While some hold the false and dangerous belief that mandates, and in particular COVID vaccine mandates, provide bulletproof benefits and are without risk to an individual, others, conversely, underestimate the value in prophylactic prevention of  disease while overestimating the risk of that treatment.  Unfortunately, society is often pitted against one another with a false dichotomous scenario when in fact, there is a reasonable path forward.

The Tennessee General Assembly has been called back into a Special Session to discuss and debate several issues, but specifically COVID and COVID mandates.  I have been working with my colleagues to find that path forward.  Protecting the health and rights of an individual while working to ensure the interests of public health should not be mutually exclusive and should be a goal that unites us.

 As a physician who has taken care of COVID patients and seen the negative individual and public health outcomes caused by the virus, as the Chairman of Health who has spent extensive time with legal services on public health issues related to COVID, and as a patient who has been “fully vaccinated” and has also had a breakthrough COVID infection, I have multi-faceted knowledge and firsthand experiences that have shaped my perspective on this topic.  

During my research, one article from the American Journal of Public Health caught my attention and has been beneficial in my discussions with others about this topic.  

https://ajph.aphapublications.org/doi/10.2105/AJPH.2004.055152

The article states that “Jacobson established a floor of constitutional protection that consists of 4 overlapping standards: necessity, reasonable means, proportionality, and harm avoidance. These standards, while permissive of public health intervention, nevertheless required a deliberative governmental process to safeguard liberty.”  

In the landmark case Jacobson vs Massachusetts in 1905, the Supreme Court(SCOTUS) ruled in a 7-2 decision that the state had “police powers” to, in some cases, limit personal freedoms for the sake of public safety.  Justice Harlan, in his opinion, stated that the Constitution protects individual liberty and that liberty is not “an absolute right in each person to be, in all times and in all circumstances, wholly free from restraint”.  However, the SCOTUS did exercise caution in their ruling by stating that a situation in which regulation did not meet the proper criteria of being reasonable and necessary could be struck down by the courts and that the court had the responsibility to prevent “arbitrary and oppressive” regulations.  

In plain language, the SCOTUS ruled that liberties could be restricted if the regulations were reasonable and necessary, but the courts had a duty to strike down anything arbitrary or oppressive.  Therein lies the crux of many issues at hand relative to COVID.  It is, also, part of the decision process that I have put forth when looking at various mandates either by government or businesses.  Is a particular mandate necessary, have proportionality, reasonable, and avoid harm to an individual or is it arbitrary and oppressive?

Understanding my process, the only criterion that might be met in order to mandate vaccines would be proportionality in that a mandate has the potential to result in decreased morbidity and mortality due to COVID-19 than compared to the absence of any mandate.  With close to 50% of the state already vaccinated, having a significant portion of the state with natural immunity from a previous infection, and 16% of the population very low risk children, the balance of proportionality is not as overwhelming as it once was.  I certainly understand the sentiment for any mandate when this is the only criteria considered, but, as with any other medicines, there are risks, individual health profiles, and circumstances that must, also, be considered.

To that point, the other three criteria of necessary, reasonableness, and harm avoidance cannot be met.  “Necessary” is not defined in our code, but has the plain language meaning of “absolutely essential”.  Due to the fact that fully vaccinated individuals can still both contract and spread COVID-19, it is my opinion that the vaccine cannot be considered necessary, or absolutely essential, particularly when discussing the health and safety of others as required in our Tennessee code.  Is it a mitigating measure? Yes. Does it help protect the individual that is vaccinated? Yes, but we do not know to what extent.  Does it prevent the spreading of the infection to another individual? No.    

It is, also, not reasonable for someone who has recovered from a previous COVID-19 infection to be compelled to be vaccinated, or to lose their job for refusing vaccination, as this would infringe upon that individual’s right to life, liberty, and the pursuit of happiness.  Is it reasonable to screen individuals in a non-invasive manner for symptoms without asking for private health information? Yes, and that would be in compliance with state law.  But, mandates that require invasive tests or private health information go beyond that threshold.

Additionally, knowing that an injection will induce an immune response, a hyper-metabolic response, and likely an inflammatory response in this same individual, how can one ensure harm avoidance? One cannot.  Yes, the vaccines are low risk, and the benefits outweigh the risks for most people, however, they aren’t risk free. One cannot know every person’s health profile before enacting a general mandate for a medication. In order to satisfy “harm avoidance”, there have to be exemptions. Any mandate, and there are plenty out there, that doesn’t meet these criteria is likely arbitrary and oppressive; thus, infringing on the rights of individuals.

While there are some that would like to frame the issue into a simple format of “freedom vs safety” or in one’s own definition of right and wrong, the intertwining of individual health, public health, and constitutional rights is often complex and a challenge that I have analyzed with diligence.  The process that I have used has helped me to draw my conclusions on this issue.  It is an honor to serve District 48 during these unparalleled times, and I look forward to helping Tennessee overcome the obstacles created by COVID.

