Showing posts with label sudden infant death syndrome. Show all posts
Showing posts with label sudden infant death syndrome. Show all posts

Sunday, April 19, 2020

Lawmakers passed several health-related bills in last two days of session, but killed others, including one to help with insulin costs

By Melissa Patrick
Kentucky Health News

The General Assembly passed several health-related bills in the final days of its session, but left many others hanging, including an insulin bill aimed at helping Kentuckians with diabetes pay for their life-saving medication.

Rep. Danny Bentley
House Bill 12, sponsored by Rep. Danny Bentley, R-Russell, would have required state-regulated insurance plans to cap a patient's cost for a 30-day supply of insulin at $100 "regardless of the amount or type of insulin needed to meet the covered person's insulin needs." It did not include Medicaid, Medicare or self-insured government plans.

The Senate committee substitute for HB 12 would also have established an insulin assistance program. This language came March 18 from Senate Bill 23, sponsored by Sen. Phillip Wheeler, R-Pikeville. After sitting in the Rules Committee for several legislative days, it was recommitted on the last day -- without explanation, as usual.

“I hate to use the word disappointing; it's worse than that, really,” Bentley said. “I apologized to all of my representatives because I had 73 co-sponsors on that bill. And that is disheartening to me, not because of me or anything for me, but because of the 550,000 diabetics in Kentucky. And right now with people not able to work, it just made it that more important.”

Sen. Phillip Wheeler
He said he thought Wheeler's addition “killed it,” largely because of the added cost that came with his assistance program, and trying to figure out who would pay for it. (He added it at a time when the covid-19 pandemic was becoming a threat to state revenues.) "It just got too complicated,” he said. “HB 12 should have come on through clean.”

Bentley said if the Senate had passed the bill with Wheeler's addition, he was planning on asking the House to reject the changes and sending the bill to a conference committee that he thought would have removed Wheeler's program.

Wheeler acknowledged that the funding for his program was an issue, but said the main reason the bill didn't pass was the shortened legislative session.

"I think it just got caught up in the whirlwind of covid-19," he said. "It just didn't make the cut." He said he was also disappointed. "I think it was a great bill that would have helped a lot of people, but like I said -- I guess we'll just have to try again next year." Bentley said his bill will be a priority when the legislature returns in January.

Wheeler said the addition of his amendment was important because Bentley's bill covered fewer than 10 percent of health plans in Kentucky and his amendment would have also helped the uninsured and those who are covered by most private-sector health plans, called ERISA plans.

“To the extent that it caused any problems for his bill, I do regret that. But honestly, I don't know that Bentley's bill really had any better chance of passing than mine did.”

Wheeler was serving his first full legislative session after winning a special election in March 2019. He is running for a full four-year term and will have a Democratic opponent after the June 23 primary. His district is Pike, Martin, Lawrence and Morgan counties.

Bentley, a pharmacist who was first elected in 2016, is unopposed for another two-year term from Greenup County and part of Boyd County.

Another major health bill that did not pass was aimed at improving the workforce that cares for patients with Alzheimer's disease and dementia.

SB 136, sponsored by Sen. Robby Mills, R-Henderson, would have required home-health aides who provide care for patients with Alzheimer's or other dementias to receive four hours of state-approved dementia-care training within the first 60 days of employment, and two hours per year after that. A committee heard that of the 75 hours it takes to become a certified nurse's aide, only two focus on cognitive impairment.

The bill was amended with a business-oriented coronavirus relief measure in the last hours of the session, and the revised version passed out the House 86-3. The Senate did not agree to the changes; a Senate spokesman told the Lexington Herald-Leader that there were issues with the bill that the legislature did not have time to correct.

The health-related measures in the amendment would have allowed chiropractors to go back to work, and allowed certified community-health workers to bill Medicaid for their services during the state of emergency. It also included language that asked occupational licensing boards and trade associations to give Beshear a plan showing how they could safely reopen while still following health guidelines.

Another transformed measure that didn't pass was Senate Bill 20, which was completely gutted in the House and amended to allow massage-therapy and optician boards to set their licensing fees in administrative regulations, rather than law, and designate a single credential-verification agency for all the state's Medicaid managed-care organizations. Health-care providers have long complained about the burden of being separately credentialed by MCOs; the state has five.

Rep. Kim Moser, R-Taylor Mill, said the bill would have set a firm deadline, July 1, for the Cabinet for Health and Family Services to create a credentialing agency, and if not, responsibility would shift to the attorney general. The General Assembly passed legislation in 2018 to create such a system, but it hasn't been implemented, she said.

Another bill related to MCOs that did not pass was SB 30, sponsored by Sen. Stephen Meredith, R-Leitchfield. It would have limited the number of MCOs to three. Meredith and others say there is no need for providers to have to deal with the administrative burdens of dealing with so many MCOs; opponents say that makes bidding more competitive.

Health bills that passed

Health bills that did pass include measures to promote organ donation, help struggling rural hospitals and Sudden Infant Death Syndrome research, boost reimbursements for ambulance services, and make it harder to get an abortion, among other things. All of these bills await action by Beshear, whose decision will be final because April 15 was the last day the legislature could meet.

