Capitol Hill Week: Legislation calls for Medicaid block grant waiver to construct an innovative plan that better serves the needs of TennCare recipients

(NASHVILLE, Tenn.), April 18, 2019 – Major legislation calling for Tennessee’s Commissioner of Finance and Administration to request a block grant waiver from the Centers for Medicare and Medicaid Services (CMS) to better serve recipients of the state’s TennCare program was approved by the Senate Commerce and Labor Committee this week.  Senate Bill 1428, sponsored by Senate Commerce and Labor Committee Chairman Paul Bailey (R-Sparta), is designed to maximize flexibility in constructing an innovative plan that serves the needs of Tennesseans, while ensuring the state continues to receive its full share of federal Medicaid dollars.

 “The overall goal is to provide an effective and innovative plan that is specific to the healthcare needs of all Tennesseans, while lowering costs and increasing access to patient-centered care,” said Senator Bailey.  “We need the flexibility to determine what is best for our citizens instead of continuing down the path of a one-size-fits-all program from Washington.”

Bailey said the legislation has been worked on diligently over the past several weeks with TennCare officials, Senator Lamar Alexander’s office, and Senate leadership.

“I, along with Senate leadership, have worked diligently to address the concerns of all stakeholders,” added Bailey.  “We are in a unique situation with Senator Lamar Alexander currently chairing the Health, Education, Labor, and Pensions Committee, and I am confident his office will continue to be a valuable resource moving forward.”

The legislation requires the commissioner to submit the block grant waiver request to CMS within 180 days of the bill’s enactment.  The block grant must convert funding for the program into an allotment that is tailored to meet the needs of Tennesseans.  Coverage for the existing TennCare population would be maintained under the proposal.

The bill specifies that funds must be indexed for costs such as population and inflation growth.  Funding must remain at the level set, without any decrease in the federal share based on deflation or a reduction in population.  Administrative costs would be excluded, permitting the state to continue to draw federal matching funds for operating the program.  To provide maximum flexibility regarding pharmacy benefits, the amendment includes fluctuation of prescription drug costs, diabetic testing supplies, and over-the-counter medications.

In addition, the proposal gives the state additional flexibility to serve other needy populations with distinct financial or healthcare needs.

The measure would become law upon Governor Lee’s signature.  It now goes to the Senate Health and Welfare Committee for consideration, and must also receive approval from the Finance, Ways and Means Committee before moving to the full Senate for a final vote.

Senate Education Committee advances legislation promoting civics education

Three key bills promoting civics education in Tennessee schools were approved by the Senate Education Committee this week before members concluded their business for the 2019 session.  This includes Senate Bill 800 establishing the “Governor’s Civics Seal” to recognize public schools and local education agencies (LEAs) for implementing high quality civic education programs that prepare students for career and civic life.  The bill, which is part of Governor Bill Lee’s legislative package, is sponsored by Senate Majority Leader Jack Johnson (R-Franklin) and Senate Education Committee Chairman Dolores Gresham (R-Somerville).

 

Senate Education Committee Chair Dolores Gresham (R-Somerville)

According to the Woodrow Wilson National Fellowship Foundation, a majority of Americans in every state, except Vermont, would fail a test based on the questions in the U.S. Citizenship Test administered by the U.S. Citizenship and Immigration Services.  Research indicates only 38 percent of Tennesseans could pass the test, with just 13 percent scoring a grade B or higher.

“A healthy democracy needs citizens to be well-informed and engaged, and that begins with educating our students,” said Chairman Gresham.  “This legislation promotes greater civic engagement by providing our students with the knowledge and skills needed to fully participate in their government as voters and as citizens.”