With Liberty,

Rep. Bryan Terry

This summer and fall have proven to be quite an active period for the office of District 48 in Tennessee, and Representative Bryan Terry, MD (R-Murfreesboro) has been working to address the various issues that have arisen.  With issues including unemployment, education, public safety, and COVID, there has been a diverse range of topics that Rep. Terry and his office have encountered.

“When we are out of session, it is just a legislator and their legislative assistant in Nashville.  When we are in session, we often get an intern, but that’s usually the extent of our staff,” explained Terry.  “As self-governance is the cornerstone of our constitutional republic, it’s important to obtain feedback and legislative ideas from constituents.  I’ve partnered with some local folks for more community input and outreach to meet these goals.  A lot has transpired in the county, state, and country that has impacted our district these past few months, and we’ve been working to address the issues as they have cropped up while continuing to plan for the upcoming session.”

 

COVID-19 Issues

The top concerns from constituents that the District 48 office is encountering stem from COVID-19, including mandates, vaccines, and passports.  President Biden’s controversial, and likely unconstitutional, federal overreach on using OSHA to enforce a COVID-19 vaccine mandate has only increased the concerns and fear from constituents. 

Having been responsible for taking care of COVID patients and seeing the effects of COVID on hospital resources, as well as surviving a breakthrough infection, Rep. Terry knows, firsthand, the impact COVID has had on individuals and the health care system.  As both a physician and a legislator, he has advocated that Tennesseans speak with their doctors about getting vaccinated against COVID-19, and he has encouraged Tennesseans, especially at-risk individuals, to protect themselves from the virus. In combination with vaccine awareness, he has promoted liberty and personal health choices when it comes to mandates.  

During the 2021 Session, Rep. Terry offered amendments to bills that would have protected Tennessee employees from a COVID vaccine mandate and consumers from vaccine passports.  In light of Biden’s overreach concerning vaccine mandates and the push to exclude unvaccinated individuals from society, Terry continues to support efforts to protect the liberty and health of Tennesseans.

“Going all the way back to last session, I’ve had detailed discussion with our legal services team on the topic of COVID-19, including mandates. Creating an executive order mandate doesn’t mean that it is constitutional. Though the Supreme Court has ruled in favor of mandates in the past, they have outlined certain requirements. Based on my discussions with our legal services, I would argue that the Biden vaccine mandate through OSHA is going to run into some legal issues and will, most certainly, be challenged,” stated Terry.  “The federal rules have yet to be presented, but I have already spoken with our Speaker and the Lee Administration on challenging the mandate. While I do believe that people should speak to their doctor about getting vaccinated, a ‘one size fits all’ approach that doesn’t account for things like natural immunity, harm avoidance, or breakthrough infections is a dictatorial and unscientific approach.”

Terry has had meetings, conversations, or correspondence with the Lee administration, the Speaker of the House, Senators, the Department of Education, the Department of Health, the superintendent, and other local officials on issues surrounding COVID-19.  This topic remains a priority for the district office.

 

Landfill Expansion

One of the top concerns voiced most often by constituents involves issues related to Middle Point Landfill.  The potential landfill expansion, the odors emanating from the area, and water quality in the area are often the focus of concern of constituents.  Representative Terry has been in frequent contact with the Governor’s office, the Tennessee Department of Environment and Conservation (TDEC), legal services, and City and County officials, working on solutions to address all of the issues surrounding the landfill. 

Republic Services is looking to expand Middle Point Landfill north toward Jefferson Pike and has completed Part 1 of the application process. The Central Tennessee Region Solid Waste Planning Board ruled that the expansion was not consistent with the 10-year plan and did not support the application. Republic has filed a lawsuit in chancery court. Though TDEC will decide on the application, this process may be settled in the courts. However, Rep. Terry is still actively working to halt the expansion and discussing the issue with legal experts. In addition, he has been in discussions with the Lee Administration about alternative solutions for the Middle Tennessee area.  

Representative Terry has also been in meetings with TDEC regarding the concerns surrounding the water quality near the Walter Hill dam. Complaints of potential health risks associated with the recreational area nearby grew following an incident involving a teenager who was hospitalized after swimming in the river near the dam.

Terry requested that TDEC close the recreational area until the Department could research the water quality in the area. In a meeting with TDEC, they opined that they could request that an entrance to a recreational area be closed, but needed evidence to make the request. TDEC conducted water sampling and, following their testing, concluded that the water quality was comparable to other rivers in the area. They did not pursue closure of the area. The entrance to the recreational area is owned by Murfreesboro City, who holds the authority to close the recreational area, and they have been conducting independent testing. Terry is continuing to monitor the situation and keep the community updated on any changes in the status of the river.

 

Fire Departments

Nearly three quarters of the fire departments in the State of Tennessee are volunteer fire departments, including the Rutherford County Fire Rescue Department.  Many of the community department stations are dependent on donations and fundraisers to support their budget. Restrictions associated with the COVID-19 pandemic have made it impossible for Rutherford County Fire Rescue to host their regular events to raise their annual funding. In order to bolster their lacking budget, Representative Terry has begun working with Governor Lee’s office to acquire additional funding through the upcoming budget. This will help to support our first responders in their work to keep the County safe until they are able to resume their regular fundraising events.

