With just six days left in Kentucky’s short legislative session, many health-related bills are near final passage; here’s a roundup

By Al Cross Published March 8, 2021 CORONAVIRUS, FEATURED, HEALTH POLICY

One bill deals with retailing of syringes.
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By Melissa Patrick
Kentucky Health News

With just six days left in the General Assembly’s short, odd-year session, many health-related bills remain on the table, and only a few have become law. Here’s a roundup of health-related legislation.

Abortion: The first health-related bill to become law this year was Senate Bill 9, sponsored by Sen. Whitney Westerfield, R-Crofton, which requires medical providers to give “medically appropriate and reasonable life-saving and life-sustaining medical care and treatment to preserve the life and health of a born-alive infant,” including after a failed abortion. It also requires them to give any “nourishment, medical care, medical treatment and surgical care that is medically appropriate.” Gov. Andy Beshear declined to sign the bill but allowed it to become law without his signature.

Colon cancer: The only other health bill to become law as of March 7 was House Bill 108, sponsored by Melinda Gibbons Prunty, R-Belton (Muhlenberg County). It codifies existing Medicaid coverage of colorectal cancer, which includes screenings starting at age 45 for most people and genetic cancer risk testing for the disease, to ensure uniform coverage for Medicaid patients that lines up with commercial plan requirements. Beshear signed the bill March 5.

Dr. Whitney Jones, the founder of the Colon Cancer Prevention Project and chair of the Kentucky Colon Cancer Screening Program, said at the Senate Health and Welfare Committee meeting on the bill that in the last 20 years, Kentucky has gone from ranking 49th for colon cancer screening to as high as 17th and is now 22nd. He said colon-cancer cases are down 27 percent, and deaths from the disease are down more than 30%, which amounts to 400 fewer colorectal cancer cases and 250 fewer deaths per year.

Another bill that addresses colon cancer is getting close to the finish line. SB 16, sponsored by Sen. Ralph Alvarado, R-Winchester, addresses several issues related to the screening program, including adding “prevention” to its name and requiring the Department of Medicaid Services to compile and present annual statistics on services related to colorectal cancer. The bill has had two readings in the House and awaits a floor vote for final passage.

Mental health: Several pending bills involve mental health. One on the governor’s desk is HB 50, sponsored by Rep. Kim Moser, R-Taylor Mill. It would make health-insurance plans comply with a 2008 federal law that requires them to treat mental-health conditions and substance-use disorders the same as physical health. It also requires health insurers to file annual reports with the state to show how they are complying with the federal law.

“Mental health and substance use disorders are often treated differently than other health conditions by insurers, but there is no health care without mental health care,” Alvarado said while presenting HB 50 on the Senate floor. “When there is a disparity in treatment, it causes harm. Many people go without treatment for years with disparities worsening by the day. There is an average delay of 11 years between the onset of mental illness symptoms and the time most people access treatment.”

Other mental-health bills that could pass include those to:

Ban people with severe mental illness from being executed (HB 148);
Expand the definition of qualified mental-health professional so that it fits the state’s juvenile code, allowing those who work in private agencies to testify in child-welfare hearings, especially around issues of emotional injury (HB 448);
Adopt the Psychology Interjurisdictional Compact, which facilitates telehealth and temporary in-person, face-to-face practice of psychology across state lines (HB 38);
Allow any qualified mental-health professional to provide outpatient treatment to any child who is 16 or older and is an unaccompanied youth, and remove legal obstacles to transportation between a hospital and a psychiatric facility (SB 21);
Create new credentialing requirements for alcohol and drug counselors and supervisors, aimed at increasing access to care (SB 166); and
Require maternity patients to receive information on maternal depression and available resources, and make the Cabinet for Health and Family Services post information about providers who treat maternal depression on its website (HB 294).

Substance-use disorder: HB 219, sponsored by Rep. Danny Bentley, R-Russell, would remove pharmacy recordkeeping requirements for sale of hypodermic syringes or needles and allow their sale without a prescription, with a limit of 30 of each and proof that the purchaser is 16 or older. It would require pharmacies offering syringes and needles to provide educational materials on their safe and proper disposal, and referral information for syringe exchange programs and treatment of substance-use-disorder; and to offer naloxone, which is used to reverse opioid overdoses. This bill has passed both chambers and is awaiting formal enrollment and delivery to the governor.

SB 51, sponsored by Alvarado, would ban the requirement of prior authorization for any prescription drug that is used in the treatment of alcoholism or opioid-use disorder that contains methadone, buprenorphine or Naltrexone, or that is approved by the U.S. Food and Drug Administration for the mitigation of opioid withdrawal symptoms. It awaits a vote on the House floor.