Under the bill, the Department of Education and the State Board of Education would adopt criteria that a school must meet to earn the Governor’s Civics Seal.  The criteria will build on Tennessee’s academic standards regarding the formation of the state and federal government, utilizing civics lesson plans and Blue Book lesson plans provided by the Tennessee Secretary of State.  It will also include instruction regarding our nation’s democratic principles and practices, significant events, and individuals responsible for the creation of our foundational documents.  In addition, the legislation calls for students to engage in real-world learning activities, including the Secretary of State’s student mock election and civics essay contest.  The Secretary of State will assist in implementing the program.

The legislation provides that the Governor’s Civic Seal recognition will be identified on the school’s state report card.  School districts in which at least 80 percent of schools received the seal will also receive the Excellence in Civic Education recognition.

In similar action, Senate Education Committee members also approved Senate Bill 1243 which raises the minimum number of questions asked on the civics exam administered to high school seniors from 25 to 50.  Current law requires a civics exam be administered composed from the 100 questions provided on the test administered to immigrants applying for citizenship.  This legislation requires that at least 29 questions on the test must be related to American government, 16 to American history, and 7 to integrated civics.   Schools in which all graduating seniors receive at least an 85 percent score or higher on the test would receive an additional recognition by the Department of Education as a U.S. Civics All-Star School.

This bill, which is sponsored by Gresham, is now headed to the Senate floor for a final vote.

 Finally, the committee approved legislation calling for students in Tennessee’s K-12 schools to receive instruction on the 19th Amendment, including Tennessee’s role and the events leading up to ratification.   Tennessee played a pivotal role in ratification, casting the final vote needed to grant women the right to vote on August 18, 1920.   The vote was narrowly won when Republican State Representative Harry Burn changed his vote from “no” to “aye.”  The young 24 year-old Burn was persuaded just prior to the vote after receiving a note from his mother who favored ratification.

Senate Bill 1248, also sponsored by Gresham, calls on the Department of Education to collaborate with appropriate groups to develop and promote instruction related to women’s suffrage.  They will also be responsible for distributing instruction materials electronically to Local Boards of Educations (LEAs), as well as provide resources to aid educators via their Internet website.

“We can be proud of our state’s heritage and Tennessee’s place in the leadership of this nation as we approach the centennial of this momentous event next year,” added Chairman Gresham.  “Our students need to understand the history of the movement which provided women with the precious right to vote and to have a say in determining our state’s and nation’s future.”

Governor Lee presents supplemental appropriation amendment to his 2019-2020 budget proposal

Tennessee Department of Finance and Administration Commissioner Stuart McWhorter presented Governor Bill Lee’s revised revenue and spending plan for the 2019-2020 fiscal year to the Senate Finance, Ways, and Means Committee on Tuesday.  The supplemental appropriations amendment is customarily introduced by the governor in the final weeks of the legislative session to make adjustments to the budget submitted earlier in the year.  It also signals the beginning of final state budget negotiations between the administration and members of the Senate and House of Representatives.

McWhorter outlined several new education initiatives, including $2.8 million to improve literacy programs.  The proposal provides $750,000 in new funds for East Tennessee State University (ETSU) to establish a public-private partnership resulting in a Center of Excellence dedicated to improving health access.  The Center will also focus on rural-based research to identify gaps in physical and behavioral outcomes, clinical improvement, and improved long-term care.

In other education expenditures, the amendment provides $1 million to be used by Columbia State, Motlow State, Roane State, Chattanooga State, and Cleveland State Community Colleges for their mechatronics program.  This is a dual enrollment program between middle college high schools and the community colleges training students to become technicians who operate, maintain and repair high-tech automated manufacturing systems. The program provides high school students with an opportunity to receive a certificate in mechatronics that will greatly enhance their opportunities to receive a high-quality job.

In addition, the amendment provides $800,000 in new funds for Tennessee State University’s Nursery Research Center in McMinnville.  This TSU facility has an annual economic impact to the nursery industry in excess of $25 million, providing research and outreach in pathology, entomology, genetics, horticulture and sustainability, and weed sciences.