“The pandemic has impacted community safety in more ways than one. Our local fire stations haven’t been able to have their monthly fundraisers, and it can have a negative effect on how they function,” explained Terry.  “Our state has a 3.1-billion-dollar budget surplus. I’m working to see that we ensure our volunteer fire departments remain solvent for our communities.”

 

SHARE Rutherford

Rep. Terry has partnered with Hywater Strategies to offer SHARE Rutherford, a program designed to share and highlight the voices of Rutherford County in a positive and productive manner. The community-oriented program will include social media outreach, citizen highlights, round table discussions, and updates on topics pertinent to Rutherford County.

The “SHARE” in SHARE Rutherford stands for Safety, Health, Affordability, Recreation, and Education.  Those five categories are often the most prevalent concerns for families and businesses when they are looking to locate or relocate.  The program will focus on those areas but will, also, highlight current affairs relevant to the state and Rutherford County.

Thus far, SHARE Rutherford has conducted surveys and held round table discussions on education, small business, the landfill, and general concerns from constituents. More information can be found at SHARE Rutherford on Facebook.

 

Temporary Assistance for Needy Families (TANF)

With the conclusion of the 2021 Session of the TN General Assembly, Representative Terry saw the completion of a two-year effort to improve the opportunities of the TANF program. He passed the Tennessee Opportunity Act (TOA) which includes an innovative program called the “Pathway to Prosperity” that will now make it possible for Tennesseans to bridge the gap between poverty and income mobility.  Temporary cash assistance and wrap-around services will help to reinforce those who wish to pursue a degree, apprenticeship, or further training in a sustainable career while they are going through these self-improvement processes.

“Many people or states discuss providing a hand up instead of a hand out, but few are able to follow through on that philosophy.  Here in Tennessee, we are able to put words into action,” stated Terry.

Another provision of the Tennessee Opportunity Act includes a data and research driven program to enhance community wrap around services to the needy which includes opportunities for child care, family services, educational opportunities, and workforce enhancement.  Rep. Terry has been appointed to the TOA commission to oversee the implementation of the program.

 

Looking Forward

Rep. Terry has been actively involved in the appointments for the newly created Cannabis Commission which is tasked with reviewing other state and federal laws and programs surrounding the use of cannabis for medical purposes. The commission will be recommending a reciprocity program for patients to be able to possess 0.9% THC cannabis medicines, as well as other pertinent cannabis legislation. In addition to helping with the appointments, Terry has been working on patient protection legislation relative to cannabis, chronic pain, and palliative care.

As an elected representative of District 48, Rep Terry recognizes his duty to bring the issues that concern Rutherford County to the attention of the General Assembly and Governor Lee. He continues to fight to maintain the community values shared by his constituents, and he is working diligently to bring home the solutions necessary to further strengthen the district and protect the liberties of his neighbors.  For further information, contact the District 48 office at (615)741-2180 or via email at Rep.Bryan.Terry@capitol.Tn.gov.

Representative Bryan Terry, MD (R-Murfreesboro) was the first Tennessee legislator to be fully vaccinated against COVID-19 and is one of the first Tennesseans to recover from a breakthrough infection.  He is thankful for the vaccine and has encouraged others to talk to their doctor about getting vaccinated. 

“I know what it was like in our hospital and across the state.  I’ve walked willingly into hospital rooms and ICU rooms to take care of COVID patients.  With what I’ve encountered, I feel fortunate to have not contracted COVID before a vaccine was available,” stated Terry.  “I have since contracted, and recovered from, COVID through what is called a ‘breakthrough infection’.  With my health history, it could have been much worse.  I’m convinced the vaccine protected my health and possibly saved me from an extensive hospitalization, or death.  All Tennesseans, especially those with risk, need to talk to their doctor about getting vaccinated”.  

Rep. Terry is the Chairman of the Tennessee House Health Committee and an anesthesiologist in Murfreesboro.  He has had asthma since childhood and survived four blood clots in his lungs in 2016.  He exercises daily and incorporates running, yoga, and HIIT training into his routine.  Yet, he says that the coronavirus knocked him down as it ran its course.

“I often joke and tell people that I may not be the picture of health; however, I am the chairman of health.  In all seriousness, though, I do exercise and get my steps in every day, but I carry a few co-morbidities,” explained Terry.  “I recently had a known exposure to COVID and developed some symptoms.  I tested positive and went into quarantine.  Muscle and joint pains, fatigue, and other cold-like symptoms kept me down, but I never developed the severe respiratory problems associated with COVID that I’m at risk for. I credit the vaccine for helping prevent major problems.  I’m still not 100%, but I’m getting there.”

Though roughly 3 million Tennesseans have been vaccinated, Tennesseans and the rest of the country are starting to see breakthrough COVID-19 infections in vaccinated people and some reinfections in those with a previous COVID infection.  The Delta variant has been prevalent in the US and is accounting for roughly 80% of new infections in Tennessee.  Statistically, 97% of hospitalizations in Tennessee and 98% of deaths are in unvaccinated individuals.  

