Legislative Update

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Senate Committees worked at “full steam” as state senators examined the budgets of the many different agencies and departments of state government and approved a number of important bills.  The budget hearings, which will continue through March 16, are part of the process of reviewing how taxpayer dollars are spent to examine whether taxpayer money is being used efficiently and effectively to meet the state’s goals. They also provide lawmakers with an opportunity to talk with state officials about a wide variety of important state issues.

Also, legislation is beginning to work through the process needed to become law. Some legislation that has been heard recently in committees include bills that deal with domestic violence, campaign finance, medical licensure compacts, hiring of veterans, public records requests, financial literacy and stroke centers to name a few.

Opioid Epidemic

Members of the Senate Commerce and Labor Committee heard testimony from Tennessee’s largest health insurance carrier, BlueCross BlueShield of Tennessee (BCBS), about efforts to combat the state’s opioid epidemic. Over the last several years, Tennessee has passed legislation to prevent abuse by “pill mills” and strengthen the state’s drug monitoring database. Even so, opiate abuse continues to have a death grip on Tennessee, making it a critical health concern.

In 2012, prescription opioid drugs surpassed alcohol as the most abused substances in Tennessee, with the state having the second highest rate of prescriptions per person in the nation. More Tennesseans died in 2015 and 2014 because of drug overdoses than in motor vehicle accidents. Tennessee is not alone. The U.S. Surgeon General has declared opioid addiction is a public health crisis nationwide.

As a result, BCBS has taken steps to address opioid abuse, including new guidelines on prescribing, a data system which identifies providers who prescribe painkillers at higher rates, and an education program called “Count It! Lock It! Drop it!” BCBS partnered with the Coffee County Anti-Drug Coalition to launch the program to educate patients about the need to count the number of pills in a container to spot shortfalls, to lock up opioids from potential abusers, and to drop off leftover medications in a designated location for proper disposal.

Approximately 55 percent of people who abuse painkillers get them from a friend or family member. Another 16 percent of abusers steal them from a friend or family member.  

Opioid abusers are not the only persons harmed by the epidemic. Other victims include children in state custody and infants born with Neonatal Abstinence Syndrome (NAS) due to their mother’s dependency on painkillers. NAS is a condition in which the newborn suffers withdrawal from drugs including tremors, weight loss, stiff muscles, seizures, inconsolable crying, gastrointestinal disorders and poor nervous system irritability. Almost 1,000 babies were born with NAS in Tennessee in 2016.

About half of children in the custody of the Tennessee Department of Children’s Services are there due to parental drug abuse. These young victims are in addition to other family members, friends and communities who are harmed as a result of prescription drug abuse, not to mention those persons who suffer from opioid-related crimes.

The financial cost is another major side effect of prescription opioid abuse in Tennessee. Approximately $155.2 million is lost in productivity due to abuse, while $27.9 million is spent in health care costs for prescription opioid poisoning and $45.6 million in state-funded treatment is spent for people at or below the poverty level seeking rehabilitation. 

The Tennessee Department of Public Health has developed an approach to fight the opioid abuse epidemic by furthering primary prevention, enhancing monitoring and surveillance of prescriptions, strengthening regulation and enforcement, increasing utilization of treatment and improving access to appropriate pain management. In his State of the State address, Governor Bill Haslam said Tennessee would be expanding substance abuse and crisis intervention treatment services and supports during the 2017-2018 fiscal year.

Lawmakers will continue to talk about opioid abuse in the coming weeks as a variety of bills tackling the problem comes before the General Assembly.

Senate Health and Welfare Committee hears update on Tennessee’s overall health status

Dr. Randy Wykoff, Dean of East Tennessee State University’s College of Public Health, spoke to the Senate Health and Welfare Committee regarding Tennessee’s overall health. According to the United Health Foundation, Tennessee ranks 44th in the nation based on 27 measures used to evaluate a state’s overall health.  

Wykoff said that unhealthy choices are a key factor in the state’s low health ranking, with tobacco use, obesity and drug abuse accounting for some of the highest death rates in the behavioral categories in Tennessee.

Tennessee ranks 43rd in the nation for the use of tobacco, with 29.1 percent of adults still smoking compared to a national rate of 17.5 percent. Linking the impact of smoking to the state’s economic health, Wykoff said that, if Tennessee could reduce smoking to the national rate, it would impact about 250,000 smokers and save about $600 million per year in annual health costs.