The administration is also recommending $5.6 million in grants for non-profits across the state to provide a variety of needed services to Tennesseans.  McWhorter said the items were identified because their missions align with Governor Lee’s priorities.  Governor Lee has expressed strong support for non-profits and faith-based organizations, which he believes can be a part of the solution for many issues facing the state.  Approximately 60 percent of the grants are related to education, 26 percent to reducing recidivism, and 14 percent to rural development, all of which are part of the governor’s priorities.

Other highlights include fully funding the Tennessee State Trooper Salary Survey, new money to treat prisoners under the custody of the Department of Correction who suffer from Hepatitis C, and matching funds which will help build a Radioactive Materials Training Center near the new Y-12 National Security Complex Uranium Processing Facility at Oak Ridge. This will be a highly advanced and technical state-of-the-art training facility where local, state, and federal personnel will develop advanced skills necessary to handle a spectrum of disaster incidents related to radioactive materials.  In combination with the Y-12 National Security Complex Uranium Processing Facility and a separate meeting facility, the projects are expected to create 900 jobs.  The $3.6 billion Uranium Processing Facility is the largest construction project in Tennessee history.

Along with consideration of the governor’s supplemental appropriations proposal, the Senate Finance, Ways, and Means Committee began reviewing 196 amendments to the budget this week which have been filed by State Senators.

In Brief….

Farmers / Tennessee Wine and Grape Board – The Senate State and Local Government Committee approved legislation to create the Tennessee Wine and Grape Board to strengthen Tennessee’s efforts to restore preeminence in the wine and grape industry. Senate Bill 302, sponsored by Senator Ken Yager (R-Kingston), also creates the Wine and Grape Fund which is dedicated to promoting grape and wine production in Tennessee. Governor Bill Lee has allocated $300,000 to this fund in his supplemental budget amendment.

At one time in history, Tennessee led the nation in grape and wine production, but the state has fallen behind. This legislation sets up a mechanism for Tennessee to make the investments needed to encourage growth in grape and wine production, which will also boost the agriculture and tourism industries in the state. Under the bill, board members will be appointed by the governor and will be specifically chosen for their expertise in the industry.

 Daylight Saving Time Year Round – Legislation that seeks to implement daylight saving time year round in the state of Tennessee overcame its first hurdle in the Senate State and Local Government Committee this week. Senate Bill 1100, sponsored by Senator Steven Dickerson (R-Nashville), would only go into effect if and when the federal government removes the prohibition on states to regulate this matter. Year-round daylight savings time would mean that during the winter months, there would be one more hour of daylight in the afternoon, and the sun would rise one hour later in the morning.  Florida and Washington have  passed similar bills, and at least two dozen other states, including neighboring state North Carolina, are considering similar measures. President Donald Trump has also expressed his support for permanent daylight saving time. The bill will now move to the floor of the Senate for final consideration.

Release Time  Classes — Legislation expanding the opportunity for students to take release time classes in religious and moral instruction passed the full Senate this week. A 2015 law allowed such courses to be taught outside of school, so long as the student was not given any academic credit. Senate Bill 1373, sponsored by Senator Ken Yager (R-Kingston), amends this law by allowing a Local Board of Education to award one-half unit of elective credit to students completing a release time course in religious moral instruction. The bill also requires the board to develop a neutral, secular evaluation of the offered program to determine whether elective credit may be awarded. The legislation now waits for final approval from the House.

Reducing Recidivism / Education Opportunities — With research showing that the more education incarcerated individuals receive the less likely they are to turn back to a life of crime, Senator Steven Dickerson (R-Nashville) sponsored a bill, which passed the full Senate, looping prisoners into Tennessee’s Drive to 55 initiative.  This is the initiative to get 55 percent of Tennesseans equipped with a college degree or certificate by the year 2025.

