Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org
By Rose Hoban
There are two or three weeks at the NC General Assembly every session that are really, really busy: One is the week before the end of the session (slated to be late June/ early July), when the budget deal is done and lawmakers push through some of their pet pieces of legislation before heading home.
The other week is “crossover,” which was this past week. Crossover is a deadline by which a bill needs to get through all its votes in either the House or the Senate lest it die for the rest of the biennial session. On Monday alone, the House worked on at least 80 bills. By the end of the week that chamber had passed at least 130 bills, while the Senate passed 91 bills this week, often in floor sessions that dragged on long after dark.
At that rate, it’s close to impossible to keep up, for legislator or reporter. In one incident this week, many House Democrats voted the “wrong way” on a bill, because they received the incorrect bill number when they were given their marching orders in caucus. As many members asked to change their votes, their confusion on the bill number became apparent to many
Speaker Tim Moore (R-Kings Mountain) allowed Democrats to “reconsider the bill,” in other words, to vote again.
But the incident was a peek into the way the caucuses process the massive flow of information coming at them.
Reporters have to pick and choose how to process the massive flow of information, too. At NC Health News, we were only able to write stories on a handful of bills. Others will be digested below, and on Tuesday.
For the third session in a row, Rep. John Torbett (R-Stanley) proposed to eliminate the state law requiring that adults over the age of 21 wear motorcycle helmets, so long as the riders carried $10,000 of additional insurance.
After an easy trip through the House Transportation Committee on Monday, this year’s bill skipped past several referrals to the House Health and Insurance Committees and went straight to the House floor for debate and a vote on Tuesday morning.
But the bill was one of several withdrawn from debate on Tuesday. It reappeared on the calendar on Wednesday, only to be withdrawn again. In the end, the bill did not make the crossover deadline.
Presumably the motorcycle helmet repeal bill is dead. However, at the legislature no bill is ever completely dead. Legislative language is often dropped into the framework of another bill, in a process known colloquially as “gut and amend.” The gut and amend process has resulted in bills such as the infamous “motorcycle / vagina bill” in 2013, where abortion restrictions were dropped into a bill on, you guessed it, motorcycle safety.
The process has also allowed for other pieces of controversial legislation to piggy-back onto more popular measures, such as the 2016 last-minute addition of language allowing for the establishment syringe exchange programs in North Carolina to a bill about increased privacy for police body camera footage.
Presumably, the loosened restrictions on motorcycle helmets are gone for now, but there’s always the possibility of a return.
One lobbyist, who asked not to be named, noted the motorcycle helmet restrictions bill was a “mom versus dad” bill.
“Mom’s will say, ‘No way!’” she said, “while dads will say, “Oh, heck, why not.”
In this related bill, Torbett presented a measure in the House Health Committee on Wednesday which would improve the state’s traumatic brain injury Medicaid waiver, which allows for enhanced services for people with TBI.
As Torbett noted during his presentation, “Many of these people unfortunately become wards of the state.”
This bill recommends that the Joint Legislative Oversight Committee on Health and Human Services consider a permanent subcommittee on aging. There is a temporary committee during this session. The bill also makes changes to the adult care home and nursing home advisory committees to conform to the Administration for Community Living Rules and recent changes to the state Long Term Care Ombudsman program.
The bill also directs the Department of Health and Human Services to study the HOPE Act and related federal regulations and to make recommendations to the Joint Legislative Oversight Committee.
The bill expands the number of “body artists” required to obtain a permit from the Department of Health and Human Services before they can practice their craft in North Carolina to include people who practice body art, piercing, branding, scarification and tattooing. Previously, the statute only covered tattoo artists. Permits must be renewed annually.
The bill does not cover tattoo removal, which is something only physicians can currently do. The House passed it almost unanimously.
The coroner system was abolished when the medical examiner system was created in the early 1970s. About nine counties still had elected coroners as of two years ago. Most do not meet the qualifications to serve as medical examiners and the position incurs cost to taxpayers.
In 2016, legislators eliminated the coroners in Caswell and Brunswick Counties.
A similar bill in the Senate to eliminate the Cleveland County coroner did not make the crossover deadline.
It comes as a surprise to some folks that the legislature has so much sway over issues of licensure of health care professionals, even with the presence of many active boards of medicine, nursing and other allied health personnel.
The first two bills, which are mostly technical in nature, allow for revisions to North Carolina’s agreements with multi-state licensure compacts that make it easier for professionals to move and transfer their licenses. Even as it becomes easier to move from one state to the other, though, the state boards retain the power to discipline professionals who step out of the bounds of practice.