“I’ve never been under the illusion that I would never get infected even after vaccination.  It’s just been my hope that, when I did get infected, I wouldn’t have a major reaction,” stated Terry.  “I’ve had medical and legislative colleagues that have had severe and deadly reactions.  I’ve seen patients on ventilators and have bad outcomes.  I don’t wish that on anyone.  I know many folks don’t trust government, the media, or politicians, but most trust their doctor.  It’s a conversation folks need to have.”

Though only 38.5% of Tennesseans are vaccinated, that statistic doesn’t tell the complete story.  When combined with patients who have developed natural immunity from a previous COVID infection and those under 12 who are ineligible for the vaccine, the percentage of Tennesseans at low risk is around 70%.  That leaves about 30% of the population who are eligible and don’t have some immunity.  Additionally, over 25% of those over age 60 aren’t vaccinated, and that number is concerning to Terry.

“When you look at the demographics of the subset of unvaccinated, eligible Tennesseans, what stands out to me is those over 60.  While the majority of those who are unvaccinated are much younger and have a much lower risk, the older you are, the greater your risk,” explained Terry.  “As an elected official, when you talk to folks over 60, Medicare and their grandchildren are the top topics.  As a state representative, I can’t do anything about Medicare, but I can advocate for a healthy grandparent-grandchild relationship.  Decreasing one’s risk of a COVID infection is certainly one way to ensure a healthy relationship.”

Once the vaccines became available, the rate of hospitalizations and deaths related to COVID dropped dramatically, but communities are starting to see an uptick in new cases and hospitalizations.  Though the majority of new COVID related morbidity and mortality is in unvaccinated individuals, breakthrough infections are occurring in vaccinated people, as well.   Lower efficacy against COVID-19 variants, one’s own immunocompromised state, or even decreased efficacy of the vaccine over time are factors doctors are studying that may lead to breakthrough infections.  Still, Dr. Terry believes that vaccination, while not perfect, is the most effective way, medically, to prevent serious complications or death from COVID.

“While every medicine, including vaccines, has some side effects or risks, and each individual has different health, family, and work circumstances, the risk/benefit ratio benefits most folks. Obviously, the more folks that get vaccinated, the lower the overall risk for the community, as well.  Every American has had, and continues to have, an opportunity to get vaccinated.  Knowing what I know, seeing what I have seen, and experiencing COVID-19 myself, I can’t stress enough the importance of seeking counsel with your doctor about getting vaccinated,” concluded Terry.

The first half of the 112th Tennessee General Assembly, which saw significant progress and protections advanced for Tennesseans, has adjourned.  Representative Bryan Terry, MD (R-Murfreesboro) had a successful session, contributing leadership and legislation that assisted the General Assembly towards a productive session.  As Chairman of the House Health Committee, he helped pro-patient legislation navigate through the House while sponsoring and co-sponsoring significant legislation on a diverse set of issues that will impact Tennesseans in a positive manner.

 

“In some respects, this session was one of the more difficult sessions since I’ve been elected as we dealt with COVID-19, some contentious issues, and unaddressed issues from last year’s abbreviated session,” stated Terry.  “On the other hand, it has been one of the more satisfying sessions as we have passed some significant pieces of legislation and helped Tennessee move forward.”

 

Rep. Terry opened the session by bringing awareness to the human rights violations occurring in China relative to organ harvesting and ended the session passing a medical cannabis bill.  In between, he took on issues relative to opioids, the 2nd Amendment, rioting, and Temporary Assistance for Needy Families(TANF).  In the end, Rep. Terry passed nine bills and several resolutions while co-sponsoring, amending, or impacting well over eighty other bills.  

 

As chairman of the bicameral House and Senate TANF Working Group, Terry helped write HB 142, Governor Lee’s administration bill on TANF, and guided it through the House committee system.  The legislation modernizes the TANF system by cracking down on fraud while providing a pathway to prosperity for TANF recipients.  In addition, the bill sets up an evidence-based system for providing wrap around services to recipients in order to ensure Tennesseans can achieve upward income mobility.

 

Terry was, also, quite influential in advancing the protection of the 2nd Amendment Rights of Tennesseans.  Terry was a prime co-sponsor of HB 786, which allows for permitless carry of a handgun for otherwise law abiding citizens, and a co-sponsor of HB 761, which provides a sales tax holiday on gun safes and gun safety devices in order to incentivize their utilization. “Protecting our 2nd Amendment rights was a priority of constituents and a priority in the General Assembly,” said Terry. “We took some important steps to push back against those wishing to infringe upon our rights.”  

 

One of the steps was HB 1171, the Firearms Information Privacy Protection Act, or FIPPA, as it was known at the Capitol.  FIPPA helps guard against firearm registration or confiscation at the federal level by creating a cause of action against an individual who provides information to the feds about a firearm owner for the purposes of gun registry or confiscation.  In addition, if government personnel provide the information, they would be subject to a Class E felony.  Terry, also, co-sponsored HB 902, which bans a state or local gun registry, and his amendment, which sets up an ouster should an elected official assist the federal government violate the Tennessee Constitution or law as it relates to firearms, got added to HB 928, the “Second Amendment Sanctuary Act”.

