MONDAY, MARCH 1, 2010 VOLUME 22 ISSUE 7
Welcome to the seventh issue of Health Care Highlights in 2010. This marks the 22nd anniversary of our unique health care publication. Our newsletter reaches more than 2,500 health professionals and health policymakers. We are glad to have you in our subscriber communications network! Subscription information and rates for non-subscribers are available by calling 304-344-8466 or by e-mail to . Please respect the publication’s privacy rights as other use of the newsletter’s material is protected by copyright and requires written permission from the editor.
Health Care Highlights is published weekly during legislative sessions and monthly during the periods in between sessions. In addition, we will provide news coverage on any additional special legislative sessions, should they be called, and should health care issues be discussed.
Health Care Highlights provides a special focus on health topics of interest, legislative health deliberations, and a special section featuring the history and status of all health care bills introduced in the West Virginia State Senate and the House of Delegates throughout legislative sessions and during interim periods. As in past years, we follow issues relating to patient advocacy; hospice services and end-of-life decisions; organ and tissue donation and education;diabetes health treatment; medical practice issues; behavioral health initiatives;child health care services; hospital topics;health care delivery systems; pharmaceutical availability; insurance; health care management; preventive health and wellness programs; and public safety. These are the issues represented by the firm Government Relations Specialists, LLC, the publisher of Health Care Highlights.
Today is the 48th day of the 60-day second regular session of the 79th Legislature. Time has expired for the regular introduction of legislation Currently there are 1,377 House bills introduced, including 667 new bills and 710 carry-over bills from last session. The Senate is considering 697 bills. Of the 2,074 total bills introduced so far this session about 403 (19%) are health care related. Inside Health Care Highlights this week we provide a complete status listing of all health related bills. In addition, we report actions taken by legislative committees and other health care news items of general interest.
This Wednesday is known as “cross-over” day at the Legislature when all bills must be passed by their house of origin. This is known as the “50th Day Rule,” an internal procedure the Legislature uses to help facilitate the flow of bills through the last ten days of the session. Starting Thursday, the House may only work on Senate passed bills and the Senate may only work on House passed bills, with exceptions for resolutions, the budget and appropriations bills. That means the pace will be frantic this week at the Capitol.
Key Legislative Dates
February 28 - Bills due out of committees in house of origin to ensure three full days for readings.
March 3 – Last day to consider bills on 3rd reading in house of origin (except for budget or supplementary appropriation bill)
(Joint Rule 5b)
March 13 – Adjournment at midnight.
(WV Const. Art. VI, §22)
Please feel free to contact us with any comments, suggestions or matters of interest.
All Eyes Focused on Blurred Optometry Expansion Bill
This week the House Health Committee will focus on SB 230, better known at the Capitol as the “Optometry Surgery Bill.” The measure passed the Senate last week with a margin of only 7 votes after extensive floor debate on both the amendment and passage stage, which is rather rare in that legislative body. Senators Ron Stollings and Dan Foster, who are both physician members of the Senate, voted against the bill and expressed serious concerns. Many senators strongly objected that the bill was not allowed to be reviewed by the Senate Health Committee where health care ‘scope of practice’ bills are considered. Instead, the bill was only considered by the Senate Government Organization Committee where lead sponsor Senator Ed Bowman is the chairman.
Interestingly, the joint interim Government Organization Committee conducted a study in 2009 and did not make a recommendation for any bill to expand the scope of practice for optometrists. Neither did nine other states last year where this issue was hotly contested by legislatures. 49 out of 50 states prohibit laser surgery by optometrists, including West Virginia.
As currently drafted the bill will:
· Allow optometrists to perform laser eye surgeries
· Allow optometrists to advertise and refer to themselves as “optometric physicians”
· Allow optometrists to perform drug injection procedures
· Allow optometrists the ability to order lab tests
· Allow lower penalties than in current law for optometrist violations
Optometrists are not physicians by current state law and do not attend medical school for their degree. They don’t participate in medical internships or hospital residency programs where medical procedures and surgeries are supervised as an important part of the medical training for physician/surgeons. There are no optometric schools in the state.