Senator Steven Dickerson (R-Nashville)

Senate Bill 1061 requires the Department of Corrections, in partnership with Tennessee Higher Education Commission and Board of Regents, to develop and submit to the General Assembly an annual report that details higher education opportunities available to inmates. The legislation also requires the department to develop a plan to equip ten percent of eligible inmates with a degree, diploma, or certificate by 2025 through increasing availability and participation in higher education among Tennessee’s prison population.  “By passing this legislation, the General Assembly has the opportunity to fight the gaps in incarcerated Tennesseans’ education while they are in our custody,” said Sen. Dickerson. “We have many employers looking for qualified workers in Tennessee, and an educated prison population has the potential to fill such vacancies.”

A separate bill furthering legislative efforts to lower Tennessee’s recidivism rates and total prison population through education and employment opportunities advanced through the Senate State and Local Committee this week. Senate Bill 904, sponsored by Senator Southerland (R-Morristown), incentivizes inmates to complete a reentry education program by establishing an educational sentence reduction credit of 60 days. The bill says that if a prison inmate successfully earns a high school equivalency credential, high school diploma, vocational education diploma, or other post-secondary or industry-recognized certification they can then qualify for the reduction program.

Senator Joey Hensley R-Hohenwald)

 Dual Enrollment / Lottery Funds — Legislation reordering how funds are distributed from Tennessee’s lottery education accounts was passed by the Senate Education Committee this week. Currently dual enrollment classes are funded last, behind the Tennessee Promise scholarship. Senate Bill 319, sponsored by Senator Hensley (R-Hohenwald), requires state lottery funds to be transferred to the dual enrollment grant program before going to the Tennessee Promise Endowment Fund. The legislation still prioritizes the Tennessee Hope scholarship first. The proposal will now go to receive a final vote on the Senate floor.

Suicide Prevention / College Students — A bill sponsored by Senator Steven Dickerson (R-Nashville) aiming to prevent suicide among college students in Tennessee passed the Senate Education Committee this week.  Suicide is the second leading cause of death among college students in the state.  At the request of Tennessee Suicide Prevention Network (TSPN), Senate Bill 1175 requires public institutions of higher education to develop and implement suicide prevention plans in consultation with campus and community mental health experts.   The state institutions will then communicate the plans to students, faculty, and staff at least twice a year through emails, websites, orientation materials, handbooks, or any other method to convey information that will help save lives. The statute calls upon TSPN to lead the state in its suicide prevention efforts and allows public colleges to rely on the resources and training available through the organization.  TSPN is a grass-roots association which includes counselors, mental health professionals, physicians, clergy, journalists, social workers, and law enforcement personnel, as well as survivors of suicide attempts. The organization works to eliminate the stigma of suicide and educate communities about the warning signs of suicide, with the ultimate intention of reducing suicide rates in the state of Tennessee. The bill now moves to the Senate floor to receive final approval.

Consumers / Automobiles — The Senate approved consumer legislation this week which authorizes the Department of Revenue to work alongside automakers who issue a major recall to conduct consumer outreach. Currently the department is prohibited from disclosing personal information in regards to motor vehicle records to anyone for any reason. Senate Bill 1492, sponsored by Senator Bailey (R- Sparta), allows the Department of Revenue’s Commissioner to disclose information regarding a vehicle owner affected by a major recall to the issuing automaker. This will allow for such automakers to more easily contact affected consumers who may be at risk. The most recent recall this legislation will affect is the Takata airbag recall.

 Tennessee Public Charter School Commission – On Thursday, the full Senate gave approval to legislation that seeks to improve the authorization process for public charter schools in Tennessee by creating a commission of experts with appellate authority. Senate Bill 796, sponsored by Leader Jack Johnson (R-Franklin) and Senator Brian Kelsey (R-Germantown), creates the Tennessee Public Charter School Commission to serve as an independent state appellate public charter school authorizer. The legislation moves the current appellate authority to authorize, oversee, and maintain accountability of charter schools from the State Board of Education and instead places that authority with the newly created Public Charter School Commission. This move will ensure the most qualified people are making decisions on charter schools in Tennessee. The bill is part of Governor Bill Lee’s education initiatives designed to improve education opportunities for Tennessee students.