 

Protecting free speech while also protecting property rights and law enforcement were some of Terry’s goals this session.  HB 881, the Mercenary Rioter Act, met those goals. The bill created penalties of aggravated rioting for individuals that are paid to riot or come in from out of state with the intent to commit a criminal offense and riot.  “Tennesseans don’t want mercenary rioters creating dangerous situations for peaceful protesters, law enforcement, or business or property owners,” explained Terry.  “If we can deter these bad actors, we can help protect Tennesseans.”

 

On the last day of session, Terry passed HB 490 which creates a medical cannabis commission and decriminalizes possession of 0.9% THC cannabis oil for patients with certain diseases, like cancer, Parkinson’s Disease or Sickle Cell Disease.  After being unable to pass a more comprehensive medical cannabis bill that allowed for decriminalization of non-smokable, non-vapable, non-edible cannabis-based medicines, Terry resurrected HB 490 and drafted a bill which he was able to pass through seven committees in one day.  Ultimately, he garnered the votes of both the Senate and the House, including the Lt. Governor and the Speaker of the House.  “While the bill doesn’t take all the steps that patients need when it comes to cannabis-based medicines, it is a step forward for patients.  I’m glad to be in a position to help Tennessee take that step,” concluded Terry.

 

Representative Bryan Terry, MD(R- Murfreesboro) is pursuing first-of-its-kind Second Amendment protection legislation entitled the Firearm Information Privacy Protection Act (FIPPA).  The legislation(HB 1171/SB 1142) is aimed at protecting the anonymity of citizens related to firearm ownership.

HB 1171 will enhance PC 380 by creating a Class A Misdemeanor for any public personnel that intentionally discloses information about a purchaser or owner of a firearm, firearm ammunition, or firearm accessory for the purpose of compiling or facilitating the compilation of a federal firearms registry or confiscation of firearms.  The bill will, also, create a cause of action for a gun owner to pursue civil action against any individual that releases information about gun ownership in order to facilitate any federal government effort to confiscate or register firearms. 

Whereas the Health Information Portability and Accountability Act (HIPAA) protects the private health information of individuals, FIPPA aims to offer similar protections for individuals exercising their constitutional rights as they relate to firearms, ammunition, and accessories.  “The privacy standards that I am held to as a physician must be replicated in regards to firearms, in order to defend the liberty of every Tennessean,” explained Terry, a Murfreesboro physician.

In 2015, Rep. Terry co-sponsored Public Chapter 380 which prohibited the use of any state funds, property, or personnel to enforce any federal gun legislation that limited the 2nd amendment rights of Tennesseans by violating a Tennessee statute, Tennessee common law, or the Constitution of Tennessee.  

Terry further explained the legislation, saying that “one’s health information is private and protected by law.  As firearms are necessary for the protection of one’s life, liberty, and family, firearm information should be private and protected, as well.  My bill ensures this information remains protected to the greatest extent possible.  FIPPA allows us to safeguard the constitutional rights and liberties of the people of our great state in this uncertain time.”

While there isn’t a federal law for firearm registration or confiscation at this time, there is a bill that has been introduced in Congress entitled the Firearm Registration and Licensing Act.  That bill requires firearm owners to register their firearms within three months and notify the federal government on how they acquired the firearm and where they store it.

“Though it currently isn’t federal law to register or confiscate firearms, there certainly is discussion on this unconstitutional infringement on our rights.  While we cannot predict precisely what overreaching policies the Biden administration may take, Tennessee must stand prepared to face these challenges as they come,” concluded Terry.

The Firearm Information Privacy Protection Act has passed through two House committees and is scheduled to he heard in the Senate.  The bill has over 50 House co-sponsors including Speaker Cameron Sexton and Majority Leader William Lamberth.

 

On Monday, Representative Bryan Terry, MD (R-Murfreesboro) announced legislation to address important issues related to public safety.  Terry’s Public Safety Policy Package contains two important pieces of legislation: The First Responder Safety Act (HB 585) and The Mercenary Rioter Act (HB 881).

The First Responder Safety Act aims to protect first responders by enhancing penalties against those who harass, threaten, or intimidate first responders.  Currently, those who take negative action against a first responder can be charged with either harassment or with terrorism.  The bill would enhance the harassment charge since negative action against a first responder impacts the ability to recruit and retain first responders.

 

To further explain, Rep. Terry commented that “harassing a first responder does not just affect that individual and their family members. By impacting the recruitment and retention of first responders, those who harass and intimidate them are impacting the ability for my family, and yours, to be protected.”  He went on to say that “their actions negatively affect everyone in the community who relies on help when they need it.  It not only impacts the liberty of that individual responder, but the liberty of the community as well.  Because of the greater impact, harassment of a first responder deserves an enhanced penalty.”  A prime co-sponsor of the Racial Profiling Prevention Act of 2015, Rep. Terry believes that substantive policing reforms need not be mutually exclusive in defending first responders.

