Legislative Alert
June 13, 2003
The first session of the 103rd General Assembly adjourned late in the day on May 29. Four out of five of the bills initiated by TNA passed. We’re still waiting for the Governor to sign some of the bills we are reporting on, so we can give you the public chapter number. It is sometimes difficult to know what a bill with several amendments is going to say in its final version. That is the advantage to reading the public chapter. The language in the public chapter is exactly what will appear in the Tennessee Code. If a public chapter number has been assigned, you will find a link on the bill information page. All public chapters can be located on the Secretary of State’s Web site at www.state.tn.us/sos.
Several other bills that would have had a negative impact on nursing did not pass, but cannot be viewed as dead since there is another year in this session to bring them out of the subcommittees or committees. A good time for TNA districts to plan a meeting with their Legislators is while they are at home during the summer and fall. They will have more time to devote to listening to your concerns about the bills described below that are not in the best interests of health care consumers. The 103rd General Assembly will convene again in Nashville the second Tuesday of January 2004. Many thanks to all of the nurses who contacted their Legislators at TNA’s request to support or oppose the following bills (and many others) on behalf of nursing and health care consumers!
State TennCare Pharmacy Advisory Committee
SB1371 by Crutchfield/HB1650 by McMillan passed the House and Senate and was signed by the Governor on June 13. Assigned Public Chapter No. 350, it establishes in the Department of Finance and Administration a State TennCare Pharmacy Advisory Committee that shall make recommendations regarding a preferred drug list (PDL) to govern all state expenditures for prescription drugs for the TennCare program. Except for initial appointments, the members shall be appointed to three-year terms. The committee will be composed of 15 members, with the Governor appointing nine members, the Speaker of the Senate appointing two members and the Speaker of the House appointing two members. The Governor shall appoint one practicing nurse practitioner or physician’s assistant who participates in the TennCare program from a list of three candidates submitted by the Tennessee Nurses Association (TNA) or the Tennessee Academy of Physician Assistants. The initial appointee for this position on the committee shall serve a one-year term.
Special License Plate
SB1890 by Kurita/HB1912 by Head authorizing a special nursing license plate passed the House and the Senate and has been signed by the Governor. It is now Public Chapter No. 130. Fifty-five Legislators signed onto this bill as it moved through the system. Go to the legislative Web site at www.legislature.state.tn.us to read the names, and let them know you appreciate their support. Click on Legislation, then Filed Bills Index, and select SB1890 or HB1912.
Proceeds from the sale of the license plates will go the Tennessee Nurses Foundation, a 501(c)3 nonprofit organization, to help support its programs. We will have one year to sell 1,000 special plates before they will be produced. Special plates cost $35 in addition to the cost for your regular license plate. We will have a contest to see if anyone can come up with an outstanding design and colors for the plate. The Tennessee Nurses Foundation voted to put “Nurses Care” on the plate. But we will still need a design. Watch the TNA Web site for this promotion. The winner will receive a free registration to the TNA Annual Convention in Chattanooga November 14-16.
Professional Assistance
Sen. Ward Crutchfield and Rep. Gary Odom have passed a bill for TNA to tighten up the law we passed in 1993 to fund our assistance programs for chemically dependent health care professionals (TCA 63-1-136). The original intent of this law was to authorize professional associations and our foundations to contract with the state to fund these programs with licensure fees and offer assistance and monitoring services to nurses, physicians, dentists and other health care professionals. In recent years, individuals have interpreted this law to mean that any foundation can contract with the state licensure boards to offer these services.
SB1366 by Crutchfield/HB1286 by Odom inserts “their affiliated” between “professional associations and foundations” and adds a new sentence to clarify that we are not the functional equivalent of the state when funded by a state grant. The Senate bill was amended by Senator Jackson to clarify it won’t affect any existing contracts and to allow the boards to contract with other organizations if they are dissatisfied with the services the professional associations provide. Our concern with this amendment is that health care professionals would not self refer to organizations other than their associations and their affiliated foundations, but we did not oppose the amendment. We added an additional amendment to prevent treatment centers from offering professional assistance programs for health care professionals due to a conflict of interest. The bill passed on May 29, but has not been signed by the Governor.
Loan-Scholarship Fund
HB807 by Rep. Diane Black passed the House on May 7, but SB 1174 by Sen. Rosalind Kurita was not heard in the Senate General Welfare Committee this session. We trust Sen. Kurita will move the bill next year. There would have been no opportunity to ask for funding for this program this year, but we need to amend the section on interest rates in case we do reach a point in the future where state budget funds become available.
Advanced Practice
SB516 by Jackson/HB257 by Shepard is TNA’s bill that changes “may apply” to “shall apply” for a certificate to practice as an advanced practice nurse in the 2002 Advanced Practice Nurse title protection law [TCA 63-7-126]. This bill has passed, the Governor has signed it, and it is now Public Chapter No. 111. For more information on this bill, read the past issues of the Legislative Alert.
