Senate passes legislation benefiting health care consumers
(NASHVILLE, Tenn.), April 5, 2018 – The Senate acted on a wide variety of legislation as the 110th General Assembly enters the final stretch of the 2018 legislative session, including several bills aiding health care consumers. This includes a mental health parity bill which helps ensure that state and federal laws are followed in Tennessee when insurers pay for mental health services. The legislation seeks to ensure behavioral and drug treatment benefits are being designed and applied fairly and that insurance carriers are accountable to consumers and small business owners.
In 2008, President George Bush signed the Mental Health Parity and Addiction Equity Act to see that mental health diagnoses are handled like any other medical diagnoses. That law does not require health insurers to cover mental health and addiction services, but if carriers do offer this coverage they must design their cost benefits comparable to other medical and surgical benefits.
Senate Bill 2165 provides insurance carriers and the Tennessee Department of Commerce and Insurance with guidance as to how they can demonstrate compliance with mental health parity. It also calls for the Department of Commerce and Insurance to review and send a report to the legislature every year to see that the federal law is being obeyed and that the insurance companies are treating mental health conditions like all the other medical conditions.
The legislation was approved by the Senate Finance, Ways and Means Committee and now goes to the full Senate for a final vote.
The Senate also approved legislation this week allowing state employees diagnosed with cancer to receive hypofractionated proton therapy if their radiation oncologist believes that it would be more beneficial to their treatment plan. Senate Bill 367 would equate the cost of the proton therapy to that of traditional radiation (IMRT) when it is the paid-for method. It follows an increased body of literature and medical research that shows that proton therapy is as effective in many types of cancer with a significant decrease in side effects.
Another bill affecting health consumers which passed this week calls for more effective notification when a mammogram detects extremely dense breast tissue. Although this condition is common, it can hide cancer findings or could be associated with breast cancer. Senate Bill 2704 enhances the current law requiring notification of their mammogram by alerting patients that additional screening may be warranted in consultation with their physician. Approximately 12.3 percent to 15 percent of women with dense breast tissue are prone to have cancer.
In addition, the full Senate approved a key health care consumer bill calling for transparency in medical charges by hospitals. Senate Bill 1869 requires a hospital to provide an estimate to patients regarding out-of-network charges. The legislation came from a constituent of the sponsor of the proposal who received a bill for $40,000 after receiving routine tests in the hospital because he was out of network and had not been notified.
In other health care news, the Senate passed two separate bills which aim to provide more information and awareness regarding Down Syndrome and Williams Syndrome. Senate Bill 2008 requires the Department of Health to make available up-to-date evidence-based information about Down Syndrome on their website. The online information would include first call programs, links to organizations providing information and resources, and other educational and support programs. It would also make it available to health care providers rendering pre-natal and post-natal care or genetic counseling to those receiving a pre-natal diagnosis of Down Syndrome.
Senate Joint Resolution 727 designates May 2018 as “Williams Syndrome Awareness Month.” Williams syndrome is a rare genetic condition that is present at birth which affects as many as 30,000 individuals in the United States. It is characterized by medical and cognitive problems, including cardiovascular disease, developmental delays, and learning disabilities. The resolution brings awareness to the need for more research, programs and initiatives to help those with the condition.
Juvenile justice bills advance as legislature prepares to adjourn
A key juvenile justice reform bill recommended by the Joint Ad-hoc Blue Ribbon Task Force on Juvenile Justice and the Juvenile Justice Realignment Taskforce advanced through the Senate Judiciary Committee this week as the legislature prepares to adjourn. Senate Bill 1821 prohibits a juvenile court from issuing a valid court order upon an unruly child or a child whose only offense is a status offense.
Status offenders are juveniles charged with or adjudicated for conduct that would not under the law of Tennessee be a crime if committed by an adult. Typical examples are chronic or persistent truancy, running away from home, violating curfews, alcohol or tobacco possession, and the like. Twenty-eight states have eliminated valid court orders in juvenile courts for status offenses.
In other action, the Senate Finance, Ways and Means Committee voted to allow Basic Education Program (BEP) funds to “follow the child” to a learning center when a youth has been ordered by a juvenile court to attend a non-public school. Currently, there are only two caveats for BEP dollars going to non-Local Education Agency (LEA) settings: children for whose education the state is directly responsible and those in residential mental health facilities. Senate Bill 1803 would add a third caveat for youth who are court ordered to attend a Tennessee Department of Education-approved non-public school in order to prevent children from entering state custody.
There are presently four Teen Learning Centers in Tennessee funded with the Department of Children’s Service’s Custody Prevention Funds. All youth served in these centers come through their respective county juvenile court orders and have a variety of status and juvenile offenses that put them at serious risk of entering state custody. The vast majority of youth served by these prevention and early intervention programs have either been removed from their local school system due to zero-tolerance offenses or have chronic truancy issues. Approximately 90 percent of students discharged from the centers remain out of juvenile court.