The Mercenary Rioter Act aims to ensure that protests remain peaceful by increasing penalties for those who are paid to participate in riots and those who come from out-of-state to riot.  Recent examples have demonstrated the alarming need for such legislation.  In a violent protest in Kenosha, Wisconsin last year, public records show that at one point, 102 of the 175 rioters that were arrested were individuals who were not from Wisconsin.  Early this year, protests at the United States Capitol complex turned violent, with out-of-state participants like “zip-tie guy” allegedly traveling to the District of Columbia with mal intentions.  This legislation punishes those rioting as “mercenaries” by handing them a Class E felony, and it increases the mandatory minimum for aggravated rioting to a 60-day sentence.

“As Americans, we have the right to peaceably assemble, and Tennesseans don’t want outside influences coming into our communities and creating violence.  Addressing grievances with our state government is constitutionally protected, but, when one is paid or comes in from out of state, their motives don’t align with these protections,” explained Terry.  “While only about 7% of protests turn violent, those that do can have dramatic impacts on local communities.  Psychologists speak of Social Contagion Theory in which individuals in groups or crowds may behave or act differently than if they were alone.  Cutting down on paid or out of state instigators can help decrease the chances that peaceful protests turn into riots and decrease the risk of otherwise law-abiding citizens committing a criminal offense.”

Rep. Bryan Terry represents District 48 in Rutherford and serves as the chairman of the Health Committee.  He is in his fourth term and can be reached at rep.Bryan.Terry@capitol.Tn.gov or 615-741-2180.

On January 12, legislators were sworn in to office for the 112th Tennessee General Assembly.  During his tenure, Rep. Terry has taken the opportunity to engage Governor’s Bill Haslam and Bill Lee in pre-session discussions that he refers to as a “District Debriefing”.  Following the swearing in ceremony, Representative Bryan Terry, MD (R-Murfreesboro) met with Governor Lee to discuss issues important to District 48 and Tennessee. 

“Throughout the year or during session, as legislators, we often have the opportunity to have meetings or discussions with the Governor on various issues.  While there is a time and place for specific discussions like I had with Governor Haslam during the TN Together opioid debate, I see these ‘District Debriefings’ as an opportunity to provide the Governor with a general overview of concerns and laying the groundwork for more specific discussions,” explained Terry.  “This debriefing was no different as we were able to discuss issues like COVID, patient protections, provider concerns, issues related to growth counties and the BEP, the TennCare 3.0 waiver, and clinical cannabis.”

Rep. Terry said that the COVID discussion focused on concerns from providers, as well as the number of hospitalizations.  Prior to the debriefing, Tennessee had begun to see a drop in hospitalizations, but not enough days had passed to consider it a trend.  “At the time of our discussion, I had noticed a peak of around 3300 hospitalizations which has put a strain on the system, but Tennessee was beginning to see a drop in those numbers.  We are now down about 600 hospitalizations which could be secondary to several factors including vaccines, behavioral changes, or an increase in those who have developed a natural immunity,” stated Terry.

Terry said that he pointed out issues related to health care access, insurance network adequacy, and billing practices in the private market, as well as concerns related to the TennCare 3.0 waiver which passed last week.  “Many providers, particularly in rural areas or distressed counties, take on a disproportionate number of TennCare patients within their payer mix.  Since TennCare pays significantly less than commercial insurance or even MediCare, it has become near impossible for rural providers to stay afloat.  If we want to improve rural health care and ensure access, we need to dedicate some of our shared savings from the TennCare 3.0 waiver to those rural providers,” explained Terry. 

In 2020, Rep. Terry proposed legislation to have the growth counties in Tennessee meet to develop a plan for handling school and infrastructure growth.  In addition, he proposed legislation to have the Basic Eduction Program(BEP) Review Committee evaluate the funding formula for growth counties.  Unfortunately, with the COVID pandemic, both pieces of legislation were halted.  “These problems related to growth still exist and economic conditions have changed since the BEP formula has been revised and since counties made long term financial decisions years ago.  Tennessee ranks as one of the top relocation states, and our state and counties must adjust to ensure that we can grow responsibly,” commented Terry.

Terry ended the debriefing with a discussion on clinical cannabis and decriminalizing patients who utilize medical forms of cannabis under medical direction or in research.  Terry believes that with the United Nations removing cannabis from the “most dangerous drugs” list, it is likely that the U.S. will follow suit and decriminalize, deschedule, or reschedule cannabis.  Tennessee should be prepared for such action.  “Republicans on the federal level failed to take action to protect patients who benefit from clinical uses of cannabis.  It was a missed opportunity and likely cost Republicans the Senate with the loss of Gardner in Colorado.  Criminal justice reform is a top issue facing the nation and most can agree that we don’t need to criminalize patients.  It’s beyond time for Tennessee to take steps in advancing science, research, and medical treatments for cannabis patients while ensuring that we do so in a manner that protects patients,” exclaimed Terry.