SB533 by Ford/HB268 by Shepard is TNA’s bill that attempted to delete physician supervision, control and responsibility for the prescribing practice of nurse practitioners in TCA 63-7-123 and replace the language with “medical consultation and referral.” As reported in the May 2 Legislative Alert, an amendment that deleted all of the language in this bill was offered by the medical lobbyists in the House Professional Occupations Subcommittee. That amendment passed and the bill went on to pass in both the House and the Senate. For more details on the language of the amendment, see the May 2 Alert.
Rep. Odom’s Subcommittee will study scope of practice issues this summer, and we will be on the agenda with the issue of physician supervision of nurse practitioners. Begin now to educate these members about what you do. They are Representatives Gary Odom (chair), John Deberry, Tre Hargett, Dennis Ferguson, David Shepard (our bill sponsor), Bob Patton and Joey Hensley, MD.
Cigarette Tax
Sen. Rosalind Kurita and Rep. Diane Black sponsored legislation to increase the tax on cigarettes. SB1173 by Kurita/HB1647 by Black increases the cigarette tax from one cent per cigarette to three cents per cigarette. This tax increase would bring the cigarette tax to sixty cents per pack and would increase state government revenues $198,600,000 and local government revenues $4,454,400. SB 1173 was assigned to the General Subcommittee in the Senate Finance Committee on May 13. HB1647 was taken off notice in the House Agriculture Committee on April 22. TNA supports this important bill. Perhaps next year will bring a better climate for this type of legislation to be successful. Talk to your Legislators between now and mid-January about this bill.
Determination of Death
SB16 by McNally/HB585 by Shepard authorizing registered nurses to make the determination and pronouncement of death for patients in hospitals has passed and has been signed by the Governor. It is Public Chapter No. 85.
School Health
SB636 by J. Ford/HB707 by Towns prohibits school personnel (except “medical” personnel) from recommending Ritalin or other psychotropic drugs to treat elementary and secondary school students for behavioral concerns. HB707 passed the House on May 21 and has been transmitted to the Senate. SB636 was assigned to the General Subcommittee of Senate Education and was not heard in the committee. This bill will no doubt be heard in Senate Education next year, so talk to your Legislators now. It is not clear whether this bill will prevent school nurses from recommending evaluation of a student or not. It definitely needs a clarifying amendment before it passes the Senate.
SB635 by J. Ford/HB708 by Towns prohibits local education agency employees or contract employees from recommending the use of psychotropic drugs such as Ritalin until a task force is formed and issues a report to the General Assembly regarding the use of psychotropic drugs to treat students with behavioral disorders. HB 708 passed out of the Public Health and Family Assistance Subcommittee and the House Health Committee. Action was deferred in the Budget Subcommittee. SB636 has been assigned to the General Subcommittee of Senate Education.
SB1673 by McNally/HB1911 by Overbey permits self-administration of asthma medications on school premises by school students with written permission by parent and physician’s written statement that the student has been trained in self-administration. SB1673 was referred to the General Subcommittee in the Senate Education Committee on May 1. HB1911 was taken off notice in the K-12 Subcommittee of the House Education Committee on April 8. TNA does not see a need for this bill since administration of medications is addressed in the Department of Education/Department of Health Guidelines for School Health.
SB547 by Fowler/HB663 by Vincent requires that psychotropic drugs be administered to students by a nurse or a physician or a person trained by the Department of Health. It requires permission from the student’s attending physician to administer psychotropic drugs and prohibits psychotropic drug administration to students for experimental purposes. SB547 was assigned to the General Subcommittee of the Senate General Welfare Committee on March 5. HB663 was assigned to the House Government Operations Committee February 13. Neither bill has been heard in committee. Current School Health Guidelines address this area, also, and this bill is not needed.
Administration of Medications
SB1591 by J Cooper/HB1751 by Maddox has been taken off notice for this year in both the Senate General Welfare Committee and the Mental Health & Human Resources Subcommittee of the House Health Committee. We will meet with the lobbyist and others before next year to see if language can be worked out that we can live with. We need volunteers that have a special interest in this area of practice to notify the TNA office of your interest in serving on this task force
Surgical Technologists
SB1916 by J. Ford/HB1909 by Overbey creates a registration process within the Department of Health for surgical technologists who have completed the certification process established by their national certifying body. This bill has been taken off notice in both committees for this year, but it will be back.
Staffing Ratios
SB1398 by Herron/HB1996 by Jones requires the Board for Licensing Health Care Facilities in the Department of Health to adopt rules that establish minimum, specific, and numerical nurse-to-patient ratios by licensed nurse classification and by hospital unit for all health facilities licensed in Title 68. Neither bill has been heard in committee this year.
To read bills and view information on where the bills are in the legislative process, go to www.legislature.state.tn.us, click on Legislation and select Filed Bills Index. To send an email to a Legislator who serves on one of the committees, click on House or Senate and select Members. Select Committees in the Senate and Committees or Subcommittees in the House to view the composition of all legislative committees. All committee composition and leadership will remain the same throughout 2003 and 2004.