Diabetes: The Senate amended HB 95 to increase the monthly co-pay for insulin in state-sponsored health insurance plans to $35, instead of the $30 in the original bill. It also added an emergency clause to make it effective immediately. The increase was a compromise made to line it up with what Medicare charges, Bentley, the bill’s sponsor, said at the March 2 Senate Banking & Insurance committee meeting. This bill is awaiting House concurrence with the Senate’s changes.

Telehealth: HB 140 would permit telehealth services that were allowed to expand due to the coronavirus pandemic to remain in place even after the pandemic ends. The bill has passed both chambers without dissent but needs House concurrence with the Senate changes.

Rural hospitals: HB 556, sponsored by Bentley, would allocate $20 million to a rural hospital operations and facilities loan fund created but not funded in the 2020 session. “We have nearly 100 hospitals in Kentucky. Of those 100 hospitals, 24 are rural hospitals that are in danger of closing,” Bentley told the House. “This measure will not only aid our rural hospitals, but it will help our rural communities recover from the effects of the Covid-19 pandemic.” The bill is in the Senate Appropriations and Revenue Committee and could become part of the state budget being negotiated by legislative leaders and committee members.

Organ donation: SB 12, sponsored by Alvarado, would prohibit a person from selling or purchasing human organs or tissue and ban for-profit entities from procuring any eye, cornea, eye tissue, or corneal tissue. It has passed out of both chambers, but must be signed by the House speaker before moving to the governor’s desk.

HB 75, sponsored by Rep. Shawn McPherson, R-Scottsville, would keep insurance companies from increasing rates on organ donors or dropping their coverage. It would also encourage the cabinet to develop educational materials relating to organ donation. It has had two Senate readings and is awaiting Rules Committee action to put it on the floor for final passage.

More than 6,000 Kentucky residents are on dialysis waiting for a kidney transplant; there were 208 kidney transplants in Kentucky last year, 39 from living donors, the House Banking and Insurance Committee was told by April Abell, executive director of the National Kidney Foundation.

Insurance: SB 45, sponsored by Alvarado, would limit the use of copay-accumulator programs by health plans, which prevent cost-sharing amounts paid on behalf of enrollees from counting towards their maximum out-of-pocket limits. SB 44, sponsored by Alvarado, ensures that any insurance payments made on behalf of an individual by a nonprofit organization are counted just as if the patient made it themselves. Both bills have had two readings and await action by the House Rules Committee to put them on the House floor for final passage.

SB 55, sponsored by Sen. Stephen Meredith, R-Leitchfield, would get rid of all co-pays required by Medicaid. It passed out of the House Health and Family Services Committee on March 5, and now moves to the full House for consideration.

Health dept. pensions: HB 8, sponsored by Rep. Jim DuPlessis, R- Elizabethtown, would have quasi-governmental entities, including health departments, to pay only what they owe to the Kentucky Retirement Systems instead of using the current “percentage of pay” formula. It passed out of the Senate with a floor amendment that added an appeals process that awaits approval by the House.

Infants and new mothers: HB 155, sponsored by Rep. Nancy Tate, R-Brandenburg, would allow the use of a “newborn safety device” that would aid the anonymous surrendering of a newborn infant at a participating staffed police station, staffed fire station, or a staffed hospital. The bill is in the Senate Veterans, Military Affairs & Public Protection Committee.

HB 212, sponsored by Samara Heavrin, R-Leitchfield, would require data in an annual state report on fatalities among children and new mothers to include information on demographics, race, income and geography associated with the fatalities. It has received one of the constitutionally required three reading and is in the Senate Health &Welfare Committee.

Immunizations: SB 8, sponsored by Sen. Mike Wilson, R-Bowling Green, would allow several exemptions for “any child or adult” in Kentucky who doesn’t want to receive a vaccine that the state mandates during an epidemic or a pandemic, including religious grounds, medical reasons or a “conscientiously held belief.” The bill has received two readings and awaits action by the Rules Committee to put it on the House floor for final action.

Alzheimer’s and dementia: SB 61, sponsored by Meredith, would require all direct-care staff members who provide care for clients with Alzheimer’s or other forms of dementia to receive initial and ongoing training. It passed out of the House Health & Family Services Committee on March 5 and now awaits action on the House floor.

SB 74, sponsored by Alvarado, would establish a coordinator in the cabinet’s Office of Dementia Services. It passed out of the House Health & Family Services Committee on March 5 and has had one reading in the House and now awaits action on the House floor.