Under the legislation, charter operators must first submit an application to local school boards. If denied, then the charter operator will be able to appeal that decision to the Commission, which may approve the appeal and oversee the school, or the school may return to local jurisdiction if an agreement can be reached.  The Public Charter School Commission will be made up of nine expert members appointed by the governor and subject to confirmation by the General Assembly.

Student Athletes / NCAA Rules — The Senate Education Committee voted this week to approve a resolution calling for the state’s public universities to oppose the National Collegiate Athletic Association (NCAA) prohibition on compensation for student athletes.  Senate Resolution 22 cites Bannon v. NCAA, a U.S. Court of Appeals case which found certain NCAA amateurism rules violated federal antitrust law and were harmful to competition among student athletes in the college education market.  The case noted that the names, images and likenesses of student athletes have been reproduced for commercial purposes for which the NCAA had barred any compensation.  The court, however, rejected proposed remedies for violation and left NCAA’s controversial “amateurism” system in place. The resolution instructs the state’s nine public universities to work with their respective athletic conferences in opposition to the rules and to implement a system which is fair to student athletes. The resolution is sponsored by Senator Brian Kelsey (R-Germantown).

Disaster Declaration / February Storms — The federal government has granted Governor Bill Lee’s request for Major Disaster Declaration to make federal recovery assistance available to 56 county jurisdictions impacted in February’s flooding and severe storms.  Counties included in the  declaration are:  Bedford, Bledsoe, Blount, Campbell, Carter, Cheatham, Claiborne, Clay, Cocke, Coffee, Decatur, Dekalb, Dickson, Dyer, Fentress, Gibson, Giles, Grainger, Greene, Hamblen, Hamilton, Hancock, Hardin, Hawkins, Hickman, Houston, Humphreys, Jackson, Jefferson, Johnson, Knox, Lake, Lauderdale, Lewis, Lincoln, Marion, Marshall, McNairy, Moore, Morgan, Obion, Overton, Perry, Rhea, Roane, Robertson, Scott, Sequatchie, Sevier, Smith, Tipton, Unicoi, Union, Van Buren, Warren, and Wayne.  Cocke, Greene, Hamblen and Sevier.

The major disaster declaration covers the time period of Feb. 19, to March 30, 2019, and will allow government entities and certain private non-profits in the eligible counties to apply for reimbursement of specific expenses related to the disaster under the Federal Emergency Management Agency’s (FEMA) Public Assistance (PA) program.  Information about FEMA’s PA program and its eligible reimbursement categories is at:  https://www.fema.gov/public-assistance-local-state-tribal-and-non-profit.  The federal declaration also makes Tennessee eligible for the federal Hazard Mitigation Grant Program, https://www.fema.gov/hazard-mitigation-grant-program, which provides assistance to communities to prevent or reduce long-term risks to life and property from natural hazards.

 Constitutional Prohibition / Ministers Serving in the Legislature — A resolution allowing voters to change Tennessee’s constitution to remove a 1796 provision ruled unconstitutional by the U.S. Supreme Court in 1978 was approved by the Senate State and Local Government Committee this week.  Article IX, Section 1 prohibits ministers of the Gospel, or priests of any denomination, from serving in the Tennessee General Assembly.  Many ministers have served in the General Assembly since the prohibition was overturned.  Senate Joint Resolution 178, sponsored by Senator Mark Pody (R-Lebanon), seeks to put the State Constitution in line with current practice ensuring that the spiritual church leaders may serve Tennessee in the State Legislature.