Here are most of the health-related bills that passed in the final two days of the legislative session:

HB 387, sponsored by Bentley, would create a revolving loan fund for financially distressed rural hospitals. It is not funded but would allow the Cabinet for Economic Development to provide loans to struggling hospitals to maintain or upgrade their facilities; to maintain or increase staff; or to provide new health-care services. It passed with an amendment to give Beshear the authority he needs to buy protective gear for health-care workers fighting the covid-19 pandemic.

HB 46, sponsored by Rep. Jerry Miller, R-Louisville, would allow full-time state employees a paid leave of absence of 240 hours for donating a human organ and 40 hours for donating bone marrow.

SB 237, sponsored by Sen. Max Wise, R-Campbellsville, would allow collection of tissue samples from post-mortem exams of children who have died from Sudden Infant Death Syndrome to be used for research purposes, with a parent's permission.

SB 9, sponsored by Sen. Whitney Westerfield, R-Hopkinsville, would require health-care providers to give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion, and would make not doing so a felony. The bill passed with language from HB 451, to expand the power of the attorney general to shut down abortion providers and keep abortion from being deemed an urgent procedure under Beshear's emergency order. Westerfield said he expects Beshear to veto the bill.

HB 8, sponsored by Rep. Rob Rothenburger, R-Shelbyville, would boost reimbursement from Medicaid for ambulance services by setting up a trust fund to let them draw a federal match.

HB 29, sponsored by Rep. Steve Riley, R-Glasgow, would make temporary licenses for long-term-care administrators run nine months, not six.

House Resolution 135, sponsored by Rep. Kim Moser, R-Taylor Mill, would encourage the Legislative Research Commission to establish the Kentucky Emergency Preparedness Task Force, with findings to be submitted by Dec. 1. Moser said it should look at the state's past and current response to disasters, including covid-19, and plan for future response.

Click here for a list of some other health-related bills that have already been signed by the governor.

Tuesday, March 31, 2020

Lawmakers returning to Frankfort to pass a budget and other bills; here are some health-related measures that could pass

UPDATE: On April 1 the General Assembly passed a state budget and related bills, including one freezing health departments' pension payments at the current level. House Speaker David Osborne said more bills are likely to pass when the legislature returns April 13, including one to help rural hospitals..

By Melissa Patrick
Kentucky Health News

As lawmakers head back to Frankfort to pass a budget -- and other bills, despite Gov. Andy Beshear's repeated request that they pass only a budget and anything related to the coronavirus -- several big bills related to other aspects of health are pending, including some controversial measures.

Beshear, a Democrat, denied the request of the Republican legislative majority 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. The lawmakers plan to pass the budget and other bills Wednesday, April 1, and return April 14 to reconsider vetoed bills.

Beshear indicated at his daily press conference Tuesday that the budget would be the only bill passed. “These folks need to pass a budget and get of town,” he said. “My understanding is that now, that’s the plan.”

One big health-related bill that has been expected to pass is House Bill 32, which would tax electronic cigarettes. It has been promoted as a way to reduce teen use of the products by increasing their price and to bring state government more money -- an increased concern in light of the pandemic, which is likely to cause a recession and a drop in state revenue.

HB 32 was trimmed down in a Senate committee to place a 15 percent wholesale tax on e-cig products and a $1.50 per-pod tax on Juul-type products, which is expected to bring in $25 million a year. The original bill was estimated to bring in $50 million, and that could be trimmed down even further, as two Senate floor amendments have been filed to decrease the tax to 10%.

The original version would have put a 25% tax on e-cig products, while raising the tax for "other tobacco products," such as cigars, to 25% from the current 15%, and add e-cigs to the list. It would have also doubled the per-unit tax on non-smokable products, but did not touch the tax on traditional cigarettes.

Health departments: Another health-related bill to watch is one that has been touted in the House as part of a three-phase approach to create a sustainable solution to local health departments' pension-driven financial woes.

House Bill 171, sponsored by Rep. Jim DuPlessis, R-Elizabethtown, would move health departments, regional universities and quasi-governmental agencies away from a "percentage of pay" pension formula to a model that requires them to pay only what they owe the system over a certain period, called "level-dollar funding." It is in the Senate State and Local Government Committee but has had two official readings, so it could pass quickly.

It could pass another way: in a House committee substitute to SB 249, with a change to include a new 30-year-amortization period for the pension debt, rather than the 27 years in HB 171. It also adds a layered, 20-year closed amortization period for any future increases or decreases in actuarially accrued liabilities after the 2019 valuation. SB 249 has received two readings in the House, and DuPlessis has said negotiations will likely be done through SB 249.

Rural hospitals: HB 387, sponsored by Rep. Danny Bentley, R-Russell, would create a revolving loan fund for financially distressed rural hospitals.

It would allow the Cabinet for Economic Development to provide loans to struggling hospitals for three purposes: to maintain or upgrade their facilities; to maintain or increase staff; or to provide health-care services not currently available. The bill has had two readings and is in the Senate Appropriations and Revenue Committee.

