Murfreesboro, Tenn., May 17, 2016– This year several bills came through that will help Tennesseans with health care including increased access and decreased costs. First, one should know that Tennessee had one of the most onerous certificate of need(CON) laws in the nation. These restrictive and costly CON regulations decreased access and increased costs by restricting the free market in health care. HB 1730, as crafted, removes some services from requiring CON while adding flexibility to the way some hospitals and physician groups operate.
It is estimated that over 60 donated organs are leaving Tennessee to recipients in other states. During the CON bill process, I worked with the Tennessee Hospital Association, St. Thomas Health, and the bill sponsor to ensure organ transplant programs would be available in Tennessee to make use of the donated organs for Tennesseans. In the end, the bill did make provisions for our Tennesseans in need.
As technology advances, our laws and our health care system must advance, as well. Telehealth or telemedicine is the use of real time video, audio or other telecommunication technologies that enables interaction between the healthcare services provider and the patient for the purpose of diagnosis, consultation, or treatment of a patient in another location. HB 2331, which I co-sponsored, helps set up fair compensation for telemedicine which in turn will encourage providers to take advantage of this medical and technological advancements.
Along the same line was HB 976 which addressed teledentistry. Under the general supervision of a dentist and with the use of video technology, dental hygienists will be able to perform certain dental services in remote locations without a dentist being physically present. I was able to work with the sponsor and the interested parties to help craft the final draft of this legislation. This law will help our nursing home, and rural patients have better access to dental care.
I, also, co-sponsored HB2323, the Health Care Empowerment Act, which paved the way for direct primary care. The law provides Tennesseans with an affordable free-market option to contract directly with their physician for primary healthcare services by ensuring that it is not considered an HMO or insurance company for purposes of regulation in Tennessee. As the patient-physician relationship is the cornerstone of health care, this law helps remove some of the barriers that have been built up over time.
Two other laws that I co-sponsored will help Tennessee to recruit nurses and EMT’s, as well as help our nurses and EMT’s that may wish to work in other states. The Emergency Medical Services Licensure Compact and the Nurse Licensure Compact will allow Tennessee to enter into agreements with other states for reciprocity of nursing and EMT licensing. As opposed to having to apply for a license in various states, a nursing or EMT license would be valid in the states that join the compact. At present time, they need more states to a join the compacts for them to become enacted, but Tennessee is leading in this issue.
The most time consuming bill this year in our health committee was HB 1840, otherwise known as the counseling bill. There was and still is a lot of misperceptions about the law. The law states that “No counselor or therapist providing counseling or therapy services shall be
required to counsel or serve a client as to goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselor or therapist; provided, that the counselor or therapist coordinates a referral of the client to another counselor or therapist who will provide the counseling or therapy.” It, also, states that it shall not apply to a counselor or therapist when an individual seeking or undergoing counseling is in imminent danger of harming themselves or others.
We amended the bill in committee to change it to “sincerely held principles” instead of “religious beliefs”. And you should notice that the bill doesn’t say that you can refuse to see someone because of who they are (race, religion, sex, LGBT, etc). It is when the client or patient has goals, outcomes, or behaviors that conflict with a sincerely held principle of the counselor that matters. And there is a process of referral that must take place, as well.
One should note that for 50 years, counselors never had an issue until Eastern Michigan violated the civil rights of a counseling student who could not affirm the goals of a patient and asked for a classroom exemption. Eastern Michigan settle out of court after they expelled Julea Ward. The American Counseling Association(ACA) changed their ethics codes to reflect the opinion of Eastern Michigan. By doing so, several states automatically adopt the ACA ethics codes as part of statute. Tennessee is one of those states and their action changed Tennessee’s statutes.
During well over 6 hours of testimony, those voting for the bill determined that the ACA code violated the 1st and 14th Amendment rights of the counselors. It, also, set up a catch 22 for corporate counseling businesses where, under certain circumstances, they could not comply with both state and federal law, as they would have to violate one or the other.
My underlying concerns were that a client’s inalienable right to life and the pursuit of happiness should not infringe on a counselor’s 1st and 14th Amendment rights, while a counselor’s rights shouldn’t infringe on a client’s. Throughout the process, I worked with both sides of the issue. I drafted several amendments over these concerns.
In the end, neither side wished to use my amendments. I determined that in the 50 years prior to the ACA changing their code of ethics that counselors had not abused their liberty to cause harm to clients, and with counseling being an honorable profession, there isn’t any reason to believe that counselors will harm patients now by protecting the counselor’s rights. However, prior to the vote on the House floor, I received assurances from the sponsor that if abuses of liberty towards patients occurred, the sponsor would work with me in the future to correct them.
It was an incredibly busy session in the health care committee, contact me at BryanTerry4TN@gmail.com if you wish to see a summary of all the health care related bills that passed this year.
Rep. Bryan Terry