Senate Health Chair Roman Prezioso, arguing against the bill in Senate floor debate talked of his concern about allowing optometrists to perform laser surgery. “We’re no closer to a consensus today than we were when the session ended last year . . . [Lasers] are dangerous and not without risk. They cut, burn and vaporize tissues around the eye and in the eye. They can create a medical emergency . . . It appears to me this is a lawsuit waiting to happen,” Prezioso said.
The WV Optometric Association and the WV Board of Optometry support the bill, but 20 leading health, nursing, medical, surgical and hospital organizations, and the AARP strongly oppose it. The WV Board of Medicine opposes the bill. Both Marshall University and West Virginia University medical school programs have major problems with the bill. PEIA director Ted Cheatham told Senator Prezioso that after consultation with his medical director, the PEIA does not support the laser surgery provisions in the bill. Speaking of laser surgery by optometrists, a recent ruling by the Veterans Health Administration is noteworthy. In November of 2009, the VHA ruled again that optometrists may not perform laser surgeries at its medical facilities – saying only ophthalmologists may do so.
“It is indeed a precedent-setting piece of legislation that will expand the practice of optometry in West Virginia making us the most radical in the country,” according to opponents of the bill like ophthalmologist Stephen Powell, MD. The most controversial provision in the legislation would allow optometrists to do laser surgery on the eyes. Dr. Powell said he is primarily concerned about patient safety protection which is also the main concern by the state AARP. “The problem is when you go to these procedures, you can have complications and you have to have the skills learned through your medical residency to deal with the complications. And if you don’t, it puts the patient at a higher risk,” Dr. Powell was quoted by Mannix Porterfield in The Register-Herald.
The bill is undoubtedly the most controversial health-related bill of the session. It has been referred to the House Health and Human Resources Committee where chairman Don Perdue has promised a deliberative review. A Public Hearing is also expected.
How to Contact Your Legislators
The West Virginia Legislature has expanded information available through its Internet web-site http://www.legis.state.wv.us/.
E-mails may be sent to Senators and Delegates by looking within the website for individual legislators or specify the name and send to . Faxes to Delegates may be sent to 304-340-3315 and to State Senators at 304-357-7829. Leave voice-mail messages for legislators or request other information, including copies of bills, by dialing 1-877-56-LEGIS (1-877-565-3447).
March Capitol Health Care Events
March 3 WV Dietetics Day
March 5 American Red Cross of West Virginia
March 8 Problem Gamblers Network of WV
March 10 WV Public Health Association
March 12 WV Alzheimer’s Association
‘Scope of Practice’ Need for Health Care Review Identified by Legislature
Having wrestled with the contentious issue of how to expand scopes of practice in the medical arena, members of the Senate Health Committee are taking a step toward establishing a permanent review process to actively engage persons with medical knowledge in considering proposals. Chairman Roman Prezioso and his committee members devoted most of a meeting informally reflecting on how the optometric scope of practice issue was handled this session. “We need to put in place something similar to the Joint Pension Committee. We need people who have knowledge looking at the issues. They would come back to the Legislature with non-binding recommendations,” he said. Prezioso had introduced a bill creating a Commission on the Scope of Practice in Health Care Delivery. The committee did not vote on the bill, (SB 528) but rather used it as a platform to explore an interim study on how to best establish the Commission, and make it flexible enough to bring in experts on an ad hoc basis to assist legislators. Your editor was among several who strongly endorsed the concept and applauded the proposal to include the state’s schools of medicine on the commission. The West Virginia Nurses Association expressed concerns that one profession would try to control another and prefers that licensing boards give recommendations to the Legislature.