Insulin costs: Another important health-related bill would cap the monthly cost of insulin for many Kentuckians at $100. HB 12, sponsored by Bentley, would require state-regulated insurance plans to cap a patient's cost for a 30-day supply of each insulin prescription at $100 "regardless of the amount or type of insulin needed to meet the covered person's insulin needs." It does not include Medicaid, Medicare or self-insured government plans.

The Senate committee substitute for HB 12 would also establish an insulin assistance program. This language comes from SB 23, sponsored by Sen. Phillip Wheeler, R-Pikeville. HB 12 has had two readings and is in the Senate Rules Committee.

Abortion: At least one anti-abortion bill is likely to move; it has been awaiting final passage for some time. Senate Bill 9, sponsored by Sen. Whitney Westerfield, R-Hopkinsville, would require health-care providers to give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion, and would make not doing so a felony. A House committee removed references to research, so it would not inhibit ongoing research.

Critics of the bill say the state already has laws to prevent this from happening and the bill does not account for palliative care needed when infants will not live, or will not have quality of life.

Another abortion bill that could pass is House Bill 451, sponsored by Rep. Stan Lee, R-Lexington, which would expand the power of the attorney general to shut down abortion providers. The Senate Judiciary Committee added authority for Attorney General Daniel Cameron to block abortions under gubernatorial emergency orders limiting "non-urgent" medical procedures.

Sen. Ralph Alvarado, R-Winchester, has filed a floor amendment to ban abortion from being deemed an urgent procedure in the state of emergency Beshear declared for covid-19. Democratic Floor Leader Morgan McGarvey of Louisville has filed an amendment to allow abortions in the case of a nonviable fetus, rape, incest, or threat to the mother's life.

HB 451 has had only one reading in the Senate, so it could not pass Wednesday unless the Senate suspended the readings requirement, which the state constitution allows it to do. Majority Floor Leader Damon Thayer said last week that was a possibility, but he voiced skepticism of the idea because it might set a precedent that legislative leaders would like to avoid. The legislature could pass it April 14 or even April 15, the day the session must end, but Beshear could veto it without fear of a legislative override.

Another abortion bill pending is House Bill 67, sponsored by Rep. Joseph Fischer, R-Fort Thomas, which would, in effect, ban abortion in Kentucky if Roe v. Wade is overturned. It would have the constitution say, "To protect human life, nothing in this Constitution shall be construed to secure or protect a right to abortion or require the funding of abortion." The bill has had no readings in the Senate, but is a constitutional amendment that would go directly to the Nov. 3 ballot, not to Beshear, so it could pass if the legislature met April 15 or if it suspended the readings requirement.

Here are some other health-related bills that could pass:

HB 29, sponsored by Rep. Steve Riley, R-Glasgow, would extend temporary license for long-term care administrators to nine months, not six. It awaits House concurrence with a Senate substitute that would prohibit certification or renewal of an assisted-living community if it is owned, manged or operated by a person who has been convicted of certain crimes it would also change the appeals and renewal processes.

HB 46, sponsored by Rep. Jerry Miller, R-Louisville, would allow full-time state employees a paid leave of absence of 240 hours for donating a human organ and 40 hours for donating bone marrow. This bill is on the Senate consent calendar, which is used to pass bills en masse without debate.

HB 8, sponsored by Rep. Rob Rothenburger, R-Shelbyville, would boost Medicaid reimbursements for ambulance services by setting up a trust fund to allow them to draw a federal match. This bill is on the Senate consent calendar.

SB 30, sponsored by Sen. Stephen Meredith, R-Leitchfield, would  limit the number of managed-care organizations to three, from the current five. This bill has received a reading in the House and been returned to the Health and Family Services Committee.

SB 237, sponsored by Sen. Max Wise, R-Campbellsville, would  allow collection of tissue samples from post-mortem exams of children who have died from Sudden Infant Death Syndrome to be used for research purposes, with a parent's permission. This bill is also in the House Health and Family Services Committee, with one reading.

A more comprehensive list of health bills in the General Assembly, compiled by Kentucky Health News in a Google Doc, is available here.

Thursday, January 24, 2019

Specialists give parent-education campaigns credit for big decline in Sudden Infant Death Syndrome in Kentucky

Fewer babies in Kentucky are dying from Sudden Infant Death Syndrome, and wellness specialists are crediting a multi-pronged educational campaign by hospitals and other health-care providers, reports Ann Bowdan of Louisville's WLKY-TV.

In 2016, 103 Kentucky children died of SIDS. By 2018 the number had dropped by more than half, to 49.

"We have done everything from teaching in our prenatal classes, there is literature that goes home, it’s on our website," Norton's Children's Hospital wellness specialist Erkia Janes told Bowdan. "It’s seeped through every class we have."

For many years, parents were given the wrong advice, "For decades, it was thought a baby sleeping on its back could choke on reflux, or vomiting," Bowdan reports. "But in 1994 the American Academy of Pediatrics reversed that way of thinking," based on research. Janes said, "The research clearly shows that a baby on their belly is desperately as risk for SIDS."

The educational materials use "ABC" to describe how a baby should sleep: "alone, on your back, in a safe crib," Janes said. "Meaning no blankets, bumpers, and no sleeping in a bed with parents."