Saturday, March 28, 2020

Beshear signs more than 35 bills amid pandemic, many related to health care; physician assistants get limited prescribing power

By Melissa Patrick
Kentucky Health News

The Kentucky legislature continues to pass bills despite Gov. Andy Beshear's plea that it just pass a budget and anything related to the coronavirus, due to the social distancing needed to thwart it. He announced Saturday that he had signed more than 35 bills into law, many of them related to health.

“While all of us should be focused on responding to the coronavirus as the number of cases grows in Kentucky, I will continue to evaluate the dozens of bills lawmakers are passing and sign those I believe will benefit the people of the commonwealth,” he said in a news release. “While all of these issues could be addressed after we defeat the coronavirus, my staff and I will continue to look out for the best interests of all Kentuckians in deciding which bills should become law.”

Beshear, a Democrat, earlier rebuffed the request of Republican legislative leaders to call a special session after the threat abates, if they adjourned early. He said it might not be safe to call them back in time to pass a budget, which must be done by June 30. They plan to pass the budget and other bills April 1, and return April 14 to reconsider vetoed bills; he has vetoed two.

Here are some of the health-related bills Beshear signed:

Senate Bill 50, sponsored by Sen. Max Wise, R-Campbellsville, requires the state to hire a single pharmacy benefit manager to manage Kentucky Medicaid's $1.7 billion-a-year prescription drug business. This bill is designed to address many of the billing practices between pharmacy benefit managers and pharmacists, which pharmacists have long said are so unfair that they are putting some of them out of business.

House Bill 135, sponsored by Rep. Steve Sheldon, R-Bowling Green, gives physician assistants "modified prescriptive authority" for controlled substances in Schedules III, IV and V after they've practiced a year. Sheldon said all other states allow prescriptive authority for PAs and Kentucky will become the sixth state to place restrictions on them for Schedule II drugs, which includes a long list of narcotics used for pain management as well as several psycho-stimulants that are used treat attention deficit hyperactivity disorder, or ADHD.

SB 56, sponsored by Sen. Ralph Alvarado, R-Winchester, brings Kentucky law in line with the new federal law raising the legal age to purchase tobacco products, including electronic cigarettes, from 18 to 21. It also removes status offenses for youth who "purchase, use or possess" tobacco products, which are often called PUP laws. The bill allows the products to be confiscated and shifts the penalty to retailers who fail to adequately check buyers' identifications. The bill had an emergency clause so it became law upon Beshear's signature.

SB 42, sponsored by Sen. Denise Harper Angel, D-Louisville, requires any student identification badge issued to a public middle- or high-school student to contain the contact information for national crisis hotlines specializing in domestic violence, sexual assault and suicide. This contact information must also be on all IDs issued by public or private postsecondary education establishments. This information must be included on the IDs beginning Aug. 1.

SB 60, sponsored by Sen. Jimmy Higdon, R-Lebanon, adds spinal muscular atrophy, also referred to as SMA, to the list of  required tests run on infants for heritable disorders. Early diagnosis of this genetic disease helps babies receive treatment when it is most effective. Including SMA, Kentucky will now do 60 newborn screenings. Alvarado said at the bill's Jan. 29 committee hearing that this condition affects five or six Kentucky babies each year. 

SB 82, sponsored by Sen. Julie Raque Adams, R-Louisville, establishes the Kentucky Eating Disorder Council to oversee development and implementation of eating-disorder awareness, education and prevention programs. It will also identify strategies for improving access to adequate diagnosis and treatment services. and make recommendations on legislative and regulatory changes. Adams said 900,000 Kentuckians, including nearly 30,000 children, have been diagnosed with an eating disorder but the state has no residential, partial-hospitalization or acute-care programs.

SB 134, sponsored by Sen. David Givens, R-Greensburg, establishes the Optometry Scholarship Program with a trust fund supplied by state appropriations (determined with each biennial budget) gifts, grants, and federal funds. A minimum of one-third of the amount appropriated for scholarships must go to eligible students at an in-state institution -- a boon to the University of Pikeville's Kentucky College of Optometry, the state's only optometry school.

SB 125, sponsored by Sen. Tom Buford, R-Nicholasville, allows the Kentucky Board of Medical Licensure to determine the allowable scope of practice for athletic trainers in Kentucky, particularly related to their training. This bill has been in the works for about 10 years.

HB 153, sponsored by Rep. Kim Moser, R-Taylor-Mill, establishes a mental-health first-aid training program to show people how to best meet the needs of someone in a mental-health or substance-use crisis. Funding will come through a trust supplied by state and federal appropriations, grants and private donations. Advocates' hope is that this training will become as common as CPR.

Beshear had already signed several other health-related bills into law, including:

HB 129, sponsored by Moser, will overhaul the state public-health system, including how health departments are funded and how they prioritize their resources.  It is called the public health transformation bill. It was fully funded in the House budget but falls about $9.4 million short in the Senate's proposal, according to Randy Gooch, director of the Jessamine County Public Health Department. HB 129 is part of a three-phase approach submitted in the state House to create a sustainable solution to local health departments' pension-driven financial crisis.

SB 122, sponsored by Adams, modifies Tim's Law of 2017, which allows judges to order assisted outpatient treatment for people who have been involuntarily hospitalized at least twice in the previous year. SB 122 would make that two years. The goal of Tim's Law is to stop the revolving door of these individuals in and out of jails and state psychiatric hospitals, allowing more participants. The law is named for Tim Morton of Lexington, who was hospitalized involuntarily 37 times by his mother because it was the only way she could get him the psychatric treatment he needed. He died in 2014.

HB 99, sponsored by House Speaker David Osborne, R-Prospect, authorizing a $35 million state loan to the University of Louisville to support its recent acquisition of Jewish Hospital and other Louisville health-care facilities.

House Concurrent Resolution 5, sponsored by Rep. Danny Bentley, R-Russell, asks the federal government to expedite research on the safety and efficacy of medical marijuana. A House-passed bill to make marijuana legal medicine in Kentucky has gotten nowhere in the Senate. 

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