Similarly, Wykoff said approximately 33.8 percent of Tennesseans are considered obese which places the state at 42nd in the nation in obesity. He said that if Tennessee had the national average obesity rate of 29.8 percent, approximately $300 million could be saved in annual healthcare costs impacting approximately 224,000 people.   As a result, Tennessee has a high incidence of diabetes with the state ranking 5th highest in the nation for the disease.

On prescription drug abuse, Tennessee ranks 49th in the nation in the number of painkiller prescriptions issued per hundred. “The death rate associated with drugs is a national epidemic and perhaps worse here than anywhere else in the country,” Wynkoff said.

Wykoff also linked economic development and educational attainment to poor health outcomes among Tennesseans. He urged lawmakers to continue advancing education and pushing for economic development improvements, as there is a huge life expectancy gap based on income.

He complemented the legislature for drastically changing the state’s ranking in education attainment, one of the factors used to determine the state’s overall health. Tennessee has moved from the worst state in the nation for high school completion in 2005 to ninth best in 2016. to commit to education and we are seeing the impact of that.”

Further explaining the impact of poverty on health outcomes, Wykoff said that there is a five to seven year difference between the richest and poorest counties of Tennessee in life expectancy based on income alone.

The General Assembly and Governor Bill Haslam have been very aggressive in improving education and job opportunities for Tennesseans over the past several years.

State’s new BEP Calculator makes Tennessee’s education funding more transparent and understandable

State Comptroller Justin Wilson appeared before the Senate Education Committee to explain his new educational tool that helps legislators, educators, stakeholders and citizens understand the state’s Basic Education Program (BEP). The BEP, which provides education funding to K-12 public schools, represents a huge portion of the state budget totaling nearly $4.4 billion for the 2016-2017 fiscal year.

For years, the BEP has been calculated by the Tennessee Department of Education (TDOE) without any way to verify the results. However, the Tennessee Comptroller’s Office has created a method to independently calculate and verify the BEP called the BEP calculator. The purpose is to make Tennessee’s very complicated education funding formula as transparent and understandable as possible.

Details and dollar amounts for every school district in Tennessee can now be viewed and downloaded from the Comptroller’s website. Users can even create their own scenarios using different inputs – teacher salaries, insurance premiums, etc. – to see how fiscal changes impact BEP allocations. The Comptroller has also created an interactive map where interested persons can easily view of snapshots of essential BEP facts and figures for each of Tennessee’s 141 school districts.

Tennessee leads nation in Small Business Job Growth

Tennessee leads the nation in small business job growth according to a report released by Paychex, the nation’s largest payroll processors. The state led in small business employment growth in January, rising over 4.2 percent last month. Paychex President Marin Mucci said the increase tracks with the positive performance of other economic indicators. The Paychex index analyzes and tracks small business employment trends each month using payroll data from their client base of more than 350,000 employers across the country.

Road Safety

The Senate Transportation and Safety Committee heard a presentation on the State of Safety in Tennessee by representatives of the American Automobile Association (AAA). Tennessee Field Vice President Tony Alberton and Tennessee Public Affairs Director Stephanie Milani reported there has been an eight percent rise in fatal crashes in Tennessee since 2015. Albertson and Milani believe an increase in distracted driving coupled with intoxicated driving-related crashes are to blame for the increase. Distracted driving has increased 134 percent since 2006. Fatalities from two of the most vulnerable driving groups increased with teen related fatalities up 18 percent and senior related fatalities up 10 percent. With one in three deaths being the product of an unrestrained passenger, AAA brought attention to the seat belt laws in Tennessee which allow for only secondary enforcement for passengers in the back seat. They suggested the General Assembly should redefine seat belt laws and make back seat passengers’ seat belts a primary enforcement to reduce fatalities.

Election Ballot

The full Senate has approved legislation that I am the sponsor of making it easier for voters to locate local election candidates on the ballot in the midst of a presidential primary year. Senate Bill 47 calls for reordering the ballot to allow candidates for state, municipal and county election to immediately follow the names of the presidential candidates. The names of presidential primary delegates would then follow.   The bill also increases the number of vertical columns for each respective party’s primary election on the ballot from two to three to help ease a voter’s search. The legislation comes after a long list of delegates were listed on the 2016 presidential primary ballot, which was confusing to some voters wanting to access local election races. The bill is pending action in the House of Representatives.