Finally, the Senate Judiciary Committee approved legislation authorizing certain courts to establish pilot regional juvenile drug court treatment programs. Senate Bill 1848 would allow parents to opt their children into supervision by regional juvenile drug courts in order to get structured treatment to aid in recovery from addiction.
Presently, the only way to get at-risk youth into treatment is for the child to be in the criminal court system or under the Department of Children’s Services. This legislation allows parents, through a pilot program of 500 individuals, to put their children under the care of a judge and allows the judge to be the quarterback of their care.”
This pilot program would begin July 1, 2018 and end June 30, 2023. The legislation now goes to the Senate Finance, Ways and Means Committee for consideration.
Legislation benefitting schools serving special needs students receives final Senate approval
Legislation was approved by the full Senate this week to ensure equitable access to the state’s special education excess cost reimbursement program. Senate Bill 1901 requires school districts and special education services associations to include all excess-costs students within their jurisdiction when they apply for reimbursement funds. It also allows public charter schools to join or form special education services associations in order to increase capacity so they are equipped to serve these special needs children.
The special education excess cost reimbursement program at present is designed to provide funding reimbursement for districts and schools serving high cost special education students. Currently, school districts or special education services associations must submit a reimbursement application to the state documenting special education students with costs exceeding the amount of funding they have received. However, current state law does not require districts to include all excess-cost students in their reimbursement applications.
This bill is a part of the General Assembly’s ongoing efforts to ensure all students are able to receive a quality education, have their needs met, and be treated with dignity and respect.
This bill now goes to the Governor’s desk for final approval.
Senate Judiciary Committee approves legislation continuing General Assembly’s efforts to protect elderly and vulnerable adults
Legislation increasing penalties for exploitation or abuse of an elderly or vulnerable adult was approved by the Senate Judiciary Committee this week, continuing the General Assembly’s ongoing efforts to protect Tennessee’s senior citizens. Senate Bill 2621 enacts the Elderly and Vulnerable Adult Protection Act of 2018.
The legislation follows enactment of a series of bills passed over the last two years protecting Tennesseans who are elderly or have diminished capacity from physical abuse and various forms of financial exploitation.
The proposed act is designed to streamline and complete the organization of existing code provisions addressed in legislation passed by the General Assembly last year and to close a loophole which exist in Tennessee’s elder abuse law. The legislation defines certain crimes more broadly; thereby, ensuring that certain criminal activities don’t fall through the cracks because they don’t fit neatly into some of the existing definitions set out in current law.
The legislation draws distinctions between types of physical abuse of the elderly, increasing penalties for certain types of aggravated abuse including rape and murder. It creates a Class E felony offense for a person to knowingly abuse, neglect, or sexually exploit an elderly person, and Class D felony offense for doing the same to a vulnerable adult. It also increases fines for elder physical abuse and sexual exploitation.
The bill now heads to the Senate Finance, Ways, and Means Committee for consideration.
Statute of Limitations / Sexual Offenses — Senate Bill 2538 was approved by the Senate Judiciary Committee this week instructing the Tennessee Advisory Commission on Intergovernmental Relations (TACIR) to conduct a study and report back next year on the effectiveness of the state’s statutes of limitations, including crimes involving sexual offenses against children. According to the National Center for Victims Rights, most states have a basic suspension of the statute of limitations for civil actions while a person is a minor. Many states have also adopted additional extensions, specifically for cases involving sexual abuse of children and a handful of states have removed the statute of limitation completely for child sex crimes.
Adoption — The full Senate gave final approval to legislation which aims to improve adoption in Tennessee. Senate Bill 1851 extends from 30 to 35 days the period of advance notice that licensed child-placing agencies and licensed clinical social workers must provide to the Department of Children’s Services before changing the fees charged for services provided to adoptive parents. “We are working with a group called Family Match, which is a website that deals with compatibility matching technology for families in state care. It will inspire even greater confidence in prospective resource families, opening the door for more families to become foster and adoptive families.” In addition, the state has been offered access to Family Match’s network services created exclusively for state workers to match adoptive families, foster families, and foster to adopt families with children in state care.
Controlled Substances / Medication Assisted Treatment – Legislation seeking to update Tennessee law to keep up with changing pharmacology regarding treatment options for patients with substance abuse disorders passed the full Senate this week. There are two medications generally used to treat substance abuse disorders: the mono-product, buprenorphine, and the combination product, buprenorphine and naloxone. Current law provides that only in specific circumstances can patients be prescribed the mono-product to treat substance abuse disorders due to its desirability on the street and potential for abuse. In all other circumstances, a patient is prescribed the combination product which counters a potential overdose. However, a new injectable version of the mono-product that must be administered by a healthcare professional is now on the market. Senate Bill 2099 allows for the new injectable mono-product to be used for people with substance abuse disorder, while also maintaining that only the same specific subset of patients are allowed to receive the mono-product in forms other than the injectable version.
