Legislation focuses on providing help for children suffering adverse childhood experiences

NASHVILLE – This week’s action on Capitol Hill was highlighted by a passage of a number of important initiatives as lawmakers continue discussions on the state’s budget. One such bill approved this week would establish a new pilot program to help children from troubled homes avoid chronic adverse childhood experiences. Senate Bill 887, sponsored by Deputy Speaker Ferrell Haile (R-Gallatin), would establish the “Zero to Three Initiative Courts” within either a Juvenile Court or General Sessions Court, similar to Tennessee’s Drug Courts.

Chronic childhood trauma, or what experts call adverse childhood experiences (ACEs), can disrupt a child’s brain-building process. Studies document the impact on brain development these chronic experiences, like emotional abuse, physical abuse, neglect, growing up in a home with domestic violence or substance abuse, have on children. Left unaddressed, ACEs and their effects make it more difficult for a child to succeed in school, live a healthy life and contribute to the state’s future prosperity — our communities, workforce, and civic life.

“The primary goal of the Zero to Three Initiative is to reduce time of permanency of children in at-risk environments by surrounding families of children age 36 months or younger with support services, whether it is returning them to parents, living with relatives or getting them ready for adoption,” said Senator Haile. “It will increase the potential that every child born in Tennessee has the opportunity to lead a healthy, productive life.”

Leaders from state government, the business world, advocates, insurers, academia and nonprofit foundations are organized as public and private sector steering groups to guide implementation and provide leadership at the state, regional and community levels.

Currently, there are two courts embracing this initiative in Nashville and Grundy County. The legislation calls for five courts to be added in Tennessee this year, with five more following in fiscal year 2018-2019. The courts would use best practices evolving from ACEs research to provide interventions and structures to optimize social, economic and health outcomes for these children.

Haile said that a similar program in North Miami, Florida has been in operation for over four years with great success. “Of the children in state custody that had their families surrounded and supported, more than half never went back into state custody. The remaining 40 percent were willingly allowed by the birth parents to proceed to adoption, many times with the birth parents collaborating with adoptive parents. It is my wish that this initiative, similarly, would lead to happy, healthy lives for children in Tennessee.”

Legislation authorizing autonomous vehicles passes Tennessee Senate

Legislation was approved by the Tennessee Senate this week which allows for the roll out of autonomous vehicles in the state as long a human is in the driver’s seat. Senate Bill 151, sponsored by Senator Jon Lundberg (R-Bristol), authorizes motor vehicle manufactures to begin a “SAVE” project,” which is an initiative by a manufacturer to makes ADS (Automatic Driving System)-operated vehicles available to the public for operation on public roads and highways. The action comes as Tennessee continues to grow as a major U.S. automotive hub.

“Auto investors have invested billions of dollars in Tennessee,” said Sen. Lundberg. “The tide has shifted. There has been a groundswell of change from Detroit, which was previously ground central for auto manufacturing, to Tennessee. The technology for vehicles is changing very quickly as well, and we have to adapt our laws to automated vehicle technology.”

Lundberg said some of that technology is already on today’s cars, like intelligent cruise control and park assist.

The bill establishes certain procedures for manufacturers to operate ADS vehicles, including making it a Class A misdemeanor offense for a person to knowingly operate a motor vehicle without a human in the driver’s seat. In addition, ADS-operated vehicles must have an instrument of insurance, surety bond, or proof of self-insurance in the amount of at least $5 million under the measure.

Lundberg said all of the state’s major auto manufacturers, including General Motors, Volkswagen, Nissan and the tech companies have signed on to the legislation. Sponsors have also consulted with trial attorneys and the insurance industry in crafting the bill to ensure adequate coverage in the event of an accident.

Eleven states and the District of Columbia have passed legislation related to autonomous vehicles, with similar executive orders in two more states. In addition, the National Highway Traffic Safety Administration released the first iteration of its “Federal Automated Vehicles Policy last year with annual updates expected.

“This legislation establishes a business climate that encourages ADS testing and production, which also leads to high-tech jobs for Tennesseans,” Lundberg added. “It is also hoped that the advancing technology will also enable metropolitan governments to relieve mass transit pressures in the not-too-distant future.”

Legislation providing greater safety for amusement park rides approved by General Assembly

Legislation to provide greater safety for amusement park rides in Tennessee is on its way to Governor Bill Haslam for his signature after passage in the Senate and House of Representatives this week. Senate Bill 430, sponsored by Senator Brian Kelsey (R-Germantown) comes after two accidents occurred in Tennessee last year.

One accident occurred at the Greene County Fair where three girls fell 35 to 40 feet when a basket overturned on a Ferris wheel resulting in serious injuries. The other was in Memphis when eight people were taken to the hospital after a carnival ride malfunctioned and was prematurely shut down at the Delta Fair.