But Senators Prezioso, Mike Hall and Ron Stollings all noted they are not trying to stack any deck. “Wouldn’t this give you a fairer shake?” Senator Hall asked. Looking back over this session’s most contentious issue, Hall said he had never even heard of YAG laser surgery until the optometry bill was introduced. Yet he was lobbied about it by both optometrists and ophthalmologists. “I’ve been here a long time. This process has varied influences that do not necessarily bring one to an objective conclusion,” he said.
Matt Walker of the West Virginia Primary Care Association endorsed the proposal, but asked that consideration be given to representation from the state’s 34 community health centers on such a commission. Richard Stevens, who represents both dentists and pharmacists, said the Legislature would have benefited from a year-long study of optometric scope of practice had such a commission been in place, with persons of expertise available to join the discussion. Reflecting back on the interim study of last year, which was not conducted by one of several legislative health committees with medical experts, Senator Prezioso said, “It got nowhere. So the decision [to decide the optometric issue] was thrust on us as laymen legislators.” The West Virginia State Medical Association also supports the concept. Spokesperson Amy Tolliver noted it has been tried successfully in other states and the American Medical Association also supports the idea, especially since more scope of practice proposals are being introduced in legislatures annually.
Legislators Want to Tap Surplus, Not Beer, for Treatment Programs
After flirting with a plan to raise the tax on beer to fund alcoholism and drug abuse prevention, treatment and recovery programs, the House of Delegates last week decided to switch gears and move in a different direction. After concluding a beer tax isn’t likely to pass the Legislature, House Health and Human Resources Committee Chairman Don Purdue steered his committee in the direction of tapping into the surplus in the Medicaid reserve fund. HB 4666 creates the funding methodology to provide substance abuse prevention, intervention, treatment and recovery services via a special revenue fund. The administration has resisted using Medicaid surplus funds, now estimated at $360 million, for anything other than Medicaid shortages officials see looming on the horizon.
The committee spent a great deal of time on the issue, including briefings from the Tax Department and a public hearing in the House Chamber. They explored beer taxes by the barrel, the can, the bottle and the keg, and compared West Virginia’s taxes with those of other states. State Tax Department figures indicate that West Virginia ranks around the middle of the pack in the nation when it comes to a beer tax. In the region, West Virginia would be in the middle as well – with Virginia, Ohio and Kentucky imposing slightly higher taxes and Maryland and Pennsylvania slightly lower taxes. West Virginia’s beer tax, now at two cents on a 12-ounce can or bottle, has not been raised since 1966.
During the public hearing, the debate broke down into two camps. The first was that a tax of three cents on a can of beer can save a life and help those dealing with addictions that are tearing families apart. On the business side, several distributors and wholesalers expressed concern that consumers will cross state lines to purchase beer if taxes are raised in West Virginia. They said good-paying jobs would be lost and that the public at large should provide funding for substance abuse programs. “The issue that I could not overcome was the knowledge that we have a big surplus, and yet we’re going to have a tax increase,” Perdue told The Charleston Gazette’s Alison Knezevich.
Healing Place Awarded Grant by Health Authority; Allows Doors to Open
The West Virginia Health Care Authority has approved a $50,000 grant for The Healing Place of Huntington. The funds will make possible the opening of a long-term recovery center for chronic alcoholics and addicts who have no available long-term services in the Huntington area to combat their addictions. Upon opening, 26 patients will be treated. Eventually, it is hoped The Healing Place will be able to house 100 men ages 18 to 70 who suffer from alcoholism and drug addiction.. It is modeled after a similar program in Louisville, Kentucky which gained national recognition because of an outstanding 65% recovery rate – five times the national average. The Healing Place provides counseling, training and life skills and is very much needed in West Virginia as an alternative to other treatments and short-term programs. “This is just fantastic news! I am deeply appreciative of the action by the Health Care Authority and the support of all of our area legislators in championing approval of the grant,” said Walter “Skip” Ewing, Director of The Healing Place. Ewing also said that the program “will teach ‘Recovery Dynamics’ which is unique to the area.”
Lawmakers Want to Review DHHR Contract Changes Above $500,000