“I greatly appreciate the opportunity to share my thoughts and concerns with the Governor.  It’s my hope that we can continue to make Tennessee a better place through positive policy,” concluded Terry.

Rep. Bryan Terry, MD is Chairman of the Tennessee House Health Committee and serves on the Health Subcommittee, both the Insurance Full Committee and Subcommittee, as well as Calendar and Rules.  His office can be reached at 615-741-2180 or via email at Rep.Bryan.Terry@Capitol.Tn.gov

On the final organizational day of the 112th Tennessee General Assembly, Representative Bryan Terry, MD (R-Murfreesboro) was named Chairman of the Health Committee in the House of Representatives by Speaker Cameron Sexton (R-Crossville).  The assignment marks the second consecutive term in which Rep. Terry, an anesthesiologist by trade, has served as Chairman of Health.  

 

“It’s an honor and privilege to serve the state of Tennessee in such a capacity,” stated Terry.  “I appreciate the faith that Speaker Sexton has in me to continue to function as our Health Committee chairman.  I’m looking forward to addressing the challenges ahead.”

 

Rep. Terry has previously served as the Health Subcommittee chairman under former Speaker Beth Harwell and played an integral role in protecting patients while addressing the opioid crisis during the passing of Governor Bill Haslam’s TN Together initiative.  Terry’s other legislative health committee experience includes serving as the chairman of the Temporary Assistance for Needy Families (TANF) working group and serving on the TennCare Committee.   

 

In addition to the chairmanship appointment, Terry was appointed to serve on the Health Subcommittee, Insurance Committee, Insurance Subcommittee, and the Calendar and Rules Committee.

Yesterday was interview day as I was interviewed for this article and on another issue. This article is behind a paywall, so I can’t share it.  But I can share my take on the issue as I am working on legislation and chaired the working group.

TANF(Temporary Assistance for Needy Families) is a federal program that allots funds to each state as a block grant in order to support needy families.  TANF replaced the old AFDC welfare program and has  requirements and limitations like a work requirement and maximum length of time on the program is 60 months.  The recipients on average earn less than $10 per hour at their jobs while the Tennessee average hourly private wage is over $25/hour.

The funds can essentially be used a few ways and there are restrictions/strings on each.

1)Held in a reserve 

2)Cash assistance

3)Wrap around services (2Gen grants)

4)Workforce Development

5)Overhead

6)30% transfer to a qualified program like the Child Care Development Fund

In order to receive the annual allotment, each state must prove their “maintenance of effort”(MOE) in the program.  Basically, each year a state must meet a spending threshold on needy families before the feds will grant the allotment.  For Tennessee, the allotment is $191 million per year.

During the Bredesen years, Tennessee’s needs exceeded the $191 million and Tennessee spent the MOE + TANF allotment + Additional funds from our General Fund.  

During the Haslam/Lee years as Tennessee’s economy improved and less people needed TANF, Tennessee only needed to utilize the MOE + a portion of the TANF allotment.  As less and less of the TANF allotment had to be used for cash assistance, the reserve grew to around $732 million.  

This issue was brought to our attention by the Beacon Center.  Subsequently, Speaker Sexton and Lt. Governor McNally appointed a bipartisan TANF Working Group to look into the issue and see if we could assist DHS in determining fiscally sound ways of utilizing the funds to better serve Tennesseans.

I was subsequently elected by the Senate and House members to chair the working group.  Though the Comptroller’s office audits the various departments, it is usually a combination of a 30,000 ft audit with some targeted metrics.  We asked for a more forensic audit of the program and for guidance in how much of a reserve we needed to keep.

The audit discovered that as the economy improved and less of the TANF allotment was needed, DHS actually continued to spend monies from the General fund above and beyond the MOE.  In essence, instead of using federal dollars for TANF recipients, DHS used state dollars to the tune of $221 million.  We ensured that they put an end to that practice and worked to get reimbursed by the feds from our $732 million reserve which would have brought the reserve down to $511.  They denied Tennessee that request.

Left with $732 million + $191 million annual allotment, we worked with DHS to set an adequate reserve while looking at other avenues to utilize the funds in a fiscally sound manner.  

Of note, overhead is roughly $35 million(Yes, it is that much) and cash assistance is roughly $35 million.  So Tennessee has been spending about $70 million of the $191 million.  Prior to COVID, DHS had put forth a $50 million dollar plan for 2Gen grants which would have brought the utilization up to $120 million.  The $50 million isn’t necessarily spent in one year, but for conceptual purposes, I will present the numbers that way.

We, also, were working on a bill that was the original “Pathway to Prosperity” which would have increased a family’s assistance(cash or wrap around services) up to 100% if they actively participated in an apprenticeship, technical college, or other educational endeavors(TN reconnect) that would get them on a pathway off of TANF.  TANF recipients are currently required to work, but we know that it takes about two years of additional education or training for an individual to improve their workforce skill set or educational background to experience upward income mobility.  This would fall under workforce development and would be up to $35 million.  