Child Sex Offenders / Photographing — Legislation strengthening Tennessee’s child sex offender laws as it pertains to unlawfully photographing a minor was approved by the Senate Judiciary Committee this week.   Senate Bill 684, sponsored by Senator Janice Bowling (R-Tullahoma), was introduced in response to an issue raised in the opinion of State of Tennessee v. David Scott Hall, which involved a defendant placing a video camera in the bedroom of a minor.  The case was overturned because the language in Tennessee’s current child exploitation statues does not include a reference to the defendant’s subjective purpose. This bill clarifies and improves current child exploitation statutes by including language regarding the defendant’s purpose for sexual arousal or gratification. The legislation also increases penalties from a Class A misdemeanor to a Class C Felony for knowingly photographing a minor in a state of nudity.  It further strengthens penalties to a Class E felony if the photograph is disseminated to any other person, or if the victims if under the age of 13.   However, if both occur, the defendant will face a Class D felony offense, which means even more jail time.  A person convicted under this statute will also be required to register as a sex offender. The legislation now travels to the Senate floor to receive final approval.

Senator Shane Reeves (R-Murfreesboro)

 Health Care Consumers / Clarity in Billing Practices — The Senate Commerce and Labor Committee passed the Healthcare Billing Clarity Act which will help patients decipher what charges come from a hospital and what charges come from a specialty physician.  The current hospital billing system in Tennessee lacks the clarity needed for patients to easily comprehend their medical bills. Often times, hospital bills include charges for supplies and equipment labeled as specialty service charges which are mistaken by patients as a total amount being billed by their physician.  Senate Bill 613, sponsored by Senator Reeves (R-Murfreesboro), restricts hospital billing statements from including any language that refers to specialty healthcare services rendered at the hospital which could confuse the patient into thinking the bill came from their physician instead. According to the Urban Institute, 54 percent of patients in the United States claim that their medical billing paperwork and invoices are confusing. The legislation now heads to the full Senate to receive their final vote.

Senator Frank Niceley (R-Strawberry Plains)

 Bingo / K-12 Schools — Legislation allowing voters to amend Tennessee’s constitution to legalize Bingo games which benefit public and private schools passed final consideration on Thursday.   Senator Frank Niceley (R-Strawberry Plains), sponsor of  Senate Joint Resolution 97, said the bill would provide an additional voluntary source of funds for Tennessee’s K-12 schools by allowing electronic and manual bingo to be played for their benefit in a manner that is enjoyable to participants.  Legislation must be passed by the General Assembly authorizing the game if voters approve the constitutional amendment.  Such action would align Tennessee law with 46 other states which allow bingo.

Senator Becky Massey presents resolution to the family of late Senator Ben Atchley

Honoring Resolution / Senator Ben Atchley — On Thursday, Tennessee State Senators stood to honor the life of former Senate Republican Leader Ben Atchley who died in November at age 88.  He served in the House of Representatives for 4 years and the Senate for 28 years.  He was elected Senate Republican Leader for 16 years before retiring in 2004.   Senate Joint Resolution 59, sponsored by Lt. Governor Randy McNally, Senator Becky Massey (R-Knoxville), Senator Richard Briggs (R-Knoxville) and other members of the Senate, heralds Atchley’s distinguished public service.  Among special guests joining the Senate in remembering him was his wife, former State Senator Sue Atchley, who also served Knoxville’s Senate District 6.

“Ben Atchley was a good man who served Knoxville well for many years,” said Senator Becky Massey (R-Knoxville), who also represents the 6th district. “His nickname was Gentle Ben because of his ability to work across the aisle to make government more effective. I am honored to try to follow in his footsteps.”

Community Oversight BoardsThe full Senate approved a conference committee report on legislation aiming to create greater balance within community oversight boards in Tennessee, sending the bill to Governor Bill Lee for his signature.  Although community oversight boards have existed since the 1950s, there are currently no guidelines in Tennessee governing their creation, membership, and function. Senate Bill 1407 amends the current unlimited subpoena power of an oversight board by requiring them to go to the local legislative body or city council and request a subpoena.  The legislation, as amended by the report, also provides guidelines regarding the subpoena requests.  The subpoenas would not be issued in the form of a blanket authorization, rather it must specify each document to be produced or witness to testify. The bill is sponsored by Senator Mike Bell (R-Riceville).

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