“These injuries are the type of issues we are hoping to prevent with passage of this legislation,” said Sen. Kelsey. “We need more safety measures in place to keep these kinds of accidents from ever occurring again. This bill tightens up regulations and calls for increased inspections to help ensure that amusement devices in Tennessee are safe.”

The legislation addresses safety issues on the front end with increased inspections and oversight of the devices, while strengthening standards for device operators and requiring a prominent display of proof of inspection. To accomplish the inspections, the bill allows the Department of Labor and Workforce Development to continue either their current practice of using qualified, third party device inspectors, or they can employ their own inspectors.

The bill also requires that an operator of an amusement device must be competent, 16 years of age, operating only one device at a time and that they must be present while the ride is engaged. In addition, it authorizes persons injured in accidents to bring a cause of action against the owners and operators of these amusement devices.

Legislation establishes Medication Therapy Management pilot program for TennCare Enrollee for high-quality cost-effective care

State Senators approved legislation this week that would establish a medication therapy management (MTM) pilot program to provide high quality, cost-effective services for TennCare enrollees. Senate Bill 398, sponsored by Deputy Senate Speaker Ferrell Haile (R-Gallatin), is modeled after similar successful programs in 17 other states.

MTM is a group of services provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients. The program is particularly beneficial to patients who do not take their medication according to the prescribed timing, dosage, frequency and directions. Any situation when the patient does not take their medication according to one of these factors is referred to as medication non-adherence.

“Medication non-adherence is highest among patients with chronic illnesses and results in an increased risk of side effects, adverse events, hospitalizations, disease state complications, drug-related problems or even death,” said Senator Haile. “Direct costs of medication non-adherence to our healthcare system are estimated at up to $290 billion annually and are considered the largest fixable problem in health care today.”

Other persons benefiting from the program include those who use several medications, have multiple health conditions, are taking medications that require close monitoring, have been hospitalized, or who utilize more than one pharmacy.

The MTM services will be delivered by Tennessee-licensed pharmacists practicing under a collaborative pharmacy practice agreement with prescribers within their routine scope of practice. They would work in consultation with patients, caregivers, prescribers, and other healthcare providers. Any cost savings realized by TennCare through this pilot program will be prioritized for use in expanding the administration of the MTM pilot program.

According to a U.S. Public Health Service report, pharmacist-provided services such as MTM have demonstrated an average return on investment of $3 to $5 in savings for every $1 spent.

“MTM programs have generated cost savings in drug spending and overall costs of care, and most importantly have improved health outcomes for patients,” Sen. Haile concluded.

Senate approves Middle College Scholarship Program

The State Senate approved a measure sponsored by Senator Ken Yager (R-Kingston) this week creating a Middle College Scholarship Program to help students who are earning a Middle College degree. Middle College is a public community college program that, in partnership with the Local Education Agency (LEA), permits high school students to earn both a high school diploma and an associate degree during their junior and senior years. Although the program facilitates a seamless transition to post-secondary education, due to the requirement that recipients have a high school degree, the students are not eligible for the Tennessee Promise Scholarship.

Senate Bill 720 calls for a grant of $600 per semester, or $1,200 per year, to offset the cost of tuition and books during the two-year program. The legislation also expands eligibility for the Tennessee HOPE Scholarship to students who complete Middle College.

Middle College students are among the most sought-after students in the nation by four-year colleges and universities and typically achieve 100 percent proficiency on high school benchmark exams. On average, 90 percent of Middle College graduates transfer to a four-year college or university.

Legislation builds new infrastructure to promote recreational use of Tennessee’s world famous Ocoee River

Legislation which builds a new infrastructure to help promote the recreational use of Tennessee’s world famous Ocoee River has passed the Senate on final consideration. Senate bill 466, sponsored by Senator Mike Bell (R-Riceville), supports a new direction in Ocoee River management, marked by new interagency agreements and a commercial-use permitting program administered by Tennessee State Parks.

The Ocoee River, which is recognized by outdoor enthusiasts as one of the best whitewater rafting locations in the world, was the kayaking venue for the 1996 Summer Olympics based in Atlanta, Georgia. The whitewater industry generates about $44 million in economic activity to the Southeast Tennessee area according to a study conducted by the University of Tennessee five years ago.

“This legislation is almost a decade in the making,” said Senator Bell. “Recreational use of the Ocoee River is a major economic factor for the Southeast Tennessee region. This bill gives the Tennessee Department of Environment and Conservation (TDEC) full regulatory authority over the Ocoee River Management Zone to encourage economic growth and to support recreational water releases.