There were a few other bills out there, but on paper, it would have been 35+35+50+35 or approximately utilization of 155 of the 191 with the the capacity to entertain other legislation or amendments.

However, when the tornado and COVID hit, we did not know the extent of new need.  I looked at how we could assist those victims and amended my bill for emergency utilization.  The fiscal note was around $56 million.  However, the administration and DHS found a way where we could possibly assist thousands of more Tennesseans.  The potential utilization could have been well over $400 million.  Thus, in order to ensure we still had a reserve, other bills were held.  The 2 Gen grant program was already moving forward and didn’t need legislation.  Ultimately, only $25 million of the potential $400 million was needed.  

For the year, DHS essentially utilized 35(overhead)+35(cash assistance)+50(2Gen, but not all counts for this year)+25(emergency assistance)+60(CCDF pandemic child care transfer) = 205

The article focus on the growth of the reserve from last year and makes the point that there isn’t a specific plan in place to spend the funds.  In my interview, I pointed out most of the details above and that obviously, circumstances had evolved and changed.  I met with DHS this week to discuss the situation and the potential legislation for next year.  They provided an update to the Working Group members, as well.  Next week, we are meeting to go over more specifics and dive a bit more into legislation.

Hope this helps everyone to better understand the issue.

With liberty,

Bryan

The future of health care is consistently one of the top issues facing Tennesseans and America.  Encouraging steps are being made to address access with recent announcements by Belmont University to launch a new college of medicine and Middle Tennessee State University’s medical school partnership with Meharry Medical College.  While these programs will increase medical providers, Representative Bryan Terry, MD (R-Murfreesboro) has been working on solutions to improve patient access and care. 

“Health care is always one of the top issues for constituents,” stated Terry, an anesthesiologist and Chairman of the Health Committee of the Tennessee House of Representatives. “When it comes to health care, quality, affordability, and access are the three pillars that need to be addressed.  But the issues are not as simple as some candidates or elected officials blindly opine.  A lack of understanding by many, not just of the industry but of human nature, places patients and communities at risk.  That’s why I’ve been introducing solutions and continue to fight for patients.”

During his tenure in the House, Terry has not only served as the chairman of the Full Health Committee, but also chaired the Health Subcommittee and the Temporary Assistance of Needy Families(TANF) Working Group.  In addition, he has served on the Public Health, Mental Health and Substance Abuse, Facilities, Licensure, and Regulations, TennCare, and Insurance Committees.

Terry’s extensive experience has provided him the opportunity to have a significant impact on health care policy like the TN Together opioid law, Telemedicine, and the TennCare Katie-Beckett Waiver that provides home-based medical needs for children.

Terry points out that over time the health care system has evolved and adapted because of the negative market conditions and regulations, but these changes don’t necessarily address the three pillars of quality, affordability, and access.  The consequences of the changed system have included leakage of revenue producing providers from rural areas and independent medical groups across the state with the end result impacting small practices, hospitals, and patients.

“Tennessee is ranked as one of the best states for providers and we have some nationally ranked facilities for patient care and research.  So overall, Tennessee is satisfying the quality pillar,” explained Terry.  “But the issue is often ensuring affordable access to these providers, particularly in certain pockets of our state.  Since I’ve been elected, Tennessee has 8,000 new physicians, 5,000 new nurse practitioners, and an additional 5,000 licensed hospital beds.  While that is great news, the reality is that because of onerous regulations and narrow insurance networks related to the Affordable Care Act, increased medical practice overhead, and provider reimbursement disparities between rural and urban areas, these recruitment efforts are still facing significant challenges to address access and affordability.”

Terry has offered solutions to address these disparities to promote access and affordability.  Two measures he has offered include the Healthy Adults Opportunity Block Grants(HB 2573) and Anti-predatory contracting legislation (HB 709).  HB 2573 instructed the Department of Commerce and Insurance to research the viability of a Trump Administration program that could help cover uninsured with non-Medicaid insurance via a combination of federal funds along with employer and patient contributions.  The second bill, HB 709 would require fair contracting for providers, particularly in rural areas, if that provider or facility accepts TennCare patients.  This measure would help address the payer mix disparities between urban and rural providers and facilities, and decrease provider leakage.  This would improve access in rural areas while promoting competition in urban areas.

Terry has, also, put forth legislation that would protect patients with pre-existing conditions, as well as address the issue of balance billing.  “In the 1980’s, President Ronald Reagan signed into law the Emergency Treatment and Active Labor Act (EMTALA).  Hospitals and providers were required to treat emergency or laboring patients regardless of their ability to pay, but the law never required insurers to cover those emergency treatments.  Addressing the issue of uncovered emergency treatment would fix 95 percent of balance billing,” explained Terry.  “I’ve offered legislation to protect patients with pre-existing conditions, as it can be addressed at the state level, as well.”

Terry pledged to continue to work on these health care measures.  “As a patient, a provider, and a business owner, I see the various aspects of health care.  It is a complex balance of ensuring quality, affordability and access,” Terry said. “Regardless of the issue, people want solutions. Socialism, and in particular socialized medicine, is not a solution. It’s surrender.”