Pre-K Growth Portfolio Assessment Model – Legislation addressing concerns in the Department of Education’s new Pre-K Growth Portfolio Model received final Senate approval this week. The model was put into place during the current school year to measure yearly academic growth for Pre-K and kindergarten students; however, the program experienced several early implementation problems. These problems included a lack of appropriate training for teachers, computer system issues and difficulties with the way the portfolio’s standards were clustered together. Senate Bill 1854 directs the Department of Education to increase training and to reevaluate the program with significant input from teachers to make needed improvements. Under the bill, the Pre-K Growth Portfolio essentially would become a pilot program, meaning the results could not be used against a teacher in employment evaluations.
Boards and Commissions / Freedom of Speech — The Senate passed and sent Governor Bill Haslam legislation prohibiting boards or commissions from issuing policies, codes, or statements that infringe on a member’s First Amendment rights to freedom of speech, including any member’s right to express an opinion regarding matters pertaining to the government entity. Senate Bill 1929 counters the problem of a board or commission which attempts to prevent its members from commenting on matters concerning issues affecting it or its operations. This includes criticism of matters dealt with by that board or commission. It comes after an incident last year when a board issued an internal policy prohibiting its members from speaking to the media without approval of the board. The bill does not apply to confidential matters as set out in the Public Records Act and gives the General Assembly’s Government Operations Committee the ability to sunset an entity for violation.
Food Deserts / Low-Income and Underserved Tennesseans — Legislation was given final Senate approval directing the Tennessee Advisory Commission on Intergovernmental Relations (TACIR) to conduct a study examining the overall effects of creating a grant or loan program for food relief enterprises who sell fresh food in low-income and underserved areas of Tennessee. Senate Bill 2634 calls for TACIR to weigh the benefits of creating the Fresh Food Financing Fund within the Department of Economic and Community Development in order to assist these efforts.
DUI Offenses / Alcohol Sales – The Senate Judiciary Committee approved a bill this week that strengthens penalties for DUI offenses so that a person convicted of the crime would forfeit the privilege to purchase alcohol in Tennessee for a period of time based on the number of offenses. The legislation also establishes a new driver license format for this scenario. Under Senate Bill 1784, a first-time offender would forfeit the ability to purchase alcohol for one year, and a second-time offender would forfeit that privilege for two years. Then, third- and fourth-time offenders would forfeit the ability to purchase alcohol for six and eight years respectively. Additionally, the bill makes the purchase of alcohol by a person who has forfeited the right to purchase alcohol a Class C misdemeanor.
Volunteer Firefighters / Vehicle Registration Fees – State Senators approved legislation that would exempt volunteer firefighters or rescue squad members from having to pay the regular registration fee for their license plate. Funding for this legislation, Senate Bill 270 is included in Governor Haslam’s appropriation amendment submitted to the legislature last month.
TDOT / Three-Year Transportation Program — The Tennessee Department of Transportation released their annual three-year transportation program this week, featuring approximately $2.6 billion in infrastructure investments for 143 individual project phases on 116 projects. The program also places a high emphasis on the repair and replacement of bridges, with activities beginning on 80 structures. Ten of those bridges are on the state highway system, with the other 70 on local roads. The comprehensive program continues to build on the progress of the IMPROVE Act, which provides for infrastructure investments in all 95 counties. This year’s program budgets dollars for 195 of the 962 projects listed as part of the 2017 legislation. A complete list of projects and programs funded through the 2019-2021 three-year multimodal program can be viewed on the department’s website. For an interactive map view of the 962 IMPROVE Act projects, please visit https://www.tdot.tn.gov/projectneeds/spot#/.
Small Cell / 5G Technology — Major legislation passed the Senate Finance, Ways and Means Committee this week to accelerate investment in mobile broadband infrastructure and prepare the State of Tennessee for the next wave of economic development in the digital economy via 5G technology. Senate Bill 2504 creates a uniform, statewide and predictable application and deployment process for small cell wireless broadband providers no matter what community is being served. Once implemented, it would enhance existing networks and encourage wireless broadband providers to invest in the latest small cell technology. Studies show that deployment of 5G alone will create more than 16,000 new jobs in Tennessee. It would also lead to more than $1 billion in investment and grow the state GDP by nearly $3 billion. The legislation now goes to the full Senate for final consideration.
Seven-Day Sales — The Senate Finance, Ways and Means Committee approved legislation on Tuesday permitting retail food stores to sell wine and retail package stores to sell alcoholic beverages seven days a week. Senate Bill 2518 would put retailers on par with restaurants, hotels, convention centers, tourist resorts and other businesses in Tennessee which are already allowed to sell wine and spirits any day of the week under state law. Forty states allow for seven-day sales by retailers, including five which border Tennessee. The legislation now heads to the floor of the Senate for a final vote.