In 1983, Congress passed a law enabling a contract between the state of Tennessee and the Tennessee Valley Authority (TVA) to provide reliable recreational releases from the Ocoee #2 Power Project for 116 days per year. That contract is set to expire in March 2019, with the last recreational release occurring in October 2018.

Presently, the Ocoee River Management Zone is owned by TVA and the U.S. Forest Service, with management provided by the Tennessee Department of Environment and Conservation through agreements with the agencies. This legislation creates the Ocoee River Recreation and Economic Development Fund (ORREDF). The fund would support management of the area by the Tennessee State Parks, with commercial outfitters paying a portion of the revenues generated to cover the state’s expenses such as site maintenance, emergency response, law enforcement and traffic management. ORREDF will condense three existing fees owed by Polk County, TDEC, and the TVA into one management fee that will be paid into the trust fund created by the legislation, simplifying the business environment for rafting businesses.

The bill also establishes an 11-member ORREDF board made up of interested parties in Southeast Tennessee, as well as state government, to allocate money from the fund to reimburse TDEC for management, build new infrastructure and to promote the region.

In Brief…
Hospital Assessment – The State Legislature voted to continue the annual Hospital Coverage Assessment for the 2017-2018 fiscal year at the current 4.52 percent rate. This action prevents more than $1.2 billion in potentially catastrophic TennCare cuts from taking effect on July 1, 2017. Such cuts would have a large negative impact on hospitals, physicians, patients and enrollees across the state. The assessment, which has saved Tennessee over $2.6 billion over the last seven years, is used to draw down federal funds available through a Medicaid match program approved by the Centers for Medicare and Medicaid Services (CMS). The bill’s language ensures that the coverage assessment cannot be passed along to patients. It is sponsored by Senator Doug Overbey (R-Maryville).
Safe Haven for Newborns — Senator Doug Overbey (R-Maryville) took a moment on the Senate floor Monday, May 1 to reflect on and recognize the month of April as Safe Haven Awareness Month. He also acknowledged that since enactment of Tennessee’s Safe Haven Law in 2001, 90 newborns in Tennessee have been saved. The law was designed to protect newborns who were not wanted if they were surrendered within 72 hours of birth by the distressed mother. “It’s been 16 years since we enacted that law,” said Sen. Overbey. “And, according to the Secret Safe Place in Tennessee website, to date 90 newborns have been saved in our great state. The General Assembly did the right thing in 2001, and 90 newborns are alive today because of it.” Additional information regarding Tennessee’s Safe Haven program can be found at http://secretsafeplacetn.org.

Juveniles / Sexually Explicit Images — The Senate passed legislation on Tuesday to address minors who are caught knowingly possessing or distributing sexually explicit images via electronic means in violation of Tennessee’s pornography statutes. Senate Bill 866, sponsored by Senator Jack Johnson (R-Franklin), will provide Tennessee District Attorneys and Juvenile Court Judges with an alternative to the felony conviction required under current state law for such actions. The crime has been growing with the huge escalation over the last decade in the number of cell phones with cameras owned by teens. A felony conviction could potentially list these juveniles in possession of a sexually explicit photo on Tennessee’s Sex Offender Registry. The legislation allows district attorneys and judges to charge minors with an “unruly act” for such actions which may carry a sentence of community service, fine, professional counseling, etc. It, however, reserves the right for prosecutors to charge the juvenile under the felony statute if the crime warrants a higher level of punishment such as distribution of the photo or online posting. The legislation also provides protections to those minors who do not solicit the photograph, video, or other material, or who delete it or report it to the minor’s parent or legal guardian, school staff, or law enforcement official.

Hybrid Pension Plan / State Employees and Teachers — As Tennessee’s pension plan for state employees and teachers moves up the ranks from fifth best to fourth in the nation, the 110th General Assembly continued this week to push efforts improve the state’s ranking. Senate Bill 1000, sponsored by Senate Finance, Ways and Means Committee Chairman Bo Watson (R-Chattanooga), moves the stabilization reserve account, currently part of the state hybrid pension plan, into a separate trust that would maximize investments and returns. The legislation creates the State Employee Legacy Stabilization Trust Fund for the purpose of protecting the participants and beneficiaries of the hybrid retirement plan from a reduction or loss of benefits with the implementation of cost controls contained in present law. The Legacy Pension Stabilization Reserve Fund will be established and funded through appropriations made in the General Appropriations Act from time to time for such purpose.

