Legislative Health Care Round Up - North Carolina Health News
By Rose Hoban & Taylor Knopf
As this year’s legislative work session rapidly draws to a close, lawmakers are pushing through multiple small bills having to do with health care.
Naturopathic Medicine Study
A bill that passed unanimously in both chambers of the legislature directs the Department of Health and Human Services to study naturopathic medicine, give recommendations on how to license naturopathic doctors, and decide what their scope of practice should be.
“Naturopathic medicine is a distinct health care profession that affects the public health, safety, and welfare of the State’s residents. Certification of professionals practicing naturopathic medicine will aid in protecting citizens from deception, fraud, and damage to their health status,” reads House Bill 277.
Sen. Joyce Krawiec (R-Kernersville) has wanted to study the certification process for naturopathic doctors for a while.
“They are medical doctors professionalized in primary care and they attend naturopathic medical school,” she told the Senate Health Care Committee last week. “We want to find a way to work toward getting them able to be licensed in North Carolina so that can practice the craft that they have.”
She noted that some hospitals in the state have physicians with naturopathic training on their staffs.
In the past, there’s been little appetite for extending practice privileges to naturopathic physicians in the state. Bills to study the licensure of naturopaths, or license them outright, have been filed at the General Assembly in every session, as far back as 2001, filed by lawmakers from both sides of the aisle.
A study on licensing the practitioners was performed back in 2005, but with the state’s powerful medical society in opposition, the initiative died there and has not been revived until now.
“Naturopathic doctors need to be licensed or certified in North Carolina,” she told the Senate Health Committee this week. “Currently, they are practicing but they are not certified or licensed. This is putting forth a study committee to see the best way to handle that.”
Krawiec said most specialize in primary care, and there are already naturopathic doctors on staff at many of North Carolina’s major hospitals.
Naturopathic medicine emphasizes “prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process,” according to the American Association of Naturopathic Physicians.
The AANP says that naturopathic practices include: laboratory diagnostic testing, nutrition, botanical medicine, manipulative therapy, public health measures, hygiene, counseling, minor surgery, homeopathy, acupuncture, prescription medication, intravenous and injection therapy, and naturopathic obstetrics (natural childbirth).
Cremation of multiple infants together
Krawiec, who sits on the Senate Health Care Committee, has moved a number of health care bills late in the session. One of those other bills, HB741, authorizes the legislature to perform a study on how to improve access to maternal and neonatal care for women across the state.
As the bill was coming up for final committee votes, Sen. Tamara Barringer (R-Cary) added a provision that would tweak North Carolina law and allow for two fetuses or infants under the age of one year to be cremated together.
Barringer said her amendment was in response to a constituent’s tragic situation.
“A few weeks ago, a family in my district in Apex called my office saying that they could not cremate their twin girls who had died before they could be carried to term,” she told the Senate Health Care Committee.
Apparently, the fetuses were “intertwined” and could not be separated. Because there was a prior prohibition in the law prohibiting “the human remains of more than one person in the same cremation chamber,” the family had to ship the children’s remains to Virginia where they could be cremated together.
Barringer added language allowing for multiple cremation for children up to one year old.
“It’s my understanding that oftentimes in these multiple birth situations, the children are often in the NICU for months at a time,” she said. “If that were the case we would like to allow for them to be cremated together and to have their last … days together.”
The amendment passed easily, with Sen. Ralph Hise (R-Spruce Pine) inserting a personal note: “As the father of twins, I could not imagine such a tragedy or the furor if the state was telling me that somehow the burial wishes of the family could not go forward.”
The bill had an easy path through both legislative chambers and is currently sitting on Gov. Roy Cooper’s desk.
Health-Local Confinement/Prison HealthConnex. (S750)
A bill that deals with health issues inside jails and state prisons passed through the General Assembly with ease and is also on the governor’s desk awaiting his signature.
Krawiec told fellow health committee members last week that Senate Bill 750 came about after a woman incarcerated in one of her counties’ jails didn’t receive proper medication and died.
“So this bill will just say that health care issues in the local jails or state facility prisons are full participants in the health information exchange so we will be able to see what these patients need and make sure their medical needs are taken care of,” Krawiec said.
It also directs the N.C. Department of Health and Human Services to study how to improve prisoner health screenings. Krawiec said the goal is for prisoners to receive the life-saving medication they need while incarcerated.
The bill directs the Department of Public Safety and DHHS to work together to securely share inmates’ medical records using NC HealthConnex to ensure inmates’ medical needs are met. SB 750 contains other clarifying language regarding inmate health care and what steps must be taken when an inmate dies in prison.
Krawiec amended the bill in the Senate Health Care Committee earlier this month to address the completely separate issue of veterinarians prescribing opioids.
“Many of you will remember when we passed the STOP Act last session, there was a portion about veterinarians in there that we removed and turned into a study,” Krawiec explained. “This amendment takes forth the information from the study and puts it into a bill.”
The STOP Act limits the number of opioids that can be prescribed for acute pain. It also directs providers to consult the N.C. Controlled Substance Reporting System (CSRS) — a database of all prescriptions for opioids and other drugs that can be abused — before prescribing opioids in an effort to cut down on “doctor shopping” and ensure patients aren’t receiving opioids elsewhere.
SB 750 exempts veterinarians from consulting the CSRS before prescribing an opioid. However, it does require vets to report into the CSRS when they are prescribing controlled substances in classes II-V.
This bill also clarifies the law regarding veterinarians ability to prescribe opioids for animals, allowing them to continue using written prescriptions and clarifies the seven-day opioids prescribing limit doesn’t apply to animals in an emergency facility or veterinary hospital. It does require that the N.C. Veterinary Medical Board provide continuing education on substance abuse for its providers and adds the board as a member of the prescription drug advisory committee.