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Legislators Return to a Variety of Health Care Issues In the General Assembly

Part 1 of 2: Lawmakers will be focused on the budget during the upcoming short session, but there will be lots of healthcare-related bills to keep members of the General Assembly busy.

By Rose Hoban

This week, the General Assembly reconvenes for the ‘short’ session, the second legislative session of the biennium, held in order for lawmakers to make adjustments to the two-year budget created last year.

NC General Assembly building

Lawmakers return to Jones St this week for the short legislative session.

Leaders of the Republican majority have said repeatedly they want to truly make this year’s short session as short as possible. Many say they intend to recess by late June.

But state legislators usually do more than simply tweak the budget during the short session, and changes to laws governing aspects of the state’s health care system are on the docket.

Below is a list of health-related committees and sub-committees, and what initiatives they will be sending to the larger legislative body later this week.

(Part 2, tomorrow: Medicaid, WakeMed/ Rex and mental health)

Hospital regulation revisions

Since last fall, a committee has been reviewing the laws governing hospitals in the state, the “Certificate of Need” law that dictates the regulatory process hospitals go through in order to expand, offer new services, or open more beds. Decisions to allow hospitals to expand are made by a state board, and the complicated process can take years to complete.

Rep. Fred Steen (R-Landis) created the committee that was mandated to review all parts of the regulations. Steen said in an interview last summer in the Salisbury Post that he was interested in letting the free market work, and reforming the process to allow more open market decisions to be made.

After months of work, however, only technical changes appear to be in the works. Those include streamlining the application process for Certificates of Need, reducing the paperwork involved with applying for a Certificate of Need and shortening the appeals period.

Pharmaceutical Liability

A proposal to make it harder to sue pharmaceutical companies for harm caused by prescription drugs was resurrected after being stricken out of a larger tort reform bill (SB 33)that passed during the long legislative session last year.

During a series of hearings held earlier this year, family members of people harmed by prescription drugs gave at-times wrenching testimony about the deaths of their relatives due to pharmaceuticals.

Phipps speaks at Pharma Liability Hearing in Feb, 2012

At a March subcommittee hearing on the drug liability bill, Whitney Phipps gave emotional testimony about losing his father after he was given the drug Trasylol.

At the same hearings, pharmaceutical industry representatives came out in force to support the proposed bill, saying passage would demonstrate to pharmaceutical companies North Carolina’s commitment to their industry.

Only one other state, Michigan, has a similar law on the books. As a result, that state was barred from participating in a class action lawsuit to recoup Medicaid expenses from drugmaker Merck over the painkiller Vioxx, passing on a settlement worth more than $20 million.

North Carolina Attorney General Roy Cooper opposes the legislation.

Usually subcommittee members make public their legislative suggestions to their committees. However, subcommittee chair Sen. Thom Goolsby (R-Wilmington) demurred from creating a legislative memo to the larger senate judiciary committee.  He said that committee’s chairman, Pete Brunstetter (R-Winston-Salem) would decide on whether to proceed with the bill to the full Senate.

Children’s Health

The Child Fatality Task Force has been chugging along continuously since 1990, researching, and suggesting legislation to benefit the health of children in North Carolina. Task Force recommendations that have subsequently become law include measures that require children use bicycle helmets, a graduated drivers’ license program, and the use of child safety seats in motor vehicles.

This year, the task force’s recommendations to the General Assembly focused on reducing the infant mortality rate, currently at an all-time low for North Carolina of 7.0 infant deaths per 1,000 live births. The rate has come down steadily from high of 12.8 infant deaths/ 1,000 in 1988 when North Carolina had the worst infant mortality in the country.

However, despite this progress, North Carolina continues to rank in the bottom third of states in infant mortality rates.

Task Force chair  Elizabeth Hudgins said this year’s recommendations include:

  • $202,000 to promote safe sleeping practices for infants statewide
  • $425,000 for a ‘preconception’ health campaign, to improve the health of women before the become pregnant
  • re-instating $375,000 cut out of last year’s budget to fund the High Risk Maternity Clinic at East Carolina University
  • $47,000 to insure availability of the drug 17-Progesterone, that helps reduce preterm labor in women with a history having premature babies.
Child Fatality task Force Logo

Child Fatality Task Force Logo

“Our priorities are in the governor’s budget,” said Hudgins. “I think there’s a good chance all of it will be passed. On infant mortality front. North Carolina has a long tradition of funding these activities. Even though the dollars are often non-recurring funding, the funding has always been there.”

Hudgins admits the task force pulled back on some more controversial parts of their agenda, including pushing for speed cameras in school zones and pushing to restore funds to driver education for high school students. Instead, only a pilot project will test the use of speed cameras, and last year’s $45 million cut to driver education funding will remain in place.

“The task force tries to be cognizant of the fact that in the short session often there’s not the time to take on complicated issue,” Hudgins said.

Methamphetamine Abuse

Over the past four months, members of the House Select Committee on Methamphetamine Abuse have been treated to dramatic presentations about cleanup of meth-contaminated houses, they’ve heard about a statewide initiative in Nevada to show an anti-drug documentary on all that state’s television stations simultaneously, and they’ve had several presentations from State Bureau of Investigation agents on the number of meth labs busted in North Carolina in 2012.

Portable Meth Lab

A new tracking system allows law enforcement to find meth manufacturers more easily, even those making small quantities in portable labs, such as this one. Image courtesy of Advanced Environmental Options, Inc.

But the committee’s recommendations to the larger General Assembly for the short session will be modest: tweaking the state’s existing restrictions on purchases of pseudoephedrine, the main ingredient used to make meth, simplifying the record-keeping for pharmacists who sell pseudoephedrine, and making it easier for homeowners with houses formerly contaminated by methamphetamine to get a clear title on their property.

“As we’ve learned more about the effects and impacts on children, families, individuals, and all the ancillary impacts… the burns, the injured fire fighters and the cost to the state during difficult economic times…” said Rep. Craig Horn (R-Weddington). “I know we’ll never totally get rid of it. But I believe we can make a major dent in the proliferation of meth abuse.”

Even though laws are on the books limiting how much pseudoephedrine any individual can purchase in one month, Horn said he was eager to push legislation to make the drug, commonly contained in cold medicines such as Sudafed, available only by prescription.

But Horn also said there’s only so much that can be accomplished in the short legislative session. He also said House leadership has told members the legislative body would be taking up few controversial issues this summer.

“I’ve got to be a realist,” Horn said. “You’ve gotta keep your powder dry.  I have to aim at what can i realistically expect to accomplish, and these are things I realistically expect to accomplish.”

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