Sevier County Wildfires — The State Senate took another step towards aiding the victims of the November wildfires that ravaged portions of Gatlinburg, Pigeon Forge and Sevier County during Thursday’s floor session. Senate bill 409, sponsored by Senator Doug Overbey (R-Maryville), would provide relief for the region in two ways. The legislation utilizes the cities’ “premier resort” status under Tennessee law to allow Gatlinburg and Pigeon Forge to retain an additional amount of the state sales tax revenue by removing the cap for four fiscal years beginning July 1 2017 and ending June 30, 2021. The bill also raises the amount of sales tax relief provided to those who are rebuilding their home from $2,500 to $3,500 and extends it to secondary residences. Tennesseans who live in any federally declared natural disaster area and who receive disaster assistance from the Federal Emergency Management Agency (FEMA) may request a refund of sales tax they paid on certain items. Items that qualify for the sales tax refund include major appliances, furniture and building supplies used to restore, repair or rebuild a person’s primary residence. Previously, the sales tax relief law only applied to those whose primary residence was affected. “This will give the local governments an opportunity to increase their funding and make their own decisions about fire recovery and relief without an outright appropriation from the state. It also helps those whose homes were their secondary residences receive tax relief to rebuild.”

Community Paramedicine — Legislation that ensures rule-making authority is provided to allow for the practice of “community paramedicine” and “mobile integrated healthcare” has been approved on final Senate consideration. Senate Bill 1270, sponsored by Senate Majority Leader Mark Norris (R-Collierville), implements an act previously adopted by the General Assembly to allow paramedics to operate in expanded roles to provide routine health care services to underserved populations. “These are both emerging healthcare professions, and they are particularly important in rural parts of the state and even in some urban areas that are underserved,” said Sen. Norris.

Wind Turbines — Legislation was approved this week regarding wind turbines and their impact on Tennessee communities. Senate Bill 1336, sponsored by Senator Paul Bailey (R-Sparta), creates a moratorium on wind turbines until July 1, 2018 and creates a joint legislative study committee to evaluate and make recommendations to the General Assembly relative to their placement in the future. The six-member joint legislative study committee will report their findings by January 1, 2018.

Farm Property / Inequitable Taxation – Legislators approved and sent to the governor legislation that ensures agricultural property is not reclassified as commercial for the purpose of property tax assessment. Article 2, Section 28 of the Tennessee Constitution requires farm property to be assessed at 25 percent of its value. The legislation comes after reports of agricultural properties being reclassified as commercial real property, which is assessed at 40 percent of its value. Senate Bill 904, sponsored by Senator Mike Bell (R-Riceville), ensures that both the letter and spirit of Tennessee law and the State Constitution are followed to protect farmers from inequitable taxation.

Public Guardians –State Senators voted this week to establish a Public Guardian Working Group led by the Commission on Aging and Disability to review Tennessee’s public guardianship for the elderly program and make recommendations on how the public guardianship program can be more effective. Public guardians, also known as conservators, help people over 60 who can no longer help themselves. Senate Bill 1287 , sponsored by Senator Rusty Crowe (R-Johnson City), calls for the working group to review who has access to the services of a public guardian and who does not and what best practices, if any, are available from other states with similar programs. The Commission shall report to the General Assembly by January 15, 2018. The legislation also clarifies that background checks on employees or volunteers who come into direct contact with service recipients should be done. In addition, it provides immunity for lawsuit for any licensed nursing home facility that declines employment to someone based on that background check.

Abortion / Tennessee Infants Protection Act — Senate bill 1180, sponsored by Senator Joey Hensley (R-Hohenwald), that would enact the “Tennessee Infants Protection Act” was approved on final Senate consideration to protect a viable fetus 24 weeks gestational age and older. The legislation calls for the doctor to test viability before an abortion when the woman is at least 20 weeks past the gestational age, and there will be a rebuttable presumption that an unborn child of at least 24 weeks is viable. The bill provides health exceptions in the cases for abortions to be performed after the 20-week time frame, including those in which the mother is in imminent danger of death or where there is a serious risk of substantial and irreversible impairment of a major bodily function.

License Plates / “In God We Trust” — The full Senate approved a bill this week which gives motor vehicle owners in Tennessee the option to obtain a license plate with the nation’s official motto “In God We Trust.” The motto was adopted by the 84th Congress in 1956 but has appeared on U.S. coins since 1864. It has also appeared on the nation’s paper currency since 1957. Under Senate Bill 1355, sponsored by Senator Paul Bailey (R-Sparta), the request for the plate could be made at the time the owner’s vehicle registration.

Medical Licensure Compact — Legislation which would enact an “Interstate Medical Licensure Compact” to facilitate the expedited licensure of physicians in multiple participating states advanced through the Senate on final consideration. Senate Bill 595 follows the passage of similar compacts, including those involving nurses and physical therapists, which increase easier access to care. One of the reasons for the development of the compact includes telehealth and its expanding technologies which cross state boundary lines. Telehealth is particularly important to rural areas where there is a shortage of physicians. The legislation will also address physician recruitment to reduce shortages by enabling physicians to work across state lines.


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