To “modernize” the Respiratory Care Practice Act, the House approved a measure to make it easier for someone with a degree in respiratory therapy in another state and passes the national board exam to work in North Carolina. There are 14 accredited programs in North Carolina (associate degree). In 2015, there were 158 graduates in the state.
The new Interstate Commission of Nurse Licensure Compact eases the way for nurses licensed in any of 25 states participating in the compact to practice in another state. Main sponsor John Szoka (R-Fayetteville) promoted the bill as a way to help military families where the non-military spouse is a nurse to move more easily when his or her spouse is transferred to a post such as Ft. Bragg.
The Substance Abuse Professional Practice Act was a bill requested by the Addiction Professionals of North Carolina, headed by Mark Ezzell.
“HB 615 makes small but needed changes that will help substance use disorder professionals to get continuing education credits they need,” Ezzell said in an email. “It will also make the credentialing/licensing process more efficient by getting rid of unused credentials and create a robust program for impaired professionals, much as we have in other vital professions across the state.”
Senate Bill 104 adds a criminal background check to pharmacist licensure, something not currently required, yet is required for many other professionals.
Removes a prohibition on manipulation of the spine from the definition of “physical therapy.” There’s an identical bill in the Senate, but as this bill passed crossover, it will likely be the bill that proceeds onto the senate floor. The bill pits physical therapists against chiropractors, and is likely to be controversial in that chamber.
This bill effectively removes two of Gov. Roy Cooper’s potential appointees to the Medical Board. Now appointment of the member rotating off the board in 2017 will be made by the Speaker of the House of Representatives and the member rotating off in 2018 will be appointed by the President Pro Tempore of the Senate.
Any future governor would have two remaining appointments, and keeping those two appointments gets around the ruling made in McCrory v Berger, which found that the legislative appointments to executive branch agencies may violate the separation of powers provision of the North Carolina Constitution.
The bill has no stated sponsor other than the “Committee on Rules, Calendar, and Operations of the House.” A spokesperson for the Medical Board said the board did not request the bill.
When the bill was heard in the Rules Committee on April 25, it passed by a voice vote, but when the chair asked for no votes, minority leader Darren Jackson (D-Raleigh) was the sole member to loudly vote “no.”
When asked why, he responded, “because it takes two appointments away from the governor.”
“I don’t know why the bill is necessary,” he said. “No one, whether the day it was introduced or today, spoke in favor of the bill, so why it was needed… it appears to be just purely partisan because a Democrat is in the Governor’s mansion.”
The bill would designate the third Wednesday in May as the annual Hypertension Awareness day. The legislative Justus‑Warren Heart Disease and Stroke Prevention Task Force, the American Heart Association/American Stroke Association, and the North Carolina Academy of Family Physicians have agreed to support the event, to bring attention to the prevention of high blood pressure, which affects more than a third of adults in North Carolina.
The bill instructs the State Board of Education, along with the Department of Health and Human Services, to develop a youth suicide awareness and prevention training program. The training is supposed to consist of at least two hours of evidence-based instruction to increase awareness of risk, identification of risk factors, and signs and information for prevention services and support.
The one-year cost of the training requirements will initially be $768,386, which reflects the cost of hourly wage employees’ participation in a two-hour training. New teachers will also be required to do the training as they come on board, which will cost about $76,000 every other year.
These two bills are part of a suite of bills introduced by House members with current or former affiliations with the military. Rep. John Szoka (R-Fayetteville), a retired Army Lieutenant Colonel, and Rep. Grier Martin (D-Raleigh), who served in the Army in Afghanistan and is a member of the reserve, are the primary sponsors of the bills aimed at helping members of the military who live in the state.
We covered HB 483 here.
Meanwhile, HB 489 would make it easier for county social service departments to share information about abused, neglected or dependent children with appropriate military authorities if their caregiver has a connection to the military. This way, military resources can be deployed to help the entire family.
Original studies done in 2007 in North Carolina by researchers from UNC Chapel Hill and RTI found that among military families with at least one incident of child maltreatment, a parent’s deployment increased the likelihood that further maltreatment would occur.
More recently, researchers from RTI and N.C. State University have found that veterans experiencing post-traumatic stress disorder who engage in treatment can have “post-traumatic growth” – such as an increased appreciation of life, awareness of new possibilities, and enhanced inner strength.
NCSU researcher Sarah Desmarais, one of the lead authors, said in a statement that the findings are important “because they show that the way veterans respond to trauma is not a zero-sum game.”