LEGISLATION ON COMMERCE AND JOBS

Legislation that requires state lawmakers to look at the impact a proposed law will have on commerce and jobs in Tennessee was approved this week in the Senate State and Local Government Committee.  Senate Bill 116, sponsored by Fiscal Review Committee Chairman Bill Ketron (R-Murfreesboro), directs the Committee to consider, as part of its analysis on proposed legislation, the financial impact of certain bills on commerce and jobs in Tennessee.

When a bill is introduced, it must have a summary from the Fiscal Review Committee accompanying it that explains the financial impact the measure would have on the state budget should it become law.  However, there is no objective process for legislators to also consider the impact these bills will have on commerce in the state.
  
 “We should all be aware of how prospective legislation affects the lives and jobs of Tennesseans, as well as how it affects the state’s finances,” said Chairman Ketron.  “This bill is about making more informed decisions by ensuring that we, as elected officials, understand the effect new laws will have on our state’s employment and economic well-being.”

Approximately one-third of bills filed in the General Assembly effect business and commerce.  If a piece of legislation impacts multiple industries in different ways, the analysis would focus on the overall net impact to commerce in the state.  Florida, Maryland, New Jersey, Texas and Delaware have similar requirements. 

The business-friendly bill is endorsed by the Chattanooga Area Chamber of Commerce, Knoxville Chamber of Commerce, Greater Memphis Chamber of Commerce, Nashville Area Chamber of Commerce and the National Federation of Independent Business (NFIB).

IN BRIEF…

Health Care Compact – Legislation was approved in the Senate Government Operations Committee this week calling for Tennessee to join an interstate Health Care Compact with the express purpose of returning the responsibility and authority for regulating health care to the states.  Senate Bill 406, sponsored by Senator Mae Beavers (R-Mt. Juliet), provides a legal framework in which states can create their own healthcare systems.  If approved by Congress, the bill essentially provides a permanent waiver to each member state to create whatever healthcare regulations the legislature deems best for the citizens of that state.  The structure protects healthcare funding by allowing member states to access federal tax revenues directly and without strings attached. Beavers said the combination of a secure funding stream and maximum flexibility for state legislators will create the conditions for health care multiple solutions to emerge.

Misuse of Welfare Benefits — In Senate floor action, final approval was given to legislation to curb abuse of purchases made through Electronic Benefit Transaction (EBT) cards used by recipients of the Temporary Assistance to Needy Families (TANF) program.  Senate Bill 244, sponsored by Senator Jim Tracy (R-Shelbyville), prohibits use of a welfare recipient’s EBT card in liquor stores, adult cabarets, casinos and other gambling facilities.  The bill also bans the use of EBT benefits at an ATM located inside a liquor store, adult cabaret, casino or gambling establishment.  Under the bill, welfare recipients who use EBT benefits at liquor stores, adult cabarets or gambling establishments would be subject to disqualification from the program as permitted by federal law.  The measure also calls for those misused benefits to be recouped by the Tennessee Department of Human Services.

Emissions Tests — Automobiles under three years old would be exempt from Tennessee’s vehicle emission test under legislation sponsored by Senator Jack Johnson (R-Franklin).  The legislation, which is pending a hearing in the Senate Transportation Committee, would apply to owners of vehicles in six Tennessee counties where emissions testing is required.  Vehicles with a gross vehicle weight of up to 10,500 pounds in Hamilton, Davidson, Rutherford, Sumner, Williamson or Wilson Counties must currently pass an emissions test prior to registration renewal.  Senate Bill 1080 would exempt testing for gasoline and diesel vehicles from that requirement if the automobile’s model is three years old or newer. 

Veterans / Charitable Funds — A resolution seeking to amend Tennessee’s Constitution to allow 501 (c) (19) charitable veterans groups to raise funds, in the same manner as other 501 (c) (3) charitable organizations, was approved this week by the Senate Judiciary Committee.  Veterans groups were left out of the Constitutional Amendment approved by voters in 2002 that allowed charitable groups registered with the Internal Revenue Service as 501 (c) (3) organizations to conduct an annual fundraising event like duck races, cake walks, raffles and other games of chance.  Senate Joint Resolution 60, sponsored by Senator Rusty Crowe (R-Johnson City), requires that any funds raised by the games go to purposes that benefit the community, veterans or retired veterans.  It was approved by the 107th General Assembly and must receive a two-thirds plurality in the current 108th General Assembly. If it passes both the House and Senate, it then goes to voters in a statewide referendum in November 2014, where it must receive a simple plurality of votes cast in the race for governor. 

Student Athletes / Concussions — Legislation designed to protect student athletes who suffer concussions from risking further medical complications or death passed the full Senate by a vote of 30 to 0.  Senate Bill 882, sponsored by Senator Jim Tracy (R-Shelbyville), ensures guidelines are in place to help coaches, youth athletic instructors and parents recognize a concussion and its symptoms in order to keep an injured player from risking their health by returning to competition too soon.  In addition, schools and organizations must have a policy of removing youth who show signs of concussion from activity for medical evaluation by a team doctor or designated person and must be cleared to play.  The Center for Disease Control (CDC) reports that from 2001-2009, concussions among youth increased 60%, leading the agency to label concussion frequency as reaching “epidemic” proportions. 

Food Gardens – The full Senate and House of Representatives have passed Senate Bill 102, sponsored by Senator Becky Massey (R-Knoxville), authorizing the sale of produce grown in community gardens.  The proceeds from the sale are not designated to a specific use; however, they most likely would be re-invested in the garden or given to the workers.

Education / Graduation Rates — Civic Enterprises released a report this week showing Tennessee is making the largest gains in the nation in graduating high school students.  The report, entitled “Building a Grad Nation – Progress and Challenge in Ending the High School Dropout Epidemic,” analyzes the latest graduation rates and “dropout factory” trends at the state and national levels.  The report says that Tennessee’s graduation rate rose 20.8 percentage points to 80.4 percent and is among 18 states that are poised to achieve the national goal of a 90 percent rate by 2020.

Death Rate / Children — The overall death rate for Tennessee children dropped by 20 percent between 2007 and 2011, according to information released today by the State Child Fatality Review team. Notable factors in that reduction are a decrease in sleep-related infant deaths due to suffocation or strangulation, which were down 16.8 percent from 2010 to 2011, and a 20 percent drop in deaths of black children between 2007 and 2011.  In 13 categories of fatalities measured in the report, Tennessee was identified as improving in 10 and stable in three. The reduction in total children deaths from five years ago represents a difference of 189 lives, the equivalent of more than nine Kindergarten classrooms of children.

Reestablishment of Native Species in Reclaimed Coalfields — The Senate Energy, Agriculture and Natural Resources Committee approved Senate Joint Resolution 111 this week urging the Tennessee Department of Environment and Conservation and federal Office of Surface Mining Reclamation and Enforcement to study the feasibility of reestablishing plant and animal species native to Tennessee’s coalfield areas.  The goal of this cooperation is to encourage appropriate reclamation methods of coal mined lands in order to maximize the reestablishment of native species.  The coal mining industry is actively involved in efforts to reestablish the American chestnut tree that once was plentiful in Tennessee.  Reclaimed coal mines have also facilitated the reintroduction of more than 400 elk into Tennessee.  The bill is sponsored by Senate Energy, Agriculture and Natural Resources Committee Chairman Steve Southerland (R-Morristown).

Prescription Drug Abuse / Licensing — The full Senate has approved a bill to require any podiatrist, dentist, medical doctor, nurse, optometrist, osteopathic physician, or physician assistant who is indicted in this state for an offense involving the sale or dispensing of controlled substances, to report to the appropriate licensing board within seven days of such indictment. Senate Bill 955, sponsored by Senator Randy McNally (R-Oak Ridge), encourages the district attorneys general and appropriate federal attorneys to alert the appropriate board when an indictment regarding the sale or dispensing of a controlled substance takes place so they can take appropriate